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12
It is scarcely necessary to comment upon the ante-natal and post-natal conditions associated
with illegitimate births. In the majority of cases the mothers work almost up to the time of
confinement and often resume work as quickly as possible afterwards. Owing to the mother
having to earn her living, the child does not generally receive adequate attention, unless it be in an
institution.
In many cases the child is not wanted.
In view of the disabilities imposed by society on unmarried mothers and their children, an
even higher death rate might have been expected, and the remarkable decrease in the rate which
has taken place in recent years, as shown in the last column of the above table, is very gratifying.
For a certain number of illegitimate children satisfactory provision is made by rescue workers
but for the majority, the Council's Women Health Officers are unable to obtain such assistance
other than that granted by the poor law authorities, which would be necessary to bring about a
further material reduction in the illegitimate infant death rate.
For the purpose of allocating births and deaths, the Registrar-General regards the employer's
house as the permanent home address of a domestic servant, and as 11 of the 26 illegitimate babies
dying were born to single women of this class, it will be seen that the Registrar-General's ruling
results in the allocation to Kensington of a number of deaths of children whose mothers probably
do not belong to the Borough.
Maternal Mortality.
In 1923 there were 17 deaths of Kensington women from diseases or accidents directly
connected with child-birth, and this figure represents a death rate of 5.4 mothers per 1,000 births.
The rate for England and Wales in 1922, the last year for which figures are available, was 3.58.
The general death rate in England and Wales has been reduced by one-third, and the infant
mortality rate has been halved since the beginning of the century, but the maternal mortality rate
is little lower than it was twenty years ago. The rate for 1902 was 4 47 against the rate of 3'58
for 1922.
The position in Kensington is even less satisfactory as a result of an increase in the maternal
mortality rate which has taken place in recent years; in 1921 it was 3.9, in 1922 it increased to 5,
and for 1923 it has reached the high figure of 5.4.
Of the 17 women who lost their lives in connection with child-birth in 1923, three belonged to
South Kensington and the remainder to North Kensington. Eleven died in the St. Mary Abbot's
Hospital to which institution they had been admitted for confinement or other treatment, two died
in Queen Charlotte's Hospital, two at home, one at a mental hospital outside the Borough and one
in a nursing home.

These 17 deaths represent a serious and largely preventable loss of life at the time of its
highest capacity and in its most fruitful effort. But these deaths do not tell the whole story of
avoidable suffering, for an unknown number of mothers are permanently injured or invalided in the
process of child-birth, which should be a physiological and normal act.
Dr. Campbell, of the Ministry of Health, speaking of the high maternity mortality rate in
England and Wales, says:—
"This is a situation which must necessarily cause grave concern to all interested in the wellbeing
of women and little children. It scarcely seems necessary to enlarge upon the serious effect
of a high maternal mortality rate upon tne health and welfare of many hundreds of families every
year, with certain exceptions the women concerned are in the prime of life and are actively
engaged in fulfilling the most important duty of bearing and rearing children for the nation.
Most of them might in the ordinary course of events look forward to many years of health and
usefulness. The unexpected loss of the mother is a tragedy to the family. It is not infrequently
associated with the death of the infant for whom the maternal life has been sacrificed, and is often
followed by the impaired health and nutrition of the remaining children. Further, the fact that
the mortality returns reveal only part of the total damage and disability, and that an incalculable
amount of unreported and often untreated injury and ill-health result from pregnancy and labour,
has many times been pointed out. It is this burden of avoidable suffering which we seek to relieve
scarcely less than to save lives which need not be lost."
This question has received considerable attention in Kensington during the past twelve months.
There is a sufficient number of Infant Welfare Centres in the Borough, at each of which
facilities for ante-natal examination and advice are available. Six centres have special ante-natal
sessions where advice is given by experts, and at the seventh expectant mothers are advised
privately on infant consultation days.
These ante-natal clinics are not used as fully as they should be, and the problem before us now
is to secure a better attendance of expectant mothers.
Queen Charlotte's Hospital authorities hold a special ante-natal clinic at their Nurses' Home
in Ladbroke Grove, which can be attended by any poor expectant woman irrespective of whether
her confinement is to be conducted by the Queen Charlotte's nurses or by a private midwife.
In 1923, there were 3,121 births in Kensington, and of these 618 may be said to have occurred
in families which are regarded as "above standard" financially, and do not come within the scope
of the Council's Maternity and Child Welfare scheme.