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further increase the facilities whereby North Kensington mothers who cannot afford private medical
attention for their children may obtain medical treatment when necessary with the minimum of
inconvenience to themselves.
The health services for infants and pre-school children in the borough appear indeed both
adequate and comprehensive. Twenty-one infant consultation sessions are held each week to supervise
the health and upbringing of the normal child ; these sessions are conducted by medical officers,
with special experience in the feeding and care of infants and toddlers, who devote their whole
time to the council's service. Frequent home visiting is carried out by the council's health visitors
assisted by the staff attached to the welfare centres. Milk and cod liver oil are provided free by the
council for the children of necessitous parents in order to maintain health. Massage and artificial
sunlight treatment are available within close reach of the children's homes ; curative medical
treatment is available at the baby clinic, whilst for cases needing in-patient treatment there is a
baby hospital and also a children's hospital situated in the borough. Convalescent homes are available
for delicate children.
One of the difficult problems existing in the borough is presented by the large section of the
population which is constantly moving in and out of Kensington and which it is difficult to bring
under the influence of the council's officers. With the appointment of two additional health visitors,
who commenced work in April, 1937, a systematic search for families belonging to this migrant population
will be instituted by house-to-house visiting, and it is hoped that good results will be obtained.
Maternal Mortality.
There were only two deaths of Kensington women attributable to childbirth during 1936, which
represents a maternal death-rate of 0.9 per 1,000 births. This is a record for the borough. The
corresponding death-rate for London is 2.1, and for England and Wales 3.6. Both women dying
after confinement during the year belonged to the well-to-do class and both were attended by
obstetric specialists.
No woman belonging to the classes suitable for welfare attention, which represent about
80 per cent. of the total births in Kensington, lost her life as a result of childbirth during the year.
It seems justifiable to correlate this gratifying result with the extensive use made by these mothers
of the services provided by the council, and the success of the measures adopted is encouraging.
Nor is this successful result limited to one year only which might be the result of chance. Three
years have now elapsed since the council appointed a whole-time medical officer, who had previously
specialised in obstetrics, to be responsible for the conduct of their maternity services under the
supervision and direction of the medical officer of health, and it is interesting to compare the maternal
mortality rate in the borough during these three years with that of the three years preceding the
appointment:—
Year.
Kensington.
London.
England and Wales.
1931 6.0
1932 3.8
1933 3.5
average 4.4.
3.8
2.9
3.5
average 3.4.
4.1
4.2
4.5
average 4.3.
1934 1.3
1935 2.2
1936 0.9
average 1.5.
2.7
2.5
2.1
average 2.4.
4.6
4.1
3.6
average 4.1.
In the consideration of these figures, the very large increase in the use made of the ante-natal
services since the council appointed a whole-time ante-natal medical officer must be remembered,
and it would seem justifiable to claim the low mortality rate as an indication of the success of the
intensive ante-natal work which has been performed. That careful supervision of the expectant
mother can lower the mortality rate by detection and treatment of any abnormality can be seen by
examination of the obstetric records of women attending the Kensington ante-natal centres. Among
the many hundreds of women who attended during 1936 there were several who had serious
and dangerous disease, sometimes unknown to the patient: cases of heart failure, of acute toxaemia,
of tuberculosis and so forth, and much time was spent by the council's officers over some of these
cases. The patients' husbands were interviewed by the medical officer to obtain their co-operation,
the council's services for boarding-out the children were utilised to allow of the mothers' immediate
admission to hospital, the hospital staff were consulted personally about the cases, and in each instance
the woman's life was saved.
The council's ante-natal services would be worth maintaining if it were only for these few
cases, but the routine examination of the normal case has in addition a considerable value. By
this private consultation in the reassuring atmosphere of the ante-natal centre, the natural fears of
the young expectant mother are removed and she is brought under the influence [of the council's
officers at a time when she is especially receptive to education in matters of health. The personal
contact which is established between the borough ante-natal centres and the mothers living in the
district has made the clinics far more valuable as a factor in health education than it is possible for
any hospital out-patient department to become, however well equipped and staffed that hospital
may be. The council's medical officers and health visitors are in close touch with the mother; they
know her home, her family and her circumstances, and can give the individual advice and help