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9 The Borough Midwife has established a steady practice, the
popularity of which is shown by the large number of her patients
who re-book with her for subsequent confinements. I laving regard,
however, to the fall in the birth rate, the existence of the numerous
public and private midwifery agencies operating in or near the
Borough, and the steady increase of confinements in hospital,
we cannot look to any increase in the Borough Midwife's practice,
which may indeed decline with the birth rate in the next few years.
10 For rather similar reasons, little use has been made of the
services of the Council's panel of Obestetric Consultants. Very
few doctors in the Borough undertake midwifery, and practically
all the midwives' cases likely to present difficulty at the confinement
are previously removed to hospital. Nevertheless we need
to provide for the emergency that may happen and I am of
opinion that the Consultant's services should be available for any
serious difficulty or abnormality which may occur during pregnancy
or the puerperium.
11 In the case of the Home Helps service, it is somewhat disappointing
that this useful form of assistance to the lying-in
mother is not as fully used as it might be. This service was started
in 1928 and reached its peak in 1931 with 275 engagements,
since when it has declined to 206 engagements in 1933. Of
course, the demand for Home Helps must vary with the number
of births, especially those taking place at home, but even in 1931
the number of engagements was only 15 per cent. of the births
(or roughly 50 per cent. of the births at home). Having regard
to the burdens resting upon the average Bethnal Green mother
at this time, it is felt that considerably more use should be made
of the Home Helps, and I think that greater publicity should be
given to the scheme. I think also that the service might be
made more practically useful if it were available to mothers during
illness in the course of pregnancy or arising out of childbirth.
There are many such occasions where a satisfactory recovery
would be aided if the mother were temporarily relieved of her
domestic labours. An alternative method would be to arrange
for the children to be cared for at a hostel, but I think the Home
Help method is preferable.
12 The demand for the Council's sterile Maternity Outfits is
steadily growing but there is still room for considerable expansion
in this service, which might also benefit from greater publicity.
13 The provision of Convalescent Treatment has been a valuable
and substantial part of the Council's Maternity and Child Welfare
service since 1921. There has, in fact, been a difficulty in recent
years in obtaining accommodation for all the mothers and children
it was desired to send away. This matter has been recently
under consideration and certain all-the-year-round accommodation
has been definitely booked and it is hoped that additional