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46
APPENDIX I.
EXTRACTED FROM REPORT TO THE MATERNITY & CHILD WELFARE
COMMITTEE—22nd JUNE, 1948.
The Metropolitan Borough of Islington has been a welfare authority since the
passing of the Maternity & Child Welfare Act, 1918. During this period there has
been a vast change in the maternity and child welfare services and in the health of
mothers and small children. Objectives which seemed impossible of attainment or
fantastic to hope for in 1918 have been surpassed by actual fact in 1948.
With the transfer of welfare powers from the Borough Council to the County
Council under the National Health Service Act, 1946, it is thought appropriate to
mark the passing of the Council's Maternity & Child Welfare Committee by a brief
survey of Islington's maternity and child welfare developments to date. I think it
will be seen from the survey that if progress in the past has at times been less rapid
than might have been hoped for, a condition of the services has now been arrived at
which is comprehensive and of which advantage can be taken by every mother and
child, and which has contributed very materially to the present satisfactory
aspect from the health angle.
It should be appreciated that prior to the passing of the Maternity &
Child Welfare Act, 1918, the risks to mother and child, although taken for granted
at the time, would by present day standards be considered incredibly high.
Knowledge of child care and upbringing were at a very low level and many infants
were fed on the most undesirable forms of infant food. Cleanliness in the home,
particularly the protection of food and milk, was of a much lower standard and the
quality of the milk, as then supplied, made it a dangerous food in many instances
because of the degree of bacterial contamination.
With regard to the expectant mother, a very high proportion received no antenatal
care whatever and called in the midwife or presented themselves at hospital
only when the confinement became due.
The Medical Officer of Health received inadequate information since notification
of births was not made compulsory until 1915, although the adoptive Act was passed
in 1907, and in any case, he had no health visitors at this time to visit in the homes
and advise, even if he had received information of the births.
Some measure of the risks to which both mother and child were exposed in the
early days can be deduced from the proportion of deaths which have taken place in
the various years in children under the age of one, and in mothers due to causes
associated with childbirth. I have therefore incorporated tables of infant mortality
and puerperal mortality for the last forty years.
Infant Puerperal
Mortality Mortality
1908 103 1.8
1909 102 3.3
1910 95 3.0
1911 129 2.3
1912 86 1.6
1913 107 3.5
1914 104 2.7
1915 107 2.2
1916 87 2.9
1917 97 2.0
1918 110 1.3
1919 83 3.8
1920 72 2.3
1921 81 2.1
1922 77 2.6
1923 66 2.4
1924 66 2.9
1925 63 2.6
1926 66 4.4
1927 53 3.9
Infant Puerperal
Mortality Mortality
1928 64 4.3
1929 73 3.4
1930 70 3.3
1931 64 4.2
1932 68 2.8
1933 63 3.6
1934 62 2.3
1935 52 2.4
1936 61 2.1
1937 66 2.8
1938 65 2.2
1939 50 1.5
1940 47 1.6
1941 59 3.0
1942 54 2.3
1943 46 2.7
1944 48 2.0
1945 46 0.3
1946 39 1.5
1947 32 0.7