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112
Appendix C.
Extract from the Minutes of the Council,
24th June, 1937.
Maternal Mortality : Ministry of Health Circular No. 1622.
We have received the following report from the Medical Officer
of Health, which we submit for the information of the Council:—
Report.
The circular calls attention to the report of the Departmental Committee
on Maternal Mortality, and under the several following heads indicates the
means by which the maternal mortality rate can be reduced.
(1) The importance oj team work.
This aspect has received the close attention of the committee for
many years and there is now active co-operation between the public
health department and the voluntary hospitals, the municipal hospitals,
and all the voluntary organisations associated with the Lambeth
Maternity and Child Welfare Scheme. Every expectant mother applying
for medical aid at any hospital, whether for confinement at home or in
the institution is reported to the department by the hospital for the
purpose of ascertaining the home conditions and preparations for the
coming baby. The woman is visited by a health visitor who invites her
to attend her local welfare centre for advice at sewing classes, for instance,
and if necessary for extra nourishment. Cases which do not attend the
ante-natal clinic at the hospital are followed up.
There is a similar active liaison between the municipal hospitals and
the welfare centres but it is carried one stage further. Where a normal
confinement is probable' the expectant mother is transferred to the antenatal
clinic of her local welfare centre for supervision until the 34th
week, when she is returned to the hospital ante-natal clinic. By this
arrangement the ante-natal clinics of the hospitals are relieved of congestion,
and as in most instances the welfare centre is more accessible
from the woman's home, travelling is reduced.
The only class of case which does not attend an ante-natal clinic is
the one who books directly with a practising midwife. Were supervision
of the latter vested in the Borough Council there would be a
close co-operation which is now almost entirely lacking. A parallel to
this can be cited in the case of infant life protection. Before these duties
were transferred to the Borough Council, not one-quarter of the foster
children attended the Lambeth welfare centres. Since the transfer
it is a condition of registration of a foster mother that she shall take the
foster child regularly to a welfare centre and in consequence 100 per
cent, now attend.
In so far as medical team work is concerned, the position is one of
difficulty as in one part of the circular the local authority, i.e., the