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58
INFANTILE DEATHS.
Reference to Table 2 on page 10 of this report shows that of
the 86 deaths of children under one year of age, 34 occurred during
the first week of life, 7 during the second week, 2 during the third
week and 4 during the fourth week. In other words, 47 of the
86 deaths occurred before the children attained the age of one month.
In 31 of the 47 cases the cause was prematurity, in 4 injury
at birth, in 3 atelectasis (failure of the lungs to expand), in 1
congenital malformation and in 2 marasmus.
During the course of the year I investigated 40 cases where
death occurred during the first two weeks of life, and 22 still-births.
In these 62 cases special attention was directed towards the
attendance of mothers at ante-natal clinics, for any attempt to
avoid still-births and early infantile deaths must be made, in most
cases, during the ante-natal period.
Of the 62 cases, only 16, or 26 per cent. of the mothers of these
children attended at one of the Council's ante-natal clinics. Now
the percentage of expectant mothers in Enfield who attend at our
clinics is 46.1 per cent., and at this rate one would have expected
that 28, or 46.1 per cent. of the 62 Enfield mothers who lost their
children before they were two weeks old would have attended our
clinics, whereas in actual fact the number was 16, or 26 per cent.
These figures are small and there are other factors that should
be taken into consideration. They tend, however, to indicate that
the chance of survival of children whose mothers attend our antenatal
clinics is nearly double that of those whose mothers do not.
Ante-natal work should not consist, and in Enfield does not
consist, of a medical examination to see that the lie of the child
is correct, that the pelvic measurements are normal and the health
of the mother satisfactory, although this is the major problem that
must be considered. The work of the ante-natal clinic ensures that
expectant mothers are well fed and obtain additional nutritive foods
if malnutrition is present. It consists in seeing that the home is
properly prepared for a confinement, that a Home Help is
provided if necessary, and that the clothing of the mother and
her general hygiene are satisfactory.
The ante-natal clinic is not only a medical clinic instituted
to discover medical defects, but is directed towards the placing of
the ante-natal mother in the best medical and hygienic state to
achieve healthy motherhood. It includes, moreover, adequate