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56
1937 is chiefly due to a reduction in deaths under one week.
The cause of these early deaths is largely ante-natal.
An investigation was made concerning 9 of them. In 2 cases
only did the mother attend at an ante-natal clinic. In 4 cases delivery
was instrumental, five of the children died in hospital, five of the
mothers were primiparae and four multiparae.
It must be admitted that ante-natal care would not have saved
2 children, for in one case death followed an operation for harelip
and in another the child was suffering from spina bifida.
If there is any moral to be drawn from these figures small as they
are, it is that ante-natal treatment in its widest sense can do much
to lessen infantile mortality.
In the opening remarks of this report I have referred to the
increase of ante-natal work carried out at our Clinics, and the cooperation
with the North Middlesex County Hospital in connection
therewith. Fifty-four per cent of the mothers of Enfield are now
receiving their ante-natal care at the Council's own Clinics.
I use the phrase “ ante-natal care in its widest sense ” to denote
that I mean something more than adequate medical attention.
I refer to such things as the proper preparation of the home ;
the obtaining of a suitable layette ; adequate help in the home during
the confinement and puerperium; the provision of suitable nourishment
for the mother during pregnancy, and the addition to her diet
of essential food stuffs in special cases. I include, moreover, the
care of the ears, the eyes and the teeth.
All these advantages can be obtained for those who need them
through the ante-natal clinics, but these advantages are not limited
to the mothers who are under the care of a municipal midwife or
whose pregnancy is supervised by one of the Council's Medical Officers.
These services, which promote healthy mother-hood and the birth
of a normal child, are available to all those women in Enfield whose
circumstances warrant it, and the Enfield patients of the private
practitioner can be and are provided with these services at the request
of the patient and her doctor.
I am inclined to admit that they are more often obtained by those
who are under the care of the Council's staff. This is chiefly due
to the fact that the clinics tend to deal with the poorer mothers of
Enfield, but I do not think this is the only reason. At the Clinic the
mother is at the very place where municipal services are discussed
and thought of.
The object of these remarks is that the General Practitioners of
Enfield and the public may be made aware that the Council and its
Officials desire to co-operate with them in providing all such services
as will make mother-hood safer and promote healthier children.