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Of the 18 women who failed to accept advice 4 did so for religious reasons.
2 — were West Indian Jehovah's Witness
1 — was Iraqi Jew
1 — was Irish Roman Catholic
3 were subnormal unmarried mothers (one was West Indian, two were British).
1 was chronic schizophrenic (West Indian).
1 was chronic alcoholic (Irish).
Of the other 9 — 6 were unmarried (3 of these were West Indian, 3 were British).
These 18 women had a total of 73 children: average 4 children/family.
The women who refuse advice are often apathetic and lonely with deep feelings of inadequacy. They feel that they
are worthless. The only thing that they can do is have babies and this gives them self-esteem. They become solely
concerned with their reproductive function; they may have many different partners; sex is unimportant, it is a
means to an end. For them to accept contraception means denying themselves of their most precious possession—
their fecundity. These women are so often rejected by their own mothers and do not grow up with a sense of their
own uniqueness and worth. They are thus unable to give this to their own children and may reject them in turn as
they cease to be babies and become toddlers with their own wishes and demands. Intensive individual care and
interest must be given to such women to give them a sense of their own personal value. The social services usually
become involved with the secondary problems of such families — the bad housing, debts, neglected children and
these are often so overwhelming and absorbing that it is not surprising that the primary psychological problems
may be shelved.
Some of the unmarried mothers with perhaps 2 — 3 children also come into the above category and an awareness
of the above factors may enable early recognition and help to be given to such women before they become
overburdened.
Number of pregnancies occurring after domiciliary visit 49
(a) of these the number going to term and having babies 28
5 of these pregnancies were planned and wanted
16 were unplanned and result of method failure
Sheath failure 6
Failure of women to take O.C. properly 7
IUD expelled 2
Vasectomy failure 1
7 became pregnant because of failure to become established on any method.
(6 are now using reliable method of contraception).
15 women were pregnant at time of referral and went to term and had their babies. 8 of these were
sterilised postpartum at hospital outside the Borough.
50