View report page

Reasons for request — Medical = 13
Muscular dystrophy 1
Wife had disseminated sclerosis 1
Wife had rheumatic heart disease 2
Wife had deep vein thrombosis 2
Wife had rheumatoid arthritis 1
Husband epileptic 2
Mental Illness 4
13
Medical and Social 48
Male sterilisations performed at Marie Stopes Clinic
1. The number of referrals to the domiciliary service have continued to increase mainly from health visitors.
However, there has only been one referral for February 1971—February 1972 from the social services
possibly due to the reorganisation that has taken place this year.
There has been an increased number of unmarried mothers referred to the service. A gratifying affirmation of
the success of the domiciliary service has been the "self-referral" by women who have heard of the domiciliary
service from relatives and friends. This may look like "sex on the rates" but these women were all in need;
many of them were unmarried mothers living in welfare accommodation. One woman who referred herself
had 2 children and her husband was in prison and due for release. She told me that she went to her G.P. for
advice but found that he wanted her to pay £3 for a prescription for the pill. Her sister-in-law was receiving the
pill through the domiciliary service and so we were contacted as she could not afford £3.
It has been encouraging to have had a number of patients referred from the North Middlesex Hospital mainly
by one of the Medical Social Workers.
2. Since my last report when the need for clerical help was shown this has been provided at the Town Hall.
It has proved a great boon to the domiciliary service having this additional help because it forms a focal
point where messages can be left and addresses checked etc., freeing the doctor's and nurse's time for
visiting. With the number of referrals increasing each month the time has probably come for the appointment
of a second nurse to share the visiting load. Mrs. Hinshelwood the domiciliary nurse (without whose hard
work the service would not function) not only does home visits but also ferries women to the IUD clinic
on Tuesday and Thursday evenings where necessary and there is no one to fall back on should a crisis
develop.
3. Since September 1971 a student social worker from Hatfield Polytechnic College has come to work with the
domiciliary service and has been allocated 4 cases. The domiciliary service could in fact act as a referring agent
to the social services. A special report will be written about this at the end of the student's year.
4. The domiciliary service continues to function as a pregnancy advisory service (despite the fact that this was not
its intention). Women who have terminations are followed up at home and contraceptive advice is given. So
often women who have had a termination fail to keep appointments made for them at Family Planning
Clinics and so do not get advice and may get pregnant and request termination again. This has not occurred
with women referred to the domiciliary service for termination. The terminations and sterilisations were done
at a hospital outside the Borough. The reasons for this were given in a previous report.
General practitioners have continued to be helpful and co-operative. Many of the women referred for termination
are referred by their general practitioners.
5. Medical Problems
(a) There has been one case of pulmonary embolus, fortunately not fatal, with the pill in a 19 year old
unmarried West Indian girl who already had 3 children. She now has been fitted with an IUD.
(b) There have been 3 suspicious smears that were negative when repeated. All pill and IUD patients have
smears performed.
52