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It should be possible for local Medical Practitioners to arrange
a hospital confinement for all their expectant mother patients in
the priority groups, details of which include the following—
(i) patients requiring admission on account of obstetrical
complications;
(ii) patients requiring admission on account of medical or
surgical complications, etc;
(iii) patients who are primapara (first babies) or para four
and over;
(iv) patients requiring admission to hospital for social reasons,
e.g. unsuitable living conditions.
As 70-75 per cent. of all expectant mothers fall within one or
other of the priority groups for hospital confinement it is obvious
that many Romford priority cases were confined at home during the
year. There were, in fact, approximately 300 such cases.
All mothers in the priority groups should be confined in hospital
where the risks to which they are usually prone are more easily
controlled.
In last year's report I mentioned that mortality data are only
a very crude measure of the efficiency of a Maternity and Child
Welfare Service. For every perinatal death there are probably many
more near-deaths from such conditions as Prematurity, Toxaemia,
Haemorrhage, Asphyxia, etc., and such morbidity is known to be
associated with the occurrence of Mental of Physical defects in some
of the survivors.
Paediatricians claim that 50 per cent. of the 70,000 spastics
in this country might have been avoided by a better obstetric service
for the babies when they were born.
Other conditions which may be associated with accidents at
birth include epilepsy and mental subnormality.
Home Confinements. 761 mothers were confined at home
during the year. All expectant mothers booking a Midwife were
advised to book a doctor, if they had not already done so, and
ante-natal care in all cases was undertaken by the doctor and
midwifery staff. This had the effect of rendering the Ante-natal
clinics held by the Local Authority unnecessary, and these sessions
ceased early in 1963.
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