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5. MATERNITY AND CHILD WELFARE.
(1) Information on the inspection of midwives and the other activities of the supervising authority
under the Midwives Acts. 1902 and 1918.
This work is in the hands of the Middlesex County Council.
(2) Information on the general arrangements made for attending to the health of expectant and
nursing mothers and children under five years of age, including the work of Health Visitors, midwives
and nurses, consultation and treatment centres, and maternity homes and hospitals and other institutions
for the reception of expectant and nursing mothers and young children as in-patients. Special reference
should be made to investigations of stillbirths and infant deaths. The development of ante-natal work
at centres and in connection with the midwifery service where this has proved practicable, methods of
dealing with unmarried mothers and illegitimate children and with children permanently or temporarily
deprived of a home with their own parents, and the arrangements for the supply of food and milk. The
work of voluntary societies in the district in connection with maternity and child welfare and the place
occupied by each in the local authority's scheme should be briefly described, as also the co-ordination of
all the work under this sub-section with the school medical service.
Vide Annual Report, 1919, pp. 42-44, and the sections of this Report on the Milk (Mother and
Children) Order, 1919, and Provision of Meals, Mothers and Children, for the arrangements for
the supply of food and milk.
At the Municipal Clinics, expectant mothers attended the medical consultations on 2,812
occasions; nursing mothers, 16,476 and children under 5 years, 32,180 times; making a grand
total of 51,468.
35.2 per cent. of all births registered in Willesden during the year 1920 attended the Municipal
Clinics. In all, 4,232 births were registered in Willesden during the year 1920. Of these, 1,490
subsequently attended the clinics.
During the year 1920, 274 children under 1 year died in Willesden. Of this number, 65
attended the clinics, and 209 did not, giving an infant mortality rate of 43.6 per thousand births
amongst babies attending the clinics, and 76-2 per thousand births amongst those who were not
in attendance. The infant mortality rate for all babies was 64.74 per thousand births, the lowest
on record.
(3) Information on the incidence of puerperal fever, ophthalmia neonatorum, measles, whooping
cough, epidemic diarrhoea, poliomyelitis and other infectious diseases of parturient women, infants and
young children, and the methods adopted to diminish the mortality and permanent injury to health caused
by these diseases, and the results achieved by these methods. In particular, details should be given of each
case of ophthalmia neonatorum notified, showing whether one or both of the eyes suffered permanent
injury, and, if so, to what extent.
Puerperal Fever.—During the year, 20 cases of puerperal fever were investigated; 10 cases
were removed to the Municipal Hospital, 4 of these cases died and 6 recovered; 5 cases were removed
to other hospitals, 2 of these cases died and 3 recovered; and 5 cases were treated at home, 1 had
a private doctor but inadequate nursing attendance and died, while the remaining four, with adequate
medical and nursing attendance, all recovered. This gives a case mortality of 35 per 100 cases.
Ophthalmia Neonatorum.—Forty-nine cases of this disease were investigated during the
year. 18 of these cases were attended by a doctor at the confinement, and 31 by a midwife. In
one of these cases, no particulars are obtainable as to result of treatment; in 44 cases, the length
of treatment varied from six days to seventy-nine days and the eyesight was unimpaired, while in
the 4 remaining cases, one eye was permanently injured, in 1 case, one eye was blind, while the other
eye had a definite corneal ulcer and was still under treatment after 153 days; while in the 2 remaining
cases both eyes were permanently injured and were receiving treatment in other hospitals at the
end of the year.
j^Other Infectious Diseases.—These are referred to in the section dealing with Infectious
Diseases generally.