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Hospital Confinements.—During 1937, 1,014 women were confined in the Willesden Maternity
Hospital. In addition to these a number of Willesden mothers were confined in institutions outside
Willesden, 508 births of Willesden residents being notified from such outside institutions—106 from
Queen Charlotte's Hospital, 50 from Queen Mary's Maternity Home, Hampstead, 56 from St. Mary's
Hospital, 15 from University College Hospital, 24 from Middlesex Hospital, and smaller numbers
from other hospitals; 72 from a nursing home and smaller numbers from other nursing homes. These,
together with some 411 in the Central Middlesex County Hospital, are approximately 60 per cent,
of the births belonging to Willesden and show the desire of the present-day mother for institutional
confinement.
A report on the Willesden Maternity Hospital by Mr. Arnold Walker, F.R.C.S., the Council's
Consultant Obstetrician, appears later on in this report.
Ante-Natal Work for Institutions not under the Council.—Requests are received
from the Middlesex County Council and from various London Hospitals for home visits to expectant
mothers, and for special reports by the Council's Health Visitors in connection with women who are
to be confined in these Hospitals.
140 such reports were supplied to London Hospitals and 278 to the Middlesex County Council
during the year.
85 Expectant Mothers booked for confinement in the Central Middlesex County Hospital
were referred to the Willesden Health Centres for Ante-natal care.
Puerperal Fever.—Puerperal Fever ceased to be notifiable on October 1st, 1937, when the
Public Health Act 1936 came into force. During the first 9 months of the year 13 cases were notified
as against 6 in the whole of 1936 and 3 in 1935.
Three of these patients died.
Puerperal Pyrexia.—32 cases were notified during the year. 1 of these 32 cases proved
fatal, the death being attributed to other accidents of childbirth. This was a patient living in London
but confined in Willesden and her death is allocated to London.
Maternal Mortality.—During 1937 there were 10 deaths classed to pregnancy and childbearing—3
to Puerperal Sepsis, and 7 to other puerperal causes.
The puerperal mortality rate from Sepsis was, therefore, 0.98 per 1,000 registered live births
and 0.95 per 1,000 registered total births. The corresponding figures for 1936 were 0.71 per 1,000
registered live births and 0.68 per 1,000 registered total births.
The total puerperal mortality rate was 3.27 per 1,000 registered live births and 3.17 per 1,000
registered total births. The corresponding figures for 1936 were 1.76 per 1,000 registered live births
and 1.71 per 1,000 registered total births.
During 1937 there were, in addition, 2 maternal deaths from non-puerperal causes and 2
maternal deaths from criminal abortion.
The total maternal mortality from all causes excluding criminal abortion, was thus 3.92 per
1,000 registered live births and 3.80 per 1,000 registered total births as against 3.17 and 3.08 in 1936.
The total maternal mortality from all causes including criminal abortion was 4.58 per 1,000
registered live births and 4.43 per 1,000 registered total births as against 3.53 and 3.42 in 1936.
Sterilised Accouchment Sets.—These sets are supplied in accordance with the arrangements
stated in my Annual Report for 1930, p. 10.
During 1937, 338 were supplied free, 10 at full cost and 21 at part cost.
Specialist Help.—The Council accept responsibility for the payment of the fee of one of
their specialists called in by a medical practitioner to assist him in connection with a difficult
case of labour occurring in a Willesden resident. 1 such consultation was paid for in 1937.
The services of the Council's Consultant Obstetrician are also available in cases of Puerperal
Fever and Puerperal Pyrexia when desired by the practitioner in attendance.
Provision of Ancssthetist.—The Council further accept responsibility for the payment of a
fee to an anaesthetist called in by a medical practitioner in connection with confinement cases. No
such fee was paid in 1937.
Maternal Mortality Investigations.—The Council has continued to take part in the
investigation of deaths of mothers in childbirth for the Maternal Mortality Committee of the Ministry
of Health. The investigations are carried out by the Council's Consultant Obstetrician. 14 cases
were inquired into during 1937.
Hospital Treatment of Children under 5 Years of Age (See page 39).