London's Pulse: Medical Officer of Health reports 1848-1972

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Willesden 1949

[Report of the Medical Officer of Health for Willesden]

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5
THE FALL IN THE BIRTH RATE
Effect on Place of Confinement
The fall in the birth rate in Willesden in the three years 1947.49 had a profound effect on the place of
confinement. The number of births dropped by almost 1,000, but there was an increase of 10 per cent in the
number of mothers confined in institutions, as compared with a decrease of almost 50 per cent in the number
confined at home. The fall in the birth rate in 1948 was reflected in the work of the Central Middlesex and
Kingsbury Hospitals and the Domiciliary Midwives, but appeared to have no effect on the number of mothers
confined in hospitals outside Willesden.
The operation of the National Health Service Act from July 5th, 1948, soon had an effect on altering
the balance between the various agencies. On July 5th, 1948, both the Central Middlesex Hospital and the
Kingsbury Maternity Hospital came under the control of the Central Middlesex Hospital Management
Committee. The falling birth rate had different effects in these hospitals. In 1949 the total number confined
in these two hospitals was increased by 108—even in the face of the falling birth rate—but the number of
mothers delivered in the Kingsbury Maternity Hospital was reduced by 208, while the number delivered in
the Central Middlesex Hospital was increased by 316. The Central Middlesex Hospital increased their
deliveries at the expense of the Kingsbury Maternity Hospital and the Domiciliary Midwives.
In spite of the falling birth rate, the number delivered in outside hospitals such as Queen Charlotte's,
St. Mary's, Guy's and Charing Cross, remained stationary at about 380, while the number confined in nursing
homes fell by 94. The trend towards hospital confinement was probably due to the overcrowded conditions
in the homes and the fact that hospital confinements are now free, and therefore cheaper than domiciliary
confinements—where the mother has the expense of board, home help, extra linen and laundry. In addition,
as a result of the increase in the number of confinements in the Central Middlesex Hospital, the Hospital
Management Committee found it had empty beds in the Kingsbury Maternity Hospital, and therefore
encouraged the mothers who had booked to have their babies at home, to transfer to hospital.
Some of the Willesden mothers have become accustomed to seek hospital beds outside Willesden because
of the previous shortage of beds in the Willesden hospitals. In the interests of the maternity services, consideration
might have been given to encourage these mothers to transfer to the Kingsbury Maternity Hospital.
Unfortunately, there is no central authority in Willesden or in the area which can make a continuous
survey of the effect of the birth rate on all the maternity services and plan accordingly. There is a tendency
for all the interested parties—the Management Committee and hospitals, and the Queen's District Nursing
Association, the local authority and the Willesden District Nursing Association employing the midwives, to
look at the problem from their point of view only.

Illegitimate Birth Rate. Effect on Day Nursery Applications.

YearIllegitimate BirthsTotal BirthsWillesden
19121304,07531.90
19131324,03732.60
19141494,11536.20
19151433,63236.28
19161173,66831.89
19171122,81639.77
19181502,65156.58
19191172,92440.00
19201484,23234.97
1921923,46426.56
1922943,16029.75
1923783,06325.46
1924792,84327.79
1925902,75532.67
1926832,70030.74
1927802,56831.15
19281012,66637.88
19291032,71437.95
1930932,86932.42
19311112,83839.11
19321082,74539.34
1933842,67131 .45
1934942,74334.27
19351002,84835.11
1936962,83533.86
19371453,05847.41
19381192,96840.09
19391212,73844.19
1940692,31529.81
1941761,75843.23
19421102,55043.14
19431272,65747.80
1944992,69736.71
19451432,62754.43
19461573,42045.91
19471743,75346.36
19481863,14759. 10
19491202,44749.04