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BIRTHS
The trend towards hospital confinement has been accentuated; there was a further increase in the
proportion of mothers having their babies in hospital (see table). The number confined in hospitals and
nursing homes was actually less, but with the continuing fall in the birth rate the numbers confined at home
showed a further marked reduction.
The causes of the increase in the numbers of hospital confinements were discussed in the annual reports
of 1949 and 1950. Medical reasons, overcrowding or an adverse social environment probably account for
the majority of the hospital admissions, but some of them are determined not so much on an unbiased or
planned choice but on the fact that the mother finds it cheaper to have her baby in hospital. It is essential
that the question of hospital or domiciliary confinement should be determined on the basis of a planned and
co-ordinated policy, otherwise the staff and arrangements for home confinements may be reduced or disbanded
at a time when there may be a return of a greater demand for home confinements. Even if the birth
rate in Willesden shows no further decline there will be very few home confinements if the hospitals admit
the same numbers as they did in 1950.
A closer co-operation between the local health and hospital authorities would go a long way to solve
these problems to the benefit of the health services and the community. If it is decided that the hospital
should be preferred to the home for the confinement, attempts should be made now to provide hospital facilities
for general practitioner obstetricians and domiciliary mid wives in order that they may retain their skill and
continue to help in this vital service.