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Health visitors conduct mothercraft classes (one afternoon a week at the main clinics) on the birth and
care of the expectant mother and the child. They arrange carefully planned programmes of talks and
demonstrations, which are given by the assistant medical officers, health visitors and midwives. Mothers
are encouraged to ask questions and interesting discussions follow over a cup of tea (Table 50).
The Physiotherapist conducts ante-natal relaxation classes on two afternoons a week in the
orthopaedic department at Stonebridge Clinic, and a health visitor conducts similar classes at Kilburn Clinic
on one afternoon (Table 51). The mothers enjoy these classes, and their association with other expectant
mothers has a good psychological effect. There is no doubt that the exercises assist the mother at the time
of the confinement; most of them report on their easy confinement and how they were able to practice what
they had been taught.
Some hospitals do the ante-natal care, mothercraft, and relaxation exercises for their own expectant
mothers. Health visitors and midwives encourage mothers to have post-natal examinations six weeks after
confinement, either at the hospital, at the clinic, or by general practitioners. Health visitors make follow-up
visits where mothers fail to keep appointments at the hospital or clinics.
Child Welfare Clinics
Child welfare sessions are held in three main clinics (5 afternoons a week), and in four church hall
clinics (two afternoons a week in three and three afternoons a week in one). (Table 52.)
Assistant medical officers and health visitors give advice on the feeding, hygiene and general
management of infants and young children. The doctors immunise children under one year against
diphtheria, whooping cough and poliomyelitis.
There was a large increase in the number of children vaccinated against poliomyelitis as more
supplies of vaccine became available (Table 64). There was also a large increase in the number of children
who were vaccinated against smallpox (Table 62), but the number immunised against diphtheria was almost
the same as in 1956 (Table 63).
It has become part of the health visitors' duties to give advice on immunisation against poliomyelitis
to mothers in the health clinics and when visiting in the homes, and to discuss any special queries with them.
Mothers of young babies are advised on immunisation against poliomyelitis at the same time as
advice is given on protection against diphtheria, whooping cough and smallpox.
Greeting cards are sent to children on their first and second birthdays, inviting their mothers to bring
them to the clinic for routine yearly examinations and a tuberculin patch test.
These greeting cards remind parents that the routine examination and patch test of their children
are due, and many mothers attend with their children as a result of these invitation cards.
Assistant medical officers inform general practitioners if treatment is required. A Mothers' Club is
held in Kilburn Clinic once a fortnight in the evening and in Stonebridge Clinic once a week. The mothers
form their own Committees and run the clubs themselves with the help of the nursing staff. They arrange
interesting programmes of lectures and demonstrations on health and homecraft, which are given by assistant
medical officers, health visitors and outside speakers. The clubs have had an active and interesting year.
Outside activities have included visits to the theatre and television shows and a day trip to Chessington Zoo.
A delightful Children's Christmas party for a number of voung children, and a visit to the Ice Show at
Wembley for older children, were arranged.
MIDWIFERY SERVICE
At the beginning of the year the Middlesex County Council employed four midwives in Willesden.
During the year one midwife left and was not replaced, making a total of three midwives, with two vacancies
at the end of the year. There is generally a shortage of midwives, and during the year midwives who work
in the Wembley part of the area helped in Willesden.
Three or four pupil midwives work in Willesden (under the supervision of midwives who are approved
midwife teachers) for three months as part of their second period training for the Central Midwives' Board
Examination.
General practitioners and midwives supervise the care of expectant mothers. When a mother
chooses both a general practitioner and a midwife for her confinement, the doctor supervises the care of the
expectant mother, and arranges for the taking of a blood specimen and a routine chest X-ray. The midwife
examines the mother at her special clinic (Table 53), visits her at home, and ensures that everything is prepared
for the confinement. Mothers are encouraged to have both a general practitioner and a midwife for their
confinement.
A mother who chooses a midwife alone for her confinement attends the local health clinic, where
the assistant medical officer makes the initial medical examination, takes a blood specimen, and arranges for
a chest X-ray. She then attends the midwife's clinic regularly throughout her pregnancy and is instructed
on the use of the apparatus for gas and air analgesia. The assistant medical officer examines the mother again
at the 36th week of pregnancy and gives a certificate of fitness for gas and air analgesia. Mothers who had
gas and air analgesia during labour had substantial relief from pain (Table 54). Midwives work very closely
with general practitioners who were present at some of the deliveries (Table 55). When a midwife attends a
case on her own and requires help, she must call in a doctor according to the rules of the Central Midwives'
Board (Table 56).
For serious emergencies, the midwife or doctor calls the Central Middlesex Hospital for the obstetric
"flying squad", consisting of an ambulance, a doctor, a nurse, two ambulance men and blood transfusion
apparatus. The "flving squad" was called out three times during the year for ante-partum haemorrhage,
following a miscarriage, and post-partum haemorrhage with third stage complete.