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17
Towards the end of the year the North-West Metropolitan Regional Hospital Board made a monthly
allocation to this area of a certain number of beds at St. Andrew's Hospital. These were to be made available to
expectant mothers only if home conditions were unsuitable for domiciliary confinement. This was intended
to relieve pressure on the emergency bed service, and from the commencement in November to the end of
the year 39 beds have been allocated and taken up.
Health visitors continue to follow-up expectant mothers who have failed to keep their appointments
at local and hospital clinics.
CHILD WELFARE CLINICS (Table 48)
Child welfare sessions are held in the seven clinics staffed by assistant medical officers, health
visitors and clinic nurses.
Mothers are able to discuss the general management and feeding of the baby or toddler. Weight
can be checked, and initial examination given and routine medical check-ups are available.
More general practitioners are conducting their own child welfare sessions and some have asked
for a health visitor to assist them at these sessions.
Immunisation continues to be carried out against whooping cough, diphtheria, tetanus and poliomyelitis,
also vaccination against smallpox.
A nursing assistant continues to be employed at Pound Lane Clinic for three sessions a week to
care for children when their mothers are attending at clinic sessions. 103 sessions were held and 437 attendances
were made.
PREVENTION OF BREAK-UPS OF FAMILIES IN WILLESDEN
The Family Service Unit continues its work in this area. During the year a further 3 cases were
opened making a total of 25 families. The total number of contacts with families numbered 1,194 whilst
contacts on behalf of families numbered 753 making a total of 1,947 contacts. Co-operation continued
between all workers concerned.
MIDWIFERY SERVICE (Tables 49 and 50)
At the beginning of the year the Middlesex County Council employed seven midwives in Willesden.
During the year four midwives left, and three midwives were appointed making a total of six at the end of
the year. Sixteen pupil midwives completed their three months domiciliary training during the year. Midwives
continue to work in close liaison with general practitioner obstetricians and use a personal maternity
record card.
The number of deliveries attended during the year shows an increase over the number of deliveries
in 1962. More ante-natal sessions have been held with a greater number of ante-natal visits to the patients'
homes. Institutional discharges were higher this year, although the nursing visits to these patients were fewer,
because the patients being discharged from hospital were coming home later in the "lying-in' period.
The Maternity Record Card based on the Enfield Chase pattern is being used by the general practitioners
and the midwives.
The assistant medical officers take blood specimens from expectant mothers referred by general
practitioners.
Midwives instruct expectant mothers on the use of the apparatus for analgesia. Midwives work
very closely with general practitioners who were present in approximately one-half of the deliveries. 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.
The emergency obstetric squad was called 8 times during the year for the following emergencies:
2 retained placenta, 4 post-partum haemorrhage. 1 retained placenta with post-partum haemorrhage
and 1 severely shocked baby.
The Hammersmith Hospital premature baby unit provides a special ambulance for premature babies
who require treatment in this unit. The ambulance with two qualified nurses trained in the care of premature
babies carries special equipment, including a fitted cot and apparatus for administering oxygen. The
ambulance is sent for by the doctor who may be present at the confinement or who has been called for
medical aid by a midwife. Two babies were admitted to the unit during the year.
The Middlesex County Council also provides similar equipment which is kept at the Willesden
Ambulance Station and it is sent out by ambulance with two ambulance drivers when it is required to take a
premature baby into a hospital other than Hammersmith Hospital. The midwife in attendance at the confinement
accompanies the baby to hospital.
In addition the midwives have assisted in the obstetric survey which is being carried out by the
North-West Metropolitan Regional Hospital Board, by completing questionnaires on certain groups of cases.
The midwives visited mothers and babies discharged early from hospitals and they also answered
calls made to them by general practitioners or the ambulance station to attend mothers booked under the
Emergency Bed Service.
HEALTH VISITING (Tables 51 and 52)
The health visitor's function is primarily that of teaching the principles of health—physical and
mental. In her visits to families in the home the health visitor becomes aware of early stress or tension,
and can, with their permission, seek the help of the other social workers in the team. Visits are also paid to
advise on the care of those suffering from infectious illness at home.