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off about 870—more than three-quarters of all those who die. Tuberculosis,
stomach diseases, and accidents each account for about 40. The danger of
dying from poliomyelitis is no greater than dying from suicide or from childbirth.
Each of these causes accounts for three deaths or less.
Maternal Mortality.
I regret to record that in 1949 three expectant mothers died either in
pregnancy or child-birth. Although in these three cases the circumstances
were quite exceptional, Twickenham has for years prided itself on its arrangements
for safe child-bearing and delivery. The clinics for expectant mothers
have always been well attended until recently, when the numbers have
declined. Since the National Health Service came in, an expectant mother
can make arrangements for her ante-natal care in one or more of three different
ways—with a hospital, with a general practitioner, or with a clinic. Many
women are making arrangements with hospitals and general practitioners
for their ante-natal care as they have a perfect right to do, but I am not
convinced that the hospitals and the practitioners have all the time needed
to deal with preventive hygiene, which is the main function of the ante-natal
clinic. A good mother is made not born; in the clinics they are taught the
important rules of personal hygiene, the essentials of good nutrition, facts
about clothing and preparation for motherhood; they are given reassurance
about the forthcoming confinement, how to establish and maintain breast
feeding; their physical health is watched and routine measures such as the
taking of blood pressure, urine testing and regular weighing are carried out.
In addition they are taught up-to-date methods of relaxation, and suitable
physical exercises. All this, together with additional classes in mothercraft,
separate for primiparae and multipares, make the preparation for the confinement
very complete. From a preventive point of view, it is difficult to see
how all this can be provided for each expectant mother in the minimum of
three consultations with a practitioner, as required by the new Act. All these
things can still be done in co-operation with the hospitals and practitioners.
I hope the expectant mothers will continue to take advantage of them. While
I repeat that the three deaths I have mentioned were exceptional, I hope this
rise in the maternal mortality rate is not the beginning of a rise which we in
the Public Health Service fear may occur as a result of decreased attendances
at the ante-natal clinics.
Living.
In 1938 there were 28,240 dwelling-housts in the Borough, and the
population was 96,550. In 1949 there were 29,776 houses, with a population
of 108,000—the increase in the number of houses is 1,536, but the increase in
the population is 11,450. In 1938 the average number of persons per dwelling
was 2.8; in 1949, 3.6. If the number of persons per dwelling could have been
kept constant, we should have needed 4,000 new dwellings to accommodate
the increase in the population. There have been 1,100 dwellings provided
since the war, many of which replace those destroyed. Allowing for some
increase in density per dwelling, there are between 3,000 and 4,000 families
for whom separate dwellings are not available. The number of families on
the Twickenham housing waiting list is 3,535. Since 1946, the Public Health
Department has reported 284 families (1,455 persons) with very severe overcrowding;
163 families have been rehoused (883 persons), leaving 121 families
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