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simplest and more practical difficulties of the younger, less experienced
girls, and the more complex psycho-sexual problems. The experience of the
doctor conducting this session has shown that there are considerable difficulties
in combining these two functions in one session. It is not predictable
until the first interview is in progress, in which clients underlying problems
are brought to light, but when they emerge, the interviews may be too time
consuming to continue without a sense of hurry, when other appointments have
been made for the session.
Provision of a second session to which clients may be referred from the
first one is to be considered. This session for young people is obviously
fulfilling a need, and it is interesting that the average age of those
attending is lower than when it first opened.
Domiciliary visits
The demand for this service, which is run by the Family Planning Association
on the Council's behalf, has continued and proved a great help to 68
women whose domestic commitments, and occasionally prejudices, prevented them
from attending a clinic. The doctor and nurse specialising in home visits
have done an extremely valuable piece of work. Persuasion of some of their
clients was often time consuming and required great tact and kindness. The
service appears to be reaching women of lesser intelligence and those less
co-operative than when it first started in 1967 which is encouraging as this
is one of its prime objects.
An informative report on this service has been made by the doctor who
carried out the visits. She states that the service has been welcomed by
general practitioners and there has been practically no opposition.
The kind of woman who needs the service is the one with a large family
who gives low grade child care, and in any crisis is unable to cope with her
responsibilities, and so "spills over" into the group termed "problem family".
In a certain number of those visited, their husbands are unco-operative.
Apathy and fear, combined with their many commitments prevent these women,
some of them very young, making the effort to attend a clinic. Nearly all the
women are referred by health visitors. Many of those subsequently attending
for the insertion of an I.U.D. have transport arranged for them to and from
the clinic and their children are looked after while they attend.
There are numerous problems in the course of the work, such as tracing
women who have moved house without warning, dealing with crises as when
supplies of pills are thrown away or lost.
About 10 women have not accepted advice. This, the doctor thinks, is
due to their sub-normal intelligence. Every effort is made to keep in touch
with these difficult cases.
There is an obvious financial saving of public money on repeated maternity
allowances and hospital bed expenses, once a woman is firmly established with
a method of family planning. The saving in terms of reduced distress and
increase in human happiness cannot be estimated in figures, but is undoubtedly
and of far greater importance.
Follow-up Scheme
Mention might be made here of another joint enterprise - the follow-up
of patients seen in maternity wards. In August 1968, the Family Planning
Association began a scheme to visit the maternity wards at hospitals in
the Hackney Group to advise recently delivered women of the whereabouts
and times of family planning clinics, to make appointments as requested, and
generally help them to understand what a clinic was like. A survey of 100
women showed that very few of those interviewed, in fact, ever came to a