Supplementary maternal and child health services. Part I. Post-natal care. Part II. Nurseries

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Abstract
Women interviewed during the maternity survey in 1946 were revisited 2 years later and asked questions relating to post-natal care and ill-health attributed by them to childbearing. Only 45 % had had a post-natal examination. This low figure may be attributed on the one hand to lack of facilities for examination and for care of children while their mothers are being examined and, on the other, to failure to emphasize at ante-natal clinics and after confinement the importance of post-natal examinations. The high maternal morbidity among women in this sample emphasizes the need for an adequate maternal health service. During the first 2 years after delivery 40% of mothers suffer some discomfort or disability attributable to childbearing. Although many of these complaints are not serious and soon clear up, 26 % still have symptoms 2 years after delivery. Complaints are more likely to be treated, and treatment is more often effective when a post-natal examination has been given. The inference is that the present low incidence of examinations is a cause of avoidable maternal ill-health and a serious defect in our maternity services. Only 3 % of all mothers with children born in March 1946 had sent their children to either day or residential nurseries before their second birthday. Less than half of the children who had been admitted to nurseries of all types were still attending in March 1948. About one-tenth of all mothers in the sample were doing paid work in March 1948, and of these, only 26% of the full-time workers and 8% of the part-time workers had placed their children in nurseries. There appears to have been a considerable unsatisfied demand for nursery care among working mothers, particularly in the poorer social classes. One-fifth of the women not in paid employment in March 1948 said they would have liked to send their children to nurseries if places had been provided. Children under 2 years of age who attended nurseries were exposed to greater risks of infectious disease than those who remained at home. Further research is required into methods for reducing this excessive risk of infection.