In this week’s blog, Archivist Louise has been looking into how maternity care developed in Edinburgh:
At the end of last year, I promised to write more about another pioneering development in public health that was ‘born’ in our city. Time flies, but a visit from the newest member of the extended LHSA team last week (in the shape of Project Cataloguing Archivist Clair’s new-born) has reminded me to fulfil my promises!
A Maternity and Child Welfare Scheme health visitor gives one Edinburgh mother a helping hand (LHB16/38/19)
The beginning of the twentieth century in Edinburgh saw
considerable progress in public health that carried forward the work of the
first Medical Officer of Health, Henry Littlejohn. The
introduction of pieces of legislation (in particular, of notification
regulations) acted as catalysts to these changes. These laws included the 1907
and 1915 Notification of Births Acts, which required the local Medical Officer
of Health to be notified as soon as possible after any birth. LHSA has records
of these notifications from 1916 to 1962 in a series of registers in our public
health collection (LHB16/47), which record basic details (including the mother’s
name, sex of the child and place of birth). The 1915 (Extension) Act also gave local authorities the power to found schemes for monitoring mothers before and
after birth and to take responsibility for the care of children under five years old.
In his report on the
need for a Maternity and Child Welfare Scheme (MCWS) for Edinburgh, the then Medical Officer of Health, A Maxwell Williamson,
recognised that, despite the considerable financial strain being put on the
City during the First World War, such a scheme was necessary on account of high child mortality, particularly in poorer districts. In
1911 to 1915, the death rate of children under five throughout Edinburgh was
38.2 per thousand. However, by district the figures were much starker: in the
same period, 112 under-fives in the southwest suburb of Morningside died,
whilst 797 died in St Giles’ district (which was around the High Street area,
extending north to Princes Street and south to Tollcross).
The Edinburgh MCWS was
launched in 1917. It was described by Williamson as having essentially ‘preventative’
and ‘curative’ aims – medical supervision would attempt to combat infectious
diseases in children, whilst provision of care before, during and following
birth would try to arrest deaths from poor maternity conditions. Maternity
and child clinics were set up, with the centres of these being the
existing Edinburgh Royal Maternity Hospital (ERMH) and the Royal Edinburgh Hospital
for Sick Children. The centres were supported by a series of local dispensaries. The
female-staffed maternity Hospice (run by Elsie Inglis for poor mothers) and
Bruntsfield Hospital were also incorporated, along with
kindergartens, open-air play centres and provision for ‘mothercraft’ classes.
Ante-natal classes were also started in the ERMH to identify potential concerns prior
to birth.
A 1917 Public Health Department circular, outlining the key provisions of the Scheme (LHB3/25/2).
In addition, a children’s convalescent home was set up in Gogarburn House, later to be turned into Gogarburn Hospital, an institution for those with learning difficulties:
By the 1950s, MCWS was in
full swing, with three ante-natal clinics, nine mothercraft clubs, playgrounds
and child welfare clinics. The only annual report that we have for the scheme (LHB16/43/1)
covers the range of its activities in 1954, including vaccinations, nurseries,
mother and baby homes and food distribution.
Maternity and Child Welfare Scheme exhibition, Craigmillar School, 1947 (LHB16/38/19).
Although Edinburgh had offered free medical facilities for
poorer women and children since the eighteenth century, MCWS provided
status, stability and guaranteed funds for the care of mothers and babies. It is now
recognised as a step on the way to the medicalisation of maternity care in the
years that followed.
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