Birmingham was a pioneering City when it came to the establishment of municipal Infant Welfare Centres (IWCs). Laurie has been looking at the role of IWCs and the changes during 1914-1924.
The purpose of Infant Welfare Centres (IWCs) was to reduce the high infant mortality rate (IMR), to improve the health of babies who survived their first year, and to look after the health of mothers before and after giving birth. They were enthusiastically promoted by Dr John Robertson, Birmingham’s Medical Officer of Health (MOH).
The first IWC in Birmingham was established in 1907 by voluntary subscriptions to Birmingham Infants’ Health Society using a room in the Medical Mission, Floodgate St, followed in 1908 by the first municipal IWC in New John St West, in two of the poorest districts in the city with the highest IMRs.
In May 1914, presenting his annual report to the Public Health and Housing Committee for the previous year, the MOH included a separate report on Child Welfare, in which he deplored the city’s 3,070 deaths of infants under 12 months of age as a great waste of life. Dr Robertson claimed that over half the deaths were preventable, such as those from diarrhoeal diseases and ante-natal causes. He believed that education of mothers was the best way forward, and he outlined the work already underway in the existing 4 voluntary and 4 municipal IWCs, the latter staffed by lady doctors appointed by the Committee. His aim was to expand such work across the city by creating 6 further ‘welfare stations for mothers and children’. The plans of the MOH were hampered by the outbreak of war, as rented accommodation suitable for use as IWCs became difficult to obtain, and many staff in the Public Health Department left for war work.
In 1915 a Maternity and Infant Welfare Sub-committee was established which included two women, one of whom, Mrs Dora Walker, was appointed Chair at the end of its first year. Training was organised for IWC workers at the Municipal Technical School. Government grants of 50% towards the running costs of municipal IWCs (and voluntary centres meeting certain requirements) became available and by the end of the war, Birmingham had 13 municipal and 8 voluntary centres; some had been relocated to more suitable premises from their original buildings.
The main functions of the IWC were to monitor the progress of infants by weighing them, followed by consultation with the doctor if necessary. Minor ailments were dealt with in the centre, and more serious cases referred as appropriate. This enabled earlier diagnosis and treatment of problems which otherwise might have worsened, as mothers living in poverty may well delay seeking medical advice they had to pay for. The Superintendent (a qualified nurse, midwife or health visitor) oversaw the maintenance of records and was available at each consultation to provide advice for mothers. Older infants (aged 1-5) had their own sessions in some centres, or were supervised in a separate room.
Mothers would be encouraged to attend health talks on a wide variety of topics related to correct methods of feeding and rearing infants. Particular importance was attached to the benefits of breastfeeding, the constant need for cleanliness, and the value of fresh air for babies. The topics sometimes included mental and moral training of children. Visits to mothers, and antenatal and postnatal consultations were also introduced.
Alongside the activities within the centres, the visiting of infants in their homes was crucial in the education of mothers. Infant Visitors attached to the IWCs aimed to see every new baby in their area within 10-14 days of birth to give advice on its feeding and care, the mother’s health and general household matters. An initial record card was completed and the mother encouraged to bring the baby to the local IWC, with repeat home visits if necessary.
IWCs had different frequencies of consultations and varying facilities, depending on the location and population of the district they served: there were 108 notified births in rural Northfield in 1921 compared to 1,636 in inner-city Hope St. Nearly all centres held sewing classes, where used garments were altered to make clothes for children, and some held cookery classes, Mother-craft competitions, and savings clubs. Dried milk was available at a reasonable price, with assured stocks throughout the war. Social activities such as summer outings and Christmas parties were often arranged by voluntary helpers, who were considered invaluable, giving a welcome extra dimension to the centre’s work.
At some centres in poorer districts, maternity feeding stations were set up for mal-nourished pregnant and nursing mothers. They were given a hot dinner for which they were asked to pay 1d if they were able. This provision was gratefully accepted by the mothers and improvements were noted in their own and their babies’ physical health and mental wellbeing. Weekly dental clinics were introduced in 1917 for mothers and children attending IWCs. It became increasingly difficult for the voluntary IWCs to attract sufficient funding by subscriptions, even with government and city grants of 80%, and eventually most opted to be taken over by the municipality.
The archives contain many references to the appreciation of mothers for the benefits they and their children gained from attending IWCs. The numbers of home visits and attendances of children at the centres in Birmingham show a healthy increase between 1918 and 1924:
| Births notified | Total visits to children | Total child attendances | |
| 1918 | 12333 | 111070 | 67080 |
| 1924 | 15981 | 232708 | 126998 |
Laurie Spencer
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