Overcrowded and in very poor condition, the Stranorlar County Home in Co Donegal, formerly the local workhouse, admitted 1,646 unmarried mothers between 1922 and 1964.
1,777 children were admitted or born there during the same time period and they, and their mothers, accounted for just over 15% of all admissions to the county home.
The last single pregnant woman admitted to Stranorlar was in 1964 but such admissions had all but stopped in 1960.
The youngest recorded maternity admission was 13-years-old but in February 1938 three girls aged 15 or 16 were admitted, pregnant.
"All 3 were boarded out children and the health board referred the matter to the gardaí", the report states.
The average age of women admitted to Stranorlar was 24 with the vast majority from Co Donegal, Roman Catholic and employed as domestic servants.
While in the county home, the unmarried mothers carried out most of the work there but were unpaid. Just over half appear to have returned to their family home or that of a relative when discharged, the report says. Over one in four placed her child for boarding out by the local authority.
One woman called "Fran" who went to the home in the early 1950s, aged 16, said she "did not mind going at the time because my own people did not want me".
Her baby died but she said she never got to where it was buried. She described work sluicing dirty nappies and sheets in big tin baths, scrubbing floors and helping the nurses with the babies but said "we were generally happy I suppose...the nurses were very nice".
The Commission identified 20 deaths among the women with six notified as being related to childbirth. However, the mortality rate of children at Stranorlar was very high with one in five dying in the county home in the period reviewed by the Commission.
339 infant deaths were identified by the Commission with about 87% of those deaths occurring before the baby reached the age of one, 17% were less than a week old.
Deaths among infants and children peaked in 1930 when 22 deaths were recorded. Among "illegitimate" children the death rate that year was 42% (343 deaths) - two in every five children born or admitted that year subsequently died.
The most common cause of death among "illegitimate" children in Stranorlar was respiratory infection, accounting for over 60% of deaths.
They were buried in the original workhouse burial ground and records show the area was a regular subject of complaint for being overcrowded.
The Commission says evidence strongly suggests that most "illegitimate" children who died there were buried with other deceased "inmates" in the old workhouse cemetery with "the records clearly stating that the graves were shallow and that the bodies were buried in an ad-hoc manner".
Overcrowding and unsanitary conditions were also regularly noted in reports and records. A report on the home in 1927 indicates that there were 269 residents but the institution only had two toilets and two "bad baths" to cater for them.
A report on the quality of the water supply found that it was "grossly polluted with sewage or manorial matter and other animal organic matter".
The Commission noted that there were multiple outbreaks of typhoid in Stranorlar during 1930 and comments that the extremely poor living conditions there "may also explain the excessively high infant mortality rates recorded in the institution during 1930".
In June 1935 the obstetrician attached to the county home, Dr J Gormley said that conditions at the maternity ward had "deteriorated to the extent that he was refusing to treat maternity cases there".
A staff member in the 1940s, Sr Stanislaus, described the conditions as "atrocious" with up to "60 kids and about 26 cots for them". Sr Stanislaus said that there were no proper nappies for the children but when Sr Ignatious took over, she gave her four nappies for each child: "I thought that was the most wonderful day," she said.
In August a "major programme of remedial and construction work" was begun by the Department of Health but this was not completed until January 1952. The work included the conversion of the old fever hospital into a new nursery which a subsequent inspection described as "bright and airy" with "the children in good health".
Miss Litster, who carried out the inspection, noted that "in the year from 1 April, 1951, 36 'illegitimate' children had either been born at or admitted to the home and 11 'illegitimate' children had died during the same time period".
She hoped "that the better conditions and equipment of the new Children’s Home will be reflected in a lower death rate".