London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Lewisham 1929
[Report of the Medical Officer of Health for Lewisham Borough]
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8
An investigation was made into each of the maternal deaths
which occurred in this Borough, and forwarded to the Maternal
Mortality Committee.
The Council were fortunate in securing the services of Mr.
G. F. Gibberd, F.R.C.S., to conduct these investigations.
It is hoped that in the near future a scheme will be in
operation for the provision of the services of two Consulting
Obstetricians to assist medical practitioners in complicated cases
of pregnancy or labour.
The services of the Consultants would only be available
where the financial circumstances of the patient are such that
the necessary expert advice could not otherwise be obtained.
The Council would be responsible for the Consultant's fee, but
would reserve the right to recover all or part of the fee from
the patient or her husband.
The provision of Home Helps and sterile maternity outfits
for necessitous cases will also be included in the scheme.
The following table shows the Maternal Deaths classified according to the certified causes of death:—
| Diseases and Accidents of Pregnancy. | Complications of Labour and the Puerperium. | Other Causes. |
|---|---|---|
| (1) Ruptured tubal pregnancy. | (1) Puerperal Sepsis. | (1) Asthma, causing heart failure 8 hours after parturition. |
| (2) Puerperal Sepsis. | ||
| (2) Accidental haemorrhage and hy-dramnios. | (3) Puerperal Peritonitis. | |
| (4) Post partum haemorrhage and Puerperal Peritonitis | ||
| (5) Retained placenta and Puerperal Sepsis. | ||
| (3) Miscarriage, followed by septic endometritis. | (6) Delayed labour and Puerperal Septicaemia. | |
| (4) Miscarriage, followed by general peritonitis. | ||
| (7) Difficult labour and Acute Yellow Atrophy of Liver. | ||
| (8) Obstructed labour and Puerperal Sepsis. | ||
| (9) Retained placenta and Post partum haemorrhage. | ||
| (10) Post-partum Eclampsia. | ||
| (11) Post-partum Eclampsia. | ||
| (12) Haemorrhage into the left suprarenal gland during labour. |
It will be seen that Puerperal Sepsis is responsible directly,
or indirectly, for the majority of these deaths. It is only by
careful medical supervision during the ante-natal period, and by
conducting all confinements with the aseptic precautions of a
major operation, by an experienced obstetrician, that maternal
mortality will be reduced to the unavoidable minimum.