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
London County Council 1908
[Report of the Medical Officer of Health for London County Council]
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The reasons assigned by the midwives for advising medical assistance were as follows:—
| Pregnancy— | Lying-in— | ||
|---|---|---|---|
| Abortion or miscarriage | 34 | Abdominal swelling or tenderness | 11 |
| Deformed pelvis | 2 | Excessive sickness | 6 |
| Growth on cervix | 2 | Offensive lochia | 5 |
| Ante partum haemorrhage | 86 | Rigor | 13 |
| Premature labour | 11 | Rise of temperature | 165 |
| Convulsions before labour | 1 | Inflammation or swelling of breasts | 15 |
| General health of patient | 29 | Post partum haemorrhage | 111 |
| Varicose veins | 28 | White leg | 3 |
| 193 | Phlebitis | 3 | |
| Convulsions and eclampsia | 16 | ||
| Collapse and exhaustion | 21 | ||
| Mania | 6 | ||
| Other illness of patient | 116 | ||
| Unable to make out presentation | 19 | 491 | |
| Abnormal vertex | 33 | Injuries during birth | 7 |
| Difficult breech (including breech in primiparæ) | 51 | Asphyxia | 50 |
| Malformation or obvious deformity | 54 | ||
| Knee | 5 | Inflammation of the eyes | 97 |
| Face | 23 | Jaundice | 17 |
| Funis | 39 | Cyanosis | 13 |
| Transverse | 72 | •/ Dangerous feebleness | 390 |
| Placenta prævia | 31 | Eruptions on skin | 14 |
| Twin birth | 18 | Convulsions | 46 |
| Triple birth | 2 | Bleeding from cord | 6 |
| Prolapse of vagina or uterus | 5 | Death of child | 44 |
| Prolonged labour (contracted pelvis, uterine inertia, etc.) | 495 | Still-birth | 40 |
| Other conditions in child | 56 | ||
| Retained and adherent placenta | 186 | 834 | |
| Laceration of the perineum or injury to soft parts | 246 | Infectious disease in patient's house | 2 |
| No reason stated | 3 | ||
| Haemorrhage during labour | 7 | ||
| 1232 | 2,755 | ||
Estimating that 30,000 births are annually attended by midwives, it would appear that in 9.2
per cent, of these cases the midwife finds it necessary to summon medical assistance, in 6.4 per cent,
on behalf of the mother, and in 2.8 per cent, on behalf of the child. It will be noticed that in nearly
half the cases in which medical help for the child was advised, the reason assigned was dangerous
feebleness. These cases are chiefly due to prematurity.
The numbers in the previous years were 1905, 405 ; 1906, 574 ; 1907, 740.
| 1 midwife reported 12 cases | 12 |
| 2 midwives reported 11 cases each | 22 |
| 3 ,, ,, 10 ,, | 30 |
| 3 „ „ 9 „ | 27 |
| 6 „ „ 8 „ | 48 |
| 8 „ „ 7 | 56 |
| 6 „ „ 6 „ | 36 |
| 12 „„ 5 „ | 60 |
| 26 „ „ 4 „ | 104 |
| 34 „„ 3 „ | 102 |
| 42 „ „ 2 „ | 84 |
| 85 „ „ 1 case | 85 |
| 228 midwives reported | 666 cases. |
If this number represents the total number of still-births in the practice of midwives it would
mean that 2.2 per cent, of the cases attended by midwives in London were still-born. There are, however
some cases in which the infant is born before the arrival of the midwife and found by her to be
apparently dead. Unless evidence is forthcoming as to whether the child was born alive or dead a
medical practitioner is summoned and the midwife usually reports the case as one of sending for medical
assistance and not as a still-birth.
The figures, which have kindly been furnished by the Secretary of the Royal Maternity Charity
(an organisation which has district midwives working in all parts of London) show that of 2,423 births
attended by their midwives, 60, or 2.5 per cent., were still-born.
The form in which still births are notified provides for information as to
(a) Sex of child.
(b) Whether full term or premature (number of months).
(c) Whether the child is macerated or not.
(d) Presentation.
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