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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| Delivery conducted by. | Cases. | Deaths. | |
|---|---|---|---|
| Medical practitioners (including cases attended by hospital students and also cases in which though a medical practitioner was engaged the birth took place before his arrival) | 158 | 75 | |
| (b) | Certified midwives (including cases where birth took place before arrival) | 51 | 15 |
| Uncertified women | 7 | 4 | |
| Confined in poor law institutions and hospitals | 28 | 15 | |
| (e) | Midwife and medical man (i.e., cases where a midwife was unable to deliver and called in a medical practitioner) | 4 | - |
| (f) | Deaths in London of women confined elsewhere | 8 | 8 |
| Miscarriages and abortions where no attendant was engaged | 22 | 20 | |
| Total | 278* | 137 | |
Causes of death in the 137 fatal cases:—
| Cause of death. | Notified cases. | Unnotified. | Cases delivered by midwives. |
|---|---|---|---|
| Puerperal septicæmia | 43 | 24 | 8 |
| Puerperal septic absorption | 3 | - | - |
| Puerperal fever | 11 | - | 2 |
| Puerperal peritonitis | 12 | 5 | 3 |
| Peritoneal abscess | – | 1 | – |
| Septic pneumonia | 3 | 1 | 1 |
| Phlegmasia alba dolens | i | 5 | – |
| Pyosalpinx | 1 | – | |
| Puerperal parametritis | – | 2 | – |
| Puerperal endometritis | 4 | – | |
| Erysipelas of leg following parturition | – | 1 | – |
| Phlebitis following parturition | – | 2 | – |
| Sloughing of rectum after labour | – | 1 | – |
| Sapræmia | 3 | 3 | 1 |
| Pyœmia | 2 | 3 | – |
| Pelvic cellulitis | 3 | – | – |
| Necrosis of ileum after labour | 1 | – | – |
| Hyperpyrexia after miscarriage | 1 | 1 | – |
| Total | 87 | 50 | 15 |
Concerning the 51 cases of puerperal fever occurring in the practice of midwives In addition to obtaining information from the midwife, the Council's inspector visits the medical practitioner who was afterwards called in to attend, during lying-in, a patient delivered by a midwife, and learns from him his opinion as to the nature of the case. The fo l lowing table is based upon the information thus obtained.
| Diagnosis. | Recovery cases. | Fatal cases. |
|---|---|---|
| Sapræmia | 12 | 1 |
| Septicæmia | 17 | 10 |
| Peritonitis | – | 3 |
| Septic pneumonia | 1 | 1 |
| Puerperal mania | 1 | – |
| Endometritis | 1 | – |
| Pelvic cellulitis | 1 | – |
| Septic thrombosis | 1 | – |
| Severe laceration | 1 | – |
| Perimetritis | 1 | – |
| Total | 36 | 15 |
* This figure includes the 228 notified cases of puerperal fever and 50 cases not so notified hut included by the
Registrar-General in his total of deaths from puerperal septic diseases.