Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London County Council]
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The form prescribed by the Central Midwives Board for notifying still-births provides for
information as to (a) sex of child, (b) period of gestation, (c) whether macerated or not, (d) presentation.
The information under (a) showed that 354 still-born children were males and 316 females,
and in 6 cases the sex was not stated.
The following table shows the number of still-born infants of 6, 7, 8 and 9 months' gestation, and whether they were macerated or not:—
Condition of child. | Total cases. | Period of gestation. | |||||
---|---|---|---|---|---|---|---|
Full term | 8 months. | 7 months. | 6 months. | Under 6 months. | Not stated. | ||
Macerated | 383 | 147 | 80 | 94 | 47 | 13 | 2 |
Not macerated | 276 | 186 | 31 | 33 | 18 | 6 | 2 |
No statement | 17 | 2 | 1 | — | 2 | 3 | 9 |
Total | 676 | 335 | 112 | 127 | 67 | 22 | 13 |
The presentations were as follows:—
Vertex | 398 | Face or brow | 6 |
Complicated vertex | 44 | Funis | 10 |
Breech | 108 | Placenta prsevia | 3 |
Complicated breech | 10 | *Born before arrival and presentation not given | 32 |
Footling | 34 | ||
Transverse | 12 | No statement | 19 |
Total | 676 |
Some additional information as to still-born infants was given by the midwife, and the
following particulars relating to unmacerated infants of 8 or more months' gestation was obtained:—
Infant one of twins 13 Cord decomposed 1
Hydrocephalic or malformed head 2 Syphilis 1
Child born before midwife arrived 8 Spina bifida 1
Abnormally large child 2 Injury to head 1
White asphyxia 4 Accident to mother—
Deformed infant 3 Ante partum haemorrhage 1
Marginal placenta 1 Uterine inertia 1
Death of mother or child.—Under the rules of the Central Midwives Board midwives are required
to give notice to the local supervising authority in all cases where the death of a mother or child
occurs before the arrival of a medical practitioner. In 33 cases midwives reported the deaths of
children, and in 5 cases notices of deaths of mothers were received. Inquests were held in all these
cases, and also in cases where a medical practitioner, though present prior to death, had not been in
attendance long enough to form any conclusion as to the nature of the illness.
By the courtesy of the London coroners, notices of inquests in which midwives are concerned
are sent to me, and one of the Council's inspectors is thus enabled to attend the court and hear the
evidence. Much useful information is gleaned in this way, and the Council's inspectors are able to
point out to the coroner any neglect on the part of the midwife to comply with the rules of the Central
Midwives Board, which might have some bearing on the case under consideration.
The following table shows the cases in which the conduct of the midwife was adversely criticized by the coroner's jury.
Confinement conducted by | Deaths of mothers. | Deaths of infants. | |||
---|---|---|---|---|---|
Censured. | No censure. | Censured. | No censure. | ||
Midwives | 5 | 18 | 5 | 77 | |
Uncertified women | 1 | 2 | 6 | 13 | |
6 | 20 | 11 | 90 |
* In some cases the midwife, although not present at the birth, was able to state the presentation, and these
are classified accordingly.