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 1911
[Report of the Medical Officer of Health for London County Council]
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Report of the Medical Officer of Health.
77
Some additional information was obtained as to still-born infants not macerated, of eight or
more months' gestation, as follows:—
Concerning the child— Born in membranes 1
One of twins 10
Hydrocephalus 7 Concerning the mother—
Malformed child 8 Ante partum haemorrhage 3
White asphyxia 1 Small pelvis 1
Cord round neck 1 Difficult labour 5
Anencephalic head 1
The rules of the Central Midwives Board require the midwife to notify to the local supervising
authority all cases in which the mother or child dies before the attendance of a registered medical
practitioner. In 53 cases midwives notified the deaths of infants, and in two cases notices of deaths
of mothers were received.
By the courtesy of the London coroners notices are sent of inquests in which midwives are concerned
and one of the Council's inspectors attends the court to hear the evidence and learn whether the
midwife has complied with the rules of the Board. One hundred and eleven inquests were thus
reported upon. These included inquests on cases attended by uncertified women, as well as by
certified midwives. The verdict in 103 cases attributed no blame to the person in attendance.
Death of
mother or
child.
The following table summarises the verdict with respect to cases in which blame was attributed :—
| Confinement conducted by | Total number of inquests. | Deaths of motners. | Deaths of infants. | |||
|---|---|---|---|---|---|---|
| Censured. | No censure. | Censured. | No censure. | |||
| Midwives | 102 | 1 | 9 | 5 | 87 | |
| Uncertified women | 9 | 1 | 1 | 1 | 6 | |
| 10 | 6 | 93 | ||||
The cause for the censure shown in the foregoing table was as follows :—
| Not advising medical assistance to mother early enough | 1 | ||
| Not making arrangements with another midwife when unable to attend case | 1 | ||
| Want of ordinary skill (uncertified women) | 2 | ||
| Delay in advising medical assistance for infant | 4 | ||
| In each case where a midwife was found to have failed to comply with the rules of the Central Midwives Board, a letter of caution was addressed to her. The medical evidence given at the inquests as to the cause of death was as follows :— | |||
| Septicaemia | 4 | Atelectasis | 11 |
| Rupture of uterus 2 | 2 | Suffocation at birth | 14 |
| Pulmonary embolism | 1 | Suffocation in bed | 13 |
| Heart disease 1 | 1 | Prematurity | 19 |
| Haemorrhage during labour | 1 | Convulsions | 8 |
| Bursting of cyst in pancreas | 1 | Bronchitis and pneumonia | 8 |
| Suffocation from regurgitation of food from stomach during labour | 1 | Concussion of brain at birth | 1 |
| Malnutrition | 2 | ||
| Collapse from long labour | 1 | Tetanus | 1 |
| Shock from scalding (accident) | 1 | ||
| Haemorrhage from cord | 1 | ||
| Septicaemia from pemphigus | 2 | ||
| Congenital heart disease or malformation | 6 | ||
| Stillbirth | 12 | ||
| 12 | 99 | ||
During the year 1911, 302 cases of puerperal fever were notified in the County and the Registrar
General records 142 deaths from puerperal septic disease during the year. Two deaths recorded by the
Registrar General refer to cases which were notified in 1910, and three deaths occurred in 1912 of cases
notified in 1911, while in two cases notified as puerperal fever the deaths were certified to be due to
eclampsia and were classified by the Registrar General under accidents of childbirth. The term
puerperal septic disease used by the Registrar General includes puerperal septicaemia, pyaemia
and sapræmia, as well as peritonitis and metritis occurring in connection with parturition.
A list of deaths is received weekly from the Registrar General and the deaths are compared
with the notified cases so that it is possible to ascertain whether the latter terminate fatally. Of the 302
Puerperal
fever.