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Now, as then, many of the underlying factors remain obscure. Maternal illhealth
during pregnancy, and perhaps also before the occurrence of pregnancy, has
been shown to be a factor which is probably of great importance in relation to the
occurrence of dead births. It is presumed that maternal morbidity is closely related,
both to foetal and to maternal mortality.
It is certain that an intra-cranial lesion, with its accompanying haemorrhage,
is at least an important contributory cause of death, although it is impossible to
ascertain the precise cause that extinguished the life of the foetus. The suggestion
is, therefore, that a proportion of intra-natal deaths are associated with manipulation
of some kind or another. It is not supposed that such manipulation is unnecessary,
but rather that efforts be directed towards the reduction of the need for such
obstetric interference.
The inference is that more and oftener ante-natal supervision would lead to the
discovery of abnormal conditions at a time when they could be rectified by relatively
simple measures, and closer co-operation between doctors and midwives, etc. is
stressed. Closer attention is now given to this whole question in the teaching
schools, particularly in respect of post graduate courses, and periodical revision
courses for midwives are now insisted upon by the Central Midwives Board.
(c) Midwifery.—The Council has been the Local Supervising Authority for
Midwives since the 1st April, 1935.
Fifty-four midwives notified the Local Supervising Authority of their intention
to practise within the Borough during the period 1st January, 1937 to the 31st
December, 1937, and the number who were engaged in practice in the Borough at
the end of the year was as follows:—
At Upney Hospital 5
Municipal District Midwive 5
At the District Nurses' Home of the Plaistow Maternity
Hospital 2
At the Salvation Army District Nurses' Home 2
In private practice 11
The number of visits of inspection paid by the Inspector of Midwives was 43,