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58
This year, there is an increased number of deaths due to the
commoner infectious diseases, to syphilis, convulsions, a
diminished number due to diarrhoea, enteritis, premature birth,
marasmus, and overlying in bed.
Whether these deaths or any of them, and if so which, are
preventable by public health measures is a matter of supreme
importance, and will now be briefly considered.
Premature Birth.—It will be noted in the above table that
more deaths are due to premature birth than to any other one
cause—381 deaths in 6 years. Most of these deaths occur
during the first week of life, and nearly all of them during the
first month. That is to say, these deaths occur while the mother
and child are still in the hands of the doctor, and before the
Council's Lady Health Visitors have visited the babies.
There is very little doubt that these cases of premature birth
are really the result of studied and deliberate action. Some of
the mothers concerned have admitted this. They frankly confess
that they cannot afford to bear and rear more children,—their
straightened resources, their poverty, their struggles for a livelihood
will not allow it. They cannot endure the double load
of child bearing and of supporting the family, necessitated by
the fathers' unemployment, or by the casual nature of his work.
Illustrative Cases. —
1. The father was a casual labourer. The mother was a
packer and accustomed to lift heavy boxes. As a result she
strained herself excessively at her work, and was prematurely
confined. The mother was kept in bed for a week. The baby
died. The mother expressed her satisfaction at the death of her
child, and stated she would now be able to return to work.
2. A mother had had two sets of twins, and became pregnant
again. She took 28 widely advertised aperient pills and a large
dose of Epsom salts, and in this way wilfully produced a miscarriage.
Her husband worked for a borough council under an
alias.