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59
3. A mother had been in the habit of taking 6 aperient pills
once a week to induce a mis-carriage. She was prematurely
confined.
4. An expectant mother was prematurely confined. This she
attributed to being kicked in the stomach by a foreigner with
whom she argued about the Insurance Act. The neighbours,
however, asserted that "her husband paid her—he done it apurpose."
It is difficult to see how these deaths may be prevented by
public health measures in the face of the opposition and determination
of the parents. The common causes of premature birth
apart from its wilful procuring are working in lead works,
syphilis, accidental falls or blows, muscular strain, diseases or
malformations of the womb, and deformities of the hip bones
and adjoining bones.
In 1911 and part of 1912, a serious attempt was made to deal
with these deaths.
For this purpose a lady health visitor was deputed to visit St.
Bartholomews Hospital every Thursday, when the maternity
letters were given out, and by this means to get into touch
with the expectant mothers and learn the histories of their
previous confinements. Those who had been prematurely confined
on previous occasions were visited at home and given
appropriate advice. In one instance there was a history of lead
poisoning, in a few cases histories of syphilis. In most cases
there was no obvious cause : the births were prematurely induced
wilfully and of set purpose.
All this preventive work, however, was practically rendered of
little or of no avail for the following reasons:—
(a) The mothers removed and were lost sight of.
(b) Even when the mothers alleged that they were anxious
to have living children, they were unable to follow the
instructions given, because they could not afford to give up
their employment to obtain the necessary rest in bed and
medical treatment.