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45
The chief dangers affecting the life of the infant during this
period are : (a) Miscarriage, (b) Still-birth.
(a) There is no statistical evidence to show the proportion
of miscarriages to live births in the Borough, but there
is no reason to believe they are more or less numerous than in
other parts of the country. Estimates have, however, been
made of the proportion of miscarriages to still births, and the
average estimate arrived at is four miscarriages to one stillbirth.
If we apply this rate to Hackney, we shall get a local
rate which will be rather startling as to the loss in infant life
due to this cause alone. During the year 1914 there were 174
still-births notified to me ; therefore, on the basis of the above
estimate, there were 696 miscarriages.
(b) The causes leading to still-births are very complex ;
but in great measure they are connected with the health of the
mother during the child-bearing period, and may be expressed
in general terms, as due to the diseases and complications of
pregnancy, which may be largely controlled by early treatment
of the mother before serious symptoms arise. Summing up the
loss to infant life during the pre natal period, we find it
amounts, approximately, in Hackney to an annual loss of
870 infant lives.
2. Natal period.—It is not possible to separate entirely this
period in its effects from the earlier period. This is borne out by
the statement by Dr. Newsholme already quoted. Experience,
moreover, shows that many deaths occur from conditions arising
during the birth of the infant. It is not necessary to go into details.
It is sufficient to recognise that this period is one requiring skilled
attention and watchfulness, in order to prevent any of the incidents
of this period from being harmful, either to mother or child.
3. Post-natal period and mortality.—This includes all deaths
of infants during the first five years of life. This period is usually