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19
In a supplement in continuation of a report of the medical officer of
the Local Government Board for 1914-15, containing a report on
maternity mortality in connection with child-bearing and its relation to
infant mortality, Dr. Newsholme points out, that although much valuable
work has been done by the Central Midwives Board, by local supervising
authorities, and by many voluntary associations and hospitals, child
bearing is still associated in some parts of the country with very
excessive mortality, and in every part of the country with much avoidable
sickness and mortality. The report is intended to draw attention
to this fact, to stimulate further local inquiry on the subject, and to
encourage measures which will make the occurrence of illness and
disability due to child-bearing a much rarer event than at present.
In the first part the national aspect of the subject is discussed. It
is pointed out that there has been a remarkable decline in the national
birth-rate and in the national death-rate. By the simultaneous decline
of both birth-rate and death-rate a fall in the rate of natural increase of
the population has been postponed. The death-rate can still be greatly
reduced. A very high proportion of the deaths occurring under the
age of 70 are unnecessary deaths. Of the total deaths at all ages, 44
per cent, occur under the age of 40, and 76 per cent, under the age of
70. But the fall in the death-rate cannot keep pace indefinitely with
a continuous fall in the birth-rate. Already the average age of the
national population and its consequent proneness to death is on the
increase. Had the birth-rate of England and Wales been the same
in 1914 as in 1876, 467,837 additional infants would have been born in
1914. These figures emphasize the importance of preventing, so far
as is practicable, further decrease of the balance of births over deaths
by measures directed to saving the lives and maintaining and improving
the standard of health of mothers and of their children.
In the second part of the report are displayed the local differences
of mortality in child-bearing, so far as these can be shown in massed
statistics. In respect of puerperal fever there is a remarkable uniformity
in the experience of counties, county boroughs, and metropolitan
boroughs in England and Wales, taken in the aggregate. The deathrate
from conditions other than puerperal fever adversely affecting
child-bearing is much lower in London than in the provinces. This
difference means that over 800 mothers die each year in England and
Wales, as the result of child-bearing, whose lives would be saved if the
experience of the rest of England and Wales were as favourable as that
of London. But the recorded experience of London in respect of