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75
Report of the County Medical Officer—General.
2,894; 1910, 3,020; 1911,3,477; 1912,3,003; 1913,3,070. Midwives in infirmaries and hospitals
acting under the direction of a qualified medical practitioner arc not required to comply with this rule.
Assuming that 30,000 births arc attended annually by midwives, the above figures show that
medical assistance was required in 11.78 per cent. of the cases.; in 6.89 per cent. on behalf of the mother
and in 4.89 per cent. on account of the child.
During the year, 219 midwives reported having stillbirths in their practice, the number of
stillborn children being 655, or 2.18 per cent. of the births; of this number 300 were reported to have
been macerated. There were normal presentations in 544 or 83 per cent. of the stillbirths.
Still births.
The rules of the Central Midwives Board require the midwife to notify to the local supervising
authority all cases in which the mother or child dies before the attendance of a registered medical practitioner.
In 67 cases midwives notified the deaths of infants, and in one instance the death of a woman
was notified.
Death of
mother or
child.
By the courtesy of the London coroners, notices are sent of inquests in which midwives are concerned
and one of the Council's inspectors attends the court to hear the evidence and learn whether the
midwife has complied with the rules of the Board. One hundred and twenty-six inquests were thus
reported upon, eighteen being on the bodies of women, and one hundred and eight on the bodies of infants.

During the year 1914, 393 cases of puerperal fever were notified in the County, and
the Registrar General records 182 deaths from puerperal septic disease during the year. The term
puerperal septic disease used by the Registrar General includes puerperal septicæmia, pyæmia
and sapræmia, as well as peritonitis and metritis occurring in connection with parturition.
A list of deaths is received weekly from the Registrar General and the deaths are compared
with the notified cases so that it is possible to ascertain whether the latter terminate fatally. Of the 393
notified cases, 113 proved fatal, a case-mortality of 28.7 per cent. The other deaths, 69 in number,
related to cases which were not notified as puerperal fever.
Puerperal
fever.

27715 l 2