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There are thus 4 morning, 3 afternoon and 2 evening antenatal
clinics held every week. In addition there is an ante-natal
clinic in connection with the maternity department of St. Olave's
Hospital. Home visiting in connection with the hospital antenatal
clinics is done by the municipal Health Visitors, and antenatal
cases are visited at least once a month at home, and more
frequently, if necessary. Health Visitors give each mother individual
instruction at these clinics. All the municipal clinics are
conducted on the appointment system, and the average attendance
during 1933 was 12. The total number of expectant mothers
who attended the municipal ante-natal centres during 1933 was
1,152, whilst an additional 349, whose children were born in St.
Olave's Hospital, were supervised at the ante-natal clinic attached
thereto. Therefore the total number of mothers taking advantage
of the ante-natal clinics was 1,501. This figure means that last
year practically all the pregnant women in the Borough received
some measure of ante-natal supervision before confinement.
MATERNAL MORTALITY.
The maternal mortality rate for 1933 was 2.57. There were
four deaths during the year, exactly the same number as in the
previous year. Every case of maternal death is carefully investigated.
In two of the four cases last year the births were illegitimate,
and, in one of these at least, there was a possibility that
artificial means had been used to terminate the pregnancy. In
another case the mother refused the treatment advised, until too
late. One of the two remaining deaths was due to an obstetric
condition which, in the present state of knowledge, cannot be
detected before confinement. The fourth death occurred in a
case in which, in my opinion, pregnancy should not have been
allowed at all. It appears to me that three of these deaths could
possibly have been prevented had there been greater knowledge
on the part of the parents, and there is obviously room for improvement
in this direction. The maternal mortality is higher in the
case of illegitimate births than in the case of legitimate births,
but it is a striking fact that the percentage of illegitimate births
in this Borough is the lowest in London, averaging 2.05 for the
last five years as compared with 12.57 for the highest Borough.