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A review of the causes of maternal deaths during the years 1921-1925,
has convinced me that in one-third of the cases death could have been
avoided had the woman at an early stage of pregnancy attended the
Ante-natal Clinic regularly for examination and supervision, also that
in a further considerable proportion—probably one-third—admission, or
admission at an earlier stage, to a maternity bed in a hospital might
have saved the mother's life.
During the year further efforts were made to insure that in Chelsea
still better results will accrue from the measures already in operation to
diminish the risk involved in childbirth. The valuable report by Dame
Janet Campbell issued by the Ministry of Health in 1924, has clearly
shown the necessity for such increased effort. Neglect in the past of
provision for the early diagnosis of conditions inimical to the health of
mothers has resulted not only in a high mortality rate but also in a
considerable, and largely avoidable amount of suffering and invalidity
amongst the survivors.
Puerperal fever, in particular, is a disease requiring early, active and
efficient treatment. The type of treatment and the highly-skilled
nursing involved are quite out of reach of the poorer sections of the
community in their own homes. These invariably consist of small
flats and tenements entirely lacking in facilities for confinement.
Wherever possible in such cases arrangements are made for the woman
to be confined in a maternity hospital or home, and there can be no doubt
as to the desirability of women entering an institution when the home
conditions are not satisfactory. Many object to making use of the
accommodation and efficient treatment provided by the Board of
Guardians, and with a view to providing for the safe confinement of such
cases, most of the Metropolitan Borough Councils have made special
arrangements. The Ministry of Health has also provided for the