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11
ABOVE STANDARD DEATHS.
In almost every area there is a number of infant births and deaths occurring in those better
class homes where it is reasonable to assume that the children receive every care and all requisite
medical and nursing assistance. These are called " above standard " cases and, although it is
difficult to make certain that none is included under this heading in which the attention of a woman
health officer might prove beneficial, they are not generally visited because, in the first place, the
health officer may not be welcomed and, in the second place, she can occupy her time more
profitably in visiting homes in the poorer quarters.
In 1931 the " above standard " notified births numbered 595 and the deaths 21, giving an
infantile mortality rate of 37.
The 1,873 notified births and 167 deaths not "above standard" in 1931 give an infantile
mortality rate of 81.
The causes of death in the " above standard " cases were as follow :—
Premature birth 8
Congenital defects 3
Broncho pneumonia 3
Inanition 2
Hydrocephalus 1
Marasmus 1
Diarrhoea 1
Convulsions 1
Unknown 1
21
MATERNAL MORTALITY.
In 1931 there were 15 deaths of Kensington women from diseases or accidents directly
connected with child-birth, and this figure represents a death rate of six mothers per 1,000 births.
The rate for London for 1931 was 3.80, and for England and Wales 4.11.
Where the figures are small, a few deaths more or less make a big difference in the percentage.
For example, in 1930 the Kensington rate was 2.3 per 1,000, whilst that for London was 3.33,
and for England and Wales 4.40. Too much attention must, therefore, not be paid to fluctuations
in percentages in any one borough from one year to another, but 15 deaths of Kensington women
between the ages of 23 and 40 years occurring in the space of 12 months, in connection with the
performance of a normal function, suggests a sufficiently serious state of affairs to warrant the
closest investigation. As each of these deaths was reported, I arranged for the late Dr Remington
Hobbs to make, in consultation with the doctor in charge of the case, a detailed examination
into all the circumstances in order that reports could be submitted to the Ministry of Health
for the information of a committee thereat enquiring into the causes of maternal mortality.
At the request of the Ministry of Health and the medical profession, these reports are regarded
as confidential by me and I have given an undertaking to keep no copies in the public health
department. It is desirable, however, that the council should have some information and for
this purpose the health visitors have made enquiries independently of Dr. Hobbs, the results of
which are submitted in the following table :—