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44
Maternal Mortality
Statistically, maternal deaths should be related to all those
women who are pregnant during the period of the review. However,
as this is impractical (for miscarriages are not registerable and many
pregnancies are terminated unbeknown to the authorities), the
extent of maternal mortality is measured against the total of live
and stillbirths which gives a reasonably accurate basis for enumerating
pregnancies during the interval of assessment.
Maternal mortality is conveniently defined as the number of
women dying from complications of pregnancy, childbirth or
puerperium during the year. This is then related to the number of
live and stillbirths during the same period to give the maternal death
rate. Abortion, because of the possible criminal element, is often
excluded but, when included, the fact should be stated.
Studies have shown that expectant mothers on a poor pre-natal
diet become greater obstetric risks and the incidence of miscarriages,
stillbirths and premature births increases. Moreover, subsequently
the offspring of the mothers appear more prone to illness and infection.
One maternal death was recorded during the current year
giving a maternal death rate of 0.26 per 1,000 total births compared
with a figure of 0.52 for 1965. The death, concerning a woman of
24 years, was certified as being due to 'self-induced' abortion.
The rates returned for England and Wales and Greater London
were 0.26 and 0.33 respectively.
Infantile Mortality
Infant Mortality of any given locality is measured by relating
the number of deaths of children under one year of age recorded
during the year to the number of live births registered for that
particular area during the same period.
Bad housing, overcrowding, poor sanitation, low standards of
education, illegitimacy, all tend to produce higher infant mortality
rates. It follows therefore that the infant mortality rate should
provide a reasonably accurate indication of the social circumstances
of any particular area. However, it must be borne in mind that as
infant mortality has now reached relatively small proportions, any
slight deviation in the number of deaths tends to misleading fluctuations
in the rate and only a long term appraisal is likely to reflect the
true position.
It is generally agreed that there is a direct relationship between
foetal loss and the amount of ante natal care received. Some 60 years
or so ago in the early 1900's there were no cyetic examinations at all
and even when examinations were introduced at about 1909 they
were carried out for ascertainment of presentation and detection of