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43
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.
Two maternal deaths were recorded during the current year giving
a maternal death rate of 0.54 per 1,000 total births compared with
a figure of 0.26 for 1966. Of the two deaths recorded, one, aged 20
years, was the result of "sub-arachnoid haemorrhage—toxaemia of
pregnancy" and the other, aged 26 years, was attributed to "acute
cardiac failure—prolonged labour (54 hours)—dystocia".
The rates returned for England and Wales and Greater London
were 0.20 and 0.33 respectively, while Inner London registered a
rate of 0.45.
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.