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42
improvements in this field were most marked in the higher social
classes.
Registered Greenwich stillbirths numbered 45 (23 males—22
females) which is equivalent to a rate of 13.05 per 1,000 total
births, a decrease of 1.72 from that for 1967. Greater London
returned a rate of 13.5 and that for Inner London was 13.1.
All stillbirths must be registered in accordance with the Registration
Service Act of 1953 as amended by the Population (Statistics)
Act, 1960, and must be accompanied by a statement as to cause.
An investigation of the 45 stillbirths occurring to Greenwich
residents during 1968 (8 of which were illegitimate) reveals that the
majority of stillbirths resulted from congenital anomalies and
haemorrhages. A full analysis of causes of stillbirths is given in
the following table: —
Abruptio placentae 1
Asphyxia—intra uterine 2
Cervical dystocia 1
Congenital anomalies 9
Haemorrhage—Accidental 4
ante partum 3
Hypertension 2
Large baby (prolonged labour) 1
Macerated foetus 2
Placenta praevia 1
Placental insufficiency 4
Prematurity 3
Thrombosis/infarction of
placental blood vessels 1
Toxaemia—pre-eclamptic 4
Umbilical cord—knotted 1
prolapsed 2
round neck 1
Tentorial tear 1
Unknown 2
Fertility
Fertility is a measure of the rate at which a specific community
adds to itself by births. It is not to be confused with population
growth which is the net result of gains from births, losses by
deaths and adjustments in connection with the movements of persons
in or out of the area. Nor must too much reliance be placed
upon the crude birth rate which, although a convenient way of
giving the gross rate of increase of a population by births, serves
only as a short term measurement of the flow of births.
True fertility rates must be based not upon the total population
but upon the "population at risk" i.e. live births expressed as a
rate per 1,000 of women of child-bearing age. This rate is called
the "general fertility rate" and for even greater accuracy, this
should be sub-divided into legitimate and illegitimate rates.
As 90% of all births are legitimate it follows, therefore, that the
extent to which people marry influences the flow of births. Moreover,
the number of persons marrying is related to the availability
of men and women within the marriageable age period which, in
turn, is dependent upon antecedent births and the marriages