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61
are for the most part developmental conditions. This group of infantile
deaths occurring in the first month of life is generally referred to
as the neo-natal mortality.
It follows therefore that the chief means by which a reduction
may be made in the number of neo-natal deaths is by careful and
expert ante-natal care, for the cause of the death of the infant in the
large proportion of cases is due to a maternal defect which could, and
should, have been remedied during pregnancy. Apart from certain
conditions, we must look for help from the midwife, who, by careful
ante-natal examination and reference of all abnormal cases for expert
guidance, is able to play a vital part in reducing infant wastage.
The ideal would be for every expectant mother to be under
regular observation by her midwife and to be examined at least twice
during the course of her pregnancy by her medical attendant. The
initial inspection by her doctor should be made early in pregnancy and
should be directed to her general physical condition, whilst the later
examination should be essentially obstetrical. Only too often does
ante-natal care consist solely of urine testing. This is strongly to be
deprecated, as it is totally inadequate and is apt to give the pregnant
mother a false sense of security, and moreover is likely to bring discredit
on both the attendant midwife and the ante-natal service in
general.
Maternal Mortality and Morbidity.
The number of women dying in, or in consequence of, child
birth during 1932 was 3. This represents a maternal mortality rate
of 2.98, as compared with 1.9 and 5.7 for the preceding two years.
During the year the Departmental Committee issued their Final
Report. The subject of Maternal Mortality and Morbidity is one of
paramount national importance and worthy of careful study by all
Maternity and Child Welfare authorities. On considering the position
as it affects the Borough of Hampstead, I find that my predecessor,
Dr. Scrase, reported fully on the matter in his Annual Report for
1930, that being his last Survey Report. From that Report it appears
that during the 10 years 1921-1930, the rate of maternal deaths in
Hampstead was 4.2 per 1,000 births, an increase compared with the
rate for the 10 years 1901-1910 which was only 3.1. The maternal
mortality rate in 1930 was as high as 5.7. In 1931 the rate dropped
to 1.9, but for the year 1932 the rate has increased to 2.98.