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43
not to be pregnant, and 24 were post-natal cases attending the clinics
for the first time.
The number of births in Hampstead during 1935 was 999. As
360 expectant mothers from the Borough attended our Clinics last
year, it is found that 36 per cent. of the Hampstead women who had
babies in 1935 received ante-natal care under my auspices.
Of the children born to those 360 women, 8 died during the first
month of life, 3 of whom were twins and another, a child who had a
congenital stricture of the duodenum. The neo-natal death rate, as it
is called, or the death rate amongst infants in the first month of life,
is still somewhat high in England and Wales, having been 31 per
1,000 in 1934. It is confidently believed that this will diminish yet
further, as more expectant mothers receive ante-natal care and extra
nourishment when needed. Our neo-natal death rate in Hampstead
last year was 20 per 1,000, which is satisfactory.
I have been studying our records for the last seven years, viz.,
1929 to 1935, inclusive, and it is a cause for great thankfulness to
discover that we can show an unbroken series of 1,361 expectant
mothers who have attended our Ante-natal Clinics during the last
four years without a single maternal death. If we consider, too, the
whole seven year period, viz., 1929 to 1935, inclusive, we find that
amongst a series of 1,988 expectant mothers there were two maternal
deaths in 1931, which gives a maternal mortality rate of 1 per 1,000
for our Clinic cases as against 44 per 1,000 for England and Wales.
This happy result has only been obtained of course by constant vigilance
and co-operation in team work with the different Hospitals where
many of these women were confined and with the practising midwives
in the Borough, but I think it helps to demonstrate the value of antenatal
care as well as the splendid work of doctors and midwives who
attended the various women during their confinements, whether in
New End Hospital or at their homes.
In this connection I thought it would be interesting to follow up the
after histories of a series of cases suffering from pyelitis, an infection
of kidneys and bladder, which sometimes attacks pregnant women.
Though an infrequent cause of maternal mortality (in a series of 2,465
maternal deaths recently investigated by the Scottish Board of Health,