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23
Maternal Mortality.
The maternal mortality is expressed as the number of deaths
attributed to puerperal sepsis and other accidents and diseases of
pregnancy and parturition, for each 1,000 live births. The rate in
Lambeth in 1936 was 0.77, whereas the previous lowest rate was
that recorded in 1933, when it was 1.77. The rate for one year is
not regarded as being of special importance, although a rate so
low as 0.77 is significant when compared with that of England
and Wales, which is almost five times as high at 3.81. The maternal
mortality during the five years 1932 to 1936 has averaged 2.0 per
1,000 live births, based upon no less than 19,971 births. Over so
long a period, and based upon a number of births little short of
twenty thousand, the rate is a clear and significant indication of
the success of the Lambeth Maternity and Child Welfare scheme.
Each year has seen improvements and additions to the facilities
offered since the publication of the interim report of the Departmental
Committee on Maternal Mortality, and the co-operation
between the various welfare centres and other institutions comprised
in the Lambeth scheme, and the mothers, has led to a maternal
mortality rate of less than one half that for England and Wales over
the corresponding five-year period. The interim report of the
Departmental Committee indicated that approximately one half
of the maternal deaths were preventable. In Lambeth during the
past five years on that assumption more than half the maternal
deaths have been prevented.
There is an active co-operation between all those who are
connected with midwifery activities, except the practising midwives
engaged in domiciliary midwifery. Representations have been made
to the Minister of Health upon several occasions during the past
fifteen years urging that the Borough Councils should be made the
Local Supervising Authority of midwives instead of the County
Council, but without the slightest measure of success. In fact
the Midwives Act, 1936, not only confirms the County Council in their
entrenched position, but has laid upon them the duty of drawing
up a scheme for confirmation by the Minister, of domiciliary
midwifery for the entire area of the County of London. It is unlikely
that the municipal midwives to be employed by the County Council
will make more use of the Borough Council's maternity and child
welfare scheme than have the private practising midwives in the
past.
The story, however, does not end at this point. For the purposes of
their domiciliary midwifery scheme the County Council propose to
sub-divide the county area into five groups of Boroughs and to