London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1920
Annual report of the Council, 1920. Vol. III. Public Health
This page requires JavaScript
Some additional information was obtained as to stillborn infants not macerated, of eight or more months' gestation, as follows:—
| Concerning the child— | |||
| One of triplets | 2 | White asphyxia | 3 |
| One of twins | 11 | Cord round neck | 4 |
| Hydrocephalic head | 2 | Anencephalic head | 9 |
| Malformed child | 7 | Spina bifida | 2 |
The rules of the Central Midwives Board require the midwife to notify to the local supervising
authority all cases in which the mother or child dies before the attendance of a registered medical
practitioner. In 47 cases midwives notified the deaths of infants, and in 6 cases notices of deaths of
mothers were received.
By the courtesy of the London coroners notices are sent of inquests in which midwives are concerned
and one of the Council's inspectors attends the Court to hear the evidence and learn whether
the midwife has complied with the rules of the Board. Ninety-seven inquests were thus reported
upon. In the following table particulars are given with respect to these cases:—
Confinement conducted by
Total number
of inquests.
Death of
mothers.
Deaths of
Infants.
Midwives 97 17 80
During the year 445 cases of puerperal fever were notified in the county, and the Registrar General
records 201 deaths from puerperal septic disease in the same period, not including one case in which the
death was not recorded by the Registrar General. The term puerperal septic disease used by the Registrar
General includes puerperal septicaemia, pyaemia and sapraemia, as well as peritonitis and metritis occuring
in connection with parturition. A list of deaths is received weekly from the Registrar-General, and the
deaths are compared with the notified cases, so that it is possible to ascertain whether the latter terminate
fatally. Of the 445 notified cases, 160 proved fatal, a case mortality of 36 per cent. The 42 other
deaths related to cases which were not notified.
The following table gives the results of these inquiries which relate to the 445 notified cases.
| Delivery conducted by | Cases. | Deaths. |
|---|---|---|
| 204 | 81 | |
| (b) Certified midwives (including cases in which birth took place before the arrival of the midwife) | 152 | 44 |
| (c) Medical practitioner and certified midwife, i.e., cases in which a midwife was unable to deliver and called in a medical practitioner | 5 | 3 |
| (d) Hospitals and poor law institutions | 68 | 26 |
| (e) Cases of miscarriage or abortion where no attendant was engaged | 11 | 3 |
| (f) Uncertified woman | 2 | 2 |
| (g) Unascertained | 3 | 1 |
| Total | 445 | 160 |
The cause of death as stated in the death certificates in the 202 fatal cases occurring in London is shown in the following table:—
| Cause of death. | Notified cases. | Unnotified Cases. | Total. |
|---|---|---|---|
| Puerperal septicaemia, post partum septicaemia, and streptococcal septicaemia | 139 | 21 | 160 |
| Puerperal sapraemia | — | 2 | 2 |
| Salpingitis | 1 | 1 | 2 |
| Puerperal pyaemia | 4 | 3 | 7 |
| „ peritonitis | 11 | 11 | 22 |
| „ mania | 1 | — | 1 |
| Septic abortion | 1 | 1 | 2 |
| „ pneumonia | 1 | 1 | 2 |
| „ endometritis | 1 | — | 1 |
| Pelvic cellulitis | 1 | 2 | 3 |
| Total | 160 | 42 | 202 |
Ophthalmia
neonatorum
It is the duty of a midwife to advise that medical help is required when inflammation of the eyes,
however slight, occurs in infants. Great stress has been laid by the Council on the importance of strictly
observing this rule. When a notice is received from a midwife that medical assistance has been sought
on this account, the Council's medical inspector at once visits the infant to ascertain that it is receiving
the medical assistance which the midwife has advised, and the medical officer of health of the borough in