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77
first acts of the Committee was to send out a form of inquiry relating to
maternal deaths to all local authorities. The Medical Officer of Health
of the local authority was requested to undertake the prescribed inquiry
into each maternal death occurring in his district. Deaths of this description
occurring in the practice of a medical practitioner are of deep concern
to him as well as to the bereaved relatives. It is therefore important
to obtain the cordial co-operation of the practitioner concerned. The
British Medical Association was consulted by the Minister as to the procedure
to be adopted. The Association expressed approval of the
objects and mode of the inquiry and circularised all divisions and
branches in the country recommending the fullest co-operation with the
Medical Officers of Health in making investigations. Where midwives
only were concerned it was recommended that the Local Supervising
Authorities should inquire into the question as regards the work of the
midwives and should consult and exchange reports with the Medical
Officers of Health of the local sanitary authority. It was further
recommended that in certain cases it might be desirable to obtain the
services of an obstetric specialist where the features of the case required
particular experience.
The City Council in approving the principles and objects of these
inquiries appointed the Medical Officer of Health to carry out investigations
and to consult with medical practitioners concerned. The Council
further appointed Dr. Aubrey Goodwin the Council's Obstetric Consultant
under the Puerperal Fever and Puerperal Pyrexia Regulations to make
special inquiries at the request of the Medical Officer of Health where
necessary. The form of inquiry embraces environmental as well as
personal or medical aspects, and factors such as home conditions, previous
medical history are generally already known to the Medical Officer of
Health through the health visitors. The remaining points as to the
clinical circumstances of the case are to be obtained from the practitioner
in attendance. Where the patient has died in hospital it may be possible
to obtain the results of bacteriological and other investigations. Since
these forms of inquiry were issued in October, one death occurred and
was inquired into. The report was made personally by the Medical
Officer of Health and sent to Dame Janet Campbell at the Ministry. It
is hoped that by examining reports sent in from all over the country to
draw conclusions and to establish certain principles which may lead to
constructive action in endeavouring to diminish a serious and apparently
preventable cause of death.
Puerperal Fever, Puerperal Pyrexia and Mortality in Childbirth.—
The year 1928 furnishes a melancholy record of deaths in childbed. The
number 17 is the highest recorded in the City.