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54
M.B. (37).—Married. Second pregnancy. Admitted to hospital as
case of acute abdomen. Denied pregnancy. Immediate operation disclosed
ruptured tubal pregnancy. Acute vomiting and collapse throughout.
Death same day.
Replies to inquiries have not been received in two of the maternal
deaths. In the eight summarized above, it is noteworthy that all had
been under ante-natal supervision except M.B., who did not consider
herself pregnant and was admitted as an acute surgical abdominal case.
Three died from acute conditions of the lungs existing prior to confinement
and are not directly attributable to labour. There remain the four deaths
from puerperal sepsis, three of them being unmarried women. Two of
those unmarried women had been receiving regular ante-natal care at
hospitals. The married woman had been under private medical supervision
before confinement which took place at home, two doctors being in
attendance. From the information supplied by the hospitals concerned,
and on reviewing the circumstances of each case in the light of such
information, it is difficult to see how these unfortunate results could have
been prevented.
Circulars 1167 and Memorandum 156/M.C.W., issued by the Ministry
of Health contained suggestions by the Minister for the improvement of
midwifery services by the provision of consultant services, assistance
from the local authority in providing and paying for the services of
midwives and doctors, particularly as regards ante-natal supervision.
Other facilities mentioned in the circular were similarly suggested as
measures to ensure the best possible care of the pregnant woman, before,
during, and after confinement.
It has been pointed out on previous occasions that the City Council
had reviewed its maternity services and had provided such extensions
or improvements before the issue of the circular in question. Through
the agency of the Maternity and Child Welfare Centres for ante-natal
and post-natal care and the arrangements made with Westminster
Hospital for home midwifery, confinements in hospital, services of medical
practitioners, consultants, laboratory facilities, etc., a complete midwifery
service is provided throughout the City. This service is available for
any woman who for any reason is not in a position to make private
arrangements.
Maternity Beds.—The agreement with the Westminster Hospital for
the provision of maternity beds continues to work very satisfactorily.
As mentioned on a previous occasion the scheme has provided a long-felt
want and is a notable contribution to the solution of the problem of