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2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1957
reduced in 1957 to 15.6 per 1,000 live births. This is a low rate for
a large urbanised area containing mixed conditions like Wandsworth.
It is right, however, that I should point out that where we are dealing
with comparatively small figures, small increases or decreases in
these numbers can make quite a substantial difference to the rate.
Over large areas and dealing with larger numbers, these comparatively
small differences, of course, even out. Allowing for this,
however, the fact that in Wandsworth in 1957 there were 5 fewer
deaths (at 79) of infants under one year of age than in the previous
year is very satisfactory. The problem of further reducing the infant
death rate, particularly of deaths of children in the first month of
life and even more particularly of children in the first week of life
is a considerable one. It is closely associated with the causation of
still-births. This problem of peri-natal mortality, that is to say, stillbirths
and deaths of infants in the first week of life, is at the moment
being actively investigated and we are participating in this enquiry
in this area.
It is equally gratifying to report another milestone in the health
of the Borough, closely associated with the health of infants. No
death occurred in Wandsworth during 1957 from accidents and
diseases of pregnancy or childbirth. This is the first year that it has
been possible to report this. Many agencies, institutions and services
as well as individuals are concerned with reducing the risk to mothers
during pregnancy and labour. General practitioners, consultants,
obstetric hospitals, domiciliary midwives, health visitors, home helps
and the health services generally all have their part to play. It would
be invidious to single out any one particular service as having made
a particular contribution to this highly gratifying record but I have
no doubt that all concerned in their various spheres have played their
part. In 1956, four mothers died from causes associated with pregnancy
and childbirth, in 1955 there were also four deaths. It would
be too much to hope that in every future year I shall be able to report
an equally satisfactory result but the fact that in a large area like
Wandsworth, it is possible to achieve a reduction in maternal mortality
to nil makes one hope that this achievement will not be an
isolated one.
The total number of cases of infectious disease notified was almost