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The clearest classification divides all these deaths into two groups.—Those deaths
occurring during pregnancy or childbirth, where the death is directly due to the puerperal
state are grouped as Puerperal Maternal Mortality. This group is sub-divided into the deaths
which have been due to Puerperal Sepsis and those due to Non-Septic Puerperal causes.
Such a group would indicate the average risk of pregnancy very accurately if we could
eliminate those cases of abortion which have been artificially induced, but leave insufficient
evidence to return a verdict of criminal interference.
The second group is reserved for those deaths which are only associated with pregnancy
or childbirth, such as the case of Asthma already quoted. They are all classified primarily
to their particular cause of death, and then re-grouped as Non-Puerperal Maternal Deaths.
They do not include cases following criminal abortion.
The Puerperal and Non-Puerperal groups are added together to form the total
Maternal Mortality. The qualification, Puerperal or Non-Puerperal, is the important
indication to the true moaning of any given term when discussing this subject.
Enquiries are made into all these deaths. Reports are made and forwarded to the
Special Maternal Mortality Committee appointed by the Ministry of Health.
In 1933 there were 10 Puerperal Maternal Deaths, 5 due to Sepsis and 5 to other
causes. The 5 Septic Puerperal Maternal Deaths include 2 cases of abortion where the
circumstances were very suspicious of criminal interference, but which were returned by the
coroner as "Open Verdicts." There were 4 Non-Puerperal Maternal Deaths due respectively
to Influenza, Infective Endocarditis, Acute Hepatitis and Peritonitis following an operation
for Hysterectomy. There was one death after an abortion which the coroner returned as
"Fefo de se."
The Puerperal Maternal Mortality rate was 3 7 per 1000 births (live and still).