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93
Report of the Medical Officer of Health
Some additional information was obtained as to still-born infants not macerated, of eight or
more months' gestation, as follows :—
One of twins 16 Ascites 1
Abnormally large child 2 Anencephalic head 1
Hydrocephalus 4
Malformed child 4 In mother—
White asphyxia 2 Ante partum haemorrhage 4
Death of
mother or
child
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 42 cases midwives notified the deaths of infants, and in three cases notices of deaths
of mothers were received. Inquests are held in these cases and also in cases where a medical man,
although in attendance before death occurs, does not arrive at a conclusion as to the cause of death.
By the courtesy of the London coroners notices are- sent of inquests in which midwives are concerned
and the Council's inspector attends the court to hear the evidence and learn whether the midwife
has complied with the rules of the Board. Reports of 89 inquests were made. These include cases
attended by uncertified women, as well as by certified midwives. The verdict in 80 cases attributed no blame to the person in attendance.

The cause for the censure shown in the foregoing table was as follows :—
Not advising medical assistance to mother early enough 1
„ „ ,, for a case of pyaemia 1
Want of ordinary skill (uncertified women) 2
Delay in advising medical assistance for infant 5
In each case where a midwife was found to have failed to comply with the rules of the Central
Midwives Board, a letter of caution was addressed to her.
The medical evidence given at the inquests as to the cause of death was as follows :—
Mothers.
Pyaemia 1
Pneumonia 1
Pulmonary embolism 4
Heart disease 1
Haemorrhage on brain 1
Haemorrhage during labour 3
Collapse from ante partum hæmorrhage 1
Suffocation from air embolism 1
13
Infants.
Atelectasis 15
Suffocation at birth 13
Suffocation in bed 7
Prematurity 8
Convulsions 5
Bronchitis and pneumonia 5
Tuberculosis 1
Cerebral hæmorrhage 4
Concussion of brain at birth 1
Jaundice 2
Syphilis 1
Inflammation of lungs 1
Enlarged glands 1
Hæmorrhage from cord 1
Septic absorption from bowels 1
Congenital heart disease 3
Stillbirth 7
76
Puerperal
fever
During the year 1910, 292 cases of puerperal fever were notified in the County and the Registrar
General records 161 deaths from puerperal septic disease during the year. Two deaths recorded by the
Registrar General refer to cases which were notified in 1909, and two deaths occurred in 1911 of cases
notified in 1910, while in one case notified as puerperal fever the death was certified to be due to
secondary post partum haemorrhage, and the death was classified by the Registrar General as accident
of childbirth. The term puerperal septic disease used by the Registrar General includes puerperal
septicaemia, pyaemia and sapræmia, as well as peritonitis and metritis occurring in connection with
parturition. A list of deaths is received weekly from the Registrar General and the deaths are compared