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14
Birth-rate Commission ("The declining birth-rate, its causes and effects," p. 367)
as follows:—
Q. But is not this one of the arguments for a reformed Registration Act ?
A. There are any amount of arguments for that.
Q. The Commission could help in that respect, surely ?
A. I should be very glad if it would. If we only had the age of the mother
recorded in the birth registers it would be of great use.
Q. And how little trouble that would be.
A. Yes.
Q. Might I ask you as a witness before this Commission whether in your
judgment the Commission ought to press for a reformed Registration
Act ?
A. Yes, I think it is a matter which is quite urgent; we are pressing in that
direction ourselves ; but we should naturally welcome any pressure
from any other source.
Q. Does it involve much expense ?
A. It involves legislation, and the difficulty is for the Government to find
time to deal with it.
This was in December, 1914, and nothing has been done.
It is as well to observe that the remarkable decrease of childbirth mortality per
1,000 married women in 1901-10 upon that of 1891-1900 is not entirely the result
of a diminished risk in childbirth brought about by improved midwifery, etc. That
will be clear from the accompanying figures:—
Decennium.
Death rates from all causes per 1,000 living at each age period. London.
Males.
Females.
20— 25— 35— 45—55 20— 25— 35— 45—55
1881-90 5.4 8.6 15.0 23.9 4.4 6.8 11.4 17.2
1891-00 4.6 7.4 14.2 23.1 3.5 5.6 10.7 17.1
1901-10 3.8 5.7 10.9 19.1 2.8 4.2 8.0 13.7
The decrease in the general mortality in 1891-1900 would have been greater but
for the repeated epidemics of influenza and the associated higher mortality from
diseases of the heart and respiratory system. The greatest improvement, however,
in the mortality of married women per 1,000 births is shown in the table
on p. 13 to have occurred at the younger ages, when influenza mortality played
a relatively smaller part.
Prenatal,
natal and
post-natal
causes of
maternal
mortality.
In considering the incidence of mortality according to age of mother during
pregnancy and childbirth it is necessary to use the data for England and Wales as a
whole in order to get numbers large enough to afford representative rates. During
the period 1911-21 there were 35,824 deaths, classed to the following causes :—
Pre-natal causes— Post-natal causes—
Abortion 1226 3.4% Phlegmasia alba dolens 615 1.7%
Ectopic gestation 769 2.2% Puerperal embolism 2,675 7.5%
Other accidents of preg- Convulsions and albumin-
nancy 1,482 4.1% uria 6,922 19.3%
Insanity, etc 351 1.0%
3,477 9.7% Disease of breast 103 .3%
Natal causes— 10,666 29.8%
Puerperal Hemorrhage 4,858 13.6%
Other accidents of child- Total 35,824 100.0%
birth 3,913 10.9%
Puerperal sepsis 12,910 36.0%
21,681 60.5%