London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1928
[Report of the Medical Officer of Health for London County Council]
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17
A comparison of the figures relating to primiparae and multiparae for the period
1911-13 and the year 1921 shows that the increased proportion of primiparae in
France in the latter year would have sufficed to account for an increase from
that fact alone of 12.6 per cent. in the maternal mortality rate upon that for
1911-13.
Trend of the
maternal
mortality
rate since
1910
The trend of the rates since 1910 is best shown by comparison of the figures
for 1911-15 with those for 1921-25, since in the intervening years war conditions and
the influenza pandemics disturbed the continuity of the rates. Some increase is
shown to have occurred in the pre-natal mortality rate while there is a slight general
decrease in natal causes; in post-natal causes there is a decrease, rather more marked
at younger ages:—
Age.
Pre-natal.
N atal.
Post-natal.
19111915.
19161920.
19211925.
19111915.
19161920.
19211925.
19111915.
19161920.
19211925.
15— .16 .10 .16 1.32 1.11 .93 1.64 1.05 .89
20— .15 .15 .18 1.57 1.47 1.49 .94 .9 0 .83
25— .23 .23 .24 1.77 1.98 1.84 .89 .96 .83
50— .38 .38 .47 2.37 2.49 2.27 1.03 1.17 1.05
35— .76 .70 .67 3.34 3.33 3 18 1.48 1.37 1.29
40.45 1.69 1.50 1.69 7.36 7.35 705 3.25 3.38 3.09
15—45 .38 .36 .40 2.30 2.35 2.23 1.14 1.15 1.04
Taking the total mortality as 100 for each age in 1911-15 and 1921-25, the proportion of deaths attributable to pre-natal, natal and post-natal causes compare as follows:—
| Age. | 1911-1915. | 1921-1925. | ||||
|---|---|---|---|---|---|---|
| Pre-natal. per cent. | Natal. per cent. | Post-natal. per cent. | Pre-natal. per cent. | Natal. per cent. | Post-natal. per cent. | |
Among pre-natal causes there is a marked increase in the deaths attributed to
ectopic gestation, but there is a decrease in the deaths due to abortion, a circumstance
pointing to the possibility of the change being the result of altered practice
in certification. The percentages of total deaths during pregnancy attributed
to the headings of abortion, ectopic gestation and other causes varied considerably
in different classes of administrative area, as appears from the following
figures:—
Cause of death.
England and Wales.
London.
Rural Districts.
1911-15. 1921-25. 1911-15. 1921-25. 1911-15. 1921-25.
Abortion 32.9 30.5 28.5 27.4 33.4 35.7
Ectopic gestation 27.5 26.0 34.2 39.0 26.2 24.2
Other accidents of
pregnancy 39.6 43.5 37.3 33.6 40.4 40.1
100.0 100.0 100.0 100.0 100.0 100.0