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but simple method has had to be adopted of presenting the figures for patients dying
from abortion separately from those concerning women who die after the twentyeighth
week of pregnancy. The total numbers were as follows :—
1933. 1934.
Classification.
No. Rate per 1,000. No. Rate per 1,000.
A Deaths of women confined in general hospitals
and institutions after the 28th
week 84 7.2 66 5.1
(а) Death due to pregnancy or confinement
57 4.9 47* 3.6
(1) Ante-natal care in L.C.C.
clinic 31 3.2 24 2.1
(2) Ante-natal care, other
sources or nil 26 13.1 23 14.1
(b) Death associated with pregnancy
or confinement 27 2.3 19 1.5
(1) Ante-natal care in L.C.C.
clinic 6 0.6 7 0.6
(2) Ante-natal care, other
sources or nil 21 10.5 12 7.4
B Confined before admission (after 28th
week) 21 — 17 —
C Abortions (cases treated in hospital)—
3,008 (1933) 3,417 (1934) 50 — 50 —
D Ectopic gestation (cases treated)—151
(1933) 109 (1934) 8 — 9 —
*Includes 1 death from nephritis at 24th week.
A summary of the figures shows clearly the advantage which accrues from
regular ante-natal care. Allowing for the fact that "emergency" cases are necessarily
a selected group, often sent into hospital because they presented some abnormality,
the difference is striking.
Total Total Rate per Deaths due Bate Deaths Rate
Ante-natal care. cases. deaths. 1,000. to pregnancy per associated with per
or con1,000. pregnancy or 1,000.
finement. confinement.
I. L.C.C. clinic 11,436 31 2.7 24 2.1 7 0.6
II. Other sources or nil 1,630 35 21.5 23 14.1 12 7.4
Total 13.066 66 5.1 47 3.6 19 1.5
A detailed study of the maternal deaths in 1934 will be published in the medical
supplement to the annual report (Vol. IV, Part III).
Mental observation wards.
The scheme for the reorganisation of the mental wards into larger units has
progressed during the year, the most notable event being the opening of the reconditioned
block at Constance Road institution. This unit contains 35 male and
35 female beds, with ample accommodation for the classification of acute cases and
a pleasant day-room and dormitory for convalescent or non-certified cases on the
upper floor. There are special baths for the hydro-therapeutic treatment of excited
patients which is intended to obviate the necessity for use of the padded room.
The medical superintendent of the Maudsley hospital visits the unit twice weekly
as consultant, and the services of a trained psychiatric social worker are available.
Every effort is being made to ensure that patients admitted to the observation
wards are dealt with under the Mental Treatment Act rather than the Lunacy Acts,
if that is possible. Certain administrative difficulties are found to interfere seriously
with the extensive application of both the "voluntary" and "temporary"
clauses, and the matter is being further explored in co-operation with the mental
hospitals and public assistance departments.