London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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Report for the year ending 3l3t December, 1934.
By Letitia Fairfield, C.B.E., M.D., Ch.B., D.P.H., Senior Medical Officer, Public
Health Department.
The strenuous efforts made by all concerned to improve at all points the maternity
services rendered by the London County Council hospitals have been rewarded
by an increased demand for admission to the wards and also by a lowered death rate
affecting almost every group of patients. During the year a total of 13,253 births
took place in the hospitals representing an increase of 1,336 on the numbers for the
previous year.
Year. Live. Still. Total.
1931 9,696 495 10,191
1932 10,974 451 11.425
1933 11,414 503 11,917

The improvement in the mortality rate is shown in the following table :—

Deaths.Rate per 1,000.Deaths.Rate per 1,000.
A.Deaths of women confined in hospitals (after the 28th week)847.2665.1
(a) Death due to pregnancy or confinement574.947*3.6
(1) Ante-natal care at L.C.C. clinic313.2242.1
(2) Ante-natal care, other sources, or nil ...2613.12314.1
(b) Death associated with pregnancy or confinement272.3191.5
(1) Ante-natal care at L.C C. clinic60.670.6
(2) Ante-natal care, other sources, or nil2110.5127.4
B.Confined before admission (after 28th week)2117
C.Abortions (cases treated in hospital) 3,008(1933). 3,417(1934)5050
D.Ectopic gestation (cases treated) 151 (1933). 109 (1934).8-9-

* Includes one death from nephritis at 24th week.
Comment has been made in previous reports on the impossibility of comparing
the rates for the Council's hospitals with the mortality rate for the country generally
or with other institutions practising midwifery. The Council's hospitals remain
the chief resort for cases of abortion and they also receive an undue proportion
of pregnant woman suffering from general diseases. The consequent effect on the
death rate needs no further stressing.
The proportion of women confined who had received ante-natal care at the
Council's clinics has risen from 83 per cent. in 1933 to 87.5 per cent. in 1934. The
number of attendances per patient is shown in table III. It should be realised that
the great majority of the patients recorded as making one attendance only are more
or less regular attendants at borough clinics conducted under the Maternity and
Child Welfare Act, and have only come to the Council's clinic for the one special
examination, which the Council's staff demand for all "booked" patients. The
amount of ante-natal care given in fact reaches a very high standard, and the
readiness with which the women co-operate is a matter of comment at all hospitals.
The divided responsibility for maternity care in London has created many difficulties,
but the past year has seen a marked improvement in co-operation with the borough
authorities in many minor points, such as the supply of extra nourishment.