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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obstetrics, and is subject to fluctuation from external causes such as influenza
epidemics. As the total numbers are comparatively small, a quite extraneous cause
might easily affect the maternal mortality rate, and create fallacious alarm about the
efficiency of maternity services. Secondly, over-meticulous certification might
easily over-weight the figures and give a misleading impression. Instances have been
found of women dying from phthisis or heart disease many weeks after child-birth,
whose death has been allocated as a "maternal death." Adverse comparisons with
a foreign country or with mortality rates of past years might well follow.
The possibility of death having been due to any truly obstetrical cause, including
sepsis, has been definitely excluded in every case allocated to this group, and all
such deaths have been classified as due to pregnancy. The case of "aplastic
amemia," for example, was known to have been gravely ill from this condition long
before she became pregnant.
The close enquiries undertaken into every maternal death in the Council's
hospitals show that no obvious or easily eliminated cause for a high mortality rate
exists. There is very rarely any evidence of failure of ante-natal care, of avoidable
sepsis, of unnecessary interference, or of failure to provide efficient obstetrical aid at
the proper time. Samples of the many and diverse obstetrical problems which defy
easy and automatic solution are now being dealt with. A steady improvement of
staffing, accommodation and organisation, as well as loyal co-operation on the
part of the patient, offer the only possibility of a further reduction in the
mortality rate.

Table I— General Hospitals and Institutions—Maternity Departments , 1934.

Hospital or institution.No. of maternity beds.Births.Ante-natal clinic.Post -natal clinic.
Live.Still.Total.No. of new cases.Attendances.No. of new cases.Attendances.
Bethnal Green18305103153091,398177267
Mile End46624196436394,66199733
New End19315113263711,24055
St. Alfege's35612276396483,820220220
St. Andrew's36660296897082,825208218
St. Benedict's
St. Charles'9110
St. George-in-the-East25270152853131,4576869
St. Giles'52945339789265,843495998
St. James'551,099531,1521,1936.532238245
St. John's-1-1----
St. Leonard's23452134654122,305105301
St. Luke's. Chelsea22383321942
St. Mary Abbots48853318848593,823159182
St. Mary, Islington20504335374701,939185251
St. Nicholas19354203744623,321106121
St. Olave's28539135524763,923254259
St. Pancras25530215514673,335113189
St. Peter's1314641502031,05554230
St. Stephen's26453194724702,134117118
St. Marylebone institution161023105-

* One ward of 20 beds additional, used as emergency accommodation. G