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 1937
[Report of the Medical Officer of Health for London County Council]
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18
Maternal
mortality
in relation
to social
condition
For the purpose of showing the effect of environment on deaths in pregnancy
and childbirth among married women, the figures for two groups of boroughs of
contrasting conditions in respect of density of population, etc., have been
abstracted :–
(1) Group "A" (Hampstead, Lewisham and Wandsworth) representing
the better circumstances population ; and
(2) Group "B" (Bermondsey, Bethnal Green, Finsbury, Shoreditch and
Stepney) representing the poorer population.
The scope of comparison possible is limited by the fact that births to women
according to age cannot be stated. Figures of this kind will become available under
new regulations relating to the registration of births, which will come into force on
1st July, 1938 (Statutory Rules and Orders, 1938, No. 569). Some general inferences
can, however, be drawn from the figures.
Table 22–County of London–Deaths among married women in pregnancy and childbirth in relation to social circumstances (including criminal abortion), 1931.1937
| Group (metropolitan boroughs) | Cause of death | Age at death | All ages | Deaths per 1,000 legitimate live births | ||||
|---|---|---|---|---|---|---|---|---|
| Under 35 | 35 and over | |||||||
| Number | Per cent. | Number | Per cent. | Number | Per cent. | |||
| A | ||||||||
| (Hampstead, Lewisham, Wandsworth) | Childbirth sepsis | 37 | 34 | 12 | 27 | 49 | 32 | .94 |
| Other causes | 56 | 52 | 22 | 50 | 78 | 52 | 1.50 | |
| Abortion sepsis | 13 | 12 | 10 | 23 | 23 | 15 | .48 | |
| Other causes | 2 | 2 | – | – | 2 | 1 | ||
| Total | 108 | 100 | 44 | 100 | 152 | 100 | 2.92 | |
| B | ||||||||
| (Bermondsey, Bethnal Green, Finsbury, Shore. ditch, Stepney) | Childbirth sepsis | 22 | 23 | 11 | 23 | 33 | 23 | .55 |
| Other causes | 48 | 50 | 28 | 58 | 76 | 53 | 1.27 | |
| Abortion sepsis | 19 | 20 | 8 | 17 | 27 | 19 | .59 | |
| Other causes | 7 | 7 | 1 | 2 | 8 | 5 | ||
| Total | 96 | 100 48 | 100 | 144 | 100 | 2.41 | ||
The rates per thousand births for the two age groups shown cannot, for the
reasons stated above, be given, but for all ages per thousand live.births the mortality
rate is 2.92 in group "A" and 2.41 in group "B." The advantage of the married
women of poorer class, group "B," is marked in respect of sepsis, but the deaths
from "other accidents of childbirth " are also lower in this group.
It will be observed that the proportion of deaths occurring among married women
under thirty.five years of age in group "A"–71 per cent, of the total at all ages–
is only slightly greater than the corresponding proportion in group "B" of 67 per
cent. The proportion of sepsis deaths in miscarriage and abortion among women
under 35 years of age is relatively higher in group "B."
Abortion
In respect of miscarriage and abortion among married women, the rate can
only be calculated per thousand legitimate births, instead of per thousand pregnancies,
since the number of pregnancies is not available; but, so calculated, group "B"
appears to have a somewhat higher mortality rate, though the figures are perhaps
rather too small to give stable values.