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18
PREVENTION OF INFANTILE MORTALITY.
Of the preventability of the greater part of the mortality a great deal has been
said in previous reports. Here there is nothing to be done but reiterate the view,
now generally held, that the vast majority of the babies who die before reaching the
age of one, need not die.
A glance at the causes of death set out in Table III. is sufficient to confirm that
view. Why, for instance, should nine babies die of measles ? If reasonable care is
exercised, no baby need be infected with measles and if it does by chance acquire
infection, provided it is properly looked after, it should certainly recover. It is pretty
safe to say that the infection of all the babies who took measles as well as the death
of the nine who succumbed to the disease resulted because there was a failure on
somebody's part to take proper precautions.
This failure may have been due to carelessness or may have been due to
ignorance, but the fact remains that it was the cause of unnecessary suffering to an
appreciable number of infants and of nine avoidable deaths.
So also with the other infectious diseases, with diarrhoea and enteritis and the
respiratory diseases. The three deaths from overlying certainly need never have
occurred, and eight deaths from injury at birth seems an almost unnecessarily large
proportion.
Even the 69 deaths due to prematurity were not all inevitable. Many of these
deaths probably resulted from conditions operating during the expectant period and
before the child was born. There were others, however, probably just as many,
which occurred through want of care at and after birth. Most of them could have
been prevented if care had been exercised; care of the mother of herself and of her
baby both before and after it was born. Unfortunately this necessity is not always
recognized. The size of the figures clearly indicates that an attempt should be made
to impress the necessity, and to some extent it is done in the Borough. There are
many difficulties in the way, however, and the chief is that the means of getting into
touch with expectant mothers are few in number.
Practically the only person who can really help the expectant mother, is
the doctor or midwife who is to take charge of the confinement. In very
many cases practically all that is done is to attempt to arrive at the date when the
birth may be expected to take place and possibly, in the case of the poorer class
mother at any rate, to give some more or less general advice as to the apparatus
and so on that will be required when the confinement takes place.
In such cases the patient, as a general rule, is not seen again until the labour
has commenced.
With expectant mothers who resort to the hospitals, the case is somewhat
different. Very much greater care is now exercised than formerly and the woman is
required to visit the hospital at stated intervals and there a preparation is made for
the occurrence of the birth.