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37
MATERNAL MORTALITY.
In previous summary reports, apart from indicating' the number of deaths due
to puerperal fever, no special reference was made to mortality due to conditions
arising or consequent upon child-birth. During the last few years, however,
increasing attention has been directed to this subject, mainly because the mortality
has remained consistently high, and very full and careful investigations have been
carried out by a departmental committee of the Ministry of Health. Amongst
other matters inquired into by this body has been the particular causes leading to
death, and in the last two or three years in this annual report as full information
as possible has been given in this connection. The numbers naturally and fortunately
are, of course, small, and from a statistical point of view really not
particularly helpful. When an analysis comes to be made, the amount of help given
indeed is practically nil, either in the direction of indicating the preventive measures
that might be taken, or providing any explanation of how it arises that amongst
the Metropolitan Boroughs, St. Marylebone occupies a rather high position. In
1930, for example, the number of deaths was 7, the Maternal mortality rate being
5 per 1,000 births. In 1929, the deaths numbered 5, and the rate was 4 per 1,000.
Of the 7 cases it was possible to obtain full information with regard to 6, and the
main facts with regard to these are : In 2, inquests were held, and death was found
to be due to septicaemia following abortion ; in 2 others the primary cause of death
was pneumonia; while 1 died of pulmonary embolism and 1 of eclampsia. All the
deaths occurred in hospital, two of the patients being 26 years of age, one 32, one
33, one 35, and one 37. Two of the six were single women. In only one case did
the baby survive.
DEATHS IN RELATION TO DISEASE.
A list of the causes of deaths, with the ages at which they occurred, will be
found in Table III. of the Ministry of Health series on page 79. This Table
also shows the distribution of deaths according to causes in the various registration
sub-districts.
The following notes with regard to certain of the causes which contributed
most largely to the death rate, may be of interest.
DIARRHOEAL DISEASES.
The total number of deaths registered as due to diarrhoea and enteritis
(inflammation of the bowels), was 18, equal to 0.16 per 1,000 of the population.
As a general rule, the majority of deaths from this cause occur amongst
infants, and in 1930 this was the case also, no fewer than 14 of the 18 being
children under 1 year of age.
In 1929, the deaths from diarrhoea diseases numbered 22, and of this number
16 were babies. In 1930, therefore, there was a slight decrease in the total over
1929, the decrease over 1925, when the total was 25, the figure for children under
1 year of age being 22, being slightly more marked.
Having regard to the general course followed by these diseases and the
mortality traceable to them, this is not remarkable. Steadily year by year these
diseases are ceasing to be the very real menace they were formerly, and the
summer and early autumn months, which were looked forward to with dread as far
as babies were concerned, are nowadays not regarded as greatly different from any
others. The reasons for the change, in addition to work done in relation to public
health and health education, are chiefly impiovements in the food supply, milk
particularly.
INFECTIOUS (COMMUNICABLE) DISEASES.
The number of deaths due to each of the diseases included in this group is
referred to when dealing specifically with the disease under the heading " Prevalence
of and Control over Infectious Diseases." It is interesting to note here,
however, that excluding influenza, which caused 8 deaths, and including diarrhoea
(18 deaths) the total number registered as due to them was 70. The figure for
1925 was only 56, but in that year there was not, as in 1930, a measles epidemic
which alone contributed 35 deaths to the total.