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5.—Maternal deaths are due principally to sepsis (puerperal fever)
and to other complications of pregnancy, but deaths due to the former
have shown a greater decline since 1902 than those due to the latter
cause.
6.—Excessive rates of maternal mortality are found in the aggregate
in the most rural areas, and in highly industrial areas.
Critical examination of the statistics pertaining to maternity
and child welfare has brought to light the uncomfortable fact that
although there has been in recent years an enormous saving of infant
life, there has been no material alteration in the maternal death-rate..
No doubt the concentration of attention upon the infant and the
remarkable results achieved have, in a measure, detracted attention
from the maternal side of the question, but that is no reason why
equal care should not be bestowed on both parties. One of the most
striking characteristics of our mortality returns has been the steadv
and continuous decline in the death-rate, and one of the most hopeful
features of our sanitary history is that at certain ages—most
noticeably in infancy—the rate of advance is not slacking, but
even accelerating, while for certain diseases, especially tuberculosis,
the temporary set back associated with the war-period is
being overcome. But in the matter of death in childbirth, the mother
has not shared equally with her child in the improvement of public
health.
The maternal deaths throughout England and Wales have
varied from 3.55 per 1,000 births in 1918 to 4.81 in 1900. In Acton
they have varied from .33 in 1901 to 7.52 per 1,000 births in 1916.
Too much reliance should not, of course, be laid upon occasional
local variations in mortality, but if we take any extended
periods for comparison, the conditions cannot be regarded as favourable
to this district.
Prior to 1905, the figures for Acton are not reliable, as no
outside deaths were included in the returns for the years 1898—1905.
If we divide the period 1905-1924 into 5 periods of 4 years,
the figures would be as follows:—
1905—1908. 3.74 maternal deaths per 1000 births.
1909—1912. 2.7
1913—1916. 4.53 ” ” ”
1917—1920. 4.59 ” ” ”
1921—1924. 4.6 ” ” ”
1924. 6.04 ” ” ”
Compared with that of the whole of England and Wales,
and with that of the Metropolitan Boroughs, the maternal mortality
here is high.
An examination of the distribution reveals some puzzling
figures and does not lead to a definite conclusion.
In the poor working class Metropolitan Borough of Shoreditch,
the rate of mortality in 1919-22 (2.55) was the lowest but two
of all the Metropolitan Boroughs, surpassed only by the City of