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48
causes have been in operation. Formerly, extra domestic labour
carried on into late pregnancy was supposed to have considerable
influence in bringing: about a premature birth. It is quite conceivable
that employment of married women in laundries, which involved
prolonged periods on their feet and in an upright position would
be conducive to premature birth, but such conditions are now rare
and in very few instances were the mothers employed in laundries
or in any other industrial employment. An examination of the
distribution of deaths from prematurity and other pre-natal causes
would suggest that extra domestic labour is not now an important
factor. The relative incidence of deaths from pre-natal causes is
Jower in the South West Ward than in the other Wards.
We hear nowadays a good deal about birth-control and
instruction in contraceptive methods, but there is another
aspect of the question which is sometimes ignored. There is no doubt
that the taking of abortifacients is a very frequent practice. It
would not be desirable or wise to name the drugs which are being
used, but from enquiries we have made, we know that it is a very
prevalent practice. It is not known to what extent this practice
is responsible for the high number of deaths from pre-natal causes,
and I do not think it possible to make any estimation, because the
necessary information would not be forthcoming. It is only a
small proportion of the women who will admit that they have
resorted to this practice in order to procure the expulsion of the
foetus.
In a discussion which took place upon Birth Control at a
recent Conference, it was suggested that the medical aspect of
control was limited to the effects of different contraceptive methods
upon the health of the mother. But no mention was made of the
abortifacients when contraceptive methods were not practised, and
the effects upon the health of the mother when these drugs were
taken.
It is possible that the use of abortifacients may have an influence
upon the number of deaths from pre-natal causes, but it is
difficult to suggest in what way the practice may be combated.
There was a slight rise from deaths of the Respiratory
system; this rise was probably due to the very severe weather
experienced in the early part of the year.
Pre-natal Clinic
The Clinic is held once a fortnight in the School Clinic and
Dr. Bell is in charge. 23 sessions were held with a total of 144
attendances.
There is an agreement with the Acton General Hospital for
the reception of complicated cases of pregnancy and during the
year 2 patients were admitted under the scheme.