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39
1930
But there is one period in which success has not been attained,
or at any rate to a very limited extent. 1 refer to the mortality
in the first few weeks of life. The lowered mortality is almost
entirely limited to the later months. The mortality in the first
month of life remains almost unaltered.
Last year of the 56 deaths which occurred amongst children
under one year of age, 33 of them occurred in the first 4 weeks
after birth, and this is about the same proportion which is observed
year after year. About one half of the deaths of infants under
12 months occur in the first 4 weeks of life. It is difficult to see
how this waste can be avoided, except by greater efforts to conserve
the health of the mother. Until this can be accomplished,
, there is not much prospect of reducing much further the infantile
mortality. Fortunately, there is a greater tendency on the part
of expectant mothers to consult their doctors or to attend a prenatal
clinic. One of the difficulties which militates against the
success of our pre-natal clinic was the want of provision of
maternity beds for normal cases of confinement. It is hoped
that the arrangements which are now being made for maternity
beds will overcome this difficulty and popularise the pre-natal
clinic.
Maternal Mortality.
Two deaths occurred from Puerperal Sepsis and two deaths
from diseases of Parturition. One of the latter was due to
Necrosis of the Liver and the other to uncontrolled vomiting of
pregnancy.
There were 4 notifications of Puerperal Fever and 9 notifications
of Puerperal Pyrexia.
It is significant that the four deaths which occurred in childbirth,
not only occurred, in a hospital, but the confinement took
place in the hospital, and there had been no difficulty in the
admission of the patient.
Two of the deaths were due to Puerperal Sepsis and this is
the condition which is generally regarded as one which should
be prevented.
The particulars of the deaths were as follows :—
(1) Single woman aged 34 years, admitted to Charing Cross
Hospital as a married woman.
Cause of death— Toxaemia of pregnancy.
Child born alive and lived 27½ hours.
Attended pre-natal clinic regularly, but there were no prenatal
symptoms.
Baby was delivered on June 18th, and the patient died on
June 22nd.
Post-mortem, there was massive Necrosis of the Liver.
(2) Single woman admitted to Hospital as a married woman.
Attended pre-natal clinic at Queen Charlottes Hospital, and
there was no difficulty in admission to the hospital.
Cause of death— Puerperal Sepsis.