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49
older babies that the instruction on feeding, clothing, and other
aspects of infant nurture would have most effect, a large proportion
of the babies have already died before the health visitor has visited
the home, or at any rate before her instructions could have had any
effect. The chief if not the only method by which the neo-natal
mortality can be reduced is by increased attention to ante-natal
care and nurture. In a subsequent paragraph, the extension of this
part of our Maternity and Child Welfare Scheme has been outlined,
and we feel that this aspect of the work has an important bearing
not only on the Maternal but also on the Infantile Mortality.
Maternal Mortality.
Five deaths occurred in child bearing women, 2 from Puerperal
Sepsis and 3 from other diseases or accidents of Parturition.
The cause of the first death was given as (a) Septicaemia
(b) Septic abortion. The information of the conditions which
obtained prior to the confinement was vague and not
satisfactory as the husband had left the district when we made
the inquiries and he could not be traced. The husband and wife
had only recently come to Acton, and had not attended the AnteNatal
Clinic. They had two other children, and we were given to
understand that the wife was very worried on account of the fact
that she was again pregnant. The doctor who was called in found
an incomplete abortion, and he advised her removal to a hospital.
The wife at first refused, and she did not consent to removal for
two days. She died 10 days after removal to hospital.
In one of the other cases, the patient had not been under
the care of a doctor before her confinement. It was stated the
patient was unaware that she was pregnant. No doctor or midwife
had been engaged. In the three other cases, the patients were in
comfortable circumstances, a doctor had been engaged for the confinement,
and the patients had been under the care of the doctor
throughout the confinement.
One of these died of Eclampsia, the second of Post-partrem
nephritis, and the third was suffering from a long standing heart
disease.
Circular 1433 was issued by the Ministry of Health in October,
1934, and reference was made to Circular 1167 of December 1930,
and the accompanying Memorandum 156/M.C.W. on the subject of
Maternal Mortality.
The Minister reviewed the action taken throughout the
country to give effect to the suggestions in Memorandum 156 and