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78
Maternal Mortality.
There were two deaths which are reckoned as maternal
mortalitythe causes being prolonged labour in one case and
septicaemia following abortion in the other. There was a third
death connected with pregnancy, but as the cause of death was given
as a pelvic abscess following self-induced abortion, the death is
reckoned as suicide, and not puerperal sepsis. This case naturally
had not called in a doctor until she was seriously ill. From one
point of view the third death is of as much importance as the other
two maternal deaths, though prevention is not so easily applied.
The home conditions were poor and there were 4 other children.
She had had another abortion about 6 years previously. There
is no doubt that she dreaded the prospect of another child on account
of poverty.
The death from prolonged labour occurred in a nursing home
and the doctor in attendance was assisted by a midwifery specialist.
The death from pelvic abscess following abortion occurred in a
Maternity hospital. She was admitted to the hospital as a possible
acute appendix. In the hospital she was found to be suffering from
Pyelitis of pregnancy. Two days after admission she aborted,
and two days later death occurred. In both these cases the highest
skilled ante-natal care and natal care were available, and it is difficult
to see under what condition the deaths could have been prevented.
In previous reports an account has been given of the agreement
with the Middlesex County Council for the admission of cases
into the Central Middlesex County Hospital. In 1931 arrangements
were made for the admission of cases into the hospital. Our scheme
was for the admission of those mothers who were not necessitous,
but who could not afford the full nursing home fees.
The scheme was a success from the beginning, and to its
termination in 1936 the number of women who applied for admission
steadily increased as the folllowing figures show:
Number of cases admitted during 1931 50
„ „ „ „ 1932 122
„ „ „ „ 1933 149
„ „ „ „ 1934 209
„ „ „ „ 1935 270
„ „ „ „ Jan/June 1936 205