London's Pulse: Medical Officer of Health reports 1848-1972

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Coulsdon and Purley 1936

[Report of the Medical Officer of Health for Coulsdon]

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When dealing with such small numbers, the resultant rate is liable
to fluctuate rather markedly from year to year, hence too much stress
should not be placed on the local figure for 1936. Thus the
average rates for the four quinquennial periods 1915-24 remained fairly
stationary at 3.20, 2.08, 2.66 and 3.21, although in one year (1932)
the rate rose as high as 10.2.
The national rate has shown a further reduction this year, which
is very pleasing.
Of the two deaths which occurred locally, one was attributed
to puerperal sepsis, and could probably have been avoided had the
mother concerned secured early attention by the midwife already booked,
but not sent for in time. More than one case during the last year has
emphasised this primary and, it would be thought, obvious necessity
for making early arrangements for expected confinements and securing
prompt treatment at the onset of labour.
The other case received skilled ante-natal and natal attendance
and must therefore be classified as unavoidable in the present state
of our knowledge. The prevention of pregnancy would have been the
only way to have avoided the fatal issue.
While considerable attention has been focussed on the risks of childbirth,
and constant attention is being given locally and nationally to
the reduction of these risks, it should be again emphasised that undue
alarm on the part of expectant mothers is undesirable and increasingly
unjustifiable. The attendant risks are much less than they were and
are decreasing annually. With reasonable forethought and co-operation
with the medical services available to all, irrespective of social position
or financial resources, childbirth should resume its place as the natural
phase in life which it fundamentally is.
The number of deaths occurring in children under one year of
age was 21, as compared with 19 last year, and 14 and 10 in the preceding
two years, all except 2 being in legitimate children.
The Infantile Mortality Rate was thus 33, as compared with 32,
26 and 30 in the last three years. As previously pointed out, this Rate
is liable to marked fluctuations owing to the small numbers concerned.
Even five-yearly grouping does not abolish this, as the average figures
for the four quinquennial periods, 1915-34, demonstrate, viz., 44, 28,
38 and 32. During the last four years, however, it has steadied at about