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53
It is manifest to me that cases Nos. 3, 5, 6 and 7 were due to
sepsis, but the causes as stated of the remaining 3 cases do not
appear attributable to that cause. The standard of living enjoyed
appears to have been good or average in all cases, and the question
of deficient diet does not appear to bear any relationship to the
deaths.
It is interesting to note that, with one exception, none of the
patients concerned attended our ante-natal clinic; this bears out
what has been stated on many previous occasions, that ante-natal
care is one of our greatest allies in our fight to reduce maternal
mortality and morbidity.
In support of this contention, the following extract from a
letter written by Sir Percy W. Everitt, Vice-Chairman of the
Plaistow Maternity Hospital, which recently appeared in the
London press, clearly illustrates the value of ante-natal supervision:—
"During the past 24 years our mid wives have attended to
114,148 maternity cases, and only 119 of the mothers died in
childbirth—a rate of maternal mortality of only 1.04 per 1,000.
This is a record which I think is unsurpassed by any maternity
hospital in the kingdom.
Our hospital is situated in West Ham. It serves districts
in which poverty, real want, and overcrowding prevail—where
conditions of life are so hard that a high rate of maternal mortality
might be expected.
''One of the conditions we make when a case is booked is that
the expectant mother must attend regularly at our ante-natal
clinics That condition, combined with a highly skilled staff of
midwives and an expert medical staff who can be called on in case
of need is, I think, the real explanation of the very low rate of
maternal mortality which our records show."
Puerperal Fever and Pyrexia.
9 notifications were received during the year; of these, 5 were
those of Puerperal pyrexia and 4 puerperal fever. Per 1,000 total
birth(i.e., live and stillbirths) the rates for these conditions were
2.5 and 2.0, the corresponding figures for the country as a whole
being 2.46 and 1.95.
The compulsory notification of these conditions has done much
to draw attention to cases presenting abnormal features during the
puerperium who other wise and formerly, received but scant
attantion. it is found that in many cases the rise of temperature
is attributable to some cause which is not directly associated with
pregnancyor parturition, the fact, however, remains that the