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48
In 22 of the 39 cases the cause was prematurity, in 3 injury at
birth, in 2 atelectasis (failure of the lungs to expand), in 2 congenital
malformation, and in 1 marasmus.
How far are these deaths preventable, and if preventable, what
steps should be taken towards this end ?
I believe that most of these deaths are preventable, but it is
obvious that little can be done to prevent them by means of postnatal
care. Prematurity should be avoidable by more care on the
part of the mother and further supervision as to her mode of living
and health during the time she is carrying; whilst injury at birth is
usually the result of a difficult confinement. It is possible that the
provision of specialist care during child-birth and increased antenatal
work would reduce this type of infant mortality.
MATERNAL MORTALITY.
During the year one case of Puerperal Fever and four cases
of Puerperal Pyrexia were notified. Two of the cases of Puerperal
Pyrexia were removed to Hospital, and in the other cases the
Doctor in charge reported that full facilities for the nursing and
treatment of the cases in question were available at the place of
confinement.
There were five maternal deaths during the year, and the
causes of death were as follows:-
Septicaemia. Incomplete Abortion In North Middlesex County Hospital.
Haemorrhage due to Ruptured Ectopic Gestation In Prince of Wales' Hospital, Tottenham.
Eclampsia North Middlesex County
Hospital.
Placenta Praevia do.
Acute Oedema of Lungs. do.
Mitral Stenosis; 24 weeks
pregnant.
The average age of these five women was 36 years.
Following upon Circular 1433 of the Ministry of Health concerning
maternal mortality, the Council agreed to pay for the
service of a Midwife where the family income was below a certain
scale, whether a Doctor was in attendance or not. It is interesting
to note the during 1935 the Council helped in 36 cases. This compares
with 5 for the previous year. Of these 36 a Doctor also attended
in 4 cases.
This large increase in the number of Midwives is understandable
when one realises that the scheme was put into operation in
December, 1934, and some time was bound to elapse before the