View report page

(a) In the close and careful examination of every infant death,
with a view to ascertaining the exact cause or causes which lead to
the tragedy and their elimination; and
(b) A greater measure of home supervision, especially during
the first few weeks of life.
The former we can and will do; the latter should also be included
in our programme.
Stillbirths.—Thirty-one stillbirths, (2 illegitimate) were
accredited to the district for 1946. This is equal to a death rate of
24.92 per 1,000 (live and still) births, the corresponding figures for
1945 being 24 stillbirths, with a rate of 24.00. The rate per 1,000 of
the population was 0.426, the rates for England and Wales and
London being 0.53 and 0.54 respectively.
From the above it will be noted that our still-birth rate shows
a very slight increase over the previous year, although it is still
slightly below the rate for England and Wales and London. This
fact gives no grounds for complacency. Every still-birth is a
tragedy, in many cases avoidable. Adequate ante-natal supervision,
together with good midwifery, will help to reduce the figure, but it
will be quite obvious that this very important problem is intimately
bound-up with other factors which have a much wider implication.
Here again, a careful investigation must be made into every stillbirth,
so that the cause or combination of causes may be properly
understood. It is hoped that investigation of the Rhesus factor,
which we are arranging to undertake, will eliminate a proportion of
these tragedies. But this proportion will almost certainly be small,
and the great bulk of the problem will still remain with us. No
study of infant mortality can ever be complete unless the question
of the still-birth rate is included with it. The two problems are
inextricably united. Indeed, there is much to be said for their
inclusion in a comprehensive index figure which would show the
total number of presumptive infant lives lost to the community in
any year. We are giving this matter very close attention, and
the Council can rest assured that every effort will be made to
reduce a total which marks one of the really tragic milestones in our
present civilisation.
As a further contribution to this problem, and to the problem
of maternity and child welfare generally, arrangements are being
made to carry out a Kahn or Wasserman test on all new cases
attending our ante-natal clinics.
13