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The figure per 1,000 registered total births is 2.1 for 1936 against 1.0 for 1935, 3.2 for 1934 and
4.7 for 1933.
All the patients recovered. Two deaths appear in the death table under puerperal sepsis.
In each case the patient was notified as suffering from puerperal pyrexia.
As no deaths occurred amongst the 6 cases of puerperal fever notified in Willesden, this gives
a case mortality of 0.0 per cent. as against 33.4 per cent. in 1935, 11.1 per cent. in 1934, 30.8 per
cent. in 1933, 25 per cent. in 1932, 14.3 per cent. in 1931, 20 per cent. in 1930, 50 per cent. in 1929,
and 33.4 per cent. in 1928.
In 2 of the 6 notified cases a private doctor attended the confinement at home. One was subsequently
removed to hospital and one was nursed at home. One case was attended at home by a
district midwife and was subsequently removed to hospital. One was a case of miscarriage at home
which was removed to hospital three days later. Two patients were confined in hospital. All recovered.
Puerperal Pyrexia.—33 cases were notified during the year. 3 of these 33 cases proved
fatal, 2 of the deaths being attributed to Puerperal Sepsis, and 1 to post-abortive sepsis. This last was
a patient living in Acton but confined in Willesden and her death is allocated to Acton.
Maternal Mortality.—During 1936 there were 5 deaths classed to pregnancy and childbearing—2
to Puerperal Sepsis, and 3 to other puerperal causes.
The puerperal mortality rate from Sepsis was, therefore, 0.71 per 1,000 registered live births
and 0.68 per 1,000 registered total births. The corresponding figures for 1935 were 1..40 per 1,000
registered live births and 1.36 per 1,000 registered total births.
The total puerperal mortality rate was 1.76 per 1,000 registered live births and 1.71 per 1,000
registered total births. The corresponding figures for 1935 were 2.81 per 1,000 registered live births
and 2.73 per 1,000 registered total births.
During 1936 there were 4 maternal deaths from non-puerperal causes and 1 maternal death
from criminal abortion.
The total maternal mortality from all causes excluding criminal abortion, was thus 3.17 per
1,000 registered live births and 3.08 per 1,000 registered total births as against 2.81 and 2.73 in 1935.
The total maternal mortality from all causes including criminal abortion was 3.53 per 1,000
registered live births and 3.42 per 1,000 registered total births as against 2.81 and 2.73 in 1935.
During 1936 the Council have continued their efforts to deal effectively with the subject of
maternal mortality.
(1) Sterilised Accouchment Sets.—These sets are supplied in accordance with the arrangements
stated in my Annual Report for 1930, p. 10.
During 1936, 273 were supplied free, 6 at full cost and 16 at part cost.
(2) Specialist Help.—The Council accept responsibility for the payment of the fee of one of
their specialists called in by a medical practitioner to assist him in connection with
a difficult case of labour occurring in a Willesden resident. 8 such consultations were
paid for in 1936.
(3) Provision of Ancesthetist.—The Council further accept responsibility for the payment of a
fee to an anaesthetist called in by a medical practitioner in connection with confinement
cases. No such fee was paid in 1936.
Maternal Mortality Investigations.—The Council has continued to take part in the
investigation of deaths of mothers in childbirth for the Maternal Mortality Committee of the Ministry
of Health. The investigations are carried out by the Council's Consultant Obstetrician. 10 cases
were inquired into during 1936.
The services of the Council's Consultant Obstetrician are also available in cases of Puerperal
Fever and Puerperal Pyrexia when desired by the practitioner in attendance.
Health Visiting and Medical Inspection of Children between the Ages of
1 and 5 Years.
The practice described under this heading on page 9 of the Annual Report for 1931 was continued
during the current year. The aims and methods adopted were outlined on pages 9 and 10
of the Annual Report for 1932.