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33
Maternal Mortality. The Registrar-General allocates 15 cases to deaths from puerperal
causes, 5 of which were due to puerperal sepsis and 10 to other puerperal
causes.
The maternal mortality on this basis would be 4.54 per 1,000 births.
The Registrar's figures, however, are based upon strict allocation according
to rule and, as "Maternal Mortality" is taken to indicate deaths as a result
of child-birth or associated with child-birth, there are 3 other cases which I
must add to the list. One of these was a death from septicaemia as a result
of an induced abortion—an inquest was held on this case and an open verdict
was returned. One was a death on the certificate of which there was no
mention of pregnancy—the mother died in premature child-birth probably
as a result of drugs taken to procure abortion. One was a death from
Hyperthroidism which would not have taken place if the mother had not
been pregnant. It is only because of local investigation that the last 2 cases
could be considered as maternal deaths and, having been investigated, they
must be added to the list.
There were therefore 18 deaths—a rate of 5.45 per 1,000 births. In
1933 there were 12 deaths—a rate of 3.61 per 1,000 births.
Analysis of deaths.
I. Due to sepsis—6 deaths (3 in 1933).
All these were in cases of abortion in the early months of pregnancy.
II. Due to other causes—12 deaths (9 in 1933).
Drug abortion lease.
Ruptured Ectopic Gestation 2 cases.
Pulmonary embolism after Caesarian Section lease.
Placenta Praevia 1 „
Ruptured Uterus 1 „
Post-partum Haemorrhage 1 „
Toxaemias of pregnancy 2 cases.
Inter-current disease 3 „
A rate of 5.45 per 1,000 births is naturally staggering, to say the least
of it, but we must not allow ourselves to become hysterical. We should
calmly and dispassionately analyse the cases and should carefully investigate
the cause of each of the 18 deaths. In this way we can see in which way,
if any, our Maternity Services have failed in 1934. It is always possible that
a large death-rate in any one year may be due to the coincidence that many