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63
MATERNITY AND CHILD WELFARE.
REGISTRATION AND NOTIFICATION OF BIRTHS.
The total number of live births registered during the year was
3,098, 1,620 male and 1,478 female. Of these, 90 were illegitimate,
being a percentage of total births of 2.9.
2,370 births occurred in the district (2,322 live and 48 still
births). Of this number 235 (226 live and 9 still births) were to
residents of other districts, leaving 2,096 live births and 39 still
births notified in respect of local residents. Of this number, 1,489
were notified by midwives and 881 by doctors or parents.
1,023 (982 live and 41 still birth) notifications were transferred
from other districts, being mostly in respect of births occurring to
Harrow mothers in Middlesex County Council or London hospitals.
STILL BIRTHS.
57 male and 38 female still births were registered, being a rate
per 1,000 population of 0.54 compared with a figure of 0.60 for the
country as a whole.
Out of the 71 cases in regard to which information is available,
in 42 instances the death took place at full term, the fcetus apparently
being alive up to the time of labour. Difficult or long labour
with normal presentation occurred in six instances, birth injury in
two and breech delivery in seven. Disproportion, owing to the
large size of the child accounted for difficulty in labour in seven
instances, some cases being post mature; while there was a
persistent occipito-posterior presentation on three occasions. A
dropped cord was the cause in one instance, while in three there
was knotting of the cord or the cord was round the neck. Antepartum
hæmorrhage occurred on four occasions, most due to
placenta prævia, while there was toxaemia or albuminuria in three
instances. One infant suffered from hydrocephalus, and in the
case of one Caesarian section had been performed at term on account
of a contraction of the pelvis. It is more particularly in the case
where the death of the foetus occurs at the confinement that it is
hoped that efficient ante-natal supervision will be able to reduce
the still birth rate. At times, of course, the infant is sacrificed
in the interests of the mother; in others, more particularly first
pregnancies, where there is doubt as to the possibility of delivery
by natural means a trial of labour is undertaken which, if successful,
avoids the woman being condemned to Caesarian section for each
future confinement, but if unsuccessful may result in the death of
the fcetus. Not every still birth occurring at full term is necessarily
a reflection on those responsible for the ante-natal supervision of
the mother.