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was removed to hospital, but died almost immediately after admission.
One woman died of shock due to a commencing abortion ; as this
was self-induced the death was allocated to suicide. The remaining
patient suffered from pulmonary tuberculosis and died from this
cause in the puerperium.
Ministry of Health Report on Investigation into Maternal
Mortality.
Circular 1622 of the Ministry of Health drew the attention of
local authorities to the Ministry's Report on Maternal Mortality
and summarised certain recommendations made in the report.
These recommendations and the extent to which they were already
embraced by local practice or have since been dealt with are set
out below:—
1. The establishment under the direction of the Medical Officer
of Health of an adequate service of obstetrical consultations:
(a) To assist medical practitioners who undertake domiciliary
midwifery in cases of doubt or difficulty in the ante-natal
period, at the time of confinement, and during the
puerperium.
This provision is made, consultants being available to
assist medical practitioners in ante-natal supervision
and in connection with difficulties arising during the
confinement or during the puerperium.
(b) To conduct consultative ante-natal and post-natal clinics
to which patients may be referred by general practitioners
or from the routine ante-natal and post-natal
clinics. This provision is also made, the monthly session
having been changed to fortnightly. Post-natal as well
as ante-natal cases are seen by the consultant. Practitioners
frequently attend with their patients.
(c) To exercise clinical supervision over the in-patient treatment
of maternity patients for whom the local authority assumes
responsibility.
The question of the provision of a maternity home is
dealt with separately in this report.
(d) To supervise the treatment of patients suffering from
puerperal sepsis.
Cases of puerperal sepsis requiring hospital treatment
are admitted to the wards of the Queen Charlotte's
Isolation block or the puerperal infection block of the
London County Council North Western Hospital.
(e) To be responsible for the emergency domiciliary service for
cases of grave obstetrical abnormality in which removal to
hospital is contra-indicated.
This service is provided.