London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Harrow 1945
[Report of the Medical Officer of Health for Harrow]
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to require hospital treatment, in which case arrangements are made for
them to be admitted to an isolation hospital with the mother.
Few notifications are received in any year, frequently none. In
1945 four were received, but two related to infants who had been born
in a nursing home outside the district. Both these cases were mild. The
other cases were more severe and were admitted to isolation hospitals.
MATERNAL MORTALITY.
Deaths in which pregnancy or childbirth is the primary cause are
classified by the Registrar-General into those " classed to " pregnancy
or childbirth. In addition there is a group of " associated deaths " in
which the patient has died from some cause not directly due to pregnancy
or childbirth, but in which one of these was a factor contributing to death.
The total maternal mortality includes all deaths of women directly due
to or associated with pregnancy or childbirth, expressed as a rate per
1,000 live and stillbirths registered in the year. The rate for the country
from 1911 to 1935 ranged from 3.79 to 4.60. During this period puerperal
sepsis was the largest single cause of death, puerperal toxaemia the second
and puerperal haemorrhage the third. The rate has since declined. The
fall in the sepsis rate is probably associated with the success of chemotherapy.
The total rate for the country as a whole for 1945 was only 1.79.
Below are set out the figures relating to the puerperal mortality in the district since 1934 :
| No. of deaths. | Sepsis rate. | Other causes. | Total. | |
|---|---|---|---|---|
| 1934 | 13 | 2.23 | 3.57 | 5.80 |
| 1935 | 9 | 1.92 | 1.54 | 3.46 |
| 1936 | 12 | 0.67 | 3.35 | 4.02 |
| 1937 | 13 | 2.19 | 1.88 | 4.07 |
| 1938 | 12 | 0.88 | 2.64 | 3.52 |
| 1939 | 8 | 0.58 | 1.75 | 2.33 |
| 1940 | 2 | — | 0.62 | 0.62 |
| 1941 | 9 | 1.06 | 2.12 | 3.18 |
| 1942 | 5 | 0.60 | 0.90 | 1.50 |
| 1943 | 9 | 1.14 | 1.43 | 2.57 |
| 1944 | 2 | 0.28 | 0.28 | 0.56 |
| 1945 | 4 | 0.31 | 0.93 | 1.24 |
The puerperal mortality rate can be only an insensitive index of the
efficiency of the local maternity service, or at least of those services
administered by the welfare authority, especially in such a district as
this where there is so much division of responsibility. In a provincial
county borough where the one authority is largely responsible for the
ante-natal service, for the domiciliary confinements and for the institutional
confinements, the one body is involved, and in such a district the
rate might be accepted as an index. Here, though, much of the work is
or was done by the voluntary hospitals in London. Any fatalities, and
of those that did occur, many were in these institutions, would be debited
to the local area and would reflect on the local services. In the same way
the County Council, providing as it does accommodation for the institutional
confinement of a large proportion of local mothers, is responsible