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Of the 55 stillbirths about which particulars are known, 45 were
to mothers confined in hospitals, four in nursing homes and six in their
own homes. Some women for unknown reasons are prone to miscarriages.
If the pregnancy advances sufficiently far, the premature
expulsion results in a stillbirth. In this series there were three such
instances, the mother having failed to retain the foetus to term. Then
there are many abnormal states of the mother which might bring about
the death of the foetus which is later expelled. There were three instances
of this in the series, two of the mothers having suffered from toxaemia,
the other from diabetes. In other cases the foetus was probably alive
up to the onset of a very premature labour. In many of these cases no
cause can be found which could account for the early onset of labour.
In one instance it seemed to occur after a fall. There were two instances
of premature death of a twin. In ten of the sixteen cases where delivery
was premature, there seemed to be no cause for the early labour or for
the death of the foetus. In most of these stillbirths, the foetus was
alive up to the time of delivery at or near full term. In three cases
where the mother was suffering from toxaemia and in four in which there
was ante-partum haemorrhage, the foetus was probably dead at the
onset of labour; it certainly would be in the two instances where the
foetus was macerated. In nine cases there were developmental abnormalities
of the foetus. These might in some have caused intra-uterine death;
in others they perhaps so complicated labour as to result in death during
labour. In eight instances death apparently occurred during the course
of labour. In eight of the 34 cases there was no apparent cause. The
possibility of saving some of these deaths at full term is related to the
standard of obstetric practice. Some of the intra-uterine deaths due to
abnormal states of the mother have been reduced by effective ante-natal
care. That there should have been a fall in the stillbirth rate during the
war years when special attention was given to the dietary of the expectant
mother suggests that nutrition has some part to play in these stillbirths.
Deaths of Infants 1 to 5 Years of Age
A child who survives the first year of life enters a period when the
probability of dying is very small. Some survive their first birthday in
spite of suffering from congenital abnormalities which later become
responsible for, or contribute to death. Weaker children, especially
in the earlier years, might succumb to infections which older children
can throw off. Accidents too early start to exert their toll.
Six children survived their first but did not reach their fifth birthday.
Of these two were in their second year, two in the third and two in the
fourth. Of these, three suffered from abnormal developmental states.
One child died of burns caused by her clothing having caught alight.
Maternal Mortality
The total maternal mortality rate includes all deaths of women
primarily due to, or associated with pregnancy or childbirth expressed
as a rate per thousand live and stillbirths registered in the year.
The rate up to comparatively recently used to be about four per
thousand. For some years now the figure has been nearer one.