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The low maternal mortality rate in the Borough is very gratifying
when the economic and home conditions of the population
are considered. There is very considerable overcrowding, more
especially in the districts on the South side: there is, too, a large
amount of unemployment, in many cases of long duration. The
fact that this rate is so much lower than the rate for the country
as a whole may be attributed to the following amongst other
factors:—
(1) Antenatal Supervision. The Borough is well served with
Antenatal Clinics, and the women avail themselves readily of this
supervision, and of the additional facilities available through
attendance at a clinic.
(2) There is no shortage of trained midwives in the district,
so that all women can ensure the presence at confinement of skilled
help. The majority of women do not engage a doctor for confinement,
but seek the services of a trained nurse, as is shewn by the
fact that 83 per cent. of the notified births were notified by midwives.
Further, the standard of midwifery is high in the Borough
—except for fourteen private midwives (of whom only six are in
actual and regular practice) all the other nurses work under the
aegis of large Maternity Hospitals or Nursing Associations
approved by the Ministry of Health as training centres for pupil
midwives.
(3) The third factor conducing to the satisfactory result is the
adequate and regular visiting of the homes of expectant mothers
by the Health Visitors, particularly in regard to following up
those expectant mothers who fail to keep the appointments for reexamination
at the Antenatal Clinics. By this means the women
are urged to re-attend to prevent the development of complications
of pregnancy; or if such have developed, the patient is put
in touch with the necessary help and supervision to prevent serious
consequences.
Puerperal Fever and Puerperal Pyrexia.
During the year there were 15 cases of Puerperal Fever and
26 cases of Puerperal Pyrexia notified to the Medical Officer of
Health: this represents 3.5 per 1,000 notified births in regard to
Puerperal fever, and 9.6 cases of Pyrexia per 1,000 births.
Arrangements are in force whereby a patient with her baby
can be admitted immediately to hospital if such is considered
necessary. Three Consultant Obstetric Specialists have been
appointed, so that the patient may have the benefit of consultant
services in her own home.
Home Nursing of puerperal cases is carried out by the nurses
from the various District Nursing Associations in the Borough.
Further, if necessary expectant mothers are admitted to
hospital to await their confinement or to receive appropriate
treatment beforehand.
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