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Maternal Mortality.
There were fifteen deaths in 1935 due to pregnancy or associated
with child-birth in this Borough. Of this number seven
were due to sepsis, all of whom died in hospital, and eight to
causes other than sepsis, of whom three died at home and five in
hospital.
The Maternal Mortality rate for 1935 was 3.23 per 1,000.
The average age of the mothers at death was 29.25 years. Eight
of the fifteen deaths occurred among primiparae.
Of the seven cases where death was due to sepsis, three
deaths occurred after abortion at varying periods from 8 to 20
weeks; in no case was there any suggestion of illegal interference:
there had been no ante-natal care in these cases, but this is
not surprising in view of the comparative early stage of pregnancy.
The majority of patients still tend to wait until about the fifth
month before presenting themselves for ante-natal examination,
hence abortions may, and do, frequently occur before the patient
has availed herself of help in any way. Many cases of complete
abortion remain unknown to workers amongst the mothers, and
medical treatment is frequently only obtained in those cases where
the abortion is incomplete or accompanied by other symptoms.
It would appear evident, however, that there is a better knowledge
and realisation of the dangers of abortion, and there is
assuredly now less attempt at any serious interference with the
eourse of pregnancy. This better state of affairs is partly a result
of the constant teaching of health matters by Health Visitors, by
Doctors at Maternity and Child Welfare Clinics and in practice,
by popular lectures and by articles in the press. While this widespread
advertisement of the dangers of pregnancy and childbirth
has perhaps inculcated into the minds of women an abnormal fear
of a normal process, yet it has served a useful purpose in helping
to produce the right attitude to the dangerous practice of inducing
abortion, once so universal throughout this country.
Maternal Deaths (as given by the Registrar General) from
causes other than sepsis, number eight. In two cases, however,
there was pre-existing cardiac disease undoubtedly aggravated by
the strain of pregnancy and confinement. To include these cases
as true maternal deaths—i.e. deaths attributable to conditions
directly associated with pregnancy or childbirth—produces a
higher mortality rate which is misleading : without the pre-existing
heart lesion in both these cases it is doubtful if death would have
occurred : excluding these two cases the Maternal Mortality rate
for 1935 becomes 3.09 per 1,000.
Two other deaths might be classed as unavoidable—viz.
Cerebral embolism during normal labour, and sudden rupture of
an early tubal pregnancy. Such tragedies will unfortunately
always occur, however well-organised is the Maternity Service.
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