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MATERNAL MORTALITY.
The number of women who died in childbirth in 1937 was
5. Two of these deaths were due to sepsis, and three to other
conditions associated with childbirth. 1 he maternal mortality
rate for all causes was 1.15 per 1,000 births. This is the lowest
rate in my records.
Detailed figures for the maternal mortality of the area are
set out in Table XXIX. It will be seen from this table that,
although the trend of the rate has generally been downward since
1896, the decline has not been continuous, and within the last
twenty years there has even been a slight rise. The true significance
of these facts is brought out by comparing the West Ham
rates with the rates for the country as a whole. Throughout the
whole of the period since 1896 the maternal mortality rate for
West Ham has been considerably below the corresponding rate
for England and Wales, and in the period since 1921 especially
the latter rate has been almost double that for the borough. Even
more important is the fact that the death rate from puerperal sepsis
has nearly always been considerably below the sepsis rate for the
country as a whole. In view of the fact that where figures for an
individual authority are being considered, one additional death may
give a substantial increase in the rate, this consistently low mortality
is very satisfactory. Recent years have rightly seen much
increase in propaganda directed towards the reduction of maternal
mortality, and it is not unknown for a certain area to have no
maternal deaths in one year. Yet for the country as a whole there
is probably an irreducible minimum, below which the maternal
mortality rate cannot be expected to remain consistently. In an
area of any size, therefore, a rate which remains persistently below
that for the standard area of the country as a whole must be a
better indication of the excellence of the results than evidence
provided by isolated low rates in a series of years.
The notifications of puerperal fever and puerperal pyrexia,
and the case rates for these conditions, are given in Table XXX.
The latter condition was made notifiable in 1927. It is satisfactory
to note that the percentage of puerperal fever patients who are
treated in hospital has been rising steadily in the last 40 years.
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