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82
Maternal Mortality.
The ill-health of expectant mothers and the difficulties and
risks attending child-birth and their relationship to the subject of
Maternal Mortality in Child-birth continued to engage the attention
of the Ministry of Health and Public Health Authorities
during the year. In 1928 the Ministry of Health set up two
important Committees—one to consider the working of the Midwives
Acts and the other to advise upon the application to
Maternal Mortality and Morbidity of the medical and surgical
knowledge at present available, and to enquire into the need and
direction of further research work.
This latter Committee, to assist their investigations into the
subject of reference, sought the co-operation of Medical Officers
of Health in the completion of an Inquiry Form, which had been
specially drawn up by the Committee, in every case of a maternal
death associated with pregnancy or child-birth occurring in the
district. In Circular (No. 934) issued by the Ministry dated
October, 1928, it was stated that if the Local Authority finds that
the proper investigation of these cases involves additional expense,
reasonable expenditure for this purpose would be approved. The
Council accordingly authorised the employment of the services of
an Obstetric Consultant to collaborate with me in such cases
which appeared to require special obstetric knowledge.
During the year 5 cases were referred to the Obstetric
Specialist to conduct the inquiry into the circumstances of the
death.
There were 11 maternal deaths registered as belonging to
Camberwell according to the information provided by the Registrar
General, representing a mortality rate of 2.79 per thousand
births. Of these, 7 were ascribed to puerperal sepsis.
The prevention of serious morbidity and mortality from
puerperal sepsis is largely dependent on the early recognition of
the infection, and to secure this end all cases of puerperal pyrexia
occurring in a woman within 21 days after child-birth or miscarriage
are now required to be notified.
There are nevertheless still a number of cases every year
where institutional treatment is delayed until the disease is so
advanced that the prospect of recovery is remote. In my opinion
every case of puerperal sepsis should as soon as it is diagnosed be
admitted to a M.A.B. hospital where special facilities are available
for the treatment of such patients suffering from this disease.
Post-Natal Maternal Care.
The importance of post-natal supervision is beginning to be
recognised by women, and it is to be regretted that it has not
reached the stage of general adoption.