MATERNAL MORTALITY

Hokitika Guardian, 31 August 1929, Page 3

MATERNAL MORTALITY

DRESSING PROBLEM IN PREVENTIVE MEDICINE.

EMINENT SURGEON'S VIEWS.

SIR, EWEN MACLEAN IN

WELLINGTON

WELLINGTON, August 27.

Thirty-cue days . fter. attending the annual meeting of the British Medical Association, of which he is the immediate past-president, and which conclinji d its session at Manchester on July 2f>, Sir Ewen'Maclean, M.D., an eminent gynaecologist and ohstetr.cian, arrived from San Francisco by the Tahiti yesterday on his way to Sydney to attend the triennial medical conference there as representative of the B.M.A.

Jn an interview Sir Ewen Maclean said lie had been travelling fast since he left Southampton in the Berengaria. He had only three hours at New 'York before going to Chicago, where he conferred with his ifriencls,. Dr. Franklin Martin, director-general of the American College of Surgeons, and Dr. Arthur Curtis, Professor of Gynaecology at. the University of Chicago. During I is very brief stay in that city he was able to make a hurried inspection of the chief hospitals, with which he was greatly impressed. During his brief stay at Wellington, Sir Ewen Maclean said, be would be in the bands of Dr ,T. S. Elliott, president df the New Zealand branch of the British Medical Association, to which he brought greetings from the Central Council of the D.M.A., which viewed with great pride the achievements of the New Zealand and Australian branches, and the very high proportion of the profession—something like 98 per cent.- —within the two branches. He regretted very much his inability to make a stay in New Zealand, but lie had a considerable programme' ahead of him during the seven weeks he would he in Australia. Apart from attending j>he congress, he had to perform the ceremony of laying the foundation-stone df the new British Medical Association House in Sydney mi September 7. He would also visit the hospitals and medical schools in Sydney, Brisbane, Melbourne, Hobart, Adelaide, and Perth, and on liis way hack to England those in Colombo, Bombay, and Cairo. A DISTINGUISHED OBSTETRICIAN.

Sir Ewen Maclean, on whom the honorary degree of D.Sc. was conferred at Manchester University last month, is Fellow of the Royal College of Physicians and fin Honorary Fellow of the American College of .Surgeons. He is also senior gynaecologist at the Royal Infirmary, Cardiff, arid Professor of Obstetrics and' Gynaecology at the Welsh National School of Medicine. He has long been active in the affairs of the British Medical Association, df .which he was president 1928-29. He Was chairman of the representative body of the association at the time of the passing of the National Health Insurance Act. '

M ATERNAL MORTALITY PROBLEM Sir Ewen Maclean holds the chairmanship of the National Mortality Committee of the British Medical Association, and is carrying out investigations and undertaking much work with a view to the prevention of maternal mortality. He is one of the trustees of the National Radium Fund, and his distinction in obstetrics and gynaecology is widely known. He remarked to'the representative of the “The Dominion ” that the proud position occupied by New Zealand in regard so infantile mortality, and the valuable work done to reduce maternal mortality was fully recognised and appreciated in Britain. He himself was particularly interested in the problem of reducing maternal mortality, which was generally regarded as one of the most important- problems at present in preventive medicine. The problem was the subject of a very valuable and thor‘ongh discussion at the meeting of the British Medical Association last month, and it would be discussed -in the light of Australian experience at tlm coming congress in Sydney. It had been urged with truth in connection with this great problem that obstetrics one of the most vitally important branches of medical practice, had not shared in its due proportion the benefits accruing from the Listerian epoch with regard to the incidence of infection. Much time and earnest attention was being devoted in Britain to the problem, and it was of the first,importance that the Queen had personally

associated herself with the 1 movement

adequately to investigate the governing causes and to reduce the mortality and morbidity rates. ’ CAUSES OF MORTALITY. A The predominance of sepsis as a cause of maternal mortality was a most serious aspect of the question, he said. More than 3000 mothers lost their lives every year,in England and Wales, and of this number more than half the deaths were due to septic infection which, it was claimed was, or should bo a.preventible condition. Given certain conditions, it was preventive. It was well known that rinder properly-con-ducted institutional conditions mortal septic infection arising de novo could be reduced to vanishing point. In these institutions the observance of every detail and circumstance of technique designed to secure asepsis coiild be carried out, and a confidence generated akin to that with which surgery in general was now undertaken. But in Britain it was not possible to provide institutionally for all cases or ;any very considerable proportion otf them—to provide for all cases in England arid Wales would require some 30,000 beds. It -would appear, therefore, that the . problem could be solved, if it were possible to reproduce in the homes of . the people the essential factors and conditions of the provedly effective institutional treatment. It was, of course, impossible to reproduce in the average home the conditions obtaining in the operating theatre, but to- be effective the rules to he observed need not be complicated. The association of antenatal care and treatment, adequate nursing, unhurried waiting upon events in suitable cases, and the availability of skilled experience of all kinds were equally indispensable factors in proper institutional treatment.. There were very many general practitioners whb, wherever and whenever possible, ■ transmuted the largest common denomination df these institutional advantages into their practices, and this was /demonstrated by the results achieved. There were, nevertheless, many baffling. • aspects of this great international problem, and it was earnestly to be hoped that the intensified reseearch into its bacteriology and other factors : would produce useful results. .- A . Sir Ewen Maclean said he .was very greatly interested ■in the New Zealand movement for the establishment of Jan

obstetrical hospital and’training centres for medical students arid midwives he wished it Ifull success. At Home j those responsible for the training of students were faced with difficulties in securing a greaterp number of beds for the purposes of instruction'm obstetrics and gynaeology, but the authorities in the interests of the people were now insisting upon more adequate facilities, and a larger part of the curriculum being devoted to these vitally important ssubjects. '