The Daily News. FRIDAY, OCTOBER 14, 1921. MATERNITY MORTALITY.

Taranaki Daily News, 14 October 1921, Page 4

The Daily News. FRIDAY, OCTOBER 14, 1921. MATERNITY MORTALITY.

The contents of the report of the sub-committee appointed by the Board of Health to inquire into the question of maternity mortality cannot be too widely known, nor too closely heeded. The subject was one that could only be dealt with by medical experts, and these consisted of the DirectorGeneral of Medical Services (Sur-geon-General MeGavin), and Drs. Elliott, Valintine and Wylie. The main cause of the inquiry was the publication of statistics by the United States Department, of Labor showing that New Zealand was the second, highest nation in respect of mortality connected with motherhood, a statement that demanded prompt examination and consequent action to remedy such a serious blot, on the Dominion. Even the lay mind will readily understand the difficulty of testing the accuracy of statistics compiled by different nations, even by means of Bertillon’s international system of compiling maternity mortality figures, consequent on the probability of different methods being adopted in assigning the cause of death, not only by the various nations, but also by the certifying doctor. The committee’s inquiries covered the period from 1872 to 1920, and the graph of the Dominion’s Statistician showed there were four varying periods, in the first of which (1872-81) mortality was low, reaching a minimum of 3.93 per thousand in 1880. During .the second period (1882-90) an extraordinary increase in mortality was recorded, reaching a maximum of 7.31 in 1885. This was followed (1890-1913) by a progressive decline to 3.58 in 1913, after which occurred an abnormal increase in the rate to 6.48 in 1920, possibly due to the inclusion in the figures of more cases of puerperal mortality than in 1916. The deduction drawn by the committee from these figures is that there has been a remarkable increase in the maternal death rate in the Dominion since 1914, and a large number, of these deaths were due to sepsis, a largely preventible cause. Among the factors contributing to this cause are the lack of domestic help, housing difficulties, attempts to procure abortion, unhealthy surroundings, and the undue use of instruments and other operative measures at child-birth. To reduce materially the evils of the excessive mortality, the committee made important recommendations, several of which relate to statistical returns and more definite statements as to the cause or causes of death; imposing on matternity hospitals the duty of furnishing quarterly returns of the morbidity rate relating to temperatures during the puerperal period, much stress being laid on this record. It is, however, in connection with nursing that the public will be chiefly concerned, and on that matter the recommendations are practical and will be easily understood. For instance, it is deemed by the committee absolutely essential that every mother should be attended at childbirth by a reliable and highlytrained midwifery nurse, and that facilities should be given to maternity nurses to take a refresher or post graduate course at the various St. Helen’s hospitals, or other approved institutions, at regular intervals ,of two or three years, compliance being compulsory. That provision would meet the needs of wealthy patients, but what is to be done to ensure the wives of the workers and less fortunate people having proper attention? The fees charged are already beyond the means of most people, and there is an urgent need for a practical scheme that will give every expectant mother a fair chance for herself and her offspring. The private maternity homes certainly need, the stricter and more regular inspection advocated by the committee, but these institutions are run for personal profit, and the cost to the patient is frequently prohibitive and far beyond the value of the services rendered. Until some comprehensive scheme for maternity eases is evolved and put into action throughout the Dominion the mortality is likely to be high. It is quite probable that a more general use of ante-natal clinics would result in much benefit, but here, again, the expense will prove a barrier to its general adoption. So far as they go, the recommendations of the committee are on the right lines, but they stop short of what is really the crux of the whole matter —placing within the reach of parents of small means

the provision of care and attention requisite in maternity cases where no hospitals or homes for such patients are available at fees within their reach. With a scattered population like that of New Zealand, the problem is not easy to solve, but as it is essential to keep up the birth rate and to minimise mortality arising out of pre ventible causes, there is far more to be done than is indicated in the report. At the same time the committee has done good work, and possibly paved the way for a more practical and comprehensive method of dealing with the maternity question.