Report on maternal mortality in Wales.

  • Great Britain. Welsh Board of Health.
Date:
1937
Catalogue details

Licence: Public Domain Mark

Credit: Report on maternal mortality in Wales. Source: Wellcome Collection.

    72/162 (page 70)
    week of pregnancy, and the only satisfactory standard of measurement of risk, therefore, is to relate these deaths to the number of women exposed to risk, i.e. to the number of abortions. Reliable information under this head, however, is not available. From inquiries made among doctors and nurses it would appear that abortion per se is not a common reason for calling in their services, and as a rule it is only where the condition of the woman gives rise to concern that their attend- ance is requested. It would be difficult to obtain statistics of the number of natural abortions, and there would always be a -certain number of successful procured abortions which are not revealed except to the woman’s intimate friends. It has been shown above that 12-8 per cent. of the total puerperal deaths in Wales I during 1924-33 were due to abortion (excluding criminal abortion). If the proportion of abortions to total pregnancies was (as is probable) more than 12-8 per cent., then it can be assumed that the nsk of death from abortion (excluding criminal abortion) is less than from other puerperal causes. This process of reasoning can be carried a stage further, and be applied in the consideration of the available data as to the relative incidence of abortion in different areas. While, as shown above, a death-rate from abortion per 1,000 births does not accurately measure actual case fatality from this cause, it would provide a close measure of relative fatality as between one area and another if in the areas compared the ratio of abortions to births were approximately the same. In that case an excess mortality per 1,000 births shown for one area would be a real excess. It is not possible to say, however, whether in any two given areas the ratio of abortions to births is the same, or to what extent it varies. A higher abortion death-rate per 1,000 births in one area might be due wholly or in part to a larger proportion of abortions in that area; indeed it is conceivable for the area with the higher abortion death-rate per 1,000 births actually to have the lower case fatality rate. The figures for Wales I and Wales II in the Table above may be examined in this light. It is there shown (1) that the death-: rate from abortion is higher in Wales I than Wales II; and (2) that the death-rate has increased in Wales I but not in Wales II. These death-rates, however, are expressed per I,000 births. It is possible that the higher and increasing death-rate for Wales I is not due so much (if at all) to a higher and increasing fatality rate, but to a greater and increasing incidence of abortion in industrial South Wales. It has been ascertained from inquiries made among doctors and nurses that the number of abortions which they see in their practices has greatly increased in recent years. It was also