Final report of Departmental Committee on Maternal Mortality & Morbidity.

  • Great Britain. Committee on Maternal Mortality & Morbidity.
Date:
1932
Catalogue details

Licence: Public Domain Mark

Credit: Final report of Departmental Committee on Maternal Mortality & Morbidity. Source: Wellcome Collection.

    94/160 (page 92)
    It will be seen that the maternal mortality rates in Southern and Eastern England, and in London and the Home Counties, are below the rates for the country as a whole, and substantially below those in Lancashire, Yorkshire and Wales. In Lancashire the total death rate is above the average, but the increase is almost entirely due to deaths from ‘‘other causes,’’ and not from puerperal sepsis. In the West Riding and in Wales there is an increase in deaths under both headings. In the first three groups the people are living in fairly well populated rural districts or under urban conditions which are not highly industrialised, In Lancashire and Yorkshire the towns are industrial and densely populated, and much of the country is given up to mining. In Wales the greater part of the country is either extremely rural, sparsely populated and inaccessible, or congested and industrial. Both these conditions—urban industrialism and a scattered population living in comparative isolation—are not infre- quently associated with a high maternal death rate. In Southern England we often find bad housing and overcrowded cottages, low wages and poverty, malnutrition and ignorance, but © taking conditions as a whole working-class life is less harsh, and has greater amenity and comfort than in the crowded districts in Lanca- shire, Yorkshire and South Wales. The climate is more favourable; the housewife is less subject to a constant struggle with atmospheric dirt and dust, and there has been no such widespread failure of hygiene and nutrition as is indicated by a prevalence of serious rickets. The lower general death rate in the south suggests either a sturdier people or one which is less exposed to the incidence of disease, and the more favourable conditions would tend, indirectly at least, to reduce morbidity associated with childbirth. It is true that in some parts, for example, in the Isle of Wight, the maternal death rate is unexpectedly high, and careful enquiry fails to elicit an explanation, but this does not materially affect the general question. It will be useful to review the conditions in Lancashire, the West Riding and Wales in somewhat greater detail. Both Lancashire and Yorkshire were, and to a considerable extent still are, agricul- tural rural counties; but the discovery of coal and iron and generally favourable conditions for the manufacture of textile goods during the eighteenth and nineteenth centuries led to an exceptional develop- ment and concentration of these industries and associated trades in the southern parts of the counties. As a result of the rapid expansion of urbanisation without previous planning or forethought, we find a dense population settled in an environment which is lacking in some of the essentials of a healthy life, and resulting in an inde- pendent, intelligent people bearing traces in its physical develop- ment of the long working hours, heavy labour, hardship and low wages experienced by earlier generations. in Wales there are two counties, Glamorgan and Monmouthshire, which are highly industrialised, while the remainder of the country is largely rural and contains many districts which are thinly popu- lated and of a hilly or mountainous character, so that there is little