Introductory notes on lying-in institutions : $b Together with a proposal for organising an institution for training midwives and midwifery nursesNightingale, Florence
Science
Introductory notes on lying-in institutions : $b Together with a proposal for organising an institution for training midwives and midwifery nurses
Nightingale, Florence
Women's hospitals
The value of the Registrar-General’s results, and of those given by Le
Fort, has been called in question by Dr. Duncan in his work already
cited, partly on the authority of certain results of home practice,
quoted from Dr. M’Clintock, who has collected the statistics of 16,774
deliveries exclusively from home practice. There were among these 45
deaths from accidents of labour, 52 deaths from puerperal diseases, and
34 deaths from non-puerperal diseases; giving a total mortality of 131,
or nearly 8 per 1,000. On considering these figures, the first
impression they convey is not that either the Registrar-General or Le
Fort is wrong. But it is a very painful impression of another kind
altogether. One feels disposed to ask whether it can be true that, in
the hands of educated accoucheurs, the inevitable fate of women
undergoing, not a diseased, but an entirely natural condition, at home,
is that one out of every 128 must die? If the facts are correct, then
one cannot help feeling that they present a very strong _prima facie_
case for enquiry, with the view of devising a remedy for such a state of
things. It must be seen, however, that these statistics of home practice
are as open to the charge of want of accuracy as those of the
Registrar-General or Le Fort. The question can only be settled by
enquiry, and by more carefully kept statistics of midwifery practice;
but in the meantime here are a few facts, kindly placed at my disposal
by Mr. Rigden, of Canterbury, which are by no means so hopeless as those
given by Dr. Duncan.
‘An analysis of 4,132 consecutive cases in midwifery occurring in
private practice during a period of 30 years, particularly in reference
to mortality. Eight mothers died: three from convulsions and coma; 4
from puerperal fever; and one from heart disease, about an hour after a
comparatively easy labour.’
The report states 8, but after it was supplied another death took place,
the day after delivery, making 9 in all. The cause of death is not
given.
Mr. Rigden explains that these figures relate only to the first
fortnight after delivery; but he states that if any other deaths had
taken place within the month, he must have heard of them.
Assuming the Deliveries at 4,133 and the Deaths at 9, Mr. Rigden’s facts
show a total mortality of 2·17 per 1,000, of which less than 1 per 1,000
was due to puerperal fever.
_ESTIMATED APPROXIMATE HOME DEATH-RATE._
Public-domain text, read in full here on John Shaqi.
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