In the year 1862 the Committee of the Nightingale Fund, with a view to
extending the advantages of their Training Institution, entered into an
arrangement with the authorities of St. John’s House, under which wards
were fitted up in the new part of King’s College Hospital, opening out
of the great staircase and shut up within their own doors, for the
reception of Midwifery cases. The wards were under the charge of the
(then) Lady Superintendent. Arrangements were made for medical
attendance, a skilled midwife was engaged, a certain number of pupil
nurses were admitted for training; and hopes were entertained that this
new branch of our Training School would confer a great benefit on the
poor, especially in country districts, where trained Midwifery nurses
are needed.
Every precaution had apparently been taken to render the Midwifery
Department perfectly safe; and it was not until the school had been
upwards of five years in existence, that the attention of the
Nightingale Committee was called to the fact that deaths from puerperal
diseases had taken place in each of the preceding years.
During the period of nearly six years that the wards were in use, the
records show that 780 women had been delivered in the institution, and
that out of this number twenty-six[1] had died—a mortality of 33·3 per
1,000.
The most fatal year was 1867, in which year nine out of the twenty-six
deaths took place. In the month of January a pregnant woman, who was
under treatment for erysipelas in the hospital, was delivered in a
general medical ward, No. 4, in the first-built wing of the hospital. A
midwife was told off to attend her, who was not suffered to be near the
midwifery wards for a considerable time. The erysipelas case died of
puerperal fever; and this death was followed by a succession of
puerperal deaths in the lying-in wards until November, when the wards
were as soon as possible closed.
An analysis of the causes of death showed that, with the exception of
one death from hæmorrhage, not a single death had taken place from
accidents incidental to childbearing during the whole six years. There
were three deaths due to diseases not necessarily concomitants of this
condition; while of the others, twenty-three in number, no fewer than
seventeen were due to puerperal fever, three to puerperal peritonitis,
two to pyæmia, and one to metritis.