_Midwifery Statistics, King’s College Hospital._
┌─────┬──────────┬─────────────────────────────────────────────┬───────────┐
│Year │ Total │ Fatal Cases │ Deaths to │
│ │Deliveries│ │ Labours │
├─────┼──────────┼─────┬──────────────┬────────────────┬───────┼───────────┤
│ │ │Date │ Nature of │ │Date of│ │
│ „ │ „ │ of │ Labour │ Cause of Death │ Death │ „ │
│ │ │Birth│ │ │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ 1862│ 97│Nov. │Natural │Puerperal │Nov. 25│1 in 32·3 │
│ │ │ 6 │ │ peritonitis │ │ │
│ │ │ │ │Phthisis and │ │ │
│ │ │„ 30│Twins │ puerperal │Dec. 27│ „ │
│ │ │ │ │ fever │ │ │
│ │ │Dec. │Natural │Puerperal │Dec. 20│ „ │
│ │ │ 10 │ │ peritonitis │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ 1863│ 105│Jan. │Natural. Child│Puerperal fever │Jan. 16│1 in 52·5 │
│ │ │ 10 │ still-born │ │ │ │
│ │ │April│Natural │Puerperal fever │May 20 │ „ │
│ │ │ 29 │ │ │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ 1864│ 141│Feb. │Natural │Puerperal fever │Feb. 25│1 in 47 │
│ │ │ 16 │ │ │ │ │
│ │ │April│Induced │Pyæmia │April │ „ │
│ │ │ 14 │ │ │ 29 │ │
│ │ │Dec. │Born in cab │Hæmorrhage │Dec. 7 │ „ │
│ │ │ 1 │ │ │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ 1865│ 163│Jan. │Natural │Embolism │Feb. 12│1 in 32·6 │
│ │ │ 30 │ │ │ │ │
│ │ │Feb. │Natural │Puerperal fever │Feb. 18│ „ │
│ │ │ 8 │ │ │ │ │
│ │ │ │ │Puerperal │ │ │
│ │ │June │Forceps │ metritis and │July 30│ „ │
│ │ │ 24 │ │ pelvis │ │ │
│ │ │ │ │ cellulitis │ │ │
│ │ │ │ │Laceration of │ │ │
│ │ │Oct. │Forceps │ perinæum, │Nov. 3 │ „ │
│ │ │ 20 │ │ puerperal │ │ │
│ │ │ │ │ fever │ │ │
│ │ │Oct. │Natural │Puerperal fever │Nov. 9 │ „ │
│ │ │ 29 │ │ │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ 1866│ 150│Jan. │Natural │Gastro-enteritis│Jan. 20│1 in 30 │
│ │ │ 10 │ │ │ │ │
│ │ │ │ │Retained │ │ │
│ │ │Mar. │Natural │ placenta, │April │ „ │
│ │ │ 24 │ │ puerperal │ 10 │ │
│ │ │ │ │ fever │ │ │
│ │ │Oct. │Placenta │Emphysema and │ │ │
│ │ │ 8 │ prævia. │ bronchitis │Oct. 10│ „ │
│ │ │ │ Turning │ │ │ │
│ │ │Nov. │Forceps │Peritonitis │Nov. 15│ „ │
│ │ │ 10 │ │ │ │ │
│ │ │Dec. │Natural │Puerperal fever │Dec. 31│ „ │
│ │ │ 4 │ │ │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│ │ │ │(Had │ │ │ │
│ 1867│ 125│Jan. │ erysipelas │Puerperal fever │Jan. 30│1 in 13·8 │
│ │ │ 10 │ when │ │ │ │
│ │ │ │ admitted[2])│ │ │ │
│ │ │ │ │Considerable │ │ │
│ │ │Feb. │Natural │ hæmorrhage, │Feb. 22│ „ │
│ │ │ 7 │ │ puerperal │ │ │
│ │ │ │ │ fever │ │ │
│ │ │„ 8 │Natural │Puerperal fever │Feb. 22│ „ │
│ │ │April│Turning │Puerperal fever │April │ „ │
│ │ │ 12 │ │ │ 22 │ │
│ │ │May │Natural │Pyæmia │May 27 │ „ │
│ │ │ 18 │ │ │ │ │
│ │ │June │Natural │Puerperal fever │June 19│ „ │
│ │ │ 4 │ │ │ │ │
│ │ │July │Natural │Puerperal fever │Aug. 11│ „ │
│ │ │ 26 │ │ │ │ │
│ │ │Nov. │Twins: 1st │ │ │ │
│ │ │ 5 │ dead, 2nd by│Puerperal fever │Nov. 10│ „ │
│ │ │ │ turning │ │ │ │
│ │ │ │ │Laceration of │ │ │
│ │ │„ 8 │Forceps │ vagina, │Nov. 14│ „ │
│ │ │ │ │ puerperal │ │ │
│ │ │ │ │ fever │ │ │
├─────┼──────────┼─────┼──────────────┼────────────────┼───────┼───────────┤
│Total│ 781│ │ │ │deaths:│1 in 28·9 │
│ │ │ │ │ │ 27 │ │
└─────┴──────────┴─────┴──────────────┴────────────────┴───────┴───────────┘
Under these deplorable circumstances the closing of the wards was a
matter of course; and since that event we have been anxiously enquiring
whether it would be justifiable to re-open our Midwifery Nursing School
under other conditions.
This question is discussed in the following pages, from a basis of
statistical facts supplied by the best authorities; and a few proposals
have been added, with the view of turning to the best account our past
experience, by extracting from it any leading principles which may
present themselves for practical application in the future construction
and management of Lying-in Institutions, and more especially in
connection with means of training Midwifery nurses.
These Introductory Notes, collected and put together under circumstances
of all but overwhelming business and illness, are now thrown out merely
as a nucleus, in the hope that others will be kind enough to supplement,
to add, and to alter; in fact, only as a hook with a modest little fish
on it—a bait to catch other and finer fish.
The facts themselves, the nucleus, have been made as correct as it was
possible, and as would have been done for a finished work. But the facts
themselves are only put forth as feelers—feelers to feel my own way.
I need scarcely say either that these ‘Notes’ are not at all meant to
discuss every point which presents itself in Midwifery statistics. On
the contrary, they are, for the moment, purposely limited to the
consideration of facts immediately relating to the present object.
Let me thank once more with true gratitude all those who have so kindly
supplied me with help and information, some of whose names will appear
in the following pages.