Introductory notes on lying-in institutions

Chapter 10: ESTIMATED APPROXIMATE HOME DEATH-RATE.

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The author analyzes maternal mortality in maternity hospitals and wards, compiling statistics on deaths from puerperal fever, peritonitis, pyæmia, haemorrhage, and other causes. Comparisons are drawn between hospital, workhouse, and home birth death-rates to estimate a baseline risk and to highlight higher institutional mortality in some settings. She investigates institutional contributors to infection such as crowding, poor ventilation, mixed wards, and attendants serving diverse classes of patients, and recounts a midwifery ward outbreak that led to closure. Practical proposals are advanced for building arrangements, infection control, and the organized training of midwives and midwifery nurses to reduce maternal deaths.

ESTIMATED APPROXIMATE HOME DEATH-RATE.

In estimating the probable accuracy of statistical data in which there may be both excesses and deficiencies, sources of error are diminished by largeness in the numbers employed in striking averages. Bearing this in mind, and after considering the objections brought against the accuracy of the figures, there seems no reason for rejecting the Registrar-General’s average total mortality among lying-in women in England of 5·1 per 1,000, as affording a sufficiently close approximation to the present real death-rate among lying-in women delivered at home, for all practical purposes of comparison with the death-rates in lying-in hospitals.