H.—3l

The graph presents certain interesting features. The top line, indicating the death-rate from all puerperal causes, shows extreme peaks in the years 1875, 1885, 1894, 1903, 1916-17, 1920, and now in 1927 the rate is showing a rise. The high and narrow peak of 1920 is of peculiar interest. In that year there occurred an undue proportion of first births, the result of returned-soldier marriages. Statisticians regard first births as more fatal than subsequent births, and it is thus possible the Great War temporarily influenced New Zealand's puerperal death-rate. With this exception it may be said the puerperal death-rate has shown a tendency to reach a high extreme every nine or ten years. Since 1916 there has been on the part of the Government Statistician and his staff a closer scrutiny of death certificates than in former years, and probably the more sustained high level from 1916 onwards is from that cause. A glance at the puerperal septicaemia line (bottom) shows that increases in deaths from that disease accounted in considerable measure for the high rates of 1875, 1885, 1894, 1916-17, less so in 1920, and markedly so last year. The death-rate from other puerperal causes, however (middle line), appears to have been the main factor in the high puerperal death-rates of 1903 and 1920, and to have joined issue with puerperal septicaemia in accounting for the high rates of 1884-85. One cannot be certain, particularly in the earlier years, that all puerperal-septicaemia deaths were registered as such. Before the close scrutiny of death-certificates and the questionnaires of the Government Statistician there would be a tendency for such deaths to be recorded as puerperal deaths, but not to be defined as due to puerperal septicaemia. Local Distribution of Puerperal Septicemia Deaths in 1927. The following table gives the actual number of deaths from puerperal septicaemia in each hospital district during the years 1926 and 1927 :—

It will be seen that last year a marked increase occurred in the Auckland Hospital District, but also that there was a fairly general though less marked increase in fully half the hospital districts both Islands.

2—H. 31.

9

Puerperal Septicaemia. Puerperal Septicaemia. Hospital District. Hospital District. j 1926. 1927. I 1926. 1927. North Island. North Island—continued. Mangonui .. . . .. . ■ Wellington .. .. 4 4 Whangaroa .. . . . ■ • ■ Wairarapa .. .. 1 1 Hokianga .. .. .. 1 — Bay of Islands...... .. 26 51 Kaipara .. . . • • • • j South Island. —<■ — Whangarei -. • • • • • • Wairau Auckland .. . • 13 25 Picton Waikato .. .. 5 3 Nelson .. .. .. 1 Taumarunui .. .. .. - • \ Buller Thames .. . . 1 • • Inangahua Waihi .. . • • ■ 1 j Grey .. .. .. 1 Coromandel .. . . • • • • Westland Tauranga .. .. .. 1 North Canterbury .. 7 6 Bay of Plenty .. . . .. . • | Ashburton . . .. 2 1 Opotiki . . . • ■. 1 South Canterbury .. .. 1 Cook .. .. . • • • 1 Waitaki .. .. .. Wairoa .. .. • • • • Otago .. . . 1 5 Hawke's Bay .. .. .. 4 South Otago Waipawa .. . ■ • • 2 Vincent Dannevirke .. • • 1 ■ • i Maniototo Taranaki .. .. 1 2 Southland . . . . 2 4 Stratford .. . • • • 2 ! Wallace and Fiord . . 1 Hawera .. • ■ • - 1 —— —— Patea ...... .. 13 19 Wanganui .. . • • • 1 — Palmerston North . . .. 1 Total for New Zealand 39 70