H.—3l.

Table VI.—Puerperal Deaths and Death-rate per 1,000 Live Births.

Table VII. —Peurperal Mortality, 1939, Showing Number of Deaths and their relation to Live Births.

Puerperal Sepsis following Childbirth. During the past year 147 cases of sepsis were notified, of which. 131 were in Europeans and 16 in Maoris. Of these, 120 were the subject of inquiry by questionnaires, supplemented, where possible, by personal inquiry. Of the 120 cases 111 occurred in Europeans and 9in Maoris. The returns show that only in 8 cases among the Europeans was faulty technique reported, and 4 out of the 9 investigated Maori cases were nursed under conditions in which asepsis was impossible. In my opinion, the number of cases returned as due to faulty technique is underestimated. There are still a number of nurses whose training, if any, occurred before the teaching of asepsis and by whom the principles of asepsis are not fully appreciated. Medical practitioners might with advantage give more supervision in such cases.

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1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. 1930. 1637. 1938. I 1939. ; I Puerperal sepsis following child- No. 56 42 30 27 18 13 14 17 8 9 14 21 16 birth Rate 2-01 1-64 1-12 1-01 0-68 0-52 0-58 0-70 0-33 0-36 0-54 0-77 0-55 Accidents of labour (hsemorr- No. 35 30 39 36 31 30 29 19 24 25 12 29 42 hages, shock, embolism, and Rate 1-26 M0 1-46 1-34 1 16 1-21 1 19 0-78 I 00 1-01 0-46 1 06 1-46 accidents of childbirth not otherwise defined) Toxaemia and eclampsia .. No. 27 40 34 36 38 23 29 30 34 30 35 29 24 Rate 0-97 1-47 1-27 1-34 1-43 0'92 1-19 1-24 1-42 1-20 1-35 1-06 0-83 Accidents of pregnancy (non- No. 5 8 7 7 11 9 10 10 12 14 9 2 3 septic abortion and ectopic Rate 0-18 0'29 0'26 0-26 0-41 0-36 0-41 0-41 0-50 0-57 0-34 0-07 0-1.1 gestation) Total maternal deaths (exclud- No. 123 120 110 106 98 75 82 76 78 78 72 81 85 ing septic abortion) Rate 4-41 4-42 4-11 3-96 3-68 3-02 3-37 3-12 3-25 3'14 2-69 2-97 2-95 Septic abortion — Married women .. .. No. ,, 1( , / 26 26 24 16 29 17 13 16 20 11 Single women .. .. No. J \ 4 3 2 10 13 6 1 7 10 9 Totals .. .. 14 14 19 30 29 26 26 42 23 14 23 30 20 Rate .. . • _ 0-50 0-51 0-71 1-12 1-09 1-04 1-07 1-73 0-96 0-56 0-92 1-10 0-69

Number Death Rate of per 1,000 Deaths. Live Births. Puerperal sepsis following childbirth .. .. .. .. .. 16 0-55 Accidents of labour — . Placenta prsevia .. .. ■ • • ■ • ■ 10 Post-partum hemorrhage .. .. .. .. 11 Puerperal embolism .. .. .. .. 9 Other accidents of childbirth — Shock or syncope following— Ceesarean Section .. .. .. •. 11 Obstetric shock and heart-failure .. ..10^12 Ruptured uterus .. .. .. .. 1J 42 1-46 Toxaemias of pregnancy — Eclampsia .. • • • • • • • • 12 j Puerperal toxaemia .. .. •. • • • • ® 1 24 Hyperemesis gravidarum .. .. .. .. 2 j Acute yellow atrophy of liver .. .. .. 1J 24 0-83 Accidents of pregnancy — (a) Abortion (non-septic) .. .. .. • • 2 (b) Ectopic gestation .. .. ■■ 1 •• Total maternal deaths (excluding septic abortion) . . .. .. 85 2-95 Septic abortion — (а) Married women .. .. •• •• •• H (б) Single women . . . . ■ ■ • • • ■ • • • • 9 20 0-69