Why Mothers Die

The Chicago Medical Society was in a furor last week. In the September American Mercury, Editor Morris Fishbein of the Journal of the American Medical Association had poked gently caustic fun at the elaborate routine of present-day obstetrical practice. He made bold to wonder whether modern mothers-in-child-birth are really better off than those of horse & buggy days. For this heresy the Society demanded that the A. M. A. discipline its spokesman. This the A. M. A. flatly refused to do.

Out of the East, almost simultaneously, came a barrage of statistics to back up Editor Fishbein. It is generally agreed that the U. S. is one of the unsafest places in the civilized world to have a baby. Four years ago the New York Academy of Medicine appointed a committee, headed by Dr. Ransom S. Hooker, to find out why. In New York City, home of specialists and medical centres, where maternal mortality is considerably less than that of the U. S. as a whole, the committee set out to analyze the cause of every death of a woman in childbirth. Last week it presented its appalling discoveries.

During the three years covered, 2,041 New York City mothers died in childbirth. More than one-half of them (1,343) need not have died. Were they women too ignorant or too poor to go to the doctor? No--only about one-third of the needless deaths were due to the failure of mothers to take advantage of professional care. Amazing fact introduced by the committee was that 61.1% of needless deaths were chargeable to the medical profession. "Some of these situations," thundered the report, "have arisen out of the fact that internes have been given too wide a field of independent activity. Most are plainly the results of incompetence."

How have obstetricians gone wrong? Chiefly, said the committee, in resorting to operations and anesthesia. Competent authorities say that in only 5% of all deliveries need the physician do anything but help Nature. Yet in 67 New York hospitals the investigators found that nearly 25% of deliveries were made with the aid of instruments. To these mothers death came five times as frequently as to those who bore their children naturally. Said the committee: "A certain indictment of those undertaking interference" with Nature.

How large a part the constantly increasing use of anesthetics played in causing operations, the committee could only guess. But it does know that anesthetics weaken the mother's natural power to expel the baby, thus frequently necessitate instrumental aid.

Nearly one-third of all New York's deliveries were in the home. Less than one-sixth of the preventable deaths occurred there. Granting that home deliveries are usually normal ones, the committee yet found cause for alarm in the failure of hospitalization to reduce puerperal infection, death.

Most laymen regard midwives as deplorable relics of medieval prudery. Surprisingly, the committee found that though New York City has 863 licensed midwives who attend about 10% of all deliveries, midwives were to blame for only 2.2% of the preventable deaths. For normal, home deliveries, the committee concluded that a competent midwife is as good as a physician, recommended that more midwives be trained.

The investigators further declared that:

P: Physicians should realize and tell their patients that operations undertaken merely to relieve pain or shorten labor are risky. P: Mothers should realize they must have early and frequent medical examination during the pre-natal period. P: Hospitals should obtain qualified obstetricians to head their staffs; develop specially-trained nursing staffs; establish adequate pre-natal clinics, available to every woman; maintain separate delivery rooms, rigidly guarded against infection; give subordinates careful supervision. Private hospitals should be supervised by a responsible board.

This file is automatically generated by a robot program, so reader's discretion is required.