class="tdrrb">4·77

4·08 4·44 4·85 4·21 Maternal mortality, excluding septic abortion—             Number 123 120 110 106 98 75 82 76 78   Rate 4·41 4·42 4·11 3·96 3·68 3·02 3·37 3·12 3·25 Puerperal septicæmia—                 Number 56 42 30 27 18 13 14 17 8   Rate 2·01 1·54 1·12 1·01 0·68 0·52 0·58 0·70 0·33 Septic abortion—                   Number—                       Married }   { 26 26 24 16 29 17   }14 14 19{                 Single }   { 4 3 2 10 13 6   Rate 0·50 0·51 0·71 1·12 1·09 1·04 1·07 1·73 0·96

One of the unfortunate features of this matter from the public health point of view is the extent to which this increase in deaths from abortion sepsis is counterbalancing and masking the very real improvement which has been achieved by the obstetrical services in the work for which they may justly be held responsible.

According to the international system of recording, these cases are included in the total maternal mortality.

Actually in New Zealand in the five-year period mentioned, abortion sepsis was responsible for one-quarter of the total maternal deaths.

In the larger urban areas the position is even more unfortunate, as the following instance will indicate:—

Maternal Mortality in Urban Areas for the Five-year Period, 1930-34.

Urban Area	Live Births.	Total Maternal Deaths.	Maternal Death-rate per 1,000 Live Births.	Maternal Deaths excluding Septic Abortion.	Maternal Death-rate per 1,000 Live Births excluding Septic Abortion.	Deaths from Septic Abortion.	Death rate from Septic Abortion per 1,000 Live Births.
Auckland	14,290	81	5·67	55	3·85	26	1·82
Wellington	11,690	61	5·22	32	2·74	29	2·48
Christchurch	9,599	51	5·31	29	3·02	22	2·29
Dunedin	5,960	24	4·03	17	2·96	7	1·17
Total, four urban areas	41,539	217	5·22	133	3·20	84	2·02
Total, remainder of Dominion	58,623	273	4·66	204	3·48	69	1·18

In the case of the four urban areas deaths from septic abortion account for approximately two-fifths of the total maternal mortality.

With these cases excluded, the maternal mortality associated with child-birth proper was 3.20 per 1,000 live births.

Clearly, any comparison between different maternity services should be made on the basis of these latter figures alone.

What is the Cause of this High Incidence of Deaths From Septic Abortion.

The evidence offered to the Committee by medical witnesses indicates conclusively that sepsis, and death from sepsis particularly, is almost entirely due to illegal instrumental interference.

Spontaneous abortion, provided that proper medical