Observations on the comparative advantages of affording obstetric attendance on poor woman in lying-in hospitals and in their own homes / by Denis Phelan.

  • Phelan, Denis, 1785-1871.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the comparative advantages of affording obstetric attendance on poor woman in lying-in hospitals and in their own homes / by Denis Phelan. Source: Wellcome Collection.

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    which very able and eminent midwifery practitioners preside ? All these elements in the condition of the hospital would naturally indicate a certain low mortality, at least as low as that which takes place outside, where these comforts and medical superintendence are not so much available. The answer would appear to be, that the chief cause is that, which is stated by Mr. Simon and Dr. Le Fort to produce a higher mortality of parturient women in lying-in and other large hospitals, namely, the occasional introduction into them of contagious febrile diseases, particularly scarlatina and typhus fever, and thus, though indirectly, puerperal fever is pro¬ duced. The introduction of such contagious diseases into the Rotundo is the more likely to take place, as fever usually, and scarlatina frequently, prevails in Dublin; and it may be occasionally expected that a woman who comes to the hospital to be confined is not only in actual labour, but is also affected, though not per¬ ceptibly, with fever or scarlatina. The published reports of the board of superintendence of Dublin hospitals throw much light on this subject. Previously there were no data to show what proportion of the mortality that took place in either of the Dublin lying-in hospitals was caused, year after year, by puerperal and other fevers, and the same was the case in respect to the extern attendance given by these institutions. Those reports show that in the seven years ended March, 1864, of 258 woman that died in the Rotundo, 131 died of puerperal fever, and of 45 that died in the Coombe, 15 died of it; and that this disease was a chief cause of the mortality in the Rotundo in each of the seven years. As there is no doubt that the Rotundo authorities have con¬ siderably exerted themselves to improve the sanitary condition of that fine institution, and yet that a high mortality, chiefly from puerperal and other fevers, which are preventible diseases, takes place in it, it may not be amiss to observe that for several years the rate of that mortality has increased in it. Before 1854 the mortality ranged from one in 214, the lowest in any year, to one in 32J, the highest—the average of the previous long period being one in 82; since 1854, included, the mortality has ranged from one in 64, the lowest in any year, to one in 13the highest in any; the average of this twelve years being one in 37^—facts, of which, possibly, the hospital authorities are not aware, and which can be only ascertained on a careful examination of the statistics of the in¬ stitution.