H.—3l

Table B.—Deaths from Puerperal Causes, Urban Areas and Rest of Dominion, 1922-26.

The following table (C) gives the death-rate from puerperal causes in various countries (a quinquennial average). It will be seen from this that New Zealand's puerperal death-rate, unlike her general death-rate, is still relatively high, due less to puerperal septicaemia deaths than to deaths from other puerperal causes, such as puerperal albuminuria and convulsions, puerperal haemorrhage, and other accidents of labour. It will be seen also that several other countries believed to possess skilled midwifery service which show a relatively high rate also owe their relatively high rate more to these other puerperal causes than to puerperal septicaemia. I instance Northern Ireland, Australia, Canada, Scotland, and the United States of America. Since, as seen from table (B), these deaths in New Zealand occur less frequently with urban dwellers than with those residing in the country districts and the smaller towns, it is possible that in all these countries the higher rate is due not to lack of skill, but to scattered distribution of population rendering ante-natal care and the procurement of skilled midwifery service more difficult of attainment. That is to say, we in New Zealand can considerably reduce our puerperal death-rate, but the distribution of our population makes that task more difficult.

Table C.—Deaths from Puerperal Causes in various Countries.

8

Urban Areas. Rest of Dominion. Cause, I j . j j : j —7 — 1922.1923.1924.1925.1926. 1 1922.j 1923.11924. 1925.1926.1 | ! ! H I I I En Puerperal septicaemia .. .. 26 25 13 18 17 99 26 27 39 24 22 138 Puerperal albuminuria arid convulsions ..18 9 12 13 7 59 17 25 24 19 24 109 Puerperal haemorrhage .. .. 6 8 8 15 1 38 16 18 11 9 8 62 Accidents of pregnancy .. .. 9 8 9 1 11 38 : 4 9 6 9 9 37 Other accidents of labour .. .. 3 1 1 1 4 10 10 3 5 6 5 29 Puerperal white-leg, embolus, sudden death 2 4 5 1 4 16 10 4 6 13 7 40 Following childbirth, not otherwise defined .... 1 2 1 4 2 2 4 Total deaths .. .. 64 55 49 51 45 264 85 88 91 80 75 419

Death-rate per 1,000 Births from Country. Period. Puerperal Other Puerperal All Puerperal Septicaemia. Causes. Causes. Denmark .. .. .. 1920-24 1-10 1-16 2-26 Netherlands .. .. .. 1921-25 0-72 1-72 2-44 Sweden .. .. .. .. 1918-22. 1-21 1-40 2-68 Italy .. .. .. .. 1920-24 1-08 1-73 2-81 Uruguay .. .. .. .. 1919-23 1-75 1-13 2-88 Japan .. .. .. .. 1920-24 1-28 2-11 3-39 Hungary .. .. .. .. 1918-22 1-52 1-90 3-42 England and Wales .. .. 1921-25 1-40 2-50 3-90 Northern Ireland .. . . .. 1921-25 1-55 3-21 4-76 Spain .. .. .. .. 1920-24 2-99 1-80 4-79 New Zealand .. .. .. 1922-26 1-67 3-16 4-83 Irish Free State .. .. .. 1921-25 2-10 2-88 4-98 Germany .. .. .. .. 1920-24 2-77 2-27 5-04 Jamaica .. .. .. .. 1921-25 1-09 4-10 5-19 Australia .. .. .. .. 1922-26 1-70 3-51 5-21 Switzerland .. .. .. 1918-22 2-82 2-60 5-42 Canada* .. .. .. .. 1921-25 1-46 4-09 5-55 Belgium .. .. .. .. 1920-24 2-65 3-11 5-76 Scotland .. .. .. .. 1921-25 1-86 4-41 6-27 United Statesf .. .. .. 1920-24 2-54 4-36 6-90 Chile .. .. .. .. 1919-23 2-24 6-00 8-24 Trinidad .. .. .. .. 1923-25 3-58 5-68 9-26 British Guiana .. .. .. 1922-25 2-68 11-55 14-23 Ceylon .. .. .. .. 1921-25 8-15 11-94 20-09 I * Exclusive of Quebec. f Registration area.