English Translation

Husslein, Zur Befrage Haus- oder Anstaltsbirth I have therefore collected the treatment material of the German obstetrical university clinic in Prague from the last 5 years and subsequently used it for the solution of the above question. We have 10512 births with a total of 39 deaths during this period, so this is a total mortality of 3.7o/oo. It would now be misleading and absolutely wrong to call this figure the mortality rate of the institutional birth. This must be emphasized in particular, because time and again this relatively high mortality against the institution birth is brought into the field, whereby everything that comes in the institution ad exitum is burdened with mortality. On the other hand, a strict distinction must be made here between women who were at the clinic from the beginning of their birth and those who began their birth at home, then were transferred to the hospital for complication during the birth of the clinic, and those born at home and who were only admitted to the clinic as sick women. According to a proposal by Martius, I want to refer to the first as primary births and the second as secondary births. Only the primary are to be addressed as actual institutional births, and only the mortality of this is considered institutional mortality. A total of 9954 women were in our obstetrics from the very beginning, and vir 21 of them lost. Our institutional mortality during the last 5 years is therefore 2o/oo. This figure can also be compared with the mortality rate of the birth of the house. Experience shows that the percentage of pathological and surgically terminated births at the birth is considerably higher and thus the result is also a relatively worse one. Surgical birth terminations at our clinic account for 11.04%. This lower figure reflects the objection raised against the institution's birth that the convenient possibilities of a clinic lead to surgery more often than at home. The mortality of these births, including the secondary institutional births which were not delivered until the birth due to complication and unfortunately often too late, is 7.08o/o0. On spontaneous births there are 88.96% with a mortality of O,89o/oo. And this is certainly the most important number of statistics, because it gives the best comparison possibilities with the birth of the house. Our overall morbidity, i.e. all febrile conditions of the postpartum, is 2.78%, that of the surgical cases 5.27% and that of spontaneous births 2.2%. If we look at the secondary institutional births and the external births more closely, the former results in a mortality of 46o/oo and a morbidness of 34%, for the latter a mortality rate of 15o/OO and a Morbidity of 49.1%. If we compare these mortality figures with those published by the statistical office for institutional birth and those calculated by pollen for the birth of the house, the picture is given in Table II. Our mortality of the primary and secondary institutional birth is thus virtually the same as that of the house birth despite the less favourable birth material, and the primary institutional birth alone is almost half as high. So if one takes into account that despite the heavy burden of institutional statistics on secondary births and despite the higher percentage of pathological and surgical births, mortality is the same for them as for domestic births or for primary institutional births is much lower, the excess of clinical births clearly shows. Special emphasis must be placed on the low percentage of surgical birth terminations. At our clinic, a strict waiting obstetrics in 1955