English Translation

Central Gazette of Gynaecology 1940 No. 46 Table IV Death by death by other number of Other Number of Year Puerperal- Consequences of Pregnant Deaths 0 Births Causes 00 Sepsis and Births 1935 1896 4 3 13 89 1936 1902 2 1 9 3.1 1937 2156 2 1 4 1.8 1938 2209 3 4 0 7 3.1 1939 2349 3 5 1 6 3.7 total 10512 14 19 9 39 3.7 1.3°/00 1.8°/ 00 0.57°/000 Compare these results with those published by Pohlen for the year 1936 at the birth of the house, then the following picture emerges: Table V Homebirth Institution birth in the German according to Pohlen University Hospital for the Year 1936 Prague 1935-1939 3.35°/001 3.4°/002 Mortality 0.75° 0.97° /00 Death by Puerperalsepsis 00 Death by otherwise. Consequences of Pregnant and Birth 1,48o /00 1,80° 00 1,120/00 0,57°00 Death by Other Causes It must be borne in mind that the numerous secondary births burden the statistics of the institutional birth, which relieve the burden on the birth of the house. It cannot be said that all cases of secondary institutional births, in which the birth started at home, which were then transferred to the hospital due to complications that had occurred and where they had arrived in the hospital, could have been saved if they had come to the clinic in good time; but with some, it is beyond any doubt and is quite clear from the comparison of the individual mortality figures. Nor should it be claimed that all failures of secondary births are charged exclusively with a faulty home birth support provided up to the moment of delivery; statistically, however, they relieve the birth of the house. On the other hand, it is not appropriate to charge them to institutional mortality. In addition to the often deficient care of pregnant women and inadequate prophylaxis of birth, women themselves often bear a certain responsibility if they visit a doctor too late or ignore his advice, as in eclampsia, despite existing symptoms. In addition, there are external difficulties, which often make it impossible for the midwife to have a doctor at the decisive moment; further, the time-consuming transport difficulties which often lead to a complication occurring in the birth of the house to become an unresolvable situation. In the case of obstetrics, there is no certainty that a complication will occur in the course of delivery or not. Any birth which begins under such normal conditions can at any time become pathological; therefore, the guiding principle contradicts that only the patho- 1958