Chapter 8: Infant mortality

Chapter 8
Infant mortality
60
Chapter 8: Infant mortality
The Infant Mortality Rate . . . gives probably the best index of the social
elfare and sanitary administration of any district.
!
This idea that the infant mortality rate serves as a "sef"l indicator of the economic
prosperity and sanitary conditions of a comm"nity# voiced in this instance by $r. %.
Thomas# the medical officer of &elligaer# had become commonplace in nineteenth
cent"ry 'ritain and the infant mortality rate has been "sed by historians ever since as
a sensitive index of the health stat"s of a pop"lation. (s C. ). *ee has stated:
Infant mortality has been idely accepted as an important and significant
indicator of health achievement# beca"se infancy has alays been one of the
most v"lnerable periods of h"man life# and beca"se the scale of infant
mortality has important conse+"ences. ,"rthermore# infant mortality has been
shon to be associated# in vario"s st"dies# ith a n"mber of important
economic and social indicators# s"ch as income per head# e+"ality of income
distrib"tion# and material deprivation.
-
.dard /toc0ell has described the infant mortality rate as 1the most sensitive
indicator of the overall health stat"s of any pop"lation gro"p2 and has even gone so far
as to s"ggest that infant mortality is 1a m"ch more acc"rate indicator of the level of
socio3economic ell3being of a people than its per capita gross national prod"ct or
any other of the more conventional indices of economic development.2
4
5ne of the most cr"cial and controversial aspects of infant mortality in so"th
6ales d"ring the interar period as the extent to hich levels of infant mortality
reflected the economic fort"nes of the region. .xpert opinion on the matter as
divided as some medical officers echoed the official vie that "nemployment as not
having an adverse effect on mortality# hile other medical officers noted a ca"sal
relationship beteen "nemployment and infant mortality in their ann"al reports.
Typical of the first gro"p of medical officers as $r. .. Colston 6illiams# the medical
officer for &lamorgan# ho maintained thro"gho"t the interar period that
"nemployment did not have a detrimental effect on mortality levels. In !7-8# for
example# he arg"ed that:
!
&elligaer 8$# RM5) 9!7-0:# p.66.
-
C. ). *ee# 1Regional Ine+"alities in Infant Mortality in 'ritain# !86!3!7;!: <atterns and )ypotheses2#
Population Studies, =># 9!77!:# p.>>.
4
.. &. /toc0ell# 1Infant Mortality2# in ?. ?iple 9ed.: The Cambridge World History of Human
Disease 9Cambridge# !774:# pp.--=# --6.
6!
Chapter 8: Infant mortality
It is remar0able that hard times are not more clearly reflected in statistics# the
probable explanation# hoever# is that p"blic and private assistance have
s"bstantially helped in preventing m"ch sic0ness and death.
=
/"ch comments ere often made d"ring the !7-0s. 6hen the statistics did ta0e a t"rn
for the orse# as in !74!# 6illiams commented: 1@ot so good as last year# b"t
remar0able hen considered as the health statistics of bad times2.
>
The nearest that
6illiams came to recognising a ca"sal relationship beteen "nemployment and infant
mortality as in !74- hen he commented that 1bad times are not itho"t effect on
both mother and child.2
6

5ther medical officers ere adamant that "nemployment did have a
detrimental effect on levels of infant mortality. The medical officers of Maesteg and
@antyglo and 'laina both commented in !74= that infant deaths ere more n"mero"s
in homes here the father as "nemployed. 1It may be that the "nder3no"rishment of
the expectant mother and the harassing conditions of the home have contrib"ted to
this factor2# reasoned the @antyglo and 'laina medical officer.
;
The medical officer
of <enybont R"ral $istrict as more definite in his estimation of the precise
conse+"ences of "nemployment:
6here the ee0ly amo"nt going into the ho"se is a small one# and here it is
impossible to ma0e ends meet# the n"rsing or expectant mother is the first to
s"ffer# and in conse+"ence the child is deprived of that no"rishment hich is
essential to its ell3being.
8
<erhaps the most conf"sing 9and conf"sed: position ta0en on this iss"e as by
$r. (. &. M. /evern# the medical officer of <ontypridd# ho changed his mind as to
the effects of "nemployment on infant elfare ith each year# depending on the level
of mortality relative to the previo"s year. In years hen the infant mortality rate in
<ontypridd as loer than "s"al he claimed that "nemployment did not infl"ence
infant mortality# b"t hen the rate as higher he concl"ded that "nemployment as a
=
&lamorgan CC# RM5) 9!7-8:# p.-.
>
Ibid., 9!74!:# p.-.
6
Ibid., 9!7-7:# p.!0A the Western Mail as 0een to p"blicise s"ch statementsA see for example !0 %"ly
!7-># p.>.
;
Maesteg 8$# RM5) 9!74=:# p.7A @antyglo and 'laina 8$# RM5) 9!74=:# p.!6A the medical officer
of Rhondda 8$ similarly categorised "nemployment as a contrib"tory factor to the high level of infant
mortality in his districtA see Rhondda 8$# RM5) 9!7->:# p.4;.
8
<enybont R$# RM5) 9!7-8:# p.>A for similar comments by this medical officer see RM5) 9!7-;:#
p.6A Ibid.# 9!74!:# p.4A ). %ennings# Brynmar. ! Study of a Distressed !rea 9*ondon# !74=:# p.!>;
noted that the rate of increase in eight of infants over the age of six months shoed a significant drop
in families here the father as "nemployed.
6-
Chapter 8: Infant mortality
contrib"tory factor.
7
This medical officer2s tort"o"s changes of opinion perhaps hint
at the press"re coming from central government for medical officers to provide a
favo"rable acco"nt of health conditions in the depressed areas.
!0
In a 'ritish context it is evident that so"th 6ales experienced high levels of
infant mortality d"ring the interar period.
!!
(s Table 8.! demonstrates# the infant
mortality rates for the maBor administrative areas of so"th 6ales ere consistently
higher in the interar period than the aggregate rate for .ngland and 6ales.
!7-03-= !7->3-7 !74034= !74>347
Cardiff C' 8-.- ;8.6 ;>.- >6.6
Merthyr C' 88.= 76.8 86.> ;8.8
/ansea C' ;7.- ;=.= 6;.= >6.=
@eport C' ;0.8 ;-.0 ;6.8 6-.4
&lamorgan (C 8>.0 80.0 ;-.= 6-.=
Monmo"thshire (C 8-.4 ;>.= 66.; 60.8
.ngland and 6ales ;6.8 ;0.8 6-.8 >>.=
Table 8.!: C"in+"ennial infant mortality averages# so"th 6ales and .ngland and
6ales# !7-03!747 9infant deaths per !#000 live births:.
It is clear from Table 8.! that infant mortality in so"th 6ales decreased in common
ith other areas of .ngland and 6ales in the interar period and that the decline over
the tenty years period as# ith the exception of @eport and Merthyr Tydfil#
considerable.
!-
In fact# @eport experienced a rise in infant mortality in the late
!7-0s and early !740s over the period !7-03-= and only experienced a decline in
mortality d"ring the late !740s.
)oever# hen the rate is expressed as a percentage of the .ngland and 6ales
aggregate it is evident that the fall in infant mortality as not as great in so"th 6ales
as it as in other parts of .ngland and 6ales# ith the res"lt that regional ine+"ality
7
/ee <ontypridd 8$# RM5) 9!7-7:# p.6A Ibid.# 9!74!:# p.6A Ibid.# 9!74-:# p.;A Ibid.# 9!744:# p.;A Ibid.#
9!74=:# p.8A Ibid.# 9!74>:# p.6A the Cardiff medical officer similarly adopted a rather contradictory
attit"deA see Cardiff C'# RM5) 9!7--:# p.!=A 9!7->:# p.>A in this last instance# <ic0en# the medical
officer# seems to voice to contradictory vies on the ca"sal relationship beteen "nemployment and
infant mortality on the same page.
!0
C. 6ebster# 1)ealthy or )"ngry ThirtiesD2# History Wor"shop #ournal, !4# 9!78-:# pp.!!03!-7.
!!
*ee# 1Regional Ine+"alities in Infant Mortality in 'ritain2 points o"t ho so"th 6ales experienced
relatively high levels of infant mortality d"ring the late nineteenth and early tentieth cent"ries and
that regional ine+"alities ere at their greatest in the period !86! to !7;! d"ring the interar periodA
see also R. I. 6oods# <. (. 6atterson and %. ). 6oodard# 1The Ca"ses of Rapid Infant Mortality
$ecline in .ngland and 6ales# !86!3!7-! <art I2# Population Studies, =-# 9!788:# pp.4>434>;A I. M.
'"chanan# 1Infant Mortality in 'ritish Coal Mining Comm"nities# !8803!7!!2# "np"blished 8niversity
of *ondon <h.$. thesis# 9!784:# esp. p.4-A for f"rther information on regional variations in infant
mortality d"ring the interar period see the $egistrar%&eneral's De(ennial Supplement, )ngland and
Wales *+,*, Part IIa -((upational Mortality# pp.!683!67# 4863470# 4773=0=.
!-
(s can be seen from Table 8.! @eport experienced only lo levels of infant mortality in the early
!7-0s and so decreased from lo levels.
64
Chapter 8: Infant mortality
as groing in the fifteen years before the mid3!740s.
!4
It as only in the late !740s
that infant mortality in so"th 6ales began to close the gap ith .ngland and 6ales#
altho"gh in Merthyr infant mortality contin"ed to fall more sloly than the .ngland
and 6ales average. (dopting a broader perspective# many historians have noted that
the rate of decrease in infant mortality in the first half of the tentieth cent"ry for
'ritain as a hole as at its loest in the !740s and that this is evidence that
economic crisis as an important determining factor in the level of infant mortality.
!=

That the sloer rate of improvement in infant mortality as more mar0ed in a
depressed region s"ch as so"th 6ales than .ngland and 6ales as a hole s"ggests
that "nemployment and poverty ere indeed important determinants in the level of
infant mortality.
$isaggregating the infant mortality rates in so"th 6ales f"rther
!>
it is possible
to observe the regional variations ithin so"th 6ales. Infant mortality rates in the
+"in+"enni"m !7-03-= are represented in ,ig"re 8.!:
,ig"re 8.!: (verage infant mortality rates# !7-03-= 9infant deaths per !#000 live
births:.
!4
/ee (ppendix 8.4
!=
6ebster# 1)ealthy or )"ngry Thirties2# pp.!-43!-=A M. Mitchell# 1The .ffects of 8nemployment on
the /ocial Conditions of 6omen and Children in the !740s2# History Wor"shop #ournal, !7# 9!78>:#
p.!0;.
!>
/ee (ppendices 8.! and 8.-.
6=
Chapter 8: Infant mortality
It is clear that the coal3mining districts of so"th 6ales experienced higher levels of
infant mortality than the .ngland and 6ales aggregate b"t ere similarly
experiencing a decline in the level of mortality d"ring the interar period. )oever#
as as noted above# mortality levels did not decrease to the same extent as the
.ngland and 6ales rate.
!6
Indeed# in districts s"ch as 'edas and Machen#
Mynyddislyn# @antyglo and 'laina# Caerphilly# Maesteg# and 5gmore and &ar#
the difference beteen the local rate and the national average increased d"ring the
co"rse of the interar period. In other districts# s"ch as &lyncorrg# @eath M'#
5gmore and &ar# <ort Talbot# Rhondda# <ontardae# 'edellty# <ontypool and
Rhymney# infant mortality increased or remained at abo"t the same rate from !7-03-=
to !74034= and only fell in the late !740s.
!;
(s might be expected# agric"lt"ral
districts# s"ch as Cobridge# &oer# (bergavenny# Chepsto# Magor and /t.
Mellons# Monmo"th and <ontypool# consistently experienced loer levels of
mortality than the ind"strialised# "rban areas of so"th 6ales and# indeed# the .ngland
and 6ales average. /imilarly# small m"nicipal boro"ghs s"ch as 8s0 and Cobridge
and the coastal resort of <orthcal experienced lo levels of infant mortality#
reflecting both the small n"mber of births and the more sal"brio"s sanitary
characteristics of those areas.
(n investigation of the age3specific nat"re of infant mortality in so"th 6ales
allos f"rther "sef"l insights.
!8
@eonatal mortality 9i.e. mortality in the first 40 days
of life: has been "sed by historical demographers to reveal pre3natal ca"ses of infant
mortality or mortality d"e to the birth process. These 1endogeno"s2 ca"ses of infant
mortality incl"ded developmental problems experienced in the omb# inB"ry at birth#
premat"rity and other congenital ca"ses of death and ere primarily ca"sed by
maternal n"tritional and health stat"s. <ost3neonatal mortality 9i.e. infant mortality
after the first month of life:# on the other hand# "s"ally res"lted from exogeno"s
ca"ses of death s"ch as diarrhoeal# respiratory or common infections# accidents or
other environmental ca"ses of death. This type of infant mortality serves as an
indicator of the +"ality of the maternal care# the infant elfare services and the
sanitary environment of a society. $"e to developments in modern medical science
!6
This can be seen hen the district rates are expressed as a percentage of .ngland and 6ales average.
/ee (ppendix 8.4.
!;
/ee (ppendix 8.-A even in many of these districts the excess mortality over the .ngland and 6ales
average as greater at the end of the interar period than in the early !7-0s.
!8
/ee (ppendix 8.=.
6>
Chapter 8: Infant mortality
that can prolong infant life for some time after the neonatal period and the existence
of some neonatal deaths d"e to exogeno"s factors# neonatal and post3neonatal
mortality can no longer be ass"med to be ca"sed by endogeno"s and exogeno"s
ca"ses respectively b"t the distinction is# on the hole# valid for a st"dy of infant
mortality in the interar period.
In common ith most societies# infant mortality in so"th 6ales as greatest
immediately folloing birth and declined as age increased.
!7
Infant mortality as#
ith fe exceptions# higher at all ages in so"th 6ales than the .ngland and 6ales
aggregate rate. (s has been pointed o"t# neonatal mortality reflects the n"tritional and
health stat"s of pregnant omen. <oor or deteriorating maternal n"tritional stat"s
increases neonatal mortality thro"gh increased li0elihood of developmental problems
in the omb# greater premat"rity# an increased li0elihood of diffic"lt labo"r and loer
birth eights.
-0
It is evident that neonatal mortality as consistently higher in so"th
6ales than the .ngland and 6ales average b"t also that# in common ith the rest of
.ngland and 6ales# neonatal rates in so"th 6ales ere more resistant to improvement
than death rates for infants over the age of one month.
The +"in+"ennial neonatal mortality averages sho that the decrease in this
rate in .ngland and 6ales as only very small d"ring the interar period 944.6 deaths
per !#000 live births in !7-!3-= to -7.= in !74>347:.
-!
The neonatal mortality rates
for the to administrative co"nties and the boro"ghs of Cardiff and /ansea similarly
fell d"ring the same period b"t the decreases ere even smaller.
--
)oever# Merthyr#
@eport and the Rhondda experienced small increases from the early !7-0s to the
late !740s 9and even larger increases from the early !7-0s to the early !740s: hile in
smaller districts s"ch as (bertillery# Mo"ntain (sh and <enybont neonatal mortality
rates increased by even larger margins d"ring the co"rse of the interar period.
-4
The
!7
In some cases# age3specific infant mortality as recorded in (ppendix 8.= as greater for older infants
than yo"nger infants b"t this as "s"ally here lo n"mbers of deaths ca"sed the rates to fl"ct"ate
mar0edly.
-0
R. *ee# 1Infant# Child and Maternal Mortality in 6estern ."rope: ( Criti+"e2# in (. 'rEndstrFm and
*.3&. Tedebrand 9eds:# So(iety, Health and Population during the Demographi( Transition 9/toc0holm#
!788:# pp.!>3!6.
-!
/ee (ppendix 8.>.
--
The Cardiff medical officer commented metaphorically in !74= that 1It may be said that the receding
tide of "nder3one3year mortality has left behind it a bar against hich the pool of "nder3one3month
mortality see0s in vain an ade+"ate channel for escape. ,or Cardiff the bar is high and apparently more
resistant than that for .ngland and 6ales2A Cardiff C'# RM5) 9!74=:# p.!6.
-4
/ee (ppendices 8.= and 8.>. The infant mortality rates are 1real2 rates based "pon 1definite2 statistics
and not estimates as in the case of total death rates. It is "nli0ely# therefore# that the trends described
here are the res"lt of statistical anomalies. <enybont as largely a r"ral district b"t its pop"lation as
largely concentrated in the northern part of the district and primarily engaged in ind"strial activities G
66
Chapter 8: Infant mortality
neonatal mortality rate for the (bertillery 8rban $istrict increased from 48.- deaths
per !#000 live births in !7-03-= to =-.4 in !74>348 hile the comparable rates for
Mo"ntain (sh ere -8.= and =0.># and for <enybont 46.> and 48.6.
-=
In the cases of
<enybont and Mo"ntain (sh these increases occ"rred despite the highly developed
and energetic nat"re of the infant elfare services in these localities.
->

Therefore# the decreases in the aggregate neonatal mortality rates for the to
administrative co"nties ere not shared e+"ally among their constit"ent "rban and
r"ral districts b"t ere concentrated in certain districts. 5ther localities# s"ch as
(bertillery# Mo"ntain (sh and <enybont# departed from the overall trend# and act"ally
experienced increases in their neonatal mortality. The neonatal mortality rate is a
partic"larly sensitive indicator of the n"tritional stat"s and health of expectant
mothers and it is significant that neonatal mortality rates increased in districts that
experienced high levels of "nemployment and poverty in the interar period. If the
neonatal mortality rate is analysed over the interar period# it is evident that so"th
6ales experienced a different trend from the rest of 'ritain.
,ig"re 8.-: @eonatal mortality rates for selected areas of so"th 6ales and .ngland
and 6ales# !7-03!747.
the Cens"s of !7-! en"merated =-H of the males aged over !- as employed in the coal ind"stry# ;.-H
in agric"lt"ral occ"pations# >H in transport and 4.7H as b"ildersA Cens"s !7-!# &lamorgan# p.66.
-=
/ee (ppendix 8.>. 6hile the n"mber of neonatal deaths in these districts did occasionally amo"nt to
less than -0 in the late !740s they "s"ally exceeded -0 and the res"lting rates are therefore significant.
->
/ee <enybont R$# RM5) 9!7-03!747:A Mo"ntain (sh 8$# RM5) 9!7-03!747:A the nat"re of these
services are disc"ssed belo.
6;
0
10
20
30
40
50
60
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939
Year
D
e
a
t
h
s

p
e
r

1
,
0
0
0

l
i
v
e

b
i
r
t
h
s
England and Wales
Glamorgan AC
Monmouthshire AC
Merthr C!
"hondda #$
Chapter 8: Infant mortality
,ig"re 8.- demonstrates that folloing the high mortality of the hot s"mmers
of !7-0 and !7-!#
-6
neonatal mortality rates in so"th 6ales closely approximated# or
marginally exceeded# the .ngland and 6ales rate d"ring the early to mid3!7-0s.
$"ring the later !7-0s# neonatal mortality in so"th 6ales began to increase and began
to exceed the .ngland and 6ales rate by a larger margin. The rise in neonatal
mortality rates in so"th 6ales demonstrated by ,ig"re 8.- is most clearly
demonstrated in the cases of the administrative co"nties of &lamorgan and
Monmo"thshire here s"fficiently large n"mbers of deaths prod"ced a smoother
trend line. It can be seen that neonatal mortality rates rose d"ring the late !7-0s#
pea0ed d"ring the early !740s and declined thereafter. The same general trend can be
observed for Merthyr and Rhondda b"t the greater ann"al fl"ct"ations disg"ise this to
some extent.
-;
Therefore# levels of neonatal mortality in so"th 6ales d"ring the
interar period closely reflected the economic fort"nes of the region as levels of
"nemployment and poverty ere similarly increasing d"ring the late !7-0s# pea0ed
d"ring the early !740s and decreased d"ring the mid3 to late !740s.
The pattern of neonatal mortality in so"th 6ales shared many of the same
characteristics as the pattern for stillbirth mortality. (s @ic0y )art has pointed o"t#
stillbirths ere a significant aspect of 1reprod"ctive mortality2 and yet have not
received the same amo"nt of attention from historical demographers as infant
mortality.
-8
In the Rhondda d"ring the interar period# for example# stillbirths
amo"nted to beteen ;0H and !!0H of the n"mber of infant deaths after !7-- and
ere therefore a significant aspect of the mortality regime. If stillbirths are added to
infant deaths then it is evident that the res"lting 1reprod"ctive mortality2 in interar
so"th 6ales as considerable. 6hile neonatal mortality is a "sef"l indicator of the
n"tritional and health stat"s of expectant and n"rsing mothers# the stillbirth rate
highlights even more star0ly the health stat"s of child3bearing omen in interar
so"th 6ales. (s )art comments:
/tillbirth is . . . a val"able health stat"s indicator . . . 6here death occ"rs in
"tero the external environment is mediated by the mother2s body# hich is the
-6
These hot s"mmers prod"ced an increase in mortality from diarrhoeal ca"ses and hile these ca"ses
of death are "s"ally associated ith the deaths of infants aged over three months it seems that in years
of epidemic diarrhoea yo"nger infants also s"ffered high mortality rates from this ca"seA see for
example '"chanan# 1Infant Mortality in 'ritish Coal Mining Comm"nities# !8803!7!!2# p.!!0# here
'"chanan notes the increased neonatal mortality rate d"ring the diarrhoea epidemic of !7!!.
-;
The pattern is# to some extent# also observable for the co"nty boro"ghs of Cardiff and @eport#
altho"gh not as mar0ed as for those areas shon in ,ig"re 8.-.
-8
@. )art# 1'eyond infant mortality: &ender and stillbirth in reprod"ctive mortality before the
tentieth cent"ry2# Population Studies, >-# 9!778:# pp.-!>3--7.
68
Chapter 8: Infant mortality
foetal lifeline and a means of environmental ins"lation. The female body is
the instr"ment of h"man procreation# and stillbirth is a good indicator of its
capacity# its vitality. /ince female physi+"e reflects material conditions and
the distrib"tion of s"bsistence beteen the sexes# stillbirth is also an important
potential indicator of ine+"ality beteen them.
-7
/tillbirths and neonatal deaths share many of the same determinants. 'oth are
primarily determined by the nat"re of the foetal environment in the period - to 7
months after conception. It as recognised d"ring the interar period that the ca"ses
of deaths in the first ee0 of life ere the same as those ca"sing stillbirths and that
both ere sensitive indicators of maternal health.
40
The stillbirth mortality rate for
.ngland and 6ales decreased from abo"t =0 deaths per !#000 total births in the late
!7-0s to abo"t 4; by the end of the !740s.
4!
The rates for so"th 6ales ere
consistently# and often considerably# higher than the .ngland and 6ales aggregate.
4-

Merthyr# in partic"lar# experienced one of the highest stillbirth mortality rates in the
hole of .ngland and 6ales d"ring the !740s.
44
/tillbirth rates from !7-8 to !747
are ill"strated in ,ig"re 8.4.
-7
Ibid., p.--;A a point also made by $. &raham# ,emale employment and infant mortality: some
evidence from 'ritish tons# !7!!# !74!# !7>!2# Continuity and Change# 7# -# 9!77=:# p.4!>.
40
/ee for example /ansea C'# RM5) 9!7->:# p.!>. 5"t of -44 infant deaths in /ansea that year#
!0; ere "nder one ee0 of age. If this as added to the n"mber of stillbirths the res"lting deaths
9-88# otherise 0non as perinatal deaths: ere more than do"ble the n"mber of post3neonatal deaths
9!-6:.
4!
/ee (ppendix 8.6.
4-
Ministry of )ealth# $eport on Maternal Mortality in Wales# ICmd. >=-4J# !74634;# xi# pp.!63!;
demonstrates that high stillbirth mortality as a characteristic of the hole of 6alesA see also %. 6inter#
18nemployment# n"trition and infant mortality in 'ritain# !7-03>02# in idem., The Wor"ing Class in
Modern British History 9Cambridge# !784:# p.-47A 6inter also shos# hoever# that 16ales I2
experienced a large decrease in stillbirth mortality in the period !748 to !7=6 hen the rate fell from >!
to 44 stillbirths per !#000 total births.
44
&raham# 1,emale employment and infant mortality2# p.4!>.
67
Chapter 8: Infant mortality
,ig"re 8.4: /tillbirth rates for large administrative areas of so"th 6ales and .ngland
and 6ales# !7-8347.
4=
The greater levels of stillbirth mortality in so"th 6ales are clearly
demonstrated. /tillbirths ere made notifiable from ! %"ly !7-; and so reliable
fig"res for the period before !7-8 are not available for the areas ill"strated by ,ig"re
8.4. @evertheless# some local medical officers in so"th 6ales recorded the n"mbers
of stillbirths in their ann"al reports.
4>

4=
$egistrar%&eneral's Statisti(al $e.ie# 9!7-83!747:.
4>
/ee (ppendix 8.6.
;0
0
10
20
30
40
50
60
70
80
1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939
Year
S
t
i
l
l
b
i
r
t
h
s

p
e
r

1
,
0
0
0

t
o
t
a
l

b
i
r
t
h
s
England and Wales
Glamorgan AC
Monmouthshire AC
Cardi%% C!
Merthr &d%il C!
'e()ort C!
*(ansea C!
Chapter 8: Infant mortality
,ig"re 8.=: /tillbirths in selected districts of so"th 6ales# !7-0347.
,ig"re 8.= demonstrates that stillbirth rates in these districts ere increasing
d"ring the co"rse of the interar period. )oever# this increase might have been d"e
to the greater registration of these deaths. The stillbirth fig"res for the Rhondda in the
!7-0s# for example# ere s"pplied to the medical officer by the sextons of the three
local cemeteries and since nespapers ere f"ll of reports of stillborn infants being
fo"nd in rivers# canals and other places# it seems li0ely that fig"res for the !7-0s
"nderestimate the tr"e extent of stillbirth mortality in so"th 6ales.
46
Co"ntering this
to some extent as the fact that prior to !7-;# in cases here infants died soon after
birth# doctors or midives often co"nted them as stillbirths so as to avoid the
formalities of registration# thereby exaggerating the tr"e extent of stillbirth mortality#
altho"gh hether this o"ld have changed over time to prod"ce the trends shon
seems "nli0ely.
4;
@evertheless# from !7-8 onards the statistics are more reliable and
they clearly sho an excess of stillbirths in so"th 6ales over the .ngland and 6ales
average and a rise in stillbirths in so"th 6ales in the early !740s.
( f"rther insight is available thro"gh ta0ing a longer3term vie of stillbirths in
so"th 6ales. /tillbirth rates for the Rhondda are available from !70! and for
/ansea boro"gh from !7!0 and are shon in ,ig"re 8.>.
46
/ee also .. 'a0er# /0an Boogie' The !utobiography of a Sansea 1alley &irl 9<retoria# !77-:# pp.=73
>0.
4;
Rhondda 8$# RM5) 9!7-4:# pp.-83-7.
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Chapter 8: Infant mortality
,ig"re 8.>: /tillbirth rates in Rhondda 8rban $istrict and /ansea Co"nty 'oro"gh#
!70!3!747.
48
The fig"res for the Rhondda are the more complete and the res"lting trend line
is the more instr"ctive. It shos that the stillbirth rate as decreasing in the decade
before the ,irst 6orld 6ar and contin"ed to do so "ntil !7-0 hen it reached ==.8
stillbirths per !#000 total births. Thereafter# the stillbirth rate increased thro"gh the
!7-0s and reached a pea0 of 66.> in !744 after hich time it declined. The stillbirth
rate for /ansea boro"gh as similarly higher in the late !7-0s and early !740s
relative to its level in the pre3,irst 6orld 6ar period. This pattern of high stillbirth
rates in the late !7-0s and early !740s relative to the period before the ,irst 6orld
6ar might be explained by the more effective registration of stillbirths from %"ly !7-;
b"t still fails to acco"nt for increasing stillbirth mortality in the to districts before
!7-8. This is most mar0ed in regard to the Rhondda hich# of co"rse# experienced
ind"strial depression thro"gho"t the !7-0s. The method of co"nting stillbirths seems
to have remained the same in the Rhondda for the period !70! to !7-; and so an
explanation of the pattern of stillbirth mortality in the period before !7-; cannot be
attrib"ted to changes in the method of co"nting. *ong3term changes in c"stoms and
attit"des toard stillbirths and b"rials might have affected the observed pattern b"t
cannot be acc"rately assessed.
48
Rhondda 8$# RM5) 9!7-0:# pp.!73-0A /ansea C'# RM5) 9!7-0:.
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*(ansea C!