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Death before BirthFetal Health and Mortality in Historical Perspective$
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Robert Woods

Print publication date: 2009

Print ISBN-13: 9780199542758

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780199542758.001.0001

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Fetal Pathology and Social Obstetrics

Fetal Pathology and Social Obstetrics

(p.152) 6 Fetal Pathology and Social Obstetrics
Death before Birth

Robert Woods (Contributor Webpage)

Oxford University Press

During the early years of the 20th century the pathologists held sway. Their detailed post-mortem examinations of fetuses promised to provide answers about causes of death. But the relatively small samples they used and their inability to recognize a substantial minority of causes led to the recognition of their limitations. The epidemiologists took over. The availability of registration data coupled with the popularity of large, scientifically based population surveys encouraged the development of social obstetrics. Family background, maternal health, reproductive history, income, nutrition became, during the 1930s and 1940s, the key factors in attempts to explain the now obviously high levels of fetal mortality. This clash of research cultures can be personified by the figures of Dr John Ballantyne of Edinburgh and Professor Sir Dugald Baird of Aberdeen. Their work in pathology and epidemiology symbolizes the contrast between biological and sociological explanations. This chapter focuses on the 20th century, the high plateau of late-fetal mortality before 1940, and the sustained decline thereafter. It contrasts the pathological interpretation, via Ballantyne among others, and the epidemiological-sociological, via Baird. Through the series of Child Life Investigations sponsored by the Medical Research Council the pathologists stressed the need to better quality obstetric care from both physicians and midwives, while from the social obstetrics camp came pleas for a better quality of material life and lower, planned fertility.

Keywords:   social obstetrics, John Ballantyne, Eardley Holland, Dugald Baird, Medical Research Council, Child Life Investigations, causes of fetal death

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