Classic pages in Obstetrics and Gynecology

A study of 14,053 corrected mature births which occurred from 1959 to 1963 was made in order to assay the effect of factors beyond clinical control and obstetric management in mature infant survival. The total corrected perinatal death incidence was 7 per 1,000 births, 2 greater than that of the teaching hospital for this time period. Registered and unregistered medically unattended births did not affect perinatal loss adversely, but unregistered attended births were a statistically significant fatal factor—the incidence was 14 or twice the total. High-risk vaginal delivery was 43 or 6 times the total of 7 per 1,000 births. During the time of this study and the 5 years following, the maternal loss for cesarean section was 0.5 per cent, while no mother died due to high-risk vaginal deliveries. Until the indigent patient can tolerate cesarean section as well as the more affluent mother, to raise the rate in the interest of the child is a dubious procedure.