The Incidence of Abortion at The Jubilee Hospital

FOR my presidential address to the Society I have chosen a subject which, although having a certain suggestion of impropriety, is none the less of such importance that I have no hesitation in enlisting your interest in it. Over the last number of years the incidence of abortion shows a steady increase. In the Gynaecological Flat of our Belfast Union Infirmary, in which there are forty-seven beds, the number of our abortion cases in the year has increased from under four hundred (in 1926) to over one thousand. As one of the nursing sisters remarked to me a few days ago, abortion is certainly our "big line." This state of affairs to us at present engaged in a great war is one of considerable gravity; compare for a moment the loss in still-birth and neo-natal death. In 1939 in the Maternity Flat there were 1,508 births: 96 infants were stillborn ; there were 55 neo-natal deaths, a total of 151. The most frequent causes of still-births and neo-natal deaths were extreme prematurity-little removed from abortion, maternal toxawmia, malformations, and development defaults. From abortion in 1939 we had an immediate total loss of 1,020. Allowing for considerable further losses of children before they reach adult life, it is still evident that the greatest loss of potential citizens of the country occurs from abortion; a still-birth or neo-natal death is regarded as a major disaster; it should be realised that an abortion at the third month is not a detail to be scarcely worth mentioning, but has the same significance as a neo-natal death-the loss of a potential citizen. In this address I shall consider two types of abortion only 1. Those induced-the criminal abortion. 2. Those due to some pelvic or general pathology. The criminal abortion, that is an induced one, is diagnosed by direct evidence of injury-lacerations, perforations, or foreign bodies in the cervix, or by definite history of operation, interferenoe, or drug-taking. It is surprising how many of