Social Pathology of Foetal and Infant Loss

Abstract

Social class differences in fetal and infant mortality rates in Britain since 1951 are explored. In Scotland stillbirth rates neonatal and postneonatal death rates have fallen in all 5 recorded social classes from 1951-1962 but no tendency was observed for the rates to converge. When stillbirth rates in England Wales and Scotland are examined together there is no evidence of a decrease in class differences. Sociological studies showed wives of working-class men made their first antenatal clinic visit at a later stage of pregnancy then upper-class women made fewer visits and less frequently had their babies at a hospital or general practitioner unit. Working-class women tended to have larger families lived in more crowded conditions worked later into the pregnancy and were more apt to have conceived premaritally. Taller women had fewer stillbirths than medium height women who had fewer stillbirths than short women. This association between maternal stature and perinatal mortality holds true even when socioeconomic group and parity are controlled indicating the effect of maternal growth patterns on the outcome of pregnancy. When women are divided into social classes based on their fathers occupation the same relationship holds true. In addition women with more siblings have higher perinatal mortality. Continuing social class differences on stillbirths and infant mortality can be explained by a time lag theory of the expression of social improvements on improved health or by processes of social selection and social mobility.