Perinatal Mortality Survey (1958)

NCDS has its origins in the Perinatal Mortality Survey. Sponsored by the National Birthday Trust Fund, this was designed to examine the social and obstetric factors associated with stillbirth and death in early infancy among the 17,000+ children born in Great Britain in that one week. It was the second in a series of four such perinatal studies, the others being based on a week's births in 1946 and 1970, and on births in selected wards in 2000/01. Each has formed the basis of a continuing longitudinal study.

The questionnaire used for the birth survey was designed to be completed by the midwife in attendance at delivery, with reference to all available records and after an interview with the mother. Information recorded included: social and family background, details of past obstetric history, antenatal care and abnormalities during pregnancy, length and abnormalities of labour, analgesia and anaesthesia as well as sex, weight, progress, management and outcome of the infant. This information was supplemented, in the case of stillbirths or neonatal deaths, with a clinical summary by the midwife and medical attendants.

Guidance was given by accompanying instruction sheets, supplemented by personal briefing meetings given by the survey team throughout the length and breadth of the country. Furthermore, with the help of the (then) Ministry of Health, Local Health Authorities, and Regional Hospital Boards, with their Advisory Committees in Obstetrics, Paediatrics and Pathology, details of the administration were circulated far and wide.

Facilities were arranged in each region for the survey director to meet personally those providing the maternity and newborn services. In this way maximum co-operation was attained. Without the help of the complex administrative network of the National Health Service the project would never have been possible. Questionnaires were distributed in advance to maternity departments by Regional Hospital Boards and the Boards of Governors of Teaching Hospitals, and to domiciliary midwives by Medical Officers of Health. This enabled them to be filled in as soon as possible after delivery, or after death in the case of neonatal deaths, by the midwives concerned. Sets of questionnaires were also distributed to departments (such as premature baby units) where babies were likely to be admitted or might die after birth.

The completed forms were checked by matrons, midwifery superintendents, or the supervisors of midwives and, finally, all completed forms were returned to the Medical Officer of Health for the County or County Borough area in which the births or perinatal deaths had taken place. Here the returns could be checked against the official notifications of births and deaths. Missing questionnaires were sought and any deficiencies rectified when the data was incomplete.