Aspects of neonatal death in St Kilda, 1830-1930
Clegg, E.J.; Cross, J.F.
Journal of Biosocial Science 26(1): 97-106
1994
ISSN/ISBN: 0021-9320 PMID: 8200884 DOI: 10.1017/s002193200002109xDocument Number: 286988
Two researchers analyze vital event records and parish registers to identify determinants of neonatal mortality and the effect neonatal death had on family building during 1830-1930 in St. Kilda, the most remote island of the Outer Hebrides off the northwest coast of Scotland. Before 1892, more than 50% of the infants born on St. Kilda died from neonatal tetanus (8-day sickness). Even though various sponsors sent nurses to St. Kilda to introduce antiseptic delivery techniques, the islanders did not accept these techniques until the minister became a man-midwife. The total number of known births during the period was 176. 1891-1892 also experienced a major change in the distribution of neonatal deaths by birth order. Before 1892, neonatal death was more common among early and late birth orders, while, after 1892, birth order appeared not to be related to risk of early neonatal mortality. Neonatal death could be predicted rather reliably for the first birth, but not the second or third births. Age at marriage for first births, maternal age at birth and the number of previous neonatal deaths for all birth orders, and the preceding birth interval for fifth births were significant predictors of neonatal death. The date of the first birth, regardless of neonatal mortality levels, determined the first birth interval. As for later birth intervals, the neonatal death of the previous child was the leading determinant of neonatal death.