CONFIDENTIALQUESTIONNAIRE

SlIUAL N •. . .._---_._. ---

PERINATAL MORTALITY SURVEY

NATIONAL BIRTHDAY TRUST FUND

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S£Ut:oXli\s ~E. LG(.oXrA :DE~

INTRODUCTION

..9

1958 PERINATAL SURVEY (1 week) and

1958 PERINATAL SUaVEY (3 .onths deaths)

All births in the week 3-9th March 1958 were surveyed, and a

questionnaire co.pleted about the circumstances of the biith., and

the background of the parents. This sa.ple of births beca.e the

basis of the National Development Study (HCDS) , a data set which is

already deposited with the Archive. The infor.ation froa the birth

study (PMS) was aerged with the MCDS data at 7, in some instances in

derived variables for., but a substantial a.ount was not.

In addition since numbers of deaths in one week were too saal1

to study perinatal mortality, the same infor.ation was collected for

all perinatal deaths in the month March, April and May 1958.

A coding fraae is enclosed, together with a copy of the

questionnaire.

10

.c""~tJ\ r~-;t_ N':H~12~,

R

1--:..... 1' ....l' ... _, I~..... ....,,'--'-.. " \ .

'>:ATIO"lAL nIRT'lDAY TRLST PCRl"lA'TAL MORTALITY C;l/R\"EY

x

hospital as booked caseHospital as unbooked case (1ncluding

emergency)Domici~i.ry - Midwife bookedDomiciliary - Hidw1fe unbookedN.H.S. '!ater"lity Home (G.P unit ""here

there is no res1dent Medical OrriceI')Private Nur~1ng ~omePrivate ~ard of ~ H 5 hasp. talElsev~ere (speci£y, e g tayi, 5treet,

d.mbull!Ulce, et~ )'10 rhl r and Baby H"me

1 Gnd.r 20,. 20 - 24 year.6 2' - 29 •7 )0 - )4 •3 ), - )9 • • 119 ~o - 44 •0 4, vea.rs and ov@r

V

7

~o.th of Birth (Q ,)

1 Jrd to 9th ~rch inclusi'e2 February) March, other than Jrd to 9th4 April5 'lay

y

X

County and St~~1ard Rer10n - Col 1

~oth@rI5 ~ge (Q 8)

Code direct, 2 digit. (~~tual ~ge from code 1to code 4 on Col 5)

XX No inroroa 6 1nnAgo Gro~ • Col 9

o12

Place of Delivery tQ 6 )

In.structt0"15

O. North ~estern1. N'or'thern2 ~.st and Ve9t QjdlngsJ North h~dland4 Ea,9tern5 London ~nd South Eastern6 Southern7 South Western8 Wales9 Midla.ndsX Scotland

CODl~G rD[~TIF:CAT~Oh PA~TIClL~~S

9.10(Swm>ary C~7d

CoU 14,13)

i(Stu:'.cary Car

11(Summary Card

Col 16)

12

Marit~l Status (Q.9)

Y HarriedX Singloo Wido~ed. divorced, 3eparatod1 Stable union2 Tvlcc married9 No in£ormatlon

Sccto-Economic Group (~ 11)

71).

(Y Qvcrcode used)

Y1 Group 1 - FarmersY2 • 2 - Agricultural Workers.

) ) - Higher Adcinl!1tratlve, Professionaland Managerial

4 4 - Other Administrative, Pro:fsseionaland Managerial

5 • 5 - Shopkeepers6 6 - Clerical Worker.7. 7 - Shop AS!ll!1tan't!l8 • 8 - Personal Sorvice9 9 - Foremen0 10 - Skilled Vorkers1 11 Semi-skilled •2 12 - lm!lkl11ed •

Y) • 1) - Armed ForcesX Not known IL\-

(b1&nk) '0 husband \"5"

Social Class (Q 11)

Y Retired or not ~alnrully occupiedo No in£ormation on occupation but sick or

unemployed1 Group I2 Group II, Group III4 Group IV~ Group V8 Student"9 DQad or permanently a~ayX '.'at knovn

(blank) So husband(5 E Gr 8 fall~ into S C Groups 11, Ill, IV

&nd V)

SOCIO-ECONOMIC/SOCIAL CLASS GROUPS (Socio-Econom1C codes groupod by Social Cla~a Groups derived

tram codes an Col 12)

Social Class Group I -(5.E. Group J)

Social Class GroupII -(S.~ Groups 1.4,,)

Social Class GLoupIII-(S E. Group. 6,7.9,

10.1) )

ColHigher Admin.Professional andKanll.ierial

Farmers, Shopkeeper.Other AdaLn Pro-t.ssional, and"ianageria!

ForemonShop \saistantsClerical WorkersSkilled Work ereA.rmod Forces

12

)

n. 5

4

~,60

Y)

12

14, l'

- ) -Col. 12

Social Class Group IV - Agricultural(S.E. Groups 2, 11) Workers Y2

Semi-skilledWorkers 1

30cial Class Group V - Unskilled Workers2(S.E. Group 12) - Personal Service 8

Remainder X and blank

Husband's Age (Q.12)

Code direct, 2 digit~.XX. No information.

16.(Summary Card

Col. 40)

17, 18, 19.

20.

Mother's Weight (Q.19)

X. No information.Y. (Overpunch) 7 lbs or more with stones.6. 6 stone (or less) and below 7.7. 7 stone and bolow 8.8. 8 stone and below 9.9. 9 stone and belo'{ 10.O. 10 stor-~ and below 11.1. 11 stone and below 12.2. 12 stone and below 13.). I) stone and below 14.4. 14 stone and below 1'.,. l' stone and over.

Gestation Period J digits. (~.7,Q.20, Q.28)

XXX. No information of doubt.

Code in days from L.M.P, Refer to M.O. if anydoubts, off chart or if unreasonable byweight.

Gestation Groups of 7 day intervals punchedon Col. 57.

Place of Antenatal Care (Q. 2lb)

X. No information.1. Hospital or con2ultant only.2. Hospital or consultant plus other.J. L.H.A. alone or with lower.4. G.P. (surgery, nome or N. Home) only.,. G.P. plus midwifb,6. Midwife only.9. NONE.

•

3(

13

o1oJll. ... natal Vi~ ;;~ (q 21b) Total ~umb.rThi~ ha~ usua~ly ocen c'rrectly codod inlover 3qu~ro box 0n right of na1n block

X No ::Ln:forllla t iono ~ontl1 1 only2 2 onlyJ J - 44 5 - 9.5 10 - 1

26

- 5 -

PrLvious Prcm~tur~s (SIbs 802 or lcs~)(Q ~4)LIV:: BIRTHS

xo129

No l.nform.:l.tionPara 0 or no pr~vlous premature live births

) numb~r of previous prematureetc. ) live births9 or more

27.

28

Previous Large (8Ib 140z or more) (Q 24)LIVE OR STILLBIRTHS

X ~o Infor~ationo Para 0 or no previous large babies.1 ) number of pr~v1.ous large 11.v~ or2. etc ) stillbirths9 9 or moro

Total ~umbor of Previous St111blr~hs and~conatal D~aths (Q 24)(l.t week & 7 - 28)X ~o Lnformatlono Para 0 or no pr~vlous 5 B or ~ N.D1 ) number of prcVJ.ou3 5 B or2 etc.) ~ N D's9 9 or more

PrevJ.ous Toxaemia, A P H or Caesarean (Q 24)

x '10 Inf'ormationO. Para 0 or no previous toxaemia, A.P H or

Caeaarea.n

3* 1 Provious toxaemia only2 Provious A P H. onlyJ Previous C S on~y4 Previous toxaemia + A P H5 Prov:1.ou~ "toxaeu:.1a + C S.6 PreVl.OU9 \ P H • C s7 P-:-9Vl.OUS toxac:l:l1a, A ?H and C S

JO. J1(Su.mu::ary Card

Cola. 59.50)

J2

Height o~ ~oth~r (Q 23)

xx ~o informationCode in whole incha~N D 61i, 61t. 61t nIl ~ 61le not reeorded ~r measured by midwifeovereode Y on )1

Book1ns (~ 26b)

Y Domiciliary.X. Hasp! tal.O. NHS. Maternity Home1. Private Nursln« Home.2 Private wnrd of N.M S Hospltll.) Other place (~pec:1.~Y),7 rfot;her and Baby Home9 lio booking

15

)J D1a~tolic 9 P n~for~ 20 w~ak3 ~d risL tomaXl.mu_ ('l 29,J.).... OTE 0111 apIJ11 .... s if 8 P recorded before

20 .... (.("Ok!:!

X No ~n!or-c~l.on or no~ ~pplicablo1 Ll..sS than 9u2 90 or ~or(. with riso 1 .... 53 than 10J 90 or ~orL ~ith rise 10 or ~oreO. No toxacm~o. (fox Group r)y With toxac,i~ (All other Tax Groups)

TOXkSMIA GROUPS PUNCHED I~ COL 58

)4. ~a~1m~1 Diastol!c B P (1 29b)

x. No Lnformetion1 Less than 902 90 to 99J 100 to 1094. 110 and over

J. Protain prC8cnt, all other

no in£ectiorlni'l3ctionpresont

a.bc) (Chec-<i:lclamps:laprcs~nt)

Cl. )1scc 1.£

c s U. te.k.n.C 5 U. taken,

ECLAMPSIANo informationVat present~lbumln present,Albumin present,

''0Xo12

Albu~inuria and Eclampsia~ )2 to

)S

WITH ECLJ....-lPSU5 ~o l.nformatlan6 'Ilot present7 Present in C S.U • no infection8 C.S U I protein, and infec~~on present9 Protein pr~~Qnt, all other

)6 Blood Group (Q J4a)

X No informationo ~ot tasted and no recordY A PiS1. B pos2 A B poaJ 0 poa4 Not known ABO •• po~ •.'5 A neg6. B ne«.7 A B. neg8 0 neg9 ~ot known h B 0 , ncg

)7 Haomoglobin (Q )5~)X 10 1nformntiono Not testod. .,1 60';:, - 69',. 19 to 10 4 gram~)2 Undor 60~ Undor 9 gra~s)9 70~ or ov~r (10' gr8m~ or over)

16

)8

)9(Summary Card

Col 49)

X-nay (Q Jb)

X "0 jnform~tiono ~o X- ray1 Chest only2 Chu~t ~lld ~b~om2n~1J thl.st 'lnci P~lvilr_try4 Chc.st, \.;dom nal and Pl.lvim~try5 Abdomin~l only6 I\bdominal an'l Pc.lVLmetrv7 Pclvin~try c~ly

Obstetric and ~r~nancy Abnorr~litie~ (Q 37)

Note that th~5C arc. eompli~cntnry with col. qO

Di3proportion nay noed bringing forward frOmnext po:l.ge

Y (Overcode) 1£ more than one abnormalityX No informat~ono No abnormality listed in 371 Dt&bctc~2 llo-artJ Active T B4 InfluenzaS German ~ea51e56 Disproportion, suspect or proven7 External ~~r5ion8 Epilepsy9 Other 1ncluding - V R Pas • anaemia admittQ~

for treatment where Hb b~lov 60~. Hydramn1c5Pyelitis. P ID. Chicken pox, Hyperemesisadmitted, cte

40(Summary Card

Col 50)

xo

1

2)

45678

Blccd1n in Pre nanc and Before Delviery37 'ate question 7 in labour for intra-

partum haQmorrha«eNote link w~th vaginal b eoding before28 weeks~ osp~c1ally codes 0 and 8

No inf'ormationVO bleeding I or J~ PH, of any sort .!.D1 no nofrom. column J9Accidental A P H (placenta praevia ~~cluded)onlyPlacenta Pr&cvia onlyAll other un~peciried A P H includingintrapartum haemorrhage, from Q ~7 only.Accidental + vaginal pro 28PlnC~L·~ ~r&cvia + vaginal pre 28Unspec A P.H + v~gin~l pre 28Va~inal bleeding pru 28 onlyVc A P H or vaginal bleeding but J9 positive

Includes vurs~glabour. raIse

'~l •

fa\

Admission to Hospital (Q )8a)Home but ~xcludes ~dmlss1on vlthlabour, or ruptu.ed ~Mbr~cs

X No infornl:l t iono No ad!:llss:1on1 ~dm~ssion for tox~cmia2 ~doission for other than toxr~Mla) \dlfl!saion for to"("\",nl1n and othor .. 17

'4-(

~2.

4J.

44.

Differs here from 4J.

- tl -

e of Labour or Delive Adcission (~. J9)Chock with 1 time of stagos and membranesand induction etc.

Y. Not ~dmitted ~uring labour.X. Admitt~d ~uring labour as booked case.O. Admittod during labour as emergency.1. Booked ~t n hospital but admitted to

another bocause of holiday etc. i.e. Dotto b~ rega~dec a3 emergency.

Duration est St~ge (~.41)

HOURSNote code 8.

X. No information.O. No first stage (elect. C.S.)1. Under J.2. J and under 6.J. 6 and under 12.4. 12 and under 24.5. 24 and under 48.6. 48 and under 72.7. 72 and over.8. III defined.

Duration 2nd Stage (Q. 41)MINUTES

X. No information.O. No secor..d stage (some vaginal, some C. S. )1. Undar JO.2. JO - under 60.J. 60 - under 90.4. 90 - under 120.5. 120 - under 150.6. 150 - under 180.7. 180 - under 210.8. 210 - unde::, 240.9. 240 or over.

Duration Membranes Ruptured (Q. 42)HOURS

X. No informa.ion.O. Not ruptured pre delivery.1. Under J hours.2. J - under 6.J. 6 - u~der 12.4. 12 - under 24.,. 24 - under 48.6. 48 - under 72.7. 72 - 1:""l.der 120_.8. 120- under 168.9. 168 and over (7 days).

18

(sucunary CardCol. 66)

.J.lluu'"'''l.un \ ,. ~JO}

Ch~ck th~t the patient was not in labour.

C~lccl: ..... 1~~1 'icr orr_~cs RL.ptur..:d tiMe.

(a.B.E. ~~~n failed not count~d).

X.a.l.2.J.'L5.6.7.8.9.y

No 1nfol"'ctDCio •~o ln~uctlon ~s specifl.ed below.axytocl~ but nO surgical.~ow Surgical ) ThescHieh Surglcal ~ ~{1 t:'lOl tD.K. s~rg_~al I axytccir.O.B.E. oe~~rc~en or C:1P only.Low surg~cal. ) TheseHl.gh 31.rg:!.-::o.l) \(l. thD·K. 3urgl.cal) axyt)cina.B.E./oectrogene or strlp.axytocin =U labour only.

X. No ~nfer~at10n.a. Vertex a.T. '/hen so spec. (D.T.A.).1. Vertex a.h.2. Vertex a.p.J. Breech.4. Shoulder.5. F~ce.6. Brow.7. Vertex + hand.

De11very Gr~~ (~. 46)

x. No infor~atlon.48.(Summary Card

Col. 52)

~EC.ot>ED

'a4< •al.1:X;.lY.l.

~2X.

,2.JX.

J.'4x.. _4.

5.6.7.

8j..

No tra~ned person prC5tn~ - breech.No tra nad person present - otherSpo~tancous - Vertex a.p.

" - Face and Brow- Vertex a.A. and Hand.

Forceps - Face and Brow.n _ Vertex ,A. and Hand.

Ceesaraan Sect10ns - elcct1ve11 ft _ LJ. Labour.

Breech - Spontaneous" - Assisted or Extracted.

Internal Verslon.DestructJ.ve.Laparo-=om~r•Sponta,eous Shoulders.

49.(SuI!llDary Card

Col. £J)

Indicatl.on (Q. 46a)X. No ln~ormatl0n.a. No abnormallty.1. Cord prcsen.at- jn or prolapse2. Heconlum. •J. Foetal Heart.4. Mecvnl.u~ and foetal heart.5. Other reason.

• 19

JV.

51.

J.lU1UJ. .. t;10nal J'1lalge~ia (Volatile) (Q. 48a).

X. No information.O. Not available.1. Ga~ and air only.2. Trilene only.J. Gas and air and Trilene.4. Ga~ and oxygen.5. No indication for analgesia.6. Contraindication, e.g. asthma, T.B., foetal

distress.7. No til!le.8. Refu~ed.

nnalgesic Drugs (Q. 49a). Single Entry.

X. No information.O. No drugs listed ~n this column.1. Pethidene (demerol), Peth1lorfan.2. Opiate (not peth.), Morph1ne, Omnopon, Heroin.J. Both peth1dene and opiate.4. Other analgesic or hypnotic, c.g. Chloral,

barbiturate, Not Atrop1nc.

52. Listed Drugs (Q. 49U). Multiple - add Y ifmore than one drug. Analgesic and Hypnotic.

X. No information.O. No drugs of this type.1. Chloral, Welldorm.2. Barbiturate.J. Heroin.4. Largactil (chlorpomazine).5. Sparine (promazine).6. Phenargan (promethaZine).7. Doriden.8. Oblivon.9. Other.

Anaesthotic (Q. 50). Check that this is forDELIVERY and not for Romovel of Placenta or Repa1r

53.(Summary Card

Col, 54)

10Y. Nono.X. Goneral.O. Spinal,1. Local.2. Pudendal Block.9. No information.

4 '1.5.6.7.8.

Same as codes Y-2 whong1v0n for E.U.A. up to2 hours before delivery

54. Delivored by (q. 51)O. No trained person (e.g. B.B.A., Pol..c oman et c. )

\ \ 1, Midwife.2. Consultant Obstetrician.3. Registrar.4. Hospital M.O.5. G.P.6. Medical Student. 207. Pupil Midwife.8. Other.

Delivery-Supervision Group~ punched in Col. 79.

\0 I

\')..

56(Su.:lmar / Card

Col 55)

\3

S~nlor Pcr~on PT~scnt ~t D~livcry (~ 51)Gnu b,~ ,Jo.lr.;~ "'.9 3~ For doubt.ful athors plcas,-u3k Cou£ 1n t~~s ord~r of prcf~rcncc -

2 Lon..Jul ta.n::J H.:,~l..:3 traT4 1I09pito.l 0 (nny nn

58 TOXacrlia Group~ (cont~ )

Xb Lnclasslfied 7oxav;:da - prot, inuri..l. -non C 5 U

X7 t'ncl... l'5S1.1._d protc.lnur1.3x8 Ecl~rrpsl.iJ.},.9 It... 'a.l.nu .... r

59 55)

.l..thDrug~

(sJ.nr1e ... ~ thoutLntry) Drugs

(Coraml.nc. lobe-line, Ynnd1d,lcthidronc)

\~

51

X No 1nforr~t10no No r~susc .. tatlon or only pl~in or na~~l

o

- I) -

COLm4NS 61-65 and 68-74 .~E USEP FOR DEATHS

6).(Summary Card

Col. 56)

64.(Su=ary Card

Col. 57)

65.

l.. ...68.(Summary Card

Col. 77)

Time of Death

O. S.D. 1.ac. ove::- 24 l">rs pre labour (ante-partum) .

1. S.B. 'I3.C. perJ.partum. (Intrapartum).2. S. B. 1'1

70.

Sveondary Causes er DeathUce Y for overeode if wultiple.

onF,enit~l abnornality.No. r lesion.

1. Trau!...·a.2. Trau;:Ja + ASphYxr-a-.-_______J. Asphyxia. _________4. Pn"Ui:lon:la. ________5. Rhc 5 us. __________6. Hyaline ~enbrane. ---__7. Na.;sivc Pu:;'mo:lary Haeoorrhage.8. LV.H.9. M:lscellanaous.- (blank) No P.~.

71.

X. Not exar.:ln3d.Y. Gros~ inQaturity &S only lesion.

---O.--NQ_ h:l:3 tolog:l.eal les ion.1. Hyil1na-liembrane.2. MaS6:l.Ve Pulbon~ Haemorrhage.J. Resorpt:lon atelec~asis.4. R&sorpt:lon atelectasis -:-I.P.~~.5. Eaeoorrhag:lc PneuDonia.6. Bronchopneuoon:la.7. Intr :terine Pneu~on:la.8. I.P.rt. Mecon:lu~ Aspiration.9. I.P.A. other.

Other Lung H:lstology (Micro.)Use Y for overcode :If multiple.

X. Not 2xao:lned.O. No lesion.1. Hyaline Meobrane.2. Mass:lve H8.emorrhag~.J. Scanty HaeDorrhagc.4. Intcrst:ltial Haenorrhage.5. Pul~onary oedema.6. Inhalat:lon of Deconiuo!dobris.7. Pneuoonia. •8. EI:lph}'sema.9. Gross lcoaturity.

~-

-~---------

72. M:lsccllaneous PathologyY (overcodc) only codes 1 - 4 Day be multiple.

X. Diagnosis uncertain.O. N:l1.1. Pneuoothorax.2. Eophysana.J. HaecoperitoneuI:l.4. lle"onlUD aspiration.5. C ••6. RhGsus.7. Asphyxia-Trau~a.8. No cause found.9. C~reb~o-Respiratory. 24

7J· Plac'.ntal '.Ioight

X. ~ot t'/I:~ 1~hert.Y. Loss tho.n 250 g:J.o. 250 - 299 Gm.

4\ 1. JOO - J49 go.2. J50 - 399 r;r.J. 400 - 4 119 gr-I.4 . 450 - 499 go.5. 500 - )49 gn.6. 550 - '::;99 gm.7. 600 - 649 gn.8. 650 - 699 g.,.9. 700 ..

74. Plac~ntal Patholo7V

WithoutHistology

1

1'li th

Histology

X. Not cxar;u.n",d.Y. Nor~al ~acro. and ~icro.o. Norn31 n~cr~. not eX&~1n~d ~1cro.1. hll chorlonltls.2. Retroplacental H'go onlyJ. Retroplac. + lnfa~ctlon4. Infarctl0n5. Other abnoroallty.6. Retroplacental H'ge only7. Rctrop1ac. + lnfarctlon8. Infarctl0n9. Other abnor~o.lity.

75, 76, 77. Welght of Baby in Ounces - 3 Cols. (Q. 54)(Sumnary Care'

Cols 74 75 76) Actual wel~ht In ounces. 4~ - 4-5. , . ~

75.(Summary Card

Col. 74)

XXX. No infor::Jation.XOX. EstJ.Gatud welght over 51b. 8oz.

(2500 graos + ) •XXO. Estl0ated weight 51b 8,:;z. or less.

(Under 2500 graos) •

Blrth 1, .:>ight GroupsD\ 3. Under 1000 gro,:;Js Under 036 ouncesDc 4. 1000- 1499 " OJ6 - 052 "" : 5. 1500- 1999 OD - 070' "~ _ 6. 2000- 21199 071 - 088 "

7. 2500 - 2999 r8? - 105 " 4-

10. Re!ponsibility Groups

only.+ otl.•not

Y3.

Y6.Y7.

Xl. llospital Booked le Doliverod - J.NC Hospito.J.X2. _ ANC HospitalX). _ ANC Other or

known otc.Y4. Dooicili~ry Booked & Delivered - ANC Hosp1tal

+ Other.- ;:NC L.H.A.

~",l one, or 'W'1 tlLower.

- ,-.NC G. P. only.-. ~ Midwife '"

G.P.- No ANC or not

known etc.01. Dor:1l.ci11ary Bool:ud, Hosp1t!l.1 Deliv"red.02. N.R.S. Uat~r~1ty Homo Booked and Delivered.0). N.R.S. ~at"rn1ty Hone Booked, Hospital Delivc=:~04. Pr1vat~ Nurs1ng Hone Booked and Delivered.05. Unbooked, Hospital Delivered.06. Unbooked, Dooic1l1ary De11vered.07. Residue - Hospital Delivered.08. Res1due - rOoic1liary Delivered.09. Residue - G.P. Un1t Delivered.

O. Reoainder.

79. Delivery-Supervision Groups

O.1.

2.

J.

4.5.

6.

7.8.9.

X.

Y.

No tra1ned person present.Delivered by Consultant Obstetrician orReg1strar.

Delivered by Hospital M.O.: Supervised byConsultant Obstetrician or Registrar.

Delivered by Hospital M.O.: Other or noSupervision.

Delivered by G.P.Delivered by Midw1fe: Supervised by ConsultantObstetrician or Registrar.

Delivered by M1dwife: Supervised by HospitalM.O.

Delivered by Midwife: Suporvised by G.P.Delivered by Midwife: No supervision.Delivered by Pupil Midw1fe or Medical Student:Supervised by Midwife.

Delivered by Pupil Midwife or Medical Student:Supervised by Doctor.

Delivered by Pup1l Midw1fe or Medical Student:•no supervi51on.

26Asphyxia.prior to labour Mac. SB. •in labour - first stage Fresh SB.in .~bour - second stage Fresh SB.1n labour - ~acerated.

1. Congen1tal Malfornation.2. Stillbirth prior to laboU1, no cuase found

despite histology.J. Stillbirth in labour, no cause found despite

histology.Trauoa.Trauna +AsphyxiaAsphyxiaA.5phyxiaA.sphyxiaRhesus.

: I" /

4.5.6.7.8.~.

X".

Causes of Death Categor1es - Stillbirths30.(Summary Card

Col. 78)

80.

- 17 -

Causes of Death Catcgor1es (Contd.)

X2. Stillb1rth in labour, no h1Stology.X3. Macerated stillbirth prior to labour, No P.M.X4. Stillbirth in labour, no P.M.

Causes of Death Categor1es - Neonatal Deaths

X5. Congen1tal Malforcation.x6. Infections other than pneuconia.X7. Atel~ctas1s only wi~h histology.X8. No cause found desp1te H1stology.X9. Traul.Ja.yJt. Trauoa + J-~sphyxia.Tl. .!t.sphyxia.Y2. Pncunonia.Y3. Rhesus.Y4. Hyalino Heobrane.Y5. Hass1ve puloonary haeoorrhage.Y6. Intraventricular haecorrhage.Y7. M1scellaneous neonatal death.Y8. Residue neonatal deaths, nO histology.Y9. Res1due neonatal deaths, no postoortem.

~\V ~\~L.. "" \Jt-\M:QS~TlI!:R

B

NATIONAL DIRTHDAY TRUST PERINATAL MORTALITY COURVEY

Mother's Ase (Q 8)

~onth oC Birth (Q 7)

County a~d St~~1~rd Region - Col 1

Instruct1.0"15

1. Jrd to 9~h March inc1usive2. February.J. March. other than Jrd to 9tb4. April •.5. Hay.

Place oC Delivery (Q.6 )

Scri~l Numb~T (top right)

Y Hospital as booked caseX Hospital as unbooked case (1ncluding

emergency)o Domiciliary - Hidvl£e booked1. Domiciliary - HldviCe unbooked2. N H.S. Maternity Home (G.P Unit where

there is no resident Hed1cal Officer),. Private NurSLnK Home4 Private ward DC N.H.S. hospital5. El.evhere (_peei£y••. g taxi, etreet,

aMbUlance. etc.),7 ~other and Baby Home

o North Western1 Northern.2 Zast and Vest ~id1n~3J North ~ddland4 EfL9tern5 London and South Eastern6 Southern7 South Western8. Wales9 MidlandsX Scotland

CODI~L IDCVTIF:CATION PAaTlrt~ArlS

l. Under 205. 20 - 24 year.6 25 - 29 •\'::f- 7. 30 - 34 •8. 35 - 39 •9 40 44 • • 28o. 45 y.ars and over

Code d1r.c~. 2 digit. (actual age from code 1 X\"-_' ':= ~i!:~t~o~C~05d~.t4p;0;;.nilic;o;;.1'!1""••9_) _.- 1J! 1~. Ho ~o4~~ion

AgO SloUpS Cbi. 9

\"a

8(Summary Card

Col. 13)

9.10(S..........,. Card

Co.!.•• 14.13)

C'olul"Ul No

i(Swr..J::l.ary Card

Col 12)

1 - 6

11.eSUllLIJary Card

Col 16)

12.

Har1t~1 Status (Q 9)

Y liarrJiIldX Sln«10o Yidoved, divorced, .eparatod1 Stabl" union.2 Twice married9 No 1nrormation

Sccia-Economic Group (~.ll)

(Y ovorcode used)

01 Tl Group 1 _ Farmers~1LY2 " 2 - Agricultural Workers.()~ ) J - Higher Adcinl~tratlve. ProfessionalalL and Managerial-ir 4 4 - Other Administrative, ProCe.sional

iand Kana«erial

65 " 5 - Shopkeepers

6 - Clerical Workers7. " 7 - Shop As.slstantl!!l8 8 - Personal Sorvice.9 9 - Foremen

i0 "10 - Skilled Workers

'1 11 _ Semi-.kl11ed n\: 2 12 - Unsk111 ed

YJ 1) - Armed Forces, ~_ Not known

(blank) No husband

1)

~\

Social Clase (Q 11)

Y Retired or not «a1nfully occupiedo No inrormation on oeeupation but .sick or

unemployed1. Group :I2 Group 1.:1, Group III4 Group IV5 Group V8 Students9. Dead or perman.ntly awayX Hot known

(blank) No husband.(S.E Or 8 ~alls 1n~o 5 C. Groups II, III. IV

and V).

SOCIO-ECONOKIC/SOClAL CLASS GROUPS (Soo1o-Economic cod•• SToupod by Social CIa.. Group. d.r~v.d

~ro. cod•• on Col 12)

Soc!al Claas Group I -(S E. Group )

Hisher Ad.mi.nProfessionalK&nacerial

and

Col. 12

)

Social Cl••• GroupIXI-(5.£. Group. 6.7.9.

10,1)

Social Clas. GroupII(S ~. Groups 1,4,5)

- Farmer•• Shopkeeper.Other Admin. Pro-~e ••1onal. andKa.na se;lal

For••onShop A••istantsClerical WorkersSkilled Vorker.Araod Force.

TI, 5

4

976 •o

YJ

29

14. 15

- ) -Col. 12

Social Class Group IV - Agricultural(S.E. Groups 2. 11) Workers Y2

Semi-skilledWorkers 1

30cial Class Group V - Unskilled Workers2(S.E. Group 12) - Personal Service 8

Remainder X and blank

Husband's Age (Q.12)

Code direct, 2 digit~.XX. No information.

16.(Summary Card

Col. 40)

17. 18, 19.

~b-2.r

20.

Mother's Weight (Q.19)

X. No information.Y. (Overpunch) 7 lbs or more with stones.6. 6 stone (or less) and below 7.7. 7 stone an~ below 8.8. 8 stone and below 9.9. 9 stone and belo~ 10.O. 10 stor.s and below 11.1. 11 stone and below 12.~. 12 stone and below 1).). 1) stone and below 14.4. 14 stone and below 15.5. 15 stone and over.

Gestation Period ) digits. (~.7,Q.20. Q.28)

XXX. No information of doubt.Code ~ days from L.M.P. Refer to M.O. i~ any

doubts, off chart or if unreasonable byweight.

Gestation Groups of 7 day ~tervals punchedon Col. 57.

Place of Antenatal Care (Q. 2lb)

X. No ~formation.1. Hospital or con~ultant only.2. Hospital or consultant plus other.). L.H.A. alone or with lower.4. G.P. (surgery, home or N. Home) only.5. G.P. plus midwi~,6. Midwife only.9. NONE. • 30

'Yltunat81 Vi:!l·.u (Q 21b) To'tal Number.This ha~ usua~ly bean c~rr.ctly coded 1nlower ~quaro bOE on right oC mnin block

:io

X No informationo None1 1 only2 :2 only). ) - 44 ~ - 95 10 - l~6. 1~ - 197 20 - 2'~8 25 - 299 JO or mor ...

22.(Summary cQ.rd

Col 41)

'SI

Smoking Pr10r t, Pregnan~ (Q 23)

X No inrorr-~tiono Non ~moker, less than onc2. 1 - 4 da~ly. constantly) ~ - 94 10 - 14~ 1~ - 196 20 - 247. 25 - 29.8 30 or me e

2)(S\UImlary Card

Col ,0)

Smoking in ?re~.ancy (Q 2)a)

X No inror Rtiono No change by 5 months1 Now non smolcer. belo.... 12. 1 - 4 no", }J .5 - 9 ~ Tb!_ part la4 10 - 14 same code ••.5 1.5 - 19 I 22 above.6 20 - 247 2~ - 298 '0 or mero )9 Variable .~t.r 5 months

history atfactor.

1nt'oT'U'atlonprevious presnanciee a~ter 28 week.

and. over.

NoNo12)4,6789

xol.2.J.4.,6.789.

For 24, 2.5. 26, 27. and 28 note that & previousmultiple pregnanele. counts as one unit ror any

24. Parity (Q 24~(Summary Card.

Col. 46)

Abortions (q 24)

X No in~oraation.o No provious stillbirths1 ) nUi:'ber oC orov1 n1l"

U-I

~or ectopico",h ... ,...,. ......

31

26

- 5 -

Frovious Prcm~tur~s (,lhs 80% or lcas)(Q 24)LIV~ BIRTHS

X No inCormationO. Para 0 or no pr~vlous premature livo births1 l numhur of previous pro mature2 etc. live births9 9 or more

27 Previous Large (81b 1401: or mOTe) (Cl 24)LIVE OR STILLBIRTHS

X No inl'ormat!on

sfc,o. Para 0 or no previous large babiesl. ) number of pr~viou5 large livu or2. etc ) stillbirths9 9 or mora

28

2Q

)0, )1(SWlm:ary Card

Cob. 59.50)

Total Number o~ Previous Stillbirths and~conatal Deaths (Q 24)(1st week & 7 - 28)x. No ~ormatlono Para 0 or no previous 5 B. or M.N.D.1 l number o-r prcv10us 5 B or2 etc. N N.D'a.9 9 or .ore

Pr.V~OU8 Toxaemia, A.P.H •. or Caesarean (Q 24)

X Ho informationo Para 0 or no prevloua toxaemia, A.P.B. or

Caeaare&n1. Provious toxa.mia o~y2 Previous A.P,R. only) Previous C 5 only4 Provious toxaemia + A P.H.~. Provious toxaemia + C.S.6 Previous d.P.H. + c.s.7. Previoue toxaemia, A.P.B. and C.S.

Be~ght of Moth~r (Q.2S)

XX. No intormationCode in whole inches.N.D 61,. 61t. 61t all ~ 61.It not recorded ?r ~eaeurod by midwifeovereode Y on )1

)2. Book1n" (Q.26b)

Y. Domiciliary.X. JIoepitalO. N H.S. Katernity Hom.. ~1 Private Kursins Hom••2 Private ward ot M.R.S. Ho.pita1.). Othor place (specity).7 Hother and Baby Ho.e.9. Ho bODkin«

32

- 6 -

JJ Diestoli~ e p no fore 20 vcaks ~d risu toll'1t1.x1mu_ (!.t. 290)NOTE onlf appll(.~ if B P recorded before

20 wc('k~

X No infor=~tion or not cpplic3blo.1 L(,.S8 than 902 90 or ~orc with rise l~ss than 10.J 90 or ~oro with rise 10 or ~or••o No toxacm~a (Tax Group I)y Vith toxae~i& (All other Tax. Groups)

TOXJ...EMIA GROl7S PU~CKED 1'1 COL. 58

J4. Maxlmu.,) Diastolic B P (1 29b)

X No informetion1. Less than 902 90 to 99J 100 to 1094. 110 and over.

t&ken, no inrectlortaken, In~actlon

pro.ont

(=l. J1 abo) (Che«scc ie ~clampsla

prc!lent)

C.S.u.C.S.U

ECLAMPSIANo informationNot presentAlbum~ present,AlbumLD present,

Albu~inuria and EclampsiaQ.)2 toNO

x.o12

J5

J. Protein present, all other.

WITH ECu"iPSIA.S. No inrormatlon6. Not present7 Present LD C.S.U., DO infection.8 C.S.u., protein. and infect~on present9 ProteLn pra.ent. all other.

J6 Blood Group (Q. 34a)X No in£ormnt1ono. No~ toeted and no record.T A p~.1. B po.2. A.B. po••J. 0 pas.4. Not known ~.B.O•• pas.~. A. ft_&,6. B ne«.7. A.B. nee8. 0 n_ ..9. Not known ~.B.O•• no«

J7 Haomoslobin (Q )'~).x. '~o in.1"oreat1ono Not testod1. 6~~ _ 69'.. (9 to 10 r. «rams)2 Undor 6~ (Under 9 grams)9 7~ or over {lO 5 crame or

•over}

33

J7140

)8

)9.(Summary Card

~~49)

5"0

~}lt'i""I

40(SWlUDAry Card

Col. 50)

x.nay (Q J6)X ~o informationo lJo X- ro.y1 Chc!it only2 Cho~t and ~bdominal). t.hU3't and Pelvimr.try4 Chc~t. Ahdom nat and PLlvime'trY5 Abdomin~l only6 Abdominal ilnd PLlv~motry7 Pclvirn~try only

Ob5tctric and rr~nancy ~bnor~nlitle~ (Q

Note that these ar~ eompliccnt.ry with col

Di~proportion oay need bringing rorvard fromnext po.go

Y (Overcode) if more than ona abnormalityX No informationo No abnormality listed in 371 Diabetes2 Hl.artJ Active T B4 Inf'lucnza5. German Hea:51e~6 D~3proportion, suspect or proven7 External vorsion8 Epilepsy9 Other ~ncludin« - Y R Pas. anaomia admittc~

for treatment whero Hb b~lov 6o~. Hydramn1csPyelitis. P I D.• Chicken pox, Hyperemesisadmitted, ete

Bleeding in Pregnancy and DQ~ore DelvieryJ7} ~ question 47 in labour Cor intra-

partum haemorrha«_Note link with vaginal b:9Qd~& borore~eelu~ espocially code. 0 and 8.

X No inrorma~lon.o No bleeding, or ,~ P.H , of' a.ny sort .!!if! nono

f"rom column J9I Accidental A P.H (placenta praevia excluded)

only2 Placenta Praevia only.). All other unspeci~ied A P H includin«

intrapartum haemorrha«_, Cram Q 47 o~y.4 Accidental + vasinal pra 28, Plnc~~·~ pr.ov!a + va«inal pre 286 Unspec A.P H + vaS1nal pr. 287 VasLnQl bl.edln« pra 28 only.8 ~o A P H or vnSlnal bleedLng but J9 positivQ.

1Dclud.. Nur.~labour. tal.e

'~l. Admission to Ho~pital (Q )83)Homo but ~%eludes ~dmlssion withlabour, or ruptured ~mbrnno.

X. No inrorm~tionO. No C1dl:1is.10n1 Admission tor to%~cm!Q2. _dmission f"or other than toxn~mia.~) \d.ls.1on tor toxn~miQ Bnd othor

34

, 42.

43.

- l:l -

e or Labour or Delive Ad~ission (~. 39)Chock with 1 timo of stagos and ~embranesand induction etc.

Y. Not admittod ~uring labour.X. Admitt~d ~uring labour as booked case.O. Admittod during labour as emergency.1. Booked at n hospital but admitted to

anoth~r bocause of holiday etc. i.e. notto be roga~dec uS emergency.

Duration 1st St~~ (~.41)

HOURSNote codo 8.

X. No information.O. No first stage (elect. C.S.)1. Under).2. 3 and under 6.3. 6 and under 12.4. 12 and under 24.5. 24 and under 48.6. 48 and under 72.7. 72 and over.8. III defined.

44. Duration 2nd Stage (Q. 41)MINUTES

X. No information.O. No second stage (some vaginal, some C. S. )1. Undar )0.2. )0 - under 60.3. 60 - under 90.

foG, 4. 90 - under 120.5. 120 - under 150.6. 150 - under 180.7. 180 - under 210.8. 210 - unde=- 240.9. 240 or over.

Duration Membranes Ruptured (Q. 42)HOURS

•

"

Dirrera here from 43.

X. No informa~ion.O. Not ruptured pre delivery.1. Under 3 hours.2. 3 - under 6.3. 6 - Q~der 12.4. 12 - under 24.~. 24 - undor 48.6. 48 - under 72.7. 72 - ~·""lder 120 ...8. 120- under 168.9. 168 and over (7 days).

• 35

(Sul:llllary CardCol. 66) Ch~ck that the patient was not in labour.

Ch.::..cl-:. '\011 ~oll 'lcr or

, -

. , X. No inforcation.O. Not availabl~.1. Gas and air only.2. Trilcne only.3. Gas and air and Trilene.4. Gas and oxygen.5. No indication for analgosia.6. Contraindication, e.g. asthma, T.B., foetal

distress.7. No til!le.8. Refused.

51. hnalgesic Drugs (Q. 49a). Single Entry.

X. No information.O. No drugs listed in this column.1. Pcthidene (dcmerol), Pethilorfan.2. Opiate (not path.), Morphine, Omnopon, Heroin.3. Both pcthidene and opiate.4. Other analgesic or hypnotic, e.g. Chloral,

barbiturate. Not Atropine.

52. Listed Drugs (Q. 49a). Multiplemore than one drug. Analgesic

X. No information.O. No drugs of this type.1. Chloral, Welldorm.2. Barbiturate.3. Heroin.4. Largactil (chlorpomazine).

- add Y ifand Hypnotic.

Anaesthotic (Q. 50). Check that this is forDELIVERY and not for Removal of Placenta or Reps1r

53.(Summary Card

Col. 54) Y. None.X. General.O. Spinal.1. Local.2. Pudendal Block.9. No information.

4.\5.6.7.8.

Same as codes Y-2 whongiven ~or E.U.A. up to2 hours before delivery

Delivered by (Q. 51)

37•

O. No trained person (e.g. B.B.A., Pol~coman etc.)1. Midwife.2. Consultant Obstetrician.3. Rogistrar.4. Hospital M.O.5. G.P.6. Medical Student.7. Pupil Midwife.8. Other.Delivery-Supervision Groups punched in Col. 79.

IQI

55

56(Sul:Ul1ar; Card

Col 55)

57(Summary Card

Col 61)

58(SulllJaary Card

Col. 70)

Senior Person Pro.cnt ut Dolivery (~ 51)Cnn b~ 3~~e ~s 54 For doubtful othors plQas~Q3k Code In th~8 ordor of preferonce -

2 Con.,Ju 1 tan tJ Hee~strar4 Hospito.l d 0 (any anu.:'3th,)t.1.st)5 G I'1 l>Ii~wir(.6 kodical ~tud~nt7 Pup11 Hid.i£co No trained

~ (~ 5))

X 'lot kno ....n1 1-L~Lr::2 FE>

58 Toxaoclia Group~ (contd )

X6 Uncln~51fled 7ox8~~ia - proteinuria -non C 5 U

X7 Unclu~5if~~d proteinuriaXB Ecl.c.lI'",p~ laX9 Ih.::la 1nd... r

59 R.SU5C1t~t10~ (~ 55 )

(lunrle ....:lthoutl".ntry) Drug~

(Coraminc, lobQ-line. vandld,lcthidrono)

W,1.thDrugs

X No 1nforr~tiono No r~3usc~tatlon or only plain or nas~l

oxygu~ or incubator1 Intragastric oxygen2 Endltrachoal oxygenJ 1 + 2~ Mouth to rlouth5 None or plain oxygenG Intragastr1c7 Endotrnc"leal8 1 + 29 ~outh to couth

'10 inCarnationNo drug:iCoraninc (nikethamido)Loboline and othor sticulantsSedativesAntagonl~t5. l~thidron~. nnlorphino,

l~vl!I.lor:fan

Synkavi~. Vika.~ab.

Sulphonacide.PenicillinStreptomycinOthor an~ib~otlcs, t~rramyc1n. aureomycin,tetracycl1ne. erythrornyeLn. novobiocin

61

~D~ru~g~.~~t~o-!8~a~b~y (Q 56) Either for resu3cltation~, or la tar {'lul tiple - add Y if' more than onc

drug)

~~ ~£i~~4

U5~;31 83)..9

Baby Illness (n 59) Chock it tran.torred t'orMEDICAL reasons

xoy

V1~hout 2Transt'er J.

456

Vi th 7.'l'ranst'or 8

9.

No i.nl'oTIII&tlon.Ko disoase or tran.t'~r (oedieal)Hacmoly~ic disea••R~spiratory or cerebralOther inrectlonsOther conditionsHncmolyt le.HaonorrhaglcRcsplra~ory or cerebralO~her 1ntoctionsOther eonditlons~

•62. Month or Doath (Q 60)

n Survivor (liJ~birth. lived)3 died in March4 di..:Jd in ....pril 39

- 13 -

COLm4~S 63-65 and 68-74 f~E USEP FOR DEATHS

6J.(Summary Card

Col. 56)

Time of Death

O. S.B. flae. over 24 prs pre labour (anto-partum) •

1. S.B. 113.c. peripartu!il. (Intrapartum).2. S.B. Ma~. d.k. when died (unspecified).J. S.D. FRESH - 1st stago.4. S.B. FRESH - death in 2nd stago.6. N.N.D. unGar JO mins.7. N.N.D. 1st week (undur 7 days).8. N.N.D. 7 days but under 28 days (2nd to

4th week).

Cause of .3ath Groups punchod in Col. 80.

64. Age at Death(Su=ary Card X. 1tG jnfprnati p S.B.Col. 57) Y. Under JO mins.

O. Over JO mins, under 1 day.1. 1 day and ovor, and under 2 days.2. 2 JJ. J 4

36 4. 4 55. 5 66. 6 77. 7 108. 10 149. 14 28

P.~. Classification

O. No P.M.1. P.M. done, macro. report only.2. P.M. done, ~acro. + micro.6. Re-assessed.

X. Cengenital abnormality.Y. Other 1nfections.O. No major lesion.1. TraUl!la.2. Trauma +

Asph. a.P nonJ.a.Rh.osus.Hyaline Membrane.Massive Pulmonary Haemorrhage.I.V.H.

9. Miseollaneous_.- (blank) No P.M.

1"~"""oll'J( (Pr1mary Cause of Death

,,- ~ !~-4.068.(SummaIT Card

car. 77)

• 40\":J/

Svcondary Causes cr DeathUce Y f~r overcode if oultiple.

X. _ongen~t~l ~bnor~ality.No J:!ajor lesion.Trau!:"a.Tr~;:la + A.sphyxia.:"sphyxia.Pncui:1onl.a.RhC5

,~~y~.~ine Menbrane.Ma~sivc Pu:~o~ary Haeoorrhage.

8. LV.H.9. MiscellBneous.- (blank) No P.M.

70. Pri~ary Lung Lesion (~icro.)

X. Not exar.in3d.Y. Gross icoaturityO. No hlstologlcal1. Hyal~ne MeID e.2. Massiv uonary Haemorrhage.

n»~rption atelectasis.Rcsorption atelectasis - I.P.A.EaeoorrhaglC Pneuoonia.nronchopneuDon1a.Intr :terine Pneu~onla.I.P.h. Mecon~uD Aspiration.LP.A. other.

Other Lung H~stology (Mlcro.)Use Y for overcode if multiple.

71.

J.4.5.6.7.8.9.

Not "':lCao~ned.No lesion.Hyaline Meobrane.Mass~ve Haemorrhage.Scanty Haeoorrhago.Interst~tial Haenorrhage.Pu1~onary oedema.Inhalation of oeconiuc/dobris.Pneuconia. .EophyseliJa.Gross icnaturity.

72. Miscellaneous Pathology~ Y (overcod"') on1y codes 1 - 4 may be mu1tiplo.S-q.. X. Diagnosis uncertain.

fr O. N11.1. Pneunothorax.It 2. Eophysema.J. HaeooperitoneuD.{'ct. 4. NeronlUO aspiration.loo 5. c. . .tq 6. Rhesus ..\,)... 7. Asphyxia-Trau~a.""'3. 8. No cause found. • 411c1Cf- 9. C~rebro-Respiratory.

.r . 7J . Placontal Iloight

X. Not wei{\"hed.Y. Loss than 250 g~.o. 250 - 299 ITrn.1. JOO - )49 {\"O.2. J50 - J99 gr.

toS' J. 400 - 4 119 gr,.4. 450 - 499 g:->.5. 500 - 549 go.6. 550 - ::;99 g&1.7. 600 - 649 gn.8. 650 - 699 ff.:J·9. 700 +

74. Placental PatholoTV

WithoutHistology

1

11/1 th

Histology

X. Not cxarn1ned.Y. Norca1 macro. and micro.o. Nornal c~cro. not exa~1n~d ~1cro.1. hll chor1on1t1s.2. Retroplacental H'go onlyJ. Retroplac. + 1nfarct1on4. Infarction5. Other abnormal1ty.6. Retroplacental H'ge only7. R2troplac. + 1nfarct1on8. Infarct10n9. Other abnormality.

75, 76, 77. We1ght of Baby in Ounces - J Cols. (Q. 54)(Sullll:lary Card

Cols 74 75 76) Actual wei~ht in ounces.. , , ~XXX. No infor~ation.XOX. Est1r.atcd weight over 51b. 8oz.

(2500 gracs +).XXO. Est1cated weight 51b 8cz. or loss.

(Under 2500 grans).

75.(Summary Card

Col. 74)

Birth W~ight Groups

J. Under 1000 graIas Under OJ6 ounces4. 1000- 1499 11 036 - 052 JI5. 1500- 1999 JI 0" - 070"'" 11 •6. 2000- 2499 11 071 - 088 11 •7. 2500- 2999 11 "89 - 105 118. JOOO- 3499 11 106 - 123 119. 3500- 3999 JI 124 - 141 11

~*3. 4000- 4499 11 142 - 158 11Y4. 4500- 4999 11 159 - 176 11Y5. 5000- 5499 11 177 - 193 JIY6. 5500 grat:lS &> over 194 oz. and overY7. No inforoation.Y8. Estioated weight 2500 gracs and over.Y9. Esticatod ll'Qight undor 2500 grans.

• 42

only.+ otl••not

Do1ivored - ANC HOl!lpit~- Jl.NC Hospital- ANC Othur or

known otc.Docici1inry Booked & Delivered - ANC Hospital

+ Other.- J.NC L.H.A.

"lone, or wi tJLower.

- ,·.NC G.P. only.-. : Midwife ..

G.F.- No ANC or not

known etc.DOD1ci11ary Boo~ud, Hospital Delivered.N.H.S. NatQruity Home Booked and Delivered.N.H.S. Haternity Ho~e Booked, Hospital Delivc~~~Private Nursing Home Booked and Delivered.Unbooked, Hospital Delivered.Unbooked, Donic1l1ary Delivered.Residue - Hospital Delivered.Res1due - ronici11ary Delivered.Rcsidue - G.P. Unit Delivered.Recainder.

~. ~niibil'ity Groupl!l00 ~~I Xl. lIoapitll.l Booked &:0).. X2.tP.J XJ.

0'+ Y4.fP~ Y5.

~-~~~t. Y6.

~ n.~t Y8.

C)'i 01.\0 02.,\ OJ.1"1- 04.\~ 05.

\~06.07.

le". 08.l=. 99.,e o.

,_ • I. •

79. De1ivery-Supervis1on Groups

O. No trained person present.1. Delivored by Consultant Obstetrician or

Registrar.2. Delivered by Hospital M.O.: Supervised by

Consultant Obstetric1an or Registrar.J. Delivered by Hospital M.O.: Other or no

Supervision.4. Delivered by G.P.5. Delivered by Midwife: Supervised by ConsultanT-

Obstetrician or Rogistrar.6. Delivered by M1dwife: Supervised by Hospital

M.O.7. Delivered by Midwife: Supervised by G.P.8. Delivered by Hidwife: No supervision.9. Delivered by Pupil Midwife or Medical Student:

Supervised by Midwife.X. Delivered by Pupil Midwife or Medical Student:

Supervised by Doctor.Y. Delivered by Pupil Midwife or Medical Student:

•no supervision.

Causes of Death Categories - Sti1lbi

43Asphyxia,prior to labour Mac. SB. lin labour - first stage Fresh SB.in _~bour - second stage Fresh SB.in labour - macerated.

1. Congenital Ha1.forna~~~2. Stillbirth 0 1aboU1, no cuase found

des il!lto1ogy.J~.~~~~birth ~ labour, no cause found despite

histology.Trauca.Trauna +AsphyxiaAsphyxiaAsphyxiaAsphyxia.Rhesus •.

4.5.6.7.8.~.

x•.

GO.(Summary Card

Col. 78)

·.~ ., \ "

80.

- 17 -

Causes of Death Cate

X2. Stillbirth in lab r, no histology.X3. Macerated still rth prior to labour, No P.M.X4. Stillbirth in abour, no P.M.

Causes of D th Cate ories - Neonata1 Deaths

Co en1ta1 Malformation.fections other than pneumonia.

Ate1cctas1s only with histology.No cause found despite Histology.

X9. Trauoa.Y;. Trauoa + Asphyxia.'Yl. J

c\-\+ NEW \llEtot .....4S"'- ~I ~~ .. c.GM&lWI!O w-f (~)~~ ~'~6- Ut&leNOW ....

(,0\- "'='"o. ~~ ~s"Te.I.'", • ,",0 a."t"'\4..a ....~. ~,. tI'''b WG'T 9. \b ".hrS

". t'ot-~ "'\~, I)Nb4-. 5lPlS~ ...

~. ,~... fItlto.lC) \. ~ «'" ~'"f'EIt. ....b. ~~tol

1-; ~~ \A,)CS""nfILNq. ~'-es

C\. ~,,~ \-.fIr-"U) S~. s.c..o-r~~b

• 45

aa .:...:. "-' ,'; " u ,cm-

till: ilJ.57

0 2 , 0 , C1. 4 - , 9 .. \2 6 1·- •J 8 9.9 •

• 10 - 11~!' .., 12 l).Q6, )4 l~LQ ..

16 17. 1'1 It, ., "" 20

~So

'!\ _~~==_=::=::====::;::::;:=l...:;:lr="=,n~-:r'=k:;:.,:;'="='_::.=~=.:::$:::t=o:;::\:;r;:.:;f:;.;:::J=5;::. J::::6;;:::>:;:.;::;T=O::::;:l:::;:P=l:;"::'C::"=d=O=C==l=~ 'n l -: 26 1) ~IIA"" w.'«ht of or.Rn 1. Dot JUiovt\ •

...... "e j. pun~h..d

where none ot the .eichta ar_ known.code • 0 1. IN!'cbed 4n col. 7!Cp Lanstb) and the r.mela~ cnl~lef't blank.

J) cod_cola

X 1. an t-po••lbl. code tOI1 - 20 aDd ••10. 23 - 26.

,', Bal>L- Onset Sywp!9aa (rer. 41)~o"'el (I H,... ...p~cl1'ie~ 9. S.B •

" • " • ~phyxll.". X. :Ia.aut't1clont "lntoraatiollp '\0' < I n"Ii:~-:io bluII O. ~o""ll OD•• t 1••• thlul. 1 ::hJ1

..t._ • qt>hy:r.i" 1. "ormal. on•• t re.t .f 10 , rl.' , lAt.:lr.r p ,~""1(' u. 2 'Ior"l, on..... 2nd " 1rd ~,ut." ..... .:1 J fl011St\1 , on.et la.tftr .... 1.. _ ;.0'-

\,,, mouth 4. Uor••l. onalltt. "f't.· 7'h d'o. n.... ,.

\ •• Poor t'rOao biJ"'~n~ Poor. onea't T""Jo,,-r .~ ,0- 'I ,

6, Poor. oll,e~ 2nd '" Jrd dhy1. Poor. on,et !I'l. .... r lot ..,&10,,"8 Poow:". all'.'; "f1;.r 10' ..,,,.1<

9.X

o.1.

28 "by _Pi'p,••l (re~. ~Z)S.B.

1D.u~~101.D~ ~o~~loD

1n.tltutlOD&~ throueboutID.tltutloaal birth. routin••arly traD.~er

(.UAlY proa )

2. 1n.tltutloDal ••••rc.noy traD.~.r

) :tn1l~·1t1\'tlone.l. di.d. at bOllle

t..tltutl0aAl t.- .a_ ~lrUl• ...-ts.-

21 ooatlJwod

7.e.

a..- ~a.I"b,All .'be..

11._ aad re .,.......

earl, ......,....(_iAl, _.)

-wo....,. .......,....

Den- CIW.l ceh.pn (n', ':J),. ..•.X. 1aea1"rio:l.••' iato..-t:l_

o. ".pu.t"•• ~r .11...1. Deteriorated, __ lfiN

2. • ••p.t.ratoZ'J' 'i..tre••~,. ·Cold·.~

~. eo...bral

,. "'Jar dof'ol'Uty

6. zat'.o'tlCIII.7......u.I. All otb.r

T. Budden de.t~ or aoll.p••

lDault'lol'Dt 1ato~t:l.aa

Ul

COIInll.loae &1_

TvUoIUac al_•..t1....... or .~r aloaeCOD'na1..1oa. 11ft. tit. bl•••iDc :rrc. _tIlTritobiq w:Lth bloo4iq rro. _ ...

R.,tl'.aD'" er atber yitb bl.~ ,..._...

'0 "by -C,r"ol "p' (re", 52)14.&,. •.•.~~ 11:.

~O.

~I' 1.

~ Z.

~ ,.U-I ~."-1. ,.q.s 6.

&4+7 •

0'" a ••d

Ia.urt'iol.at taro~'l_

ABttbiot:l. at b1r~

Aatlb10'&10 la'... , but .1tb~ 12 u, ot' d.ath

1•••1'

Osy.... a' b:Lzotll

0.,...,. 1.'.rOsy.... a' b:L,.... _

Vi•• a.OporaU... (:lJlol. ho,,-)

Other

- P'PRT (re", 5')•Tt it' ..re tJIaa ...

S.B•• 0 tr••'''11;1:

31

r

]2 ..by - I'sp' 1.

(ret. 60)

G•• 'T' U' _ ...

C9 ODe ood••••d

S.B.Iaa.rrl01.at lD'O~tlobUJ.

0.4... or .ol.r._

a,po".r.1a (J.••• tbaD "OP)'Cold' ....l'l.d oth.r thaa aboy.~or tat.a'loft.

~111.1 or ~t.raal ~'.otloaJ'aWldl0•..,.....zi.Vo.ltl..

]3 "by - '1'D' 2.(r.t. 'J.)

1-..;'..:..'_S;:.~B:.... ..,.c.-.:..:~:;.;ln:.::..-='1.:::-CD_L_~...;... _~ Xo IJuu:r'lo1eat In'or-tlon

':9. O. 1Iil.t~ 1. Si.... iD .h...

~2. ly.'0110 .ar.er

~~3. a ••pi...tory di.'r•••

~ 4. Cyaaotio .t•••k.~ ,. CoU.p••

':tl 6 PoUor~ 7 Ha'lIOrrbap f'ro. bow.l108 Ra....rrbap .l••vb....

..t

tnrt ., *1t'...,1,op' x.(ret. 66) IQo.

111.

0.. ~T' l' ..re tballl~2.on. ood. a ••d l! :J 0

,,,-4.\S"',.("6.1l-7.It 8.\C\ ,.

Aa'D.c.pbaly

Anlold ChUri

Bydroc.pbalu. aIOD'

Oth.r ColI.So

CO~D.it.1 h ••rt

a.G.All..atary

Dl.pbr....~lc h'rDl~

G••ophaC.a! 8tr~.ia

Sk.letal

Oth.r

&.-'" "'- """...>-\-~"""""-""

" Ml.s.111R'SU'(r.t 67)

:"'0

x.O.

1.

2.

3.4.,.6

7!

Mo P.X.NOD. pr"'D.t

VolYUlu,

N.opla••

Fo.tAI ,z'aaeu1nntion

Ha••orrba~c dis••••

Idiopathic .ydrop.M.conlu. par~toDitl' v1tbnut ~~Jor C

Adr.Dal ha.aorrh~be

Oth.rribrocy.~io di~aA.e with or without

C1oC'on~um j,i.u.,

,36 Pr'",:- Clef. ot p••S' (rlt. 6.)

x. Coacealtal .baor.alltyT. Oth.r 181,oS10n•

.) , o. .0 -Jor l"loD1. -rr.~

2. Trl...._ + '.phy:lr.l.

3. ....pbyzl., • PIl.a.oa.la

5. Rh.....,

6 • By.l1D.. N••br'D'

7. Ma••l•• Pul.onary Raf.arrhae_B. I.Y.B.

9. Ml.G.l1aa.ou.- (blank) Ho p.K.

'7. 3a, 39 "by" !'icht. InXXX

10 p. &roup.

Kot knoVD

ot netth Cat.corl•• - Stillbirth.

Tr._ • A.pbvxl.A..pb"W"Zit prior , 0 l.bou.r 110.•• SII.

A'rh "'2:iR .... l.bonr - 1 •• .t... f'rl.h SIA.phy '... labour - 2nd l-t... trllb SJ••phys~& 1.. labour - _a.rat.d

Rh••u..

"0, 1t1 ~~L.e.u",( r.t' • .op lot'.) 1 COQCealtal _lro~tloD

2. Stillbirth prior to labour, DOoaaa. touad d"pit. bi.tolocy

,. Stillbirth ~ labour, aD O'U"tOUDd d••pit. ht.Soloer

~. Tra_,.6.7.B.9.

XD.Xl. Mao.rat.d .tl11bl1 ~~ prior to labour,

DO h1.to10p-

X2. Stillbirth ~ labour, DO ~t~~ololY

X). Mao.rat.d .ttllblrth prioy lRbour.Ko 1'.

X4. Stillblrth iD l.bour. DO P.K.

ca!'" o~ Death C,$••orl" - "09'~1 Ptath.x,. Coa.cea1tal ..1t'or8A,&1011.x6. 1Ia1'.otlo•• otb.r tbaD pIl.WlolllaX7. .t.l'ota,1, o~y witb hl.tol0C7X8. .0 aau,. t'0UIld d••pit. hl.,&ol0cYX9. Tr._TO. Trau.a. A.pbyslaYl. ....pbyzl.

Y2. PIl.uaoll1a

!3. Rh••u, •

..". .,.lUo_.....T, .•••ift,,..1 m 7 " h. at ..T6. Ia,......,.I.ML1 a.. T1"t'..y..,. 1U••• l1aae_ 1 ~

n. •••lnl .._t.l , .. U.'.lee7T' ••• t _tal tke , ..

~ 0'"''''..6 S\=10, DpnSl. I" .sag Bomta(Col 11,) X. 80 1.DI'or.a' loa

o. 80 rtr.' 'Sac- (01000. C••• )1 \,,'d.r )

~B z., __or 6

,. 6 _ aader 1210. 12 __er zll

5. 210 __or 108

6 101 ...0 Wldor 71

7 72 ....d O"lf'.r

8. 111 della.d

JPW:51:l'IJ'w1~9I/1PU.:IIPl/ldUU~.aa IIDR/'l'ES(Col. Illo) X. 80 into...."'_

o. Wo ••cond. .,.p (._ .-aclJlal t 0_ C••• )1, Ond.,. '0

2 '0 .. und.r 60,. 60 • UDd.1' 90).q 10. 90 .. und.r 1.05. 120 - UDder 150

6. 150 - UDd.r 180

7 180 - UDd.r 210

8. 210 _ UDd.r 2100,. 2100 or oY.r

45 Duration M••braa" Ih1plv'd HOllll5

(Col. 115) X. 80 i.Jd'o..-" tallO. Wo, ruptured. .... ..11....,.

1. UDd.r J hour'

2. , .. W!4..r ,,. 6 .. muI... 1210. 11 _ \&Dd.r 110

'SO ~. 210 _ \IDCl.r 1086. 48 _ and.r 72

7. 72 - UDd.r 1208. lZ0- mutl" 168,. 16S aDd 0'"1'11' (7 ayo).

(

•

".fo int'orllll.tioh

Ho induction aM .~.~~t~~a o~l~w

O,.;vto("'\.n bet ~c -, '~1r .... 1

o B.B./o••troc.n ~~ .trip

Oxytoc1.n IX labou .. ,u11'

1.n" ')u.%'c1er t

Hish S....ei.a! )

Dol.. Sur.leal )

dieD Sur.:icaJ.

D. X. SurG:1caJ

(Col. "') :: ... ~:::l Ahr-:= ~h. ynt,onr ......... "'" ln

C:lerk W'~ th Mer.tor-"i:I.•• ",c,ptu'·.d tilll.

li.!:. when '.iled r' ... O'lnt,;:.d, I(e

~

O.

~ \0

)

4.

c

7.S.

9

~ot. ~iak vltb va.iph] t)A.d~nc b.tc~~~8 " ••k •

• ote .apeoial1y eod~a ~ and 8

X Ho ~o~tlonO. No bl.e41.Dc. or F it of' "ny ao""

!Qd DODO ~ro. ~ol ~c.\(,.,:oid.ntAl It. P.H ~l~r.nta ppa ~

a..ol\.>.L.~d nnl.y)

2 Placenta pr&a...!a In17

). All oth.r Wl.peC ...:o.":.rj,j, \. ~.H. ~_·IC~_ .. '4nC'intrapartUE ha.ca~·,,~c.

4 Aocidental ....-roe ',1U 1 1':..28, Placenta pr-RYta • ~.C1Dal pr_ 2~6, Unapeco A.P H + ~~eLD~l pre 28

Vaeinal bIoedine rl~ ~8 o~y

B Mo A P.H. or "cin~J. ~le.d1D6 b~~ 55J;to.ltive

~a. Deli...,o GrJ)upa X lIo ID1'or_'Clan(Col. U) .4. lIo tra1.n.d. peraorl pr••'Dt - breec":.

"1 lIo trA~,d per.oD pre8'D~ - other~e:.obEI) lX Spontaneoua _ Ve~_.7 0 ?

IT. . ".ce ....d Broy

''1-'"" 1 • - Vertex O.A. • ana Hand2X. J"oroep. - hce and Brow2 • - Vertex 0 "'. ....d Hand)X. C••••reaD Section. - el,ctS.••). • • . i" labour~X. lre.oh - Spoataa.eou. ,

~I ooatiaued

o

_. Br••oh - •••i.Ced or 'atraot.d

,. lat.raal V.r.ioD

6. Deatruoti••

7. L&J>U'o~o..,.

11. SPQDt&D.~. Sbould.r.

Ipdtn",. (OOl.~')O.

1-

2.

3.1,.

5.

Wo 1Dt'o~tS.OD

Wo .bao....l1ty

Cord pr••••'.tio. or prol.p••

....00111_

"o.t.l llear'\X.ooa1u. aDd ro.'.l b.~rtOth.r N ••OD

D

1

2

T.X

Pl.9. or DeIt••El

(col. 7)

Mop1h of Birth(Col. I)

Bo.pit.l •• book.d c~a.

Hoapital •• uabook.d eft •• (1nclud1 n«...rc.ncy)

~~ioiliary _ Midwir. booked

Do.iolliary - Midwire unbook.d

••H.S. Maternity Ho.. (0 P Ual~ wheretbare 1. DO r ••14an' Medlcal Orricer)

) Pr1.-t. Mural.. Ho..4 Prlyata ward or K.H.B. bo.pit.l" &l...b.ra (.peolty, •••• ' •• i •• '&7." •

..bulaDO' ••~c )

7. Moth.r and. Baby Ho_

1

2. I "eb1"'U&J'Y, March, other thaD )rd .0 9th

4. April

~. May

'2. Mother l ! ~C·(Col. ,)

'\c tual ac. II'D. oode 1 •• • do , .n c.l ~2X. •• l.Df"or.atl0DAt" ;riB;. - 001. 521- UDder 20

"- ,. 20 21, Y.Il'!'!liJ 6. 25 - a, •~ 7 30 - 34 •; 8. 35 "- 9 '0 44 •A- D " year. ....d o"er

•

T.O.

",1'1 Cl.,.(001. 1')

,...1 or ••t ..ia.f'tI.11,. _o"P"".0 iIt1'o __ .._pa.t.....

• tok '1' __..1.,...1..... 1I. Go'_ II,. _p In,. o.-p n,. Go'_"I. I_oata,. Dead or pe_aUy a_yX. _., Ial....

- (U_) _. Ial._

(I.a. Or•• fall. lato I.C. Oroup. 11. Ill.I\', Bad v).

,la . P.ri'1(Col. 2')

~\

x. Jro :I.Ilt'a....tl0.O. tlo pr.v10u.. pre...,..II.o1•• aft.r 21 ...k.

1. 1

2. 2,. ,4. ,

5. 56. 6

7. 78. 8

9. 'aDd ""'1'

AADPEMl'Sl••tbat "b.••• are oo-..lw.at&rJ' .it"

DOl. '7.(OY.roode) U ~r. t1a&It. Oil. abAo..-.11'7

110 1D.toJW'tleaWo abAo....1i~ li.t.d

Dl~bt'••H...rt.

A.ot1..' T.8.

I!l1'lu....

G.~ _a.l••Dl.proporttoa. •••peo~ or prOV'1l

Sst.raal ...r.lOA

Bpll'P'"Oth.r ~olad~ I V ••• Po•••

&Ba••'t ~"".d tor treat..at..h.... JIb. below 60s, II)'d.rAlmlo.,"..11t1" P.%.D•• Chlok,a poz.Hyp.r....1. adaitt,d••to.

~5 Ob'\'~[ic aad Pr'ceDS!Not.

(Col. "l

""~Y.

~x.

'W-' o.~S" 1.

~2.

~,4.

~,.6. -

~7.I.

$!I ,.

r/

/

~

X. If0 , UO'WD

1- 1la10

2. rt_l.3. III.'.r••z

'7. b,y,'S 'EOP' (Col. ,,)

O.

7 1.. __ .2.

6.7•

..... ~.,.:EO.

Xl.

.,. X2.

t. %3.

.). X,./. X5.

••, It'7.

"'c--D.

vador 1,6 4&70 (ozol ...ot. Dot kDOWD)

1" - 202 •

203 - 2~ •

210 - 216 •

217 223 •

2n - 230 •

231 - a37 •

a)ll - 2'" •2'5 251 •

252 - 2511 •

2" - 265 •266 272 •

273 - 27' •210 - 2116 •

2117 - 293 •a" - 300 •301 - 307 •

3011 - 31' •

315 - 321 •322 day. &Dd oyer (.sol ....t. Dot

kDo.... )

%9. Jlot known

" Toa•••ia group' (Col. 58)O. Jlor-al - .OD 'losa.mio1. Pure ••••nti.l byp.rt.D.loD

2. E.R. toz•••'a - .od.rat._ ......r.

_ proteinuria - C.S.U ••D.OD. 1Jl1'.ctl....

_ prot.~url' - DOD C s.u_ .:lld

_ aod.rat.

•_ ,••,re•

- ••".re• prot.~l' - c.s.u ••

nOli. laJ".ot:l....

_ prot.1D~' - nOD C.S.U

tosa,ul - .11d• _ .cHi....t.

•

••

• •

• •

• •• •

• •

• •

Pur. tos,a.ala

Uncla••itled

5.6.

7.a.9.

3.Io.

• • - prot.t.maria -C,S.U," noD iat'c.....

51 ......- 11 -

x6. ~.1•••1rl.d .....-.la - JrO'.1aaria ••• C•••V.

%7. na.1....1rl.d JrO'.1DIlr1llU. a.1~e1.X9. R_ioMl...

". 1''P'P&'''!99 (COl. '9)(.1Jlcle "1.h.....

• ntry) Dru••

(Cor.alD'. l~be~1 la. • Vll\ltd i4,1.C.bi4roll.).

WithDruC"

w. 1Ato~'t. ..11'0 ......0 ..''1_ 'r ~J' plaiD "' ....&1

0Z7••D 'r tAoaba.erIDtraca.trio osy..aZnd otraoll.••l OS".'1l1 + 2Mouth t ••outh

WOD' or plaia GaY.'.xn'l'*.Ca.tric

bdo*ro.oh.al1 + 2

MouCh to .oucb

60. PtuS' \0 !l!by (Col. 60 l

&lt~r ~or ....u.ol'.'l.. ~ la'.r. (Mal'~~.- acid TU ..... __ buC)

x.O.

l-

2.,.,5.6.7.I.

9.

Wo UI1'o~'io..0 clI'uc.Co..-.ta. (a1k.~d.)

Lob'lia. &ad o."r .'~1..,•.s...·U.....btaeOlli.te, J, ldr_...10.,>""1 1__

!y'bka"s.t.. Vi-kA.tab

S"lph_d••haioll1ia

Str.p.o.,.oSAOth.r aatibloclo., t'rra-ro~. -.r.~ta.t ••re.ayol1D." 'ITtJar..,..u, aoYobi.ooi.a

61. "by Il1al'! (Col. 61) Cheok U ......r.1'I'Od r IlaD:lCAl.... .

Vit:boutT1"and'.r

110 1a1'orwatioD

Wo 41••a •• or traa.:t.1" (..4loal)Ha••olytic 4i.....

R••plratory or c.rebrAlOth.r ~.otio••

O~b.r ooDd~~ion.

lIae.ol.,~:to

Jrae.ctrrbacio

... Loa!'"

WithTralleter

(7. R••p1ratory or .erebra!

(e. Otb.r lDt.oti...(9. Other ooacl1tlou

62. 'nns. of P..,b (Col. 62)O.

).

10.,.

6). Ti- ot Death (Col 6)

0

..2

"*+3

4

t.' t,.6

~ 7.a\ ;... ~~ e.... ."

SurY1Tor (U..birtlo. U .... )

4ie4 lA lI&rob

41ed lA April

died ia ....Y

S. B. Mac. o.er 24 bra pre labour(_t-part... )

S.B. Mac p.ri~rtu. (I:a.SraparSu.)S.B. Hac. d.k. whea dle~ (unapacified)

5 B. 'RaSH - let .~a..

S.8. PRESH - daath 1:D. 2nd at...

R.M.D. under )0 ~••

1I'.If.D. l.t ....It (_r 7 day.)R.M.D. 7 ~y. but .ader 21 daye

(2Dd t. lotio ....It)

6~. Ace at Death

eau.a o~ Deatb Groupa paaoked LD Col. /00. 101

(Col. 64)

X• Wo ~o~tlOD or s •••

..L UDder )0 aill••0 Oyer ]0 ~I UDder 1 day

1 1 day ......4 OYer. and_r

2 day.

2 2 )

J J 10

• 4 ,5 < 66 6 7

7 10

8 10 14

9 110 2e

o1

2

6

No P MP.~. done. "01'0. repors onlyP M. done, macro. + ~cro.

Re-as•••••d.

66. 67. 61.' G•• s.sion (Col 17. 18. 19)'1 dl«l1. code

L~ • no 1~o~t1ft~

6,. (Col. "~Io Voo T lor Oftro_ 11 -.IUp10~ J:. C_ital __li~

• O. W. _Jor 1••t._

ot 1. ~-10 2. _. uplopJAl\l 3. &olllzpioI,). Io. _-u'3 ,. 000110,"'" 6. IlJaliae •••, .....\S 7.. ...,1". pa.1aoD&lT ba.lMrrbace'e.. I. 1 .....11.\~,. lIioooll.......

- (bloak) 110 •• 11.

70 Priea Lug Lt,loR (119ro,) (Col. 70)

X. Wot. .saaiaed

T. Oro•• t....t.arltp •• oD17 1••10D

o .0 hi.tol-eioa1 1••1oD1. 1tJ'01i1lo.__

2 , Ma•• l.... pal..-arJ" ba••oZ'S'bap

,. R••orpt.t.-. •••1&0t.a• .1.

~. R••orpt,loa a ••l.o~.t.. - 1 •••A.

" Ba••orrbacl0 ....-0111.6 • BrOD.ohOpll.e1WlOAia7. XDt.r.ut.r~ pD.a.oaia8. '1.P.A. IIacOlli_ ••p1rat.:Loa

9. '1. P..... .t.b.r

71, 9t.b,r Lap« Ri,tolog ("&90 .. ) (Col. 71)

\q Voo l' rOI" oY.r.'" 11 lRlt.lpl.~O J:. Wot .zaa1aed

\1, o. Wo 1••1_~ 1- Byaltae _ ... -

~ 2.....1..... ___n+ece

~'"3. .o...~_o.........

~ Io.XDt..r,'U"t;tal ___rrbap

.u. ,. h1.1M-..r7 CM....~':$. 6. XAbalat.10D .~ ..oo~u.ld.brl.

::l.~ 7. ...uaOlliA

~ I. z.pIl".••-

30 ,. Ora.' ~ta.l't.C7

72. tI&,·,11_n' Pt"'l"! (Col. 72)l\ Y (_roodo) -.1,. oodoo 1 ......,. .. .-l'~10301 ll. ~ooio _oo_ta33 o. .il,)14- 1. -~-1~ 2. """'0_

3"-,. __rt._

i: •• ".oat_ .000lftU_,. e.M•.set ,. _...~ 7. AopbJz:l....._

"'"11. Wo _u•• , ......

\-:1 ,. C....1lro....opue••ry73. P1'g'e'tl v·...• (Col. 7')

X. ••• "o1"'odT. lAoo .... 2:10 ...D. 2:10 • 2" ...1. 300 - '" ...2. ,:10 • ,,, ...,. Itoo - ", ....... '50 • "''' ...,. 500 • ,., ...,. ,:10 - '" ...7. 600 - '" ...I. '50 - ,,, ...Il. 700 +

7'. fl"'pStl r,tlLo1ofT (C.1. 7"')

X. .ot .-uodT. • oZ"Wk1 ..ora. aa4 Idoro •

O. • o~l _ore. aat ,x··' ••• ~oro•1. All oh..-teat010

2. aotrop1•••ata1 .'.. -.1,. ),. a ••~pl.o. • tDt&ro~ioa ) ViOlleat.... ~o"t.oa ) 8:1.,'010'",. O,lIer .bDO~11'" )6. a.sropl.o....1 .... 0D17 )

7. •• troplae. .. ~IU"O'tOll ) VUIlI. 1AI'11"011_ ) atotol.'"Il. Ot!l.r aba4l:'W&11 t l" )

• '-7'. 76. 77 'tich! o( "" ~ Ogag.... , Cola. (e 1 7" 6 )- ---- - ---- •• "'. 7 • 77

A.~DL1 _1"'~ 1.11 _ ••

lCCt. •• 1a1' U.

~. • ••s.-~ _ ...... _I' 'lb•••••(_1'1500 _)

DD. Il.~s.-.... _ ...... .51b..... or 10••('500 .1')

,. V""... 1001 _. (Vad.r 0" -'0•• )-. 1001 - 1500 • (0" - 0.51 • ),. 1.501 - tOOO • (0'3 - 070 • )6. 2001 _ 2500 • (071 - - • )7. 2.501 - 3000 • (01' - 10' • )I. 3001 - 3500 • (106 - 11' • ),. 3.501 - '000 • (11_ - llo1 • )

n. _001 - '500 • (1_. - 1" • )Tlo. _'01 - .5000 • (1" - 176 • )'I'. 5001 - .5500 • (177 - 1" • )'16. '.501 _ .....r(lfo\ 0..... ""'.1')n. Wo ial'orwatioan. 1l.~~~.4 vo~~-.. 1500_~. •••uatod vo~~ 1500 _. _ ...

71. ""'Ptl-alA'! 9rogp. (001. ,I)

Xl.u.S3.

Bo.pital bookad • 4.11,..,.[•• - .-e a••p1-.1 0&17.. &IC ".pleal • o'ther

- &JfC ou.... or RO't m.VD'.0.

T'. DoaJ.cl11ary bookH • 4elS....red. - 4JfC Bo.piMl a OUa'ET,. .. .AJrC L •••A. a.1oa••

er Yl'Ua 1.....'16.T'].

'11.

- .uIC 0... oal7

- .-e a1~r. ~ 0 •••- •• IJIC or Dot aoWD

.t.c.

01. Do.1.iliorT b.o.... ao.pi~ dolt..rd0.. ..11.5. _~..."UT b_ ...ok.4 _ ..11 4

0:,. .,B.S. _t.nU"? hOlM bo"•• M.pi l ••11....re4~. Pr1_~. "''''1.IIc a.... bo_d _ ..11 d0'. Uaboolr..d. 80.p1'.1 ••11.......06. UaboOk.4. d~~ol11&r7 4.11••r-4

07. R••1du•• B••pt'.l d.11T.re401. R•• ldu do~o111..ry d.l1Y,r'.

09. R••ldu G.P. Oal' d.l1••r.4O. R.1D&1.IId..r

• 59

... ()~~ r'f~~:~ ft"mily nn,l H('l~~~_v,1 rnry1r'llt

• / r~mi 1y CUmrllJ :.:1 t10n iXld $12:j)< Sorarc tion from mo t.horX 01fficultias of rn~ily/ Usa of W8lforo rflcilitios

· J Occupotion of P;)r,~nts nnd Crnndn~r(lnts'/ Incom8

· ," Charnctoristics of tho rar~lIlts· ../ Ethnic Groufl

" Parents' Activitios with tholr Childron/ Parontal ri~p1rQtions fur tho Child. Tho Child's Dohovlour 1n tho Hom,~

\ . tHou sing"'\.... ,).\.\'~I'1NeighhcLJrhood of tho Homl), lJnd PL1Y Arnon.f.t13s

tGaograph1c Mobility

I' , -, '

1222234t\45~

677

•

•

rho f.choo 1

Pro-school and NursJry EducationSchools ettundod by tho ChildTho Presont SchoolParcnt-teochur Contnct~Spocial EducationPsychological &:·[)ohovlour~l Ch"ractLlrlstics of thu Child et SchoolBristol Suciel-Adjust~Jnt GuLrlu~T~aching of Gesic SkillsTanchor's aS30SrimOn t 0 f Chi Id IS ;\LJi 11 ty and Achi ovum.;n tTestsSchool AttondencQ

Thn Child's Intor0~ts, ~spirotions ond Lni~uro-timu ~ctlvitlos

Por!n~t~l onrl Mothor'g Obstotric History

ObstQtric Hi~tary of MothorPresont Pro9n~ncyDotoils of Lehour

Child'::; fl1adicn1 Hi~tory

Physicol CharnctoristicsHP1ndicops end i\bnorm3l ConrH lionsEarly DavalopmontGonurnl H.1;~1l".hIllnass ..lsAccldunt~

l\1udic

PAC~_1

~:.

21j,

aU)~) tion s fr ..II" Ut,! P::J rin:l h'd rr,'''':'~~2!l.t.Lr;,Jt:~2.!~:.0-1J.r:.J2.2.:.-. I, wh 1chor.:) (In e,l rds bu to nl' t cm tl:"'l' r"othc1r) .' i'!I

Study Child - seHoalth Vi.si 4:c r - HVDoctlll - [j

Mouicol Rucorda :: r"l

For uoch qUGstian thGra aro th3Aospond.mt (RaG~). )QuostionnAir~ & §WOGp (Ou'airoQuostion Numbor (au.No.)Ce:rd numhwrColumn numhar

!t)8 P0 n den t.::, ell dud n s f (l 11 n lU t.i 1

..An as t G r i skind1c~ t l3 S t hat th l3 qlJ 0 s t ion wo r din 9 0 n ~J.C.0 • 5 • I I 1 s

similer but not Idonticol to thu per~llol qu~stion 1n N.e.D.S. r II~

RllSp. Qu'airo Qu.i~"O.& SWOOp

"I.U I':.'" ij J I'

Cord Co,

PN 9 8

PN

P I

P I

17 b

13 a

13 b

For h8W rr:ar'ly p'.ICpL.l eJi.1 t.~~,,; I'·',t,i'!/ll' Cl.u!: ,~,ld kutJf.JhoLlSO::1t th'J bL~inl'lin.nc1'~di;-: .., hJr hU~~jnnd~nd h~rsalf)7 6

Plon~J 11~~t ell tho poopllJ urho nur'I1';:l'y ]i.v~) in th·)child's housoholJ. Excluo..l ~ny chilc1rl1n, or othlJ who('\1'0 only homo fur short ~H.H'iocls, u. g. 3c:hl)ul holidClys,11n v11. 0 I' r 0 ~1U ] El r vis it!' 6

PL1:lSO 11~t. ~.my childrm cIf Ut ll hms '1IDJ J Ilot includorlin list (13 o) 0.9. tho',u whrt :jL"l only r,l homo ForrI,11i d"~ ys r. r 10n v ,J

..

79,.

P I 14 from tho abovo t\loiO t~blt3s, Jll ..~'J~'] s!... · tr-, lh~J tote}numbor of chi~dron of thl.l hC1usohold unddf the ago of 21 2 29· .

P I I • 10 Q

P 11 • 10 b

A~ 13 ~ abovo * Codud for numhor uf chl1dron undar 21who normally livo in tho chilr-jls hO,-Is,lhold

As 13 b abOV8 *Codud for nu:ntJJf of chiJd'rtJn iij fi)a!i 1~1 ~:9ud undar 21who aru not Includod 1'1 tho hOloJsuhuld

Y4 15~Y4 1

I. ,Y4 }',' '.

P I 15 Plcnso st~to tht3 child's pO$ition ~,rnonq thosa chilcJron 2 31-: .

P 11 • IOn & b Codl3d as for 15 '''bOVil Y4

rt1/HV

P I

P I

P I

73 b

15

17

Chi Id's p031tion in birtll urr1:.Jt' (rd 1 hirt.hs, stillil1ivo, dond, utillbl.rlll~3)

PLy;:;:. 1 ~'.·:;l;l'rt~.in, ur' ~t: t.:' tu ypur :

,--_."._------_...•_--- -_.,_._ ..... ~ ...._...-_._, .. _.t

C~.rj Column;.--_.._--._---- ----._----------..

Rosp. Qu'e!ro Qu.~o.& Swoop

f _;.

P I 41

P I 39 &~o

'\

o.l\\J. .J.l~"\\ i~\ ~J).

.IIrI

,.

I

\.:

"~"t

I'I~I

~

iI~'

i

•!.t·II

12

13

28

3435:56373839404142434445

46

64

I.

t

tt'

I14-29 /

[.;

!I.-~II

t~iI

30-3132-33

55555~,

55555

. 5

5

DIFFICULTIES er FAMILVUndur tuhnt cetogc>rl119 would you list lhu rHfficultlasof tho femily?

- HousingFin~ncjE'll

- Physical illnoss' or dis~bility- M'lJnto! illnnss or nsurosls- Oh.. 11 to 1 su hno rrnn 11 t y- C2:.lLh of ctlild's fct.hsr•• DLJ:1 th of :::hi J:J t s mothar- DivorSlJ, ~7dIT~r,1tion or dGSilrtion- OUI.1G:.1:1c t~Jns~C'n- "In-lGui" ccmflicts- Unomp]uymunt

:'lc=:lhr'.l:. '~,rrl- ,\ ;1 y I" U, t·. r '') ;j .' ~ l. U G '/ i f' fie L' 1 t i 0 ::-; ;-. fr. J(. t 1. il •j ~.h' ::h 1 L J' s

ICH/i;] .:;H·:ur, ~

D,.lt211~) nb,)ut. tt'.J L~l)d's lon'J 1St pJrl"I': ,if ~., .lrnrCltlonfr~j,n lhu mothor (i.lJ. 111ngllr lh:~n .\ Wd';

.........--------Rasp. au Vair 0 (Ju .. No.

&Swoep

P I I .. 32

P 11 • 29

P 1

P 11 • 31

j,

71Y4

3 43

Y4 62-63 i'Y4 61 .

5 44 I

Y4 65-70,

Difficultios of furnily; Un0fl1;11oym 1lnt

tor hew many wo~kG has th,.) f(lth;~r (i .. o. 1;1;1};1 hood) boonoff VJork in thn pn~t 12 month'i t i1I'OlJgh j, 111"1)c;8 orunemploymont?

1sth lJ f rivat3 ~,otlrco what has bi,.'un tho soureD ofincomo of th.:l femi J y curing tt\(} p?st 12 munths? Y4 64

28

, ,

HV P I

M P 11 • 378

Undor wh~t cotogarius would you list the difficulties orthis family? rinaneiol 5

"Have you baan seriously troublod by finP.lncle1 hardshipin th~ PQst 12 months?" YS

5• -_. T-- -----•• - - -

35 !.iiIj!

'~

l~: :C.l

Cf1rd

Ct-l f:.. ;:;-;;r-I·~·;;;--':··r-l'~ C' r-r-:.;. i~ r- :':1;' ~ ",", I • h _, _ ' I ~ J L. .:.J I I r" I I, • " , ~)--...... ........_-_.....__._......._---- -_ .. -... -_." .....-Rosp. cut elra Qu. No.

&: SwoQJ

--------_._-- - -

M P I 40

• PI 48"- m PN 13

fl1 P 11 eO 34a

'11 PN 19

I Pi"j 25

P1 P II • 34b

M P I 45

P 11 • 20

P 11 • 74n

• 74b

I '

,,"~,..I· ,I

j'I!i:iI

[I

I

f

56-59 ,- ..

ifjO-61 :.

~

14-15

63 ItI',:

59-62

,

45L .

46-47

5173-76

16

30-31

71-80

39-42

44-45

Y6

8

8

Y4

8

Y4

Y4

8

o

3

If yes, ~t \lih'lt ago did ha finlsh fl.ill-tj~lJ cduc.,tion? :3

Age of p:::tblnt last birth:by (i. o. mothr-n')

At the tima 3ha ·le f t schoo l, how mlln y bro thurn and s1 stD redid thu pnti8nt hOV13 (living &'doau) Co

I "'" j '4 I (, I • -' j i' ' i.: r..." J J ,( \, 4

Rospo Qu'D1re au.N~& Swoep C·)rd Culumn.--- --_._----_ .._-----------------

pAREN:S' ACTIVITIES UITH m_EIR CHILORE!i (cont.

P I 44 DaDs thG fethor tako a big part in managing th~ child, orlOQva it mainly to mothor? 3 38

P 11 t 19 A9 44 ebovo * Y4 43

PARENTA L ASPI RA TIONS FOR THE CH I.lQ

P I 26 Would thr. puronts liko the child tu stny on at secondaryschool of tar the minimum school IljQvirhJ ago? 2

I •

:".

46

M P 11 , 14 As above * V4 32

P 11 • 15 Do you hopo that eft.:Jr lOi-)vinl) schocl (chilu's nnmo)will und3rteko furthor training or 'lducntion (full-timoor nurt-tin1A)? Y4 33

THE 'cHILD'S BEHAVIOl'R IN THE HCiVl[

P I 27 Is tho child ot ~ll awkward or clumsy whons walking,running, climbing stairs, tying to bow? 2 47-50

Is tho child: norm~lly activo? inactivo end ~uiot.(profers to sit ond ws'tch)? Rostless (\nd oVClractivo 9 OK? 2

OifficultlfJS or chilJ.

•

P I

P I

28

30

~)

~~d)0)f)9)h)i)

H~n complninod uf hlJodachoa (mar,) th::m onco)Has hod tomnor tnntrumsHas boon roluctnnt to go to schoolHas lied b~d dro~.1fns or nicJht t,arrorsHOfJ h[)d difficulty in g3ttlng oLf to 8lo(JpH~s slul3pwalkodHas boon faddy - rnnny dislikus oVBr foodHas had poor appolituHas ovoroaton for moro than tho occesionel moel.

22-2

222222

51

535455565758596061

...., .f ',

r·,! .r· .

I'III

!

ll,iIItI

7 i- ..-...-.

6667606970717273

7475767778

67-80

2

V6

22222

22222

. '0 ...."l ....

5

Is bulliod by othor childrenDostroys allln or ath13N3 bc:J1onging9 (tos:\rs or breaks)Is mi~or~b18 or tonrfulI S 5 qLt.J"'nly G r f 1d~p t YWorri:Js ~bout m:Jny thinq~Is irrita~ll3, Quick to fly off t.hu h~ndl13Sucks thumb or fingor durinQ dayIs Ur,g·-;t by nBlIJ situ

,;;.sp. Qu'eliro Qu.Nc,.& Swoop

~- ......_.,I,..

c~~ ~ I ~ c. ()] J ~, r, ~~.__.__- .__r

t(

II

I·L

.I

tr~ .

I.L'~' .

!646566

Y6Y6Y6

,'.i,· I U-.rui.)i ' ,: : l k ., youU: \ l-J~lt.

.' l "., t. j : '

(1) d"s L) Ol'n !'u luc L'In t to IJO t\~, S .. I1:I" .1b) HdS h~)c; b~d urut"ms or r"'iyht t(Jrrur~.c) rins s 1L wp',).' ~'\ 1k 0 ,j

Pl_'''I:i~' fl .... d Ull· to

-----------.._. --_ .• _., .. -.-._ .._....Rasp. Qu'airoQu.No.

&Sweep

Housing (cont.)

Cnr,j Column

P I I • 25• 25

P I I • 23

U1iH'l how mnny p,;or1n dens child t~h::lrLJ hi~':/h'Jr hodroom?DO.Js(clli ld) shar.J hi~Jhd.: b~)tJ wi th nnyunw .;1 ~31j?

Is thu front door to thl\ AccDmmod:):i.on: Oo]ow strootlovnl; Bt stro~lt l.!v.iliground flcur; l'lt flllnr •••••• •• 13 th f 10:) I' and ;~.'::.'u vo?

V4Y4

Y4

5253

49 '

P 11 • 28a How s?ltisficd erG yuu llJi th tho hOU~;d (flnt, ute.) youliv8 in? Y4 59

• 28b What is it 3bout yCJur humo Ulilt In~~' r1iffarmarkodly from thrit of the nUighbuurhcod7 5

5 34

l ·

47

M P I 29 0005 the child mout othor chlldron outsidil tho housahold? 2 52

M

M

•

P 11 C, 16

P 11 C· 17

P I 9

P 11 • 21

How satisfind arG Y('IJ with plr.y t'ml:lnltills for ••• (chl1d'anaem) within about 10-15 minutos walk of hare? Y4

Excluding holidays I1\1Jay from homo, Elrl3 th:3 following8v;~il~~11Q ~nd he';J of ton has (r.hi Id) UBlld thr:'!m .in his/hot: sruro timo in thn rDsl twolvo monthG?A pnrk, pL.!!Jlic gurdon, hn;,th, common or fidl:!., whorech.ildr:.m are alloUJod to phJy; ~ r(]cr'l~t.iorl ground oroutdoor play contro; t.\uim~~ing or r:-,·.ldling pL.JCOB whichPH'Ossfo for childron! nn indoor plny cant.ro t or anychildrun's clUb or 30ciuty; .~ r.inornc, nr othl3r pl!'\clJwhich has chilctrDn's films 9hown; ;) pl~blic litJrery. Y4

G[OCR~rHIC M08ILI1Y

NumblJf of timo!J fnmHyhD:3 movfJd sinca chilcj'~ birth 2

As ~bovo Y4

34

!., ~...".

II

I '

fI.

I.

I·I

35-40:I~

r

f25-26 i

f46 J

lP I

P I

9

23

W,)$ nny of thOf:3!J movas out of t.hll local aro.1'?

Sjnco th~ ago of fiv~, how many schools h~s tha childatti:lndad?

2

2

27.. --.....

P 11 • 13 As 23 above * Y4 31

Standard Geographical Ragion (N,e.D.S, I & Porinatal) 1 2,5

Standard Geographicel Region N.e.D.S, 11 VI 2-4

7• 9

i·{

I!

Rusp. UU ' aTroOu ~-:~;:" SIAIBOP

r., . '11

1

C;-nd Column

-------------- ---------------_..•_--- ----_.--.._-------~---~~lrl":-:'~ T. lr "CH E.I~ ~T~~ TI~:.i S---._._--~ ---_._.

HT t I • 17, 18

::It 19

I~) lh.Tl. i' "'r',:mt.../tiJ,,1chur ~:'!.iC'.r ~·\t.i.(lIlfi

Aru rn.;··tll~'.J~ :11'; eng.)c.' for ~Ii·,r·-,~,tu, hi qj.;r'~:ld or;):.i~or;! )~.,tl..lii ~1"1 llJuc:\t,i~)nal m IttGr',':'

1

1

1

32

eT

20

21

El· 40

Dc !' L.;r~t:; ~;rLlv.idu ~~\J'LJt·\nf.inl 1'..)l'l fuL' .-.r;l'l:wl i,n monCJy,kind or InL~I'l'? 1

~11""; YCl: ,)bll) U' ::llow I)l,'~-~:;;:llu,d r:l:ildr ..ul I.n.;p :nrt soml1timo in scll/Jol l,Uf',)fJ tho)' ~'ir:hJf)l ':! ~lL"rt? 1

How n~ny r:hil.jrlJr~ ~ru thuru irl }'l1t1r CL)~8 whus.:J pC-frontshG\lO ·1.Jan }dJ (,H' thiJ tJ:~chor) :.:i Llis·::'U.l,.1 th.Ji~' child,:3 5. ne. ~ ~~ ':' iJ t.~ ,:-: ~ J r, 1'J EA ? 1

35

36

68-69

HT

eT/HT

E: I)t 31 SineJ 1~'jr·t'~-:,tJUr, 19b4, h~v·; ~h,; :~:',:',Jr1t1 t.:\.t'~r; ~:'l)initictiv,J t'-. dlSCUS~J thlj chJld, '\'.:1 ur.i'j"'ly, ,.lJith youor; :n y m0 mb 0 r Cl f)! (t ..J r t I ~ ., chi n Cl ;, l r, f f ? 1

£ 11. 11a SincJ tha bJ~linnlllg ef thl) ~lchool y:xlr t'1t',O::; ,.d.t.hot' p,-,rtJntt~k\ln th'l ini ti~"tiv') to .ti.SC i.JS3 the c~ilr·l, 'JV;Jrl br!qfly,with you nr ~GY mornbar 0' lhe to~chin~ SL'lff? VI

45

45

l',T E I 'c 32 H~.IS th,Jr.J bOi""n (111 i ~lJch di~;cus:',! :.Jr~ \d th thil ll~rdnt8 atin 8 t.i ~, :t .i. un of you Cl' y'JU r tu,lchJ nlJ .:: vlff? 1 46

eT/HT [ 11 f# lIb A3 32 nbUVd • YI 46

HT

•£ I 33 ~Jith r\J~:r~rd to thu cnild'r; ;1"iuc·ti':Fl"l pl'(Jqrjr:.·:, do tho

p,Jrt,;nts r..1,~r:·(Jd=: OV0r r;onc.Jrn~Jd 'IlJout thl~ chill~'s rrogr3ssC'lid/Gf ~)(poctinr] ton high t'! stDnrL"rrl/VJry intnr';Jst3d!Toshow :'(jt"'lO~.n t..J ru s t/ Tu cihaw 1it t 1,) or no 1r'\ t.r] r dlJ t/CII!Sr'l ' tSf',y or in"pplicobliJ 1 47-48

HT/eT E 11 fI 12 As oboVJ

For ~"':H'ur~!.'1 ::Ispl rltions for tho chi Id SOd r'~qu S

VI 47-48

o IVl I 28e H.~~ tl"FJ i.:hi Id bO..J1"l fOl.'mil i ly u;--,scllrt

mE SCIILOL--_.-_._--_.. -------- ------Rosp. QU'B1~e Qu.No.

& Sweop QU{Js~~iun

Tho fJrBsont School (r.unt.)

--,_._--_ .. --,--------------Card Column

E I I • 7

£ I I " Be

HT

ilT

HT

E: I 16

As 16 ~boV13 *

Hotv mCirly fu 11- tim.J !TJnmbllr~ 0 f tho t.ll,Jl.hil"l(:1your school cLJrrontly h~V:1? (Excluuinq tho

1 20-31

Vl 27-29

:, t 1f r c!l,osI1 u·~ut.IJ;;lchor) VI 30-31

\IHT

~ Bb

• Bc

E I I ' 3d

\ 313

If thoro ora pnrt-Umo 'm~)m blH'~J of [.Ld'f, ~iJh:)t full-timoeqL:ivolont nw.lhor of to~,cht1rs do thf.1Y r._lrI'a~,.mt.? vI

How many 0 f the :-.:ho vu fu 11 .. timJ LlilCh or:; h:l")': b ;.1i"Jn ~ tyour school for th:l folJ.awinQ lnnCJth~ of tim1?Tompornry (or t;uf11l1y) to':Il.:hurs/LG;,:J t.h,.tn (JfH) \'.Iholu year ••Mora th~n 10 wholo y~~rr.. VI

Namo of i~o(~d or rriI1l.~1;:':11 (~lr./f\lr,/~1i:j,~) Cr~t;d,: frJr sux yJ

Nmn3 oP ehlld'f. class tsach3r (~lr./~'r:)./r.li~l~d Cedod for Vl

32 ..33

34-39

14

15

tiT

~T

E: 11 • 9

£ I 36

S8>'How old ~ra thG mnin 3ch001 bullrlinqs?

Numbol' of pupils in child's prasor:t eJ:lss

VI

1

40-42

:T/HT £ 11 " 19

: r/H T E I I (j 20

As 36 ebovo * VI

Vl

f

59-60

61

:T. f: I

•38 HOI.\J i s t hBeln s s f () rm 0 d ? All t h Gin f ,') n t. 9 ~,r'l i rJ t his 0 n 0

class/ A dcl.ibor:,to CrOH~-!hjctioninCJ b~' "'g'! ~mr,j nhlli tyof mora than on,] y02't" group of chi IdI'on - ',Drn;lt:imU5 caD od -"family grouptng"/8y ogu in y8:)I' groLJ;'s (0.(1. on0 clotJspar yoar, or parallel cl~)ssnn)/301dct'ld by ,191~ tllt thin thClyaar group (o.g. children born in th(j fJr::Jt h:df of ~nn}'0ar in one clt:ss, ~nd th [I r~.?maindGr in flrli.. lh'J!/A., uppurability (or attcinmont) clOGS within tho school/A ~lddlocbi1i ty (or f1tt3inrnont) Cl::~s9 wi thin !;t!o school//'i low~rebility (or attainmont) clE1!3s within tho ~chuol/Othor 1 59

r/HT E: 11 0 IBa\. lab

Is thG child's ::"go group str8~mod t1Y ~It.·t 11 ty? VI

If strl3£101lJd by obility, is h13 in: A hlyll8r

,', i~: 'iCHCJU IRusp. Qu i a1 ro a~I.IIJ(J ~-.----.. ---_.

& S",aop QLI .. ::i t ion.. -.. _.--_._---------_._--

Cord Column

--------------------~

Sine,) Sur'l:Jrn~lur, 1964, h~vrJ thu '~:·.I',Jrlt3 t::knn tIninitint.iviJ tr cJi2CUSS thG child, UV~:'l brinfly, with youo r ~·m y mCl mb 0 r ('\ f you r b~:)chi n9 G l n f f? 1

HT

eT

HT

[ I • 17, 18, 19t 20

21

E I • 40

[ I ~ 31

PJ\~f;~T-1T~'CHEIl l.O~TAI.TS------

l~rL: rn'..:I·!~·,jr':!':.; ,Ir:2;)'.; ..ld f:1I' ~!;H"Ylt!:, ;)'! 8chr.r,.1 e,r.j~~;(Jr.i"I.iL'r' ':Yl •.;r!\lc:,tionf:l rn~lt.t.:Jr'-;?

D..: Il·'l_~t~; ~TI,vjd.· !·.I,i.l·~t· i,'.lill ' .. drl ha' I', ;1··;.;1 .'r~ money,kind ()r l~,L\IIJ:':'

Ar,j yL'\: i·;t~l!) to ':llow ih',:-',cho(') 1':,: ~ .,I J• ,n I, ;;. :nr.l 90mlJt i m0 i n ~) c! I U01 t· (J f ,.1 r j t tl Q Y ~ c t: Jr:. 1 1 ':! q t.. r VI

He-nu i:-~n~.' Ghilrirl.:n l~rlJ t.hdru in )"ll'!' r:J.n~H' V,hllC-;,J pnrontsh ~; V·] '·3 ,·W 11 Y(J L ( 0 r t n iI t J~ c h ur) ~ I} tJ .1. ~,C U 'i :; t h ,) i = chi 1d ,si ne.. :;,'p t .)I';"biJr, 19G \?

1

1

1

1

1

1

32

33

31\

35

36

68-69

45

iIf

l,t~.tI

IJ

CT/HT E 11 • lla Sine.] thu buginning of tho school y JF.1r hc!:.; u1 th or p()run ttl"lkon th () initi~tiv') to dlacuss the child, OViJn briot'ly,with you or ~ny momb3r 0"" the toC'ching 9 t~1 f f? Vl 45

~T E: I ~ 32 HL19 thuro boun eny ~lJch discusnlon ~.i th thu pnronts atins t~ grJ tion of' }O'OU 01' your tuachlng s to ff? 1 46

eT/HT E 11 f' llb A~ 32 nbovo • YI 46

HT

•£ I 33 ~Jith rlJ9",rrl to thl'.! chiLl' 0 :1l.1L1C ,t.iDn.~l rrnqr;.i~i~, do tho

par L; n t s Cl; il ['. :r: 0 V I.; reon C I.J r n wd ~'. IJl) L,; t t h (; chi 1d 's r rag r 3 SS£'Irld/or l.~xrJ\)cti:1J t.oo high Cl stnrd;~r·lhJ~lrv i;itur~Jstod/To~how somo il1t;rc;st/ To ~hO!.lJ Ilttl J or '-I'J inh!rd~Jl/C~"'ts ;:0, ~I 0 r i ~ ~ '''ID P1i r. nh 1" 1 47-48

HT/eT E 11 4 12 As nbov,) YI 4'7-48

o m I

SPECIAL EU;:'-,\lIm~

28a H:J3 the chj ld ~)udn f(;:;l\;'1.i.ly "·,~L,":l-·irF)d ;1: :.1: j',J')j ofspol-:i~l dducntionFd tI'.:mtmGnt"? If V_H.;, 5~flCifyCt' togory 6 56

o 1\1 I I • 9£1 Cc CJb As 2Bn ohn\l:) * V7 18-19o

o

mI

'" I

29b Is thG child roco1vlng sr~ci~l oducotlunal traatm~nt Ine spociBl school?

28c Or in e sruci81 to~ching unit?

6

6

57

58

o

o

fWI I

IWl I

28d 1sth tJ chi 1d 1 i I< J 1y to b iJ C 0 ~ si dIJ rod for a R fll) C i ~ 1 6 C hool? 6

29 Irraspactivo of' locel facilities, which of the followingwould you considor to b~ most suilorl tn tho child's aduc-etional noods? Ordin~ry school/Ordinary school withr..JrlhJdial CluBS or Qxtra to::,chinq h~Jlf1 (for JQuc7'tional or