Monday, February 28, 2011

History of Midwifery - Why women died in childbirth

The history of midwifery has always fascinated me and especially those heroes and heroines who have tried to advance the profession of obstetrics and midwifery.

I am going to start with one hero in particular, Ignaz Semmelweis, a Hungarian physician working in Vienna.  It was Semmelweis, who in 1847 investigated the cause of puerperal sepsis or childbed fever among women attending the lying-in hospital.  He found that there was an increased death rate amongst women during childbirth who were attended by Doctors rather than midwives, who worked in another ward.  After conducting his own research, Semmelweis found that the cause of the sepsis was because physicians were not washing their hands between carrying out post-mortems and then attending women in childbirth.  Midwives did not attend postmortems so they were not to blame.  Semmelweis insisted that physicians attending his ward washed their hands with a chlorinated lime solution and, with this procedure enforced, he found that the death rate dropped considerably.

However, the medical fraternity dismissed Semmelweis' theory and refused to accept the blame for causing so much death.  As the germ theory had not yet been developed unfortunately the deaths continued, although Semmelweis continued to persue his theory, he was vilified from every corner of the medical profession and eventually suffered a nervous breakdown.  One comment made by an outraged physician to Semmelweis' theory was "A Doctor is a gentleman and a gentleman's hands are clean."  That would be funny if it were not so tragic, Semmelweis was committed to an insane asylum where he died in 1865.

By the end of the 19th century, the need for obstetric and midwifery hygiene and cleanliness was accepted by the medical profession.  The developement of antiseptic and discovery of antibiotics have greatly reduced the maternal mortality rate.

Further reading:
Pairman, S., Pincombe, J., Thorogood, C., Tracy, S.  (2006).  Midwifery preparation for  
     practice. Elsevier:Australia. 

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