Dr. Clif CleavelandChildbirth in early 19th-century Europe often ended tragically for mothers and their babies. Puerperal or “childbed” fever complicated many births in hospitals. Hungarian physician Ignaz Philipp Semmelweis laid the foundation for ending the epidemic. This month marks the bicentennial of his birth on July 1, 1818.
Semmelweis grew up in a German-speaking family in what is now Budapest. In college, he switched from law to medical studies, earning his doctorate from the University of Vienna in 1844. Following training in obstetrics, he accepted an appointment in 1847 as an assistant in the university’s maternity hospital, which was the largest in the world.
At that time, midwives delivered most babies at home. Maternity hospitals treated poor women and women facing complicated deliveries.
Maternity services in Vienna’s hospital were split between a doctor-run division, which included medical students, and a second, smaller service directed by midwives. High mortality for mother and baby characterized the doctors’ service, where up to 20 percent of deliveries resulted in death of newly delivered women. Fever, worsening abdominal pain, copious, cloudy vaginal drainage and kidney failure – the hallmarks of childbed fever – developed in the mother during the first two days of delivery. Death soon followed. Many of the newborn of the affected mothers died. Autopsies showed abscess formation and severe swelling and inflammation of pelvic and abdominal organs.
Care on the midwives’ service was generally safe and free of the febrile complication. Maternal mortality seldom exceeded 1 percent.