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Why Did So Many Women Die During Childbirth?

By Sam McCulloch

It’s not uncommon to hear people scoff at homebirths, saying things like, “In the olden days, that’s why so many women died!” But they don’t know all the details. Here are four major reasons why so many women died during and soon after childbirth.

1. Changes in Maternity Care

Historically, birth was a home-centered rite of passage. It included the birthing woman, her female relatives, and usually a midwife. Midwives would advise on prenatal care and nutrition, preparing the pregnant woman for the role of motherhood.

During the 1700s, male midwives (often barber surgeons) began attending both abnormal and normal labors and would often use instruments to “ease childbirth,” or shorten labor. Little prenatal care was given, other than fasting diets and bloodletting, which were intended to ensure a small baby and an easy birth. Sanitation and poor hygiene were not known to cause problems in those days, and this led to further deaths that could have been avoided.

2. Puerperal Fever

There were many theories surrounding the cause of puerperal (or childbed) fever, including bad air, vapors, cold, poor ventilation, and “putrid tendencies.” It wasn’t until the mid-1800s that a Hungarian doctor, Dr. Ignaz Semmelweis, discovered that when doctors performed autopsies and then delivered babies—without washing their hands or changing their clothes—women would develop puerperal fever and die.

Dr. Semmelweis was not applauded for his discovery. Doctors were offended by the accusation that they were responsible for causing disease, and continued to practice as always. Death due to puerperal fever averaged rates of 25 percent, rising at times to claim the lives of more than 80 percent of women birthing in maternity hospitals— truly epidemic proportions.

Eventually, maternity hospitals began adhering to strict guidelines for sanitation, which resulted in an immediate reduction in deaths by puerperal fever.

3. Obstructed Labor

By the 17th century, lying down during labor had become the accepted norm to provide greater ease and access for doctors, who had moved into the birth business. Women with pelvic problems would often be in labor for many hours, even days. Often, doctors forbade women to drink or eat during labor, only allowing them sips of wine or spirits; laboring women would become completely exhausted.

The methods of treating obstructed labor before the invention of the forceps would be considered barbaric today. Doctors used a number of gadgets (including hooks) to pull babies out. Some doctors would even break the pelvic bone of the mother, killing her but saving the baby’s life.

Cesarean sections were rarely performed, and if the mother survived the surgery, she was likely to die of blood loss or infection afterward.

4. Postpartum Hemorrhage (PPH)

Historically, one of the leading causes of maternal death was excessive bleeding after childbirth. It was feared by midwives and doctors alike. Little could be done to stop a hemorrhage; the accepted treatment at the time was to pack the uterus with linen rags that had been dipped in wine or other astringents. Other treatments included applying heated compresses or taking herbal tonics.

Human blood transfusions and the use of ergot, an extract from fungi, have paved the way for more successful treatments for postpartum hemorrhages. Today, induction of labor is known to increase their risk.

This article was originally published by