The Tragedy of Childbed Fever

The Tragedy of Childbed Fever

The Tragedy of Childbed Fever

The Tragedy of Childbed Fever


Childbed fever was by the far the most common cause of deaths associated with childbirth up to the Second World War, throughout Britain and Europe. Otherwise known as puerperal fever, it was an infection which followed childbirth and caused thousands of miserable and agonizing deaths every year. This book provides the first detailed account of this tragic disease from its recognition in the eighteenth century up to the second half of the twentieth century, examining it within a fully comprehensive history of infective diseases.


Although many have written about various aspects of childbed (or puerperal) fever, and especially about Semmelweis, I think I can claim that this is the first comprehensive history of the disease. It covers the two hundred or so years from its first recognition as a separate entity in the eighteenth century, through to the second half of the twentieth, when it rapidly became all but extinct as a lifethreatening disorder. in the title of this book I have used the term 'childbed fever' because it is simple, plain, and vivid English, and much easier to pronounce than 'puerperal fever'. Unfortunately, as the reader will discover, the term 'childbed fever' became obsolete quite early in the nineteenth century and 'puerperal fever' became firmly established.

I had never thought of it as a suitable subject for prolonged research until I undertook a study of the history of maternal mortality. Soon, I discovered that my mountain of notes and photocopies on puerperal fever threatened to swamp all other aspects of maternal mortality. It was vast. Indeed, an obstetrician in the 1880s wrote that 'More is said to have been written on this disease than on any other. Dr Fordyce Barker found that within the comparatively short period of twenty years, 1854 to 1874, upwards of 20,000 pages had been published on the subject.' Did the industrious Fordyce Barker really know? Did he really count? There is no way of telling, but I personally doubt if he exaggerated. Furthermore, I would guess that the number of pages had already come close to 10,000 before 1854, and I am certain that far more than 20,000 pages have been published about puerperal fever between 1874 and the present time. So I completed the book on maternal mortality with brief references to puerperal fever, and started on this one.

Such an abundance of sources, much of it repetitive, is not of itself a sufficient reason for a book; but the truth is that the story of this dreadful disease is as gripping and as memorable, if not more so, than the history of any other disease. Moreover, writing this story has provided a unique opportunity for the exploration of changing ideas on the nature of fevers and contagion, the role of hospitals in childbirth, the impact of bacteriology and antisepsis, and the complex pathway that led to immunization and the antibiotics. It has also provided an opportunity to explore some aspects of the history of streptococcal disease as a whole.

C. J. Cullingworth, Puerperal Fever: a Preventible Disease (London, 1888), 7.

I. Loudon, Death in Childbirth: An International Study of Maternal Care and Maternal Mortality
1800–1950 (Oxford, 1992).

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