Childbed Fever in Nineteenth-Century Iceland

Childbed Fever in Nineteenth Century Iceland No woman in Iceland has died from childbed fever during the last 43 years. Thus it is safe to say that deaths from childbed fever have been eliminated in Iceland, though this is by no means the case in every country, as childbed fever remains the world’s third most common cause of maternal mortality. Moreover, untreated post-delivery uterine infections may result in serious illnesses, both in Iceland and elsewhere. Before the advent of antibiotics, and as late as the 1930s, post-partum mothers around the globe faced the risk of a uterine infection which might lead to death. The treatments till that time were in fact of no avail: they merely attempted to reduce swelling in the woman’s body, either by letting blood — which might be effected through leeches that sucked out blood — or by applying rectal enemas, cantharide plasters to both groins, or mercury ointment to the abdomen. Childbed fever, also known as puerperal fever, is defined as a post-partum septic infection that causes a high fever, occurs from the first 24 hours through the next three weeks after birth, and is caused by the bacterium Streptococcus pyogenes. These bacteria, which were discovered by Louis Pasteur in 1879, normally live on human skin. However, they may cause infections in bodily wounds, as well as in joints, bones and respiratory organs. Even on the skin, S. pyogenes can lead to erysipelas by gaining entrance to the body through surface wounds. If the bacteria enter the birth canal post-partum, they may spread from there into the uterine wall and continue into the fallopian tubes, the peritoneum, or tissues surrounding the uterus. Unless antibiotics are used, such an infection may lead to the woman’s death within only a few days. The bacteria manage to enter the birth canal via soiled hands or unclean medical devices used for delivery. It was not until the twentieth century that such devices were washed in special disinfectants, or that those assisting during labour washed their hands in disinfectant before touching the woman. When antibiotics were finally used for childbed fever, starting in 1938, deaths due to the disease were significantly reduced in Iceland as well as Norway. Increased hygiene near women giving birth also reduced the number of infections, with women today still being advised to exercise extreme hygiene following birth, due to this particular bacteria.