Childbed fever is a fairly uncommon illness occurring at the termination of a pregnancy through childbirth, miscarriage, or abortion. Also called puerperal sepsis, this condition represents bacterial infection of the reproductive organ, which can spread to the bloodstream. This disease exists today primarily when women give birth in unhygienic circumstances or when they receive abortions that are not conducted in a sterile manner. Worse, in such situations antibiotics may not be available, making certain spread of disease will not be controlled. At one point impact of childbed fever was felt much more extensively.
17th century Britain provides the first documented cases of childbed fever, but it’s likely that cases existed long before documentation. The issue was studied in depth in several countries in the 18th-19th centuries since women faced extraordinary risk by having a baby. 10-20% of them might die during labor, and the numbers were higher for those obtaining abortions. Doctors learned to recognize symptoms, which usually began with a fever higher than 100 degrees F (37.78 degrees C) within the first 10 days after a birth occurred, but they didn't understand cause, and until the mid-20th century, there was no effective treatment.
Some of the most important work done in these two centuries on childbed fever is credited to Alexander Gordon, Oliver Wendell Holmes, and Ignaz Semmelweis. All three men supported handwashing to prevent spread of disease. In that climate, none of these men were listened to with much respect, and it is very probable that plenty of physicians were disease carriers, not just of childbed fever, but of many other illnesses.
In the early 20th century, after the work of Louis Pasteur and others, it became evident physicians could pass illness from one patient to another. Medical teaching lined up with this view, suggesting various solutions for cleansing the hands to prevent infection. Even with such measures, childbed fever cases still occurred, though less often, and they couldn’t be treated because no antibiotics existed. With antibiotic development, a cure was possible.
In developed countries today, the issue of childbed fever is a minor problem. It may still occur, but usually responds to treatment. It’s likely to be an issue after illegally obtained abortions more than after labor. In these circumstances, procedures may not be hygienic, and the person is unlikely to seek additional medical treatment for symptoms like fever. In developing countries there are areas where childbed fever remains tragically problematic and where it is hard to obtain treatment for it.
Since this illness may still occur, women having had an abortion, miscarriage or labor and delivery should report any presence of fever higher than 100 degrees F to doctors immediately if this occurs the first 10 days after end of pregnancy. Suspected cases of this condition are best treated individually. Different antibiotics might be used depending on the bacteria present. In some cases, a woman with a known infection is treated prophylactically, before birth, to prevent infection of the uterus or bloodstream.
