Thank you for acknowledging midwives who have long helped women and really have ‘known’ much about L&D and early pp care that have slowly been ‘proven’ to be advantageous.
Curious though what was going on 1841-43 when both clinics had quite a bump ?
The bump in Vienna in 1842 reflects a structural change in staffing and clinical practice at the Allgemeines Krankenhaus, not a random fluctuation.
In 1841–1842, the First Obstetric Clinic, staffed by physicians and medical students, markedly expanded its role in pathological anatomy and autopsy-based teaching. Medical students routinely moved directly from cadaver dissections to labor wards, conducting vaginal examinations without handwashing or disinfection. At the same time, the clinic experienced overcrowding and increased examination frequency, both of which amplified exposure. The Second Clinic, staffed by midwives who did not participate in autopsies, did not experience the same rise.
This temporal association between cadaver contact and puerperal fever mortality was later formalized by Ignaz Semmelweis in 1847, when he introduced chlorinated lime handwashing, leading to an immediate and dramatic mortality reduction.
This episode remains one of the clearest historical demonstrations that institutional practices, not patient characteristics, drove maternal mortality.
In Vienna in the 1840s, gloves were not used in clinical medicine. Rubber surgical gloves did not enter practice until the late 19th century, first introduced by William Halsted in 1889, and even then initially to protect the surgeon’s hands, not the patient. In obstetrics during the Semmelweis era, bare-handed vaginal examinations were universal.
Thank you for acknowledging midwives who have long helped women and really have ‘known’ much about L&D and early pp care that have slowly been ‘proven’ to be advantageous.
Curious though what was going on 1841-43 when both clinics had quite a bump ?
The bump in Vienna in 1842 reflects a structural change in staffing and clinical practice at the Allgemeines Krankenhaus, not a random fluctuation.
In 1841–1842, the First Obstetric Clinic, staffed by physicians and medical students, markedly expanded its role in pathological anatomy and autopsy-based teaching. Medical students routinely moved directly from cadaver dissections to labor wards, conducting vaginal examinations without handwashing or disinfection. At the same time, the clinic experienced overcrowding and increased examination frequency, both of which amplified exposure. The Second Clinic, staffed by midwives who did not participate in autopsies, did not experience the same rise.
This temporal association between cadaver contact and puerperal fever mortality was later formalized by Ignaz Semmelweis in 1847, when he introduced chlorinated lime handwashing, leading to an immediate and dramatic mortality reduction.
This episode remains one of the clearest historical demonstrations that institutional practices, not patient characteristics, drove maternal mortality.
In Vienna in the 1840s, gloves were not used in clinical medicine. Rubber surgical gloves did not enter practice until the late 19th century, first introduced by William Halsted in 1889, and even then initially to protect the surgeon’s hands, not the patient. In obstetrics during the Semmelweis era, bare-handed vaginal examinations were universal.