Puerperal Fever

Puerperal fever, also known as "childbed fever" is an infection within the female reproductive system, present usually after an abortion or childbirdth takes place. The infection usually results in a fever in excess of one-hundred degrees faranheit. The infection is a very serious form of septicemia that usually occurs due to unsanitary hospital conditions during the procedure. As hygiene and sanitary conditions in hospitals have improved in recent years, the infection is now very rare within first-world countries, but is still found in many developing countries.

With puerperal fever, the inner surface area of the woman's uterus becomes infected, although an infection can also result in an unclean laceration of the genital tract that allows for bacteria to enter the wound, and thus the body. The most common bacteria that enters the wound, is streptococcus pyogenes, and it gains entrance into the bloodstream and additionally the lymphatic system. Consequently, the woman is able to contract numerous infections, including: septicemia, cellulitis, and peritonitis in the pelvic area.

The disease was first prevalent in seventeenth-century Europe, where medical doctors did not use sterile techniques nor was there any understanding of antisepsis. Additionally, hospitals of this era suffered from severe overcrowding, use of contaminated tools, bleeding, and dressing, and constant vaginal examinations. Hotel-Dieu de Paris suffered from a severe puerperal fever epidemic in 1646, and afterwards, European and American hospitals began rapidly reporting mortality rates of anywhere between twenty to thirty percent of women who gave birth, and women who gave birth in what were known as "childbirth wards" often suffered up to one-hundred percent fatality rates.

With the increase of fatality rates throughout the world, a number of leading medical doctors at the time began studying and observing those affected by the fever, in order to better surmise what the precise causes of the epidemic were. Most physicians during this time period suspected that the underlying causes of the infection were unsterile and unsanitary conditions that led to infection in the woman's genital region. Alexander Gordon, a medical doctor from Aberdeen, Scotland, believed that the women who were being infected by the disease were getting infected by the physicians and surgeons themselves, as they performed operations without ensuring their own sterility.

In 1843, a book entitled The Contagiousness of Puerperal Fever was published by a gentleman named Oliver Wendell Holmes. The book suggested numerous reasons for the epidemic, speculating the original cause of the infection and the rapid transmission among women during pregnancy. It was in this book, that Oliver Wendell Holmes suggested that the physicians were transmitting the disease from one woman to another while performing surger, and he also suggested that if surgeons began washing their hands, using sterile clothing, and did not persist in performing autopsies if they were involved in the birth-giving process, that the infection would not spread as rapidly. As as result of this claim, Oliver Wendell Holmes was "outed" throughout the medical community.

Throughout most of the nineteenth century, numerous studies were conducted to try and determine the underlying causes of the infection. However, it wasn't until 1879, when Louis Pasteur discovered that streptococcus was the common denominator among women affected by puerperal fever. As a result, it became common-place among hospitals, to use sterile utensils and antiseptic techniques, during the birth-giving process.