Death in Childbirth: An International Study of Maternal Care and Maternal Mortality, 1800-1950

Author: Irvine Loudon
Published: January 1994
Publisher: Oxford University Press
ISBN: 0198229976
Hardcover Book
Number of Pages: 648

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This is the first international study of maternal care and maternal mortality. Over the last two hundred years, different countries developed quite different systems of maternal care. Death in Childbirth is a meticulously researched analysis, firmly grounded in the available statistics, of the evolution of those systems between 1800 and 1950 in Britain, the USA, Australia and New Zealand, and on the continent of Europe. Irvine Loudon examines the effectiveness of various forms of maternal care by means of the measurement of maternal mortality - the number of women who died as a result of childbirth. His scholarly and comprehensive study sets out to answer a number of important questions. What was the relative risk of a home or hospital delivery, or a delivery by a midwife as opposed to a doctor? What was the safest country in which to have a baby, and what were the factors which accounted for enormous international differences? Why, against all expectations, did maternal mortality fail to decline significantly until the late 1930s? Death in Childbirth makes an invaluable contribution to medical and social history.

Table of Contents
List of Figures
List of Tables
Introduction 1
Pt. I The Measurement of Maternal Mortality
1 The Measurement of Maternal Mortality 11
2 Problems of Measuring Maternal Mortality 19
Pt. II The Causes of Maternal Mortality
3 The Determinants of Maternal Mortality 43
4 Puerperal Fever 49
5 Toxaemia of Pregnancy and Eclampsia 85
6 Obstetric Haemorrhage 97
7 Abortion 107
8 Other Causes of Maternal Mortality 130
Pt. III Maternal Care and Maternal Mortality in Various Countries
9 The Importance of International Comparisons 151
Britain
10 Maternal Mortality in Pre-Registration England 158
11 The Eighteenth Century and the Origins of Man-Midwifery 166
12 Maternal Care in Nineteenth-Century Britain 172
13 Maternal Care in Britain, 1900-1935 206
14 Maternal Mortality in Britain from 1850 to the Mid-1930s 234
15 Maternal Care and Maternal Mortality in Britain, 1935-1950 254
USA
16 The Geography and Politics of Maternal Care in the USA: Introduction 274
17 Home Deliveries and the General Practitioner 281
18 The American Midwife 298
19 The American Lying-in Hospital, 1850-1910 327
20 Attitudes to Childbirth and the Problem of Pain 340
21 The Orgy of Interference 351
22 Maternal Mortality in the USA 365
Europe
23 Introduction 398
24 European Midwives 402
25 European Lying-in Hospitals and Obstetricians 428
26 Maternal Care and Maternal Mortality in Selected European Countries 445
27 Australia and New Zealand 463
28 Maternal and Infant Mortality 483
Appendix 1: Hidden Maternal Deaths 518
Appendix 2: England and Wales: The Classification of Maternal Deaths 525
Appendix 3: Reports on Maternal Mortality in the USA 528
Appendix 4: Numbers of Births and Statistical Significance 532
Appendix 5: The Problem of Streptococcal Virulence 534
Appendix 6: Tables 541
Select Bibliography 585
Index 616

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