The “savior of mothers,” as Ignaz Semmelweis (1818–1865) is often called, was a Hungarian physician who drastically reduced the death rate in 19th-century Austrian birth clinics by implementing a simple procedure: hand washing.

In 1844, Semmelweis was put in charge of a teaching hospital in Vienna that had two maternity wards—one attended by midwives and one attended by doctors and medical students. He noticed that the mortality rate of women in the midwife clinic was much lower than in the physician clinic, about 2 percent versus 16 percent, and that most of the deaths resulted from a mysterious sepsis (infection) known as puerperal fever, or childbed fever. When he requested that the staffs of the two wards be switched, he determined that it was the personnel, not the wards themselves, that were associated with the high mortality rates. Women who gave birth at home, he noticed, also had a much lower risk of developing childbed fever.

While all birth attendants followed the same routine, Semmelweis did recognize one difference: The physicians and students also performed daily autopsies on women who had died the day before, the medics often traveling directly between cadavers and women in labor and seldom washing their hands. In 1847, a fellow professor at the hospital cut his hand during an autopsy and subsequently died of a condition resembling childbed fever. Semmelweis determined that it must have been the same illness—which was clearly contagious, being transmitted from dead women’s bodies to living women’s exposed genital areas (and to this one unfortunate doctor) via the physicians’ hands.

Semmelweis experimented with various cleansing agents and mandated that all birth attendants wash their hands in a chlorinated lime solution before each vaginal examination. The mortality rate fell to less than 3 percent almost immediately, but his theories were widely rejected and he was ridiculed by a society that did not believe that disease could be caused by germs. By the end of the 19th century, however, germ theory had been proven by Louis Pasteur (1822–1895), and the need for antibacterial agents during childbirth was well appreciated. Today it is understood that most childbed fever was caused by Streptococcus, bacteria introduced into the genital tract during delivery.

ADDITIONAL FACTS

  1. After the medical community dismissed Semmelweis’s observations, he wrote a series of angry and embittered letters to his former professors and colleagues, accusing them of being “medical Neros” and “murderers.”
  2. It is rumored that Semmelweis became mentally ill in his later years. He died in a psychiatric institution in Vienna, ironically from what was rumored to be sepsis from a self-inflicted wound.
  3. Ancient Hindu and Greek texts offered advice on hygiene for birth attendants, and the Hippocratic Corpus mentioned childbed fever. But no physician before Semmelweis seemed to grasp the true cause.