[New born's apparent death (1781-1806) through François Chaussier's Work]

What shall we do in front of a new born looking as a dead one? François Chaussier (1746-1828) recommended Oxygen gas (Dijon 1781) and, further laryngo-intubation (Paris 1806). Closely versed in basic sciences, it did not need to be very bold to do the trick in such an occurence. Senior-Physician in Paris Maternity Hospital from 1804 to his death, he was Senior-Obstetricians' intimate friend (Jean-Louis Baudelocque and, after 1810, Antoine and Paul Dubois) as well as with Senior-Midwives, chiefly Madame La chapelle who died in 1821. Then, that Maternity Hospital, not only reputed for obstetrics success get mother-and-baby pathology top marks under Chaussier.

[From infant nurse to "baby-friendly hospital"--promotion of breast feeding in the University Women's Hospital in Leipzig]

The attitude of medical professionals towards natural infant feeding is decisive in the support of mothers who want to breastfeed. The atmosphere in a "Baby-Friendly Hospital" is determined by the creation of conditions for breastfeeding on demand and for early, undisturbed mother-child contact. At the University Women's Hospital in Leipzig the development of good breastfeeding management was supported by the employment of a "breastfeeding nurse" and enhanced by continuing education for physicians, nurses and midwives in lactation and breastfeeding. In this way comprehensive, uniform information as well as practical guidance important for breastfeeding success were ensured for pregnant and young mothers.

[Birthing institutions and births in Norwegian counties in the early 1990s]

Between 1972 and 1993 the number of hospitals and maternity homes providing obstetric help in Norway fell from 158 to 67. Most of the decline is explained by the closing down of maternity homes and obstetrical units in small hospitals, partly due to a reduction in number of births and partly to a deliberate drive towards giving birth in larger units. 16 of the 19 counties of Norway contained four or fewer obstetric institutions in 1993. Nevertheless, most of the 60,000 births took place in institutions with between 500 and 2,999 births annually. Births at home accounted for 0.3%, and births during transport for 0.2% of the total in 1990 and 1993.

[Room with a view for the "daughters of pain": 1828 was the beginning of new obstetrics in Erlangen]

The roots of clinical obstetrics at the University of Erlangen go back as far as the end of the 18th century. In 1796, Christian Friedrich Deutsch (1768-1843) was appointed as the first university teacher solely responsible for obstetrics. At the same time, he was also vehemently committed to the creation of a clinical institution for the purpose of training in obstetrics. For several reasons, the opening of a maternity home in a converted private house on the outskirts of town did not take place until 1828 under the leadership of Anton Bayer (1791-1832). In 1854/55, it was possible to move into a new building situated directly next to the university hospital; this new building was planned by Eugen Rosshirt (1798-1872). The increasing number of births and students as well as the introduction of gynecology finally led to the establishment, in 1878, of the first gynecological hospital in the sense understood by us today. The hospital was designed by Karl Schröder (1838-1887) who was the first Erlangen teacher of obstetrics to complete his habilitation in this field and probably has to be considered as the founder of the science of obstetrics at the University of Erlangen.

[The gate the Kaiser opened for women. Rotenhausgasse (1), Vienna-Alservorstadt]

This paper refers to one of the entrances to the former 'delivery house' of the old Vienna General Hospital, namely the door in Rotenhausgasse. It was used for 70 years, from 1784 to 1854. According to the wishes of Emperor Joseph II, unmarried women could be supported by specialists, anonymously and thus escaping shame. Connected with it was the protection of the newborn against exposure and infanticide.

[Losing one's life giving birth: maternal mortality at Port-Royal 1815-1826]

In this paper, we have studied the "Hospice de la Maternité", created in 1795 to replace the "Office des acouchées of the Paris "Hôtel-Dieu". Our objectives were first to conduct a demographic study of the pregnant women coming to the maternity and second, to evaluate the patterns of maternal mortality. Our data are constituted individual medical reports between 1815 and 1826. 4086 women issued from a quest at the letter B have been observed. Because of the relative low number of deaths in this population (192), we decided to investigate four other years (1817, 1818, 1819 and 1821), where the deaths were exhaustively recorded. Unwed mothers represented 80.4% of the population and their mean age was 25, whereas married women were more than 30 years old. Nearly all these women came from the working class, especially three sectors, sewing (35.4%), servants (31.8%) and workers (20%). More than three quarters dwelled in Paris; among them, less than 20% were born in the city. Mortality was very high, it reached 6%. Forsaking was more prominent for unwed women (81.7%) than for married mothers (58.3%). The stay at the Maternity was rather long, mean 23 days. Maternal mortality was high, 47 for thousand, but we noted important fluctuations amongst years and seasons. The demographic analysis of the population showed that the Maternity appears as a transition structure between the ancient "hospices" and the modern hospital. The poor economic and physiological status of women explained that, despite the noticeable improvement in care, the mortality rate will remain elevated during all the century, and even increase.

[Puerperal infections. From Semmelweis to current problems]

Maternity hospitals began to be established in the middle of the 18th century to relieve the distress of the poor. As the number of lying-in hospitals increased, so did the cases of puerperal sepsis. The death rate from puerperal sepsis in Norway was high and remained so until 1934. Semmelweis studied the maternal mortality rates in two obstetric clinics in Vienna for the years 1841-46. He declared that puerperal fever was transmitted by the doctors who taught in the dissecting room and went straight from there into the labour wards. I 1847 he instructed all doctors or students to scrub their hands in a solution of chloride of lime before they delivered, examined or touched any patient. The haemolytic streptococcus was finally proved to be the cause of puerperal sepsis by Louis Pasteur in 1879. There was a significant drop in mortality rates in maternity hospitals after the introduction of antiseptic and aseptic techniques around 1880. Deaths from puerperal fever paralleled deaths from erysipelas, and both conditions declined after 1934. Puerperal fever and pelvic inflammation is still a clinical problem. The author discusses sexually transmitted diseases and multibacterial causes.

The centenary of Ivy Cottage, Belfast City Hospital

Images

Transformations in maternity services in Jamaica

Analysis of the current organization and delivery of maternity care in Jamaica profits not only from an assessment of recent health issues but from consideration of the development of maternity services over the past century. Historical analysis indicates that a critical element in public health policy has been the effort to encourage use of biomedical obstetrical care and to eliminate the lay midwife. However, while women increasingly patronize hospitals, the delivery of services has deteriorated, resulting in widespread client dissatisfaction. Economic contingencies have contributed to the decline in maternity services, but health personnel manifest the ideology prevalent throughout the colonial era equating social irresponsibility with health complications. The cultural construction of illegitimacy and maternity is shown to be a dimension of class relations having an impact on health policy throughout Jamaica's history.

Cinderella had a champion

Images

A short history of Kandang Kerbau Hospital and the maternity services of Singapore

This article traces the history of Kandang Kerbau Hospital ("the hospital beside the Bukit Timah Canal") and the maternity and infant welfare services of Singapore from 1858 to the present. This includes the development of teaching of Obstetrics and Gynaecology to medical undergraduates and postgraduates, and the training and registration of midwives, and the resulting saving of maternal and infant lives. Why was Kandang Kerbau Hospital converted into a Maternity Hospital in 1924?

The value and need of more attention to end-results and follow-up in hospitals today. October 23, 1923

Dr. George Ward, in a long-forgotten paper presented at a meeting of the American College of Surgeons on October 22, 1923, describes a hospital with a massive commitment to the continuous improvement of the quality of care.