The role of emergency obstetric care in preventing maternal deaths: an historical perspective on European figures since 1751

Abstract

A review of the time-relationships is provided between the introduction of obstetric techniques and organization of obstetric care in Europe and the decrease of maternal death rates from 1751 to 1980. Published figures were used to discover the evolution of maternal deaths in Europe for the last 250 years, and to propose a parallel analysis of major modifications of obstetric care. The teaching of obstetrics to midwives and general practitioners, introduction of forceps and of low-segment cesarean section technique, disappearance of home deliveries, antibiotics, anesthesia and blood banks are among the addressed techniques. Even if a causal relationship cannot be proposed, the major inflection in the rate of reduction of maternal deaths is related to the introduction of low segment cesarean section in the first years of the 20th century. This progress was also related to the progressive transfer of birth sites, from home to specialized units.