The impact of early medical technology on maternal mortality in late 19th century Sweden

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Abstract
The prevention of fatal complications of childbirth is a priority of health care in the developing countries. This historical study of maternal deaths in Sweden analyzes the decline in mortality between 1751-1900 and during this years maternal mortality was reduced by 76% whereas the female mortality dropped only by 33%. The decline was especially pronounced during the period 1861-1900, when matenral mortality declined from 567 to 227 per 100,000 live births. The potential impact of medical technology was analyzed by epidemiological methods for the period 1861-1900. The introduction of antiseptic technique was estimated to reduce septic maternal mortality 25-fold in lying-in hospitals and 2.7-fold in rural home deliveries, implying that 49% of the septic maternal deaths were thus "prevented". In addition, licensed midwives assisting at home deliveries were estimated to reduce non-septic mortality 5-fold, thus "preventing 46% of the non-septic maternal deaths. This could be one explanation why Sweden had a lower maternal mortality than the U.S.and the U.K. in the beginning of the 20th century.