Let's Revive Childbed Fever! Back to the Future, Part 21

Yay! We're Reviving Childbed Fever! Back to the Future, Part 21

So, among all the other great news lately, there's this: in the two years since Texas banned abortion, rates of deadly sepsis, leading to maternal mortality, have skyrocketed.

Before the twentieth century, "childbed fever" (or "puerperal fever") was the name given to the septic infection that led to many women's deaths: "Before the advent of antiseptic practices—and, later, antibiotics to treat sepsis when it occurred—puerperal fever was almost always fatal. In the 18th and 19th centuries, there were between six and nine cases for every 1,000 deliveries, resulting in a death toll during that span of as much as half a million in England alone. Puerperal fever was far and away the most common cause of maternal mortality and was second only to tuberculosis among all causes of death for women of childbearing age."

Eugène Devéria,

La Mort de Jane Seymour,

Reine d'Angleterre (1847),

Musée de Valence

But now, in one more example of "back to the future," childbed fever is back!

As reported by ProPublica's Lizzie Presser, Andrea Suozzo, Sophie Chou, and Kavitha Surana, "Pregnancy became far more dangerous in Texas after the state banned abortion in 2021."

In their analysis of the life-threatening complications faced by pregnant women in Texas, the researchers focused first on rates of sepsis--infection--for women who were hospitalized after losing a pregnancy in the second trimester. 

Medical treatment is readily available for women in these circumstances: 

The standard of care for miscarrying patients in the second trimester is to offer to empty the uterus, according to leading medical organizations, which can lower the risk of contracting an infection and developing sepsis. If a patient’s water breaks or her cervix opens, that risk rises with every passing hour.

Sepsis can lead to permanent kidney failure, brain damage and dangerous blood clotting. Nationally, it is one of the leading causes of deaths in hospitals.

But in Texas, this medical treatment is now unavailable--doctors and hospitals are unable (or unwilling) to treat women for fear that their treatments will be regarded as an illegal abortion.

And so women are dying. The figures provided by the researchers are stark: In 2021, before the Texas abortion ban took full effect, "67 patients who lost a pregnancy in the second trimester were diagnosed with sepsis--as in the previous years, they accounted for about 3% of the hospitalizations."

But, those numbers have changed dramatically: "In 2022, that number jumped to 90. The following year, it climbed to 99."

Wait. There's more.

ProPublica zoomed out beyond the second trimester to look at deaths of all women hospitalized in Texas while pregnant or up to six weeks postpartum. Deaths peaked amid the COVID-19 pandemic, and most patients who died then were diagnosed with the virus. But looking at the two years before the pandemic, 2018 and 2019, and the two most recent years of data, 2022 and 2023, there is a clear shift:

In the two earlier years, there were 79 maternal hospital deaths.

In the two most recent, there were 120.

This is where we are now--a return not to the twentieth century or even to the nineteenth, but back to the eighteenth century and even earlier. While women have always died of childbed fever--it was recognized by the ancient Greek physician, Hippocrates--the number of cases of childbed fever grew after male physicians began to take over childbirth and delivery from midwives and, in particular, when childbirth moved from home to "lying-in" hospitals in the early modern period. As one example, an "epidemic" of childbirth fever was recorded in 1646 at the Hôtel-Dieu in Paris. (Laura Helmuth's "The Disturbing, Shameful History of Childbirth Deaths" is an excellent place to start reading if you're interested.)

So, you know, who needs all that modern medical treatment. Stuff like up-to-date obstetric care, sanitary practices, and antibiotics. Let's just go with bullshit and misogyny--what's the big deal if a few women die along the way, right?

I've written many entries in this blog noting women who died from childbed fever. Because of the popularity of the Tudors, I'll include a few names here. Jane Seymour, Henry VIII's third wife, is one of the more famous women who died of childbed fever--within two weeks of giving birth to the son that Henry VIII had so longed for, Jane Semour died. Henry VIII's mother, Elizabeth of York, also died of childbed fever, as did the woman who had been his sixth wife (but managed to survive him). Katherine Parr died after giving birth to a daughter, whose father, Thomas Seymour, was Jane Seymour's brother. 

The tomb of Katherine Parr,
St. Mary's Chapel,
Sudeley Castle

I don't usually link to Wikipedia pages--not because I don't value the resource a great deal (I donate regularly, and I suggest you do too) but because it's easily accessible to all. But I am going to link here to the list of notable women who died during childbirth or from complications to childbirth--it's an eye-opener. 

But even as I link you to “notable” women, every woman who suffers a terrible, unnecessary complication is notable to us—a beloved daughter, wife, partner, sister, friend, neighbor, even perhaps a mother already. She is a singular human being. 

Update, 7 May 2025: More data from Kavitha Surana, Lizzie Presser, and Andrea Suozzo at ProPublica:

As ProPublica reported earlier this year, the statewide rate of sepsis—a life-threatening reaction to infection—shot up more than 50% for women hospitalized when they lost a second-trimester pregnancy.

A new analysis zooms in: In the region surrounding Dallas-Fort Worth, it rose 29%. In the Houston area, it surged 63%. . . . 

This marks the first analysis in the wake of abortion bans that connects disparities in hospital policies to patient outcomes. It shows that when a state law is unclear and punitive, how an institution interprets it can make all the difference for patients.

Yet the public has no way to know which hospitals or doctors will offer options during miscarriages. Hospitals in states where abortion is banned have been largely unwilling to disclose their protocols for handling common complications. When ProPublica asked, most in Texas declined to say.

ProPublica’s Texas reporting is based on interviews with 22 doctors in both the Houston and Dallas-Fort Worth metro areas who had insight into policies at 10 institutions covering more than 75% of the births and pregnancy-loss hospitalizations in those areas.

The findings come as evidence of the fatal consequences of abortion bans continue to mount, with a new report just last month showing that the risk of maternal mortality is nearly twice as high for women living in states that ban abortion. 

 As devastating as this article is, I cannot recommend it enough.