Semmelweis and the Conquest of Puerperal Fever (1847-1940s)
Ignaz Semmelweis discovered that hand hygiene could prevent childbed fever, cutting maternal deaths from 18% to 2% in his ward. His findings were rejected by the medical establishment; antisepsis only became standard after germ theory was accepted decades later. Sulfonamide antibiotics in the 1930s and penicillin in the 1940s finally made puerperal sepsis treatable.
Semmelweis was ostracized and died in an asylum. Antiseptic techniques spread slowly through the late 19th century.
By 1960, maternal mortality in industrialized countries had fallen to roughly 60 per 100,000—one-fortieth of 19th century rates. Sepsis dropped from causing half of maternal deaths to a small fraction.
The century-long gap between Semmelweis's discovery and widespread adoption illustrates how social and institutional factors—not just medical knowledge—determine health outcomes. Today's challenge is similar: the interventions to prevent most maternal deaths exist; the barrier is access and implementation.