Institutional iatrogeny and maternal death, Semmelweis and puerperal fever


  • Oswaldo Salaverry García Centro Nacional de Salud Intercultural, Instituto Nacional de Salud. Lima, Perú. Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú. Médico, doctor en medicina.



Puerperal infection, Maternal mortality, Hospital mortality, History of medicine


Puerperal fever is a disease that becomes epidemic in the eighteenth century as a result of two factors: the urban working masses generated by the industrial revolution and the progressive hegemonization and medicalization of birth care in large public hospitals. Institutionalized maternal death reached figures above 30%, while in the case of birth care provided by midwives, it was than 2%. Semmelweis, an Hungarian physician, sustained that physicians contaminated women in labor due to insufficient hygiene after performing necropsies and established prophylactic measures in the Vienna Hospital that reduced mortality dramatically. However, his ideas were rejected because they affected the institutionalization process of medicine, based on altruism and honor, which would make it impossible to cause harm to patients. He was forced to leave Vienna Hospital and he continued his struggle in Budapest, but the rejection and disagreement of his peers with his doctrine affected his mental health. He died in an asylum, a few years before Pasteur and Koch proved the existence of the bacteria that caused diseases such as puerperal fever.


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Public Health History

How to Cite

Salaverry García O. Institutional iatrogeny and maternal death, Semmelweis and puerperal fever. Rev Peru Med Exp Salud Publica [Internet]. 2014 Mar. 11 [cited 2024 Jun. 23];30(3). Available from: