Catching babies: the professionalization of childbirth, 1870–1920

maternal mortality, were initially promoted as additions to existing practices rather than major innovations. The volume also provides a wonderful resource for anyone teaching the history of germ theories of disease. The documents from the period 1850-1904 (chapters 10-16) first show pre-germ ideas and then how bacteriological understanding was adapted into existing frameworks often with little change, for example, germs arising spontaneously as poisons, or invading the body as manufacturers of chemical poisons. Interestingly, no one seems to have reflected on the unsexing of childbed fever by bacteriology, as the disease changed from one seemingly specific to women in the puerperal state, to just another form of septic infection. Most of the documents are on the causes and prevention of childbed fever, but there were other issues, not least the pathology and nosology of the disease. Indeed, until the 1880s aetiology was not a major interest of clinicians who worried more about whether childbed fever was local or systemic, whether it was specific or a peculiar *form of sepsis, whether it was a zymotic fever, and what all this meant for the management of cases. The question of treatment in this century is covered in the two documents by Leonard Colebrook, both published in 1936. The second of these is the now famous paper on sulphonamides that he published with Maeve Kenny, but the first is a revealing review written only weeks previously which shows the state of clinical thinking and practice immediately prior to the antibiotic era. Colebrook shows that despite having detailed knowledge of germs and their actions, clinicians were still striving to make antisepsis and asepsis effective, and that he at least believed that the best hope of reducing maternal mortality lay in producing immunity with preventive and therapeutic vaccines. Sources such as these remind us of the different trajectories clinicians and researchers have followed, and also allow counterfactual reflection on how childbed fever would have been framed had there been no genms, no antisepsis and no antibiotics.