ABSTRACT
The shocking maternal mortality and morbidity and perinatal mortality statistics of ‘developing’ nations are often worse than comparable rates for Europe and North America at the beginning of the twentieth century. At the beginning of the twentieth century maternal mortality rates, long used as an index of the effectiveness of midwifery care, varied between five and ten per thousand births in Europe and America. It became apparent that well-fed, parous, rural women were less likely to as a result of pregnancy than city dwellers and those who delivered in institutions. The relationship between hypertension, proteinuria and edema, and pre-eclampsia was recognized at the beginning of the twentieth century. In the early part of the twentieth century many women died as a result of poor anesthetic technique, and the use of anesthetic gases that were dangerous for the pregnant woman.
