How has mother/ child mortality evolved from pre industrial era?

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There have been 2 big changes in the Modern era that had major effects on public health during and immediately after childbirth.

The first was the increasing population density along with centralization of public health. This made industrializing nations slowly become better and better environments for disease. (We of course aren't rooting for the disease here, so this was a Bad Thing)

The second was the advent of modern medicine, which came into play around the beginning of the 20th Century. That had a gigantic positive impact on mortality of nearly every kind.

What this means in the data is that you should be seeing a slow increase of maternal and infant mortality throughout the early modern period, followed by a dramatic drop in both in the 20th Century.

Below are some data graphs I found covering this on Our World In Data.

Historical infant mortality data

This is a bit messy, because not a lot of people have collected data on this subject using methods that can be consistent over this kind of length of time. However, I'd suggest you look at the numbers for Germany, which show it going from about 35% in 1692, to 60% for the next 2 centuries, then down to about 23% at the end of that period. The global rate is now down to a historic low of 2.3%, with the vector still headed downwards.

Its perhaps a sad commentary on the historic status of women that numbers for maternal mortality seem to be even tougher to come by, but I did find some from the same outlet, sadly only going back to the mid 18th Century.

Maternal Mortality History

Finland is the line to watch here. What we see is a noisy but perceptible slow increase around the 0.8 to 1.0% range, then a drastic drop-off starting around the beginning of the 20th century, down to almost nothing now.


To give you a real-world illustration of what was going on, consider the story of maternity ward hand-washing. In 1846 Dr. Semmelweis at a hospital in Vienna decided to gather and study the data on that hospital's high maternal mortality (touchingly called "puerperal fever"). He found that his learned male doctors were five times more likely to lose patients than the hospital's midwives were. Midwives were of course the traditional caregivers for childbirth that pretty much everyone in pre-modern Europe used.

After looking into it, and trying several things (remember, this was before Germ Theory), he discovered that forcing his doctors to hand-wash and clean their instruments with bleach dramatically cut down on the deaths. So everyone just did that from then on, and oodles of lives were saved forever, right?

Well, no. What actually happened was that the doctors really resented having to do this, and particularly the implication that they were somehow unclean and killing their own patients. That got him really mad back at the doctors, with the eventual result was that he was fired. Then he tried evangelizing this approach with the medical community at large, to similar effect, this time ending up getting committed to an asylum. There he, ironically, died of sepsis.

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