The incidence of puerperal sepsis has shown but a moderate decrease the past few years. Even today its frequency is appalling and justifies the tremendous volume of censure to which the American medical profession is now subjected.
During the past quarter of a century the surgical technic of delivery has shown definite improvement. The progress of labor is now largely determined by abdominal palpation; vaginal examinations are made with increasing care and only when a rectal examination will not furnish the desired information. But there still remains a degree of sepsis which is inconsistent with a normal physiologic process, constitutes a national peril and demands further research in contradistinction to the indifference of today.
Severe and even fatal infections can and do occur in spontaneous deliveries under ideal conditions when the patient has been in labor only the average length of time and presents no history of recent coitus, douches
MILLER HA, MARTINEZ DB, HODGDON ME. PROPHYLAXIS OF PUERPERAL SEPSIS. JAMA. 1930;95(13):923-925. doi:10.1001/jama.1930.02720130019005