The medical care of pregnant women (obstetrics) and of female genital diseases (gynecology) developed along different historical paths. Obstetrics had for a long time been the province of female midwives (see midwifery), but in the 17th century, European physicians began to attend on normal deliveries of royal and aristocratic families; from that beginning, the practice grew and spread to the middle classes. The invention of the forceps used in delivery, the introduction of anesthesia, and Ignaz Semmelweis’s discovery of the cause of puerperal (“childbed”) fever and his introduction of antiseptic methods in the delivery room were all major advances in obstetrical practice. Asepsis in turn made cesarean section, in which the infant is delivered through an incision in the mother’s uterus and abdominal wall, a feasible surgical alternative to natural childbirth. By the early 19th century, obstetrics had become established as a recognized medical discipline in Europe and the United States.
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