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Two hundred years of evidence-based perinatal care: late-fetal mortality in the past
  1. R I Woods1,
  2. A Løkke2,
  3. F van Poppel3
  1. 1Department of Geography, University of Liverpool, Liverpool, UK
  2. 2Department of History, University of Copenhagen, Copenhagen, Denmark
  3. 3Netherlands Inter-Disciplinary Demographic Institute, Hague, The Netherlands
  1. Correspondence to:
    R I Woods
    Department of Geography, University of Liverpool, Liverpool L69 7ZT, UK; riwoods{at}

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Modern evidence-based perinatal care is dependent on the ability of registration systems to record birth outcome precisely and reliably. In the English-speaking countries, this began in the early 20th century with stillbirth registration in a few states in the US. England and Wales followed in 1927, Scotland in 1939, the Irish Republic in 1959 and Northern Ireland in 1961. In The Netherlands, Belgium and France, stillbirth registration began in the mid-19th century. However, in Norway and Denmark, registration had been part of the national system for nearly 200 years, and in Sweden it began as early as the 1750s. In the Scandinavian countries, registration of stillbirths was from the very beginning thought to be an instrument with which to monitor birth attendance and to obtain evidence on what could be considered best practice. In 1802, all clergymen in Denmark and Norway were ordered to include the number of stillborn in their yearly statistics and all midwives were also obliged to report every birth to the local clergyman “where the infant came dead to the world or died within 24 hours after birth”. The report should include

…in which month of the pregnancy the mother gave birth, the reason for the premature delivery, if it could be known; with regard to the confinement, if the fetus came easily, was natural or difficult, required turning or was delivered by instrument; if there was life to be seen or not after it was born; in the first case, how long the life lasted; if the midwife used any manipulations or remedies to bring it to life, or keep it alive, and what; or not, and why not; if the mother formerly had given birth to any stillborn infant.1

Of course, many difficulties …

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  • Funding: RIW acknowledges the financial support from the Wellcome Trust for a project entitled “Fetal Health and Mortality in the Past”.

  • Competing interests: None.

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