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Ulf Högberg, MD, PhD

The author is with Obstetrics & Gynecology, Department of Clinical Science, and Epidemiology, Department of Public Health and Clinical Medicine, University of Umeå, Umeå, Sweden.

Correspondence: Requests for reprints should be sent to Ulf Högberg, MD, PhD, Obstetrics & Gynecology, Department of Clinical Science, University of Umeå, S-901 87 Umeå, Sweden (e-mail: ulf.hogberg{at}obgyn.umu.se).

The maternal mortality rate in Sweden in the early 20th century was one third that in the United States. This rate was recognized by American visitors as an achievement of Swedish maternity care, in which highly competent midwives attend home deliveries. The 19th century decline in maternal mortality was largely caused by improvements in obstetric care, but was also helped along by the national health strategy of giving midwives and doctors complementary roles in maternity care, as well as equal involvement in setting public health policy.

The 20th century decline in maternal mortality, seen in all Western countries, was made possible by the emergence of modern medicine. However, the contribution of the mobilization of human resources should not be underestimated, nor should key developments in public health policy.

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