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Views & Reviews Review

When rubella ruled

BMJ 2011; 342 doi: (Published 16 February 2011) Cite this as: BMJ 2011;342:d967
  1. James Owen Drife, emeritus professor of obstetrics and gynaecology, Leeds
  1. J.O.Drife{at}

Before the era of vaccination mothers had real dangers to worry about. James Owen Drife enjoyed a book (especially the pictures) that charts 50 years of changes in medical practice for pregnant women and in societal attitudes

When you enter the NHS website the first word you see is “choices.” Healthcare wasn’t always like this, particularly for pregnant women, and if you go back 50 years you discover another world, where choice was almost unknown. In 1960 the pill and the intrauterine contraceptive device were not yet available, and termination was illegal. A woman who chose not to continue with a pregnancy had to resort to criminal abortion, which became England’s leading cause of maternal mortality.

What if the fetus was abnormal? In 1961 thalidomide was withdrawn in the United Kingdom, but other teratogens were less easily avoided. An Australian ophthalmologist, Norman Gregg, had recognised in 1941 that rubella (German measles) in pregnancy caused cataracts in the newborn. Medical science then discovered its other risks, including deafness, heart disease, and learning disabilities, but could offer neither a cure nor, at that time, prevention. A woman who contracted …

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