The death of Izanami, an ancient Japanese goddess: An early report of a case of puerperal fever

SummaryEven in the 21st Century, approximately 60,0000 women die of pregnancy-related causes each year. WHO reported that 98% of these deaths occur in developing countries; the largest gap between rich and poor nations was evident in the maternal mortality levels. In developed countries, massive hemorrhage and thrombo-embolism are the most frequent causes of maternal death, while in developing countries perinatal infection is the leading cause.In the oldest Japanese classic tale, Kojiki, the goddess Izanami no mikoto, one of the creators of Japan, was killed by her last son, Kagutsuchi, a deity of fire who burned his mother’s birth canal. We propose that this tale reflects the incidence of local puerperal infection and subsequent sepsis, the greatest health risk to mothers in ancient Japan.