Why Is Puerperal Fever Not Regarded as a Sexually Transmitted

Why is puerperal fever not regarded as a sexually transmitted infection? What spreads the disease?

A) A physician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later.
B) The trauma of the delivery of the placenta through the vaginal tract after the fetus introduces bacteria directly into the bloodstream, resulting in puerperal fever.
C) A woman's own normal fecal microbiota can occasionally cause puerperal fever if it contaminates the genitourinary tract following delivery. This can especially occur after an episiotomy procedure (cutting between the vaginal opening and the rectum) .
D) A physician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later AND a woman's own normal fecal microbiota can occasionally cause puerperal fever if it contaminates the genitourinary tract following delivery. This can especially occur after an episiotomy procedure (cutting between the vaginal opening and the rectum) .
E) The trauma of the delivery of the placenta through the vaginal tract after the fetus introduces bacteria directly into the bloodstream, resulting in puerperal fever AND a physician that doesn't observe proper sterile technique may introduce bacteria from the environment into the genitourinary tract of a woman during delivery of a child, inducing puerperal fever several days later.