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Special Delivery

On the Cutting Edge: C-Sections Throughout History

The origins of the Caesarean section's name—like the rest of the operation's history—remain shrouded in mystery and debate.

Alleged birth of Julius Caesar by Caesarean section

Detail from a 1506 woodcut allegedly portraying the birth of Julius Caesar, a live infant being removed from the womb of a dead woman. Image courtesy National Library of Medicine.

Popular legend attributes it to the birth of Julius Caesar, claiming the Roman Emperor was cut from his mother's womb. This account has met with some skepticism since his mother is reported to be alive at the time he invaded Britain.

Some scholars say the phrase springs from the Latin verb "caedare," meaning to cut. Still others believe the name comes from the Roman decree that required the procedure be used to save infants whose laboring mothers were either dead or dying.

The concept of surgical delivery, whatever its origin, has been recognized around the world for hundreds of years. According to historian Renate Blumenfeld-Kosinski, the oldest description of a Caesarean birth appears in a cuneiform tablet from Mesopotamia dating back to the second millennium B.C.

Plate from Scultetus's Armamentarium Chirugicum

Plate from Johannes Scultetus's 1666 work on surgery, Armamentarium Chirugicum, showing a Caesarean section. Image courtesy National Library of Medicine.

Folklore holds that babies born by Caesarean section are tied to the mystical and are said to possess extraordinary strength. The Greek gods Adonis and Bacchus were both born by Caesarean section, as was the medieval hero Tristan. Pliny the Elder wrote in his Natural History of the auspiciousness of a Caesarean birth.

If early literature rarely mentions the mothers, it's because they died. The first written report of a mother and child surviving finally comes in 1500 when Swiss pig gelder Jacob Nufer sought permission from authorities to operate on his wife after several days of fruitless labor.

Francois Rousset, an early proponent of Caesareans on living women, wrote later that Nufer made a single deep cut and extracted the child on the first try, then sewed his wife up in the same manner he used with his animals. The following year, she supposedly gave birth to twins, this time without surgery.

German woodcut depicting Caesarean birth

A 15th century German woodcut depcits Caesearen birth. Image courtesy of the Pierpont Morgan Library, New York. PML 199.

Western medicine had no monopoly on the procedure. Jane Eliot Sewell, who penned a history of the Caesarean section for the National Library of Medicine, cites 19th century accounts of successful surgical deliveries in Rwanda and Uganda. African healers used botanical preparations to anesthetize their patients and promote wound healing.

Breakthroughs in anesthesia, antiseptics and antibiotics over the past 200 years have been the keys to saving both mothers and children. Reminders of that rapid change can be found in state historical markers like the one outside Donaldsonville, La., which salutes the town as the home of Dr. F.W. Prevost, who "performed first Caesarean section, 1824." —Irene Svete

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