Caesarean Section - History

History

The mother of Bindusara (born c. 320 BCE, ruled 298 – c.272 BCE), the second Mauryan Samrat (emperor) of India, accidentally consumed poison and died when she was close to delivering him. Chanakya, the Chandragupta's teacher and adviser, made up his mind that the baby should survive. He cut open the belly of the queen and took out the baby, thus saving the baby's life.

According to the ancient Chinese Records of the Grand Historian, Luzhong, a sixth-generation descendant of the Yellow Emperor, had six sons, all born by "cutting open the body". The sixth son Jilian founded the House of Mi that ruled the State of Chu (c. 1030–223 BCE).

In the Irish mythological text the Ulster Cycle, the character Furbaide Ferbend is said to have been born by posthumous Caesarean section, after his mother was murdered by his evil aunt Medb.

The Babylonian Talmud, an ancient Jewish religious text, mentions a procedure similar to the Caesarean section. The procedure is termed yotzei dofen.

Pliny the Elder theorized that Julius Caesar's name came from an ancestor who was born by Caesarean section, but the truth of this is debated (see the article on the Etymology of the name of Julius Caesar). The Ancient Roman Caesarean section was first performed to remove a baby from the womb of a mother who died during childbirth. Caesar's mother, Aurelia, lived through childbirth and successfully gave birth to her son, ruling out the possibility the Roman ruler and general was born by Caesarean section.

The Catalan saint Raymond Nonnatus (1204–1240), received his surname—from the Latin non-natus ("not born")—because he was born by Caesarean section. His mother died while giving birth to him.

An early account of Caesarean section in Iran is mentioned in the book of Shahnameh, written around 1000 AD, and relates to the birth of Rostam, the national legendary hero of Iran. According to the Shahnameh, the Simurgh instructed Zal upon how to perform a Caesarean section, thus saving Rudaba and the child Rostam.

In 1316, the future Robert II of Scotland was delivered by Caesarean section—his mother, Marjorie Bruce, died. This may have been the inspiration for Macduff in Shakespeare's play Macbeth.

Caesarean section usually resulted in the death of the mother; the first recorded incidence of a woman surviving a Caesarean section was in the 1580s, in Siegershausen, Switzerland: Jakob Nufer, a pig gelder, is supposed to have performed the operation on his wife after a prolonged labour. However, there is some basis for supposing that women regularly survived the operation in Roman times. For most of the time since the 16th century, the procedure had a high mortality rate. However, it was long considered an extreme measure, performed only when the mother was already dead or considered to be beyond help. In Great Britain and Ireland, the mortality rate in 1865 was 85%. Key steps in reducing mortality were:

• Introduction of the transverse incision technique to minimize bleeding by Ferdinand Adolf Kehrer in 1881 is thought to be first modern CS performed.
• The introduction of uterine suturing by Max Sänger in 1882
• Extraperitoneal CS and then moving to low transverse incision (Krönig, 1912)
• Adherence to principles of asepsis
• Anesthesia advances
• Blood transfusion
• Antibiotics

European travelers in the Great Lakes region of Africa during the 19th century observed Caesarean sections being performed on a regular basis. The expectant mother was normally anesthetized with alcohol, and herbal mixtures were used to encourage healing. From the well-developed nature of the procedures employed, European observers concluded they had been employed for some time.

The first successful Caesarean section to be performed in America took place in what was formerly Mason County, Virginia (now Mason County, West Virginia), in 1794. The procedure was performed by Dr. Jesse Bennett on his wife Elizabeth.

On 5 March 2000, Inés Ramírez performed a Caesarean section on herself and survived, as did her son, Orlando Ruiz Ramírez. She is believed to be the only woman to have performed a successful Caesarean section on herself.