The concept of caesarean section , that is, of being able to have a baby born through an abdominal route, is quite old and has been associated in various cultures with powers or special characteristics attributed to children who are born in this way.
In particular, there were rumors that Julius Caesar was born in this way, but they seem to be just rumors, since in ancient times it was not possible to save a woman’s life during cesarean section. The second king of Rome Numa Pompilius proclaimed that no deceased pregnant woman could be buried without the fetus being removed from her womb, a description that goes back to the caesarean section, albeit a caesarean section performed after the mother’s death. By law, it was necessary to perform this procedure on the woman to see if her fetus was still alive. On the other hand, caesarean section and babies born in this way began to be associated with certain characteristics such as extraordinary strength or an unusual destiny. It is possible to think of the subsequent story of Macbeth and the prophecy that leads to his fall that has the caesarean section as a fateful element.
Where does the word caesarean section come from?
The origin of the word is debated, as the connection to the mythological birth of Julius Caesar who was “too strong” to be born normally may be a possibility. However, this is debated, since the term is attributed to Rousset with his treatise published in 1581 after which the term cesarean section was adopted in various countries around the world.
For much of history, cesarean sections were performed post-mortem on women or resulted in the death of the mother. The first reference to a caesarean section being performed on a living woman is in 1500 , however, it is not an official record. It is made in Switzerland by Jacob Nufer who, beyond being a doctor, was a pig breeder.
The first case that is accepted without objection occurs in 1610 in Germany. It is performed by surgeons Seest and Trautmann on a woman who had been injured by an arrow. The cesarean section was performed with the survival of the baby, but the mother died after 25 days due to sepsis. That leads to the operation being condemned by surgeons of the time as it led to the death of the mother, however, it is still practiced if the pregnant woman dies before giving birth.
The risks associated with cesarean section in the past
Caesarean sections continued to be practiced , however, they led to the death of the mother, although the babies managed to survive in many cases.
The main problems associated with the operation were infections and pain management during surgery. Important discoveries in this regard involved the use of chloroform, introduced by James Young Simpson, and the antibiotics that appeared thanks to the work of Louis Pasteur and Robert Koch. Koch and Joseph Lister, in particular, introduce antiseptic treatment of the operative area.
Advances that improved the technique
In 1882, German gynecologists Ferdinand Adolf Kehrer and Max Sanger introduced the concept of silver and silk sutures to close the uterus after cesarean section. That technique led to further successes and was taken up and improved upon in the early 20th century. Edoardo Porro in 1876 helped to solve another of the problems of caesarean section, uterine infection, by performing hysterectomy after caesarean section, which led to better results for mothers.
In the 20th century, the previously developed methods were perfected and the cesarean section became a procedure with its risks, but much more routine, which in many cases ensures the survival of the mother and the baby.
Today the word caesarean section and its derivatives continue to be used in many languages, dating back to an ancient practice and to the word Caesar itself, although others have related the term caedere , from the Latin to cut. The etymology is debated to this day, although it is likely that it was formally introduced into the vocabulary in the 16th century.
But answering the initial question, regarding the first caesarean section in history, we can consider the revolutionary surgery performed in 1610. At least, it is the first well-documented. However, it is clear that the operation had been performed before to try to save the fetus of the deceased woman and that the practice of caesarean section in one way or another dates back to more ancient times. The operation that today is performed as something more routine was once impossible or was associated with myths and legends.
Martínez-Salazar GJ, Grimaldo-Valenzuela PM, Vázquez-Peña GG, Reyes-Segovia C, Torres-Luna G, Escudero-Lourdes GV. Caesarean section: History, epidemiology, and ethics to diminish its incidence. Rev Med Inst Mex Seguro Soc. 2015;53(5):608-15.
Van Dornen, P. (2009). Caesarean section – etymology and early history. South African Journal of Obstetrics and Gynaecologyl, 15 (2).