Just How Old Is C-Section Birth?

Reproduction of woodcut, 1483. Wikimedia Commons // CC BY 4.0
Reproduction of woodcut, 1483. Wikimedia Commons // CC BY 4.0

An 18th-century Hungarian woman made history this week—her mummified remains preserve the earliest direct evidence of C-section. Sadly, neither she nor her full-term son survived. Which raises the question: Just how old is C-section birth, and when did women and babies start surviving it?

CHILDBIRTH AS EVOLUTIONARY COMPROMISE

Basically since humans started walking upright, childbirth has been difficult for women. The brains of our hominin ancestors got larger and larger, with the result that today’s average newborn has a head 102 percent the size of its mother’s bony pelvis. Yes, you read that right—our babies’ heads are actually larger than our skeletal anatomy.

Obviously, an evolutionary compromise was worked out, so that humans could have large-brained babies and still walk upright. Babies’ skulls bones can slide around and overlap to help them get out. The fetus also goes through a sort of dance when it’s born, wiggling and turning with the help of contractions to make its way through the bony pelvis. And, perhaps most importantly, towards the end of pregnancy, a hormone is released that weakens the cartilage of the joints of the pelvis, letting it widen just enough for the baby to come out.

But we humans also rely on culture for our existence, and the same is often true for birth. The caesarean section—which includes the Latin root word for cut—involves extraction of a baby through a cut into the mother’s uterus. Although the practice dates back thousands of years, women didn’t survive it until comparatively recently.

HISTORICAL RECORDS OF C-SECTIONS

Ancient Roman relief carving of a midwife attending a woman giving birth. Wikimedia Commons // CC BY 4.0

There is some argument among scholars that C-sections were performed in Egypt around 3000 BCE, but the earliest clear documentation in ancient texts comes from early Rome. The second king, Numa Pompilius (c. 700 BCE) passed a law called the Lex Regia, later renamed the Lex Caesarea and reported in Justinian’s Digest (11.8.2). This law forbade burying a pregnant woman until her offspring had been excised from her body. The reason stated for the law was that there was a small chance the baby would survive, but it is unclear if the law was religious in nature or whether it simply aimed to increase the population of tax-paying citizens. A similar reference to post-mortem delivery comes from Sage Sustra, a practitioner of Hindu medicine around 600 BCE. But in neither case is it clear how often—if ever—this was carried out.

This means that the first person who was born by C-section is also hotly debated. Julius Caesar is often held up as the most famous example, with the assumption that his cognomen—third name or nickname—resulted from his style of birth. Sadly, it seems that the Roman author Pliny either made this up or was referring to a very distant ancestor of the Julii clan. Since women didn’t survive C-sections in ancient Rome, Caesar’s mother Aurelia, who lived well into her 60s, did not deliver him in that way.

Historical records of famous people born by C-section actually go back further than Caesar, though. Some scholars claim [PDF] that the earliest documented C-section produced the orator Gorgias in the 5th century BCE, but the historical evidence is murky. Although Pliny was wrong about Caesar, in his Historia Naturalis (VII.ix) he wrote that the celebrated Roman general Scipio Africanus was born in this manner in 236 BCE. If either of these cases is correct, there is evidence of viable offspring from C-sections nearly 2500 years ago. But these procedures were certainly only done when the mother died or was about to die in childbirth.

It wasn’t until the 1500s that doctors began to expect women to survive the procedure. French physician François Rousset broke with medical tradition at the time and advocated performing C-sections on living women. In practice, though, it was still only performed as a last-ditch effort to save the newborn. Certainly some women survived C-sections from the 16th to 19th centuries, but it was still a very risky procedure that could easily lead to complications like endometritis or other infection. C-sections didn’t become common until the 1940s, following advances in antibiotics that made them survivable.

ARCHAEOLOGY OF CHILDBIRTH AND C-SECTIONS

Medieval caesarian on a deceased woman. Wikimedia Commons // CC BY 4.0

The infant mortality rate was very high in antiquity, as were rates of mothers dying in childbirth. Consequently, you might expect that archaeologists have found loads of mother-fetus burials. But very few exist. In fact, the number of pregnant female burials in the published archaeological literature from around the world is only about two dozen.

There are several potential reasons for this lack of evidence. First, archaeological methods got significantly more scientific in the 1970s, so more recent excavations are better at finding tiny fetal bones. Second, the mother could outlive the fetus, and the newborn could outlive the mother. Death at different times will not be obvious archaeologically as evidence of childbirth-related complications. Even when the mother and baby both die before birth, though, this may not be evident because of a phenomenon called “coffin birth”—when the gases that build up within a corpse cause post-mortem “birth” of the fetus. And finally, cultural practices could be to blame for our lack of evidence—application of the Roman Lex Caesarea, for example, could result in a woman buried by herself and a viable newborn who grows up and dies much later.

Unfortunately for archaeologists, C-sections usually involve soft tissue only, so it is unlikely that we will ever find direct ancient evidence of it in a skeleton. There are two possible ways to see physical evidence of ancient C-sections. One is cut marks on the pelvis made around the time of the mother’s death by a surgeon. (Normally, C-sections don’t involve cut bones, but symphysiotomies—cutting through the front of the pelvis—can be done with or without accompanying C-sections to aid in delivering a baby.) The second is a mummy with an incision into the uterus and other physical changes associated with pregnancy and labor. At the International Conference on Comparative Mummy Studies earlier in April, the first-ever direct evidence of an early C-section was presented. The case study, presented by anthropologist Ildikó Szikossy of the Hungarian Natural History Museum, involves a woman named Terézia Borsodi, who died in December 1794 during the birth of her sixth child. While historical records suggest that the baby boy was delivered alive, Terézia’s mummy shows she was likely already dead when the C-section was performed. The baby also did not survive, and they were buried together.

CHILDBIRTH IS BIOLOGICAL AND CULTURAL

Successful Caesarean section performed by indigenous healers in Kahura, Uganda (1879). Wikimedia Commons // Public Domain

Childbirth is both a biological and a cultural process, today and in the past. But while biological variation is consistent across all human populations, the cultural processes that can facilitate childbirth are quite varied. A quick glance at the rates of elective C-section around the world demonstrates this easily. So archaeologically, we should also expect to see variation in the lives, deaths, and burials of women and infants.

Archaeologists use skeletons, historical records, medical artifacts, and other clues from burials to reconstruct childbirth practices and interventions in the past. New advances in microscopic analysis of the bones of ancient fetuses are also revealing whether or not the baby was alive or stillborn. As the archaeological record gets better, and as excavation, recording, and analysis techniques advance, we should soon have better methods for understanding this key time in the lives of mothers and infants, and for figuring out when the earliest C-sections occurred.

A Pair of Dutch World War II Shipwrecks Have Disappeared Off the Coast of Malaysia

jfybel/iStock via Getty Images
jfybel/iStock via Getty Images

For nearly 80 years, two Dutch submarines have been occupying the ocean floor off the coast of Malaysia, with the remains of their crews still inside. They were among dozens of shipwrecks in the same area, all of them casualties of underwater World War II battles. Now, the ships— known as HNLMS O 16 and HNLMS K VII—are gone.

There’s nothing paranormal at work, though. Instead, the ships have vanished as a result of greed. Scavengers in the area have made a profitable pursuit of placing explosives within the wrecks, blowing them into manageable pieces and taking off with the scrap metal using a crane. Copper and bronze materials can also be resold. It’s estimated that about 40 ships in Indonesia, Singapore, and Malaysia have been demolished as a result of such efforts in recent years.

Because the ships are typically considered unmarked graves, the thieves may be committing the crime of desecrating corpses. After several British ships were found ransacked, the UK’s Ministry of Defense urged Indonesia to increase their efforts to protect the ships. The United States has dispatched representatives in Indonesia to guard ships they believe have been targeted by the scavengers.

Marine archaeologists have expressed some puzzlement at the phenomenon, as the scrap can often take weeks to retrieve, is frequently corroded, and would seemingly be cost-prohibitive to steal considering the labor involved. It’s possible that the ships may be targeted for having low-background metals, which are free from radiation because they pre-date atomic bomb testing and can be used in delicate scientific instruments like Geiger counters. In China, scrap metal could bring in about $1.3 million per ship. 

[h/t Live Science]

10 Shipwrecks You Can Visit

Suphaporn/iStock/Getty Images Plus
Suphaporn/iStock/Getty Images Plus

UNESCO says that there are no fewer than 3 million shipwrecks lost beneath the waves, with many of their locations just waiting to be discovered. But for tourism purposes, the most interesting shipwrecks are those we already know about—and can visit. These 10 shipwrecks have intriguing stories, and they’re all places where you can step foot, although in some cases a boat (and possibly scuba gear) may be necessary. Remember: Look, don’t touch, since removing artifacts can spoil the chance for valuable archeological research (and is often illegal).

1. Bessie White, Fire Island, New York

Fire Island shipwreck on white sand
A Fire Island shipwreck thought to be the Bessie White
Nick Normal, Flickr // CC BY-NC-ND 2.0

The 200-foot schooner Bessie White wrecked off the shore of this barrier island while laden with coal in 1919 or 1922 (historians aren't sure of the exact date). The crew escaped, but the 3-year-old ship ran aground. In October 2012, Superstorm Sandy revealed the battered remnants of what's believed to be the ship's hull, which had been carried to a spot near Skunk Hollow in the Otis Pike Fire Island High Dune Wilderness. The National Park Service sometimes leads hikes to the wreckage, whose location over time provides scientists with clues to how the landscape of Fire Island has changed.

2. MS World Discoverer, Solomon Islands

World Discoverer wreck off Guadalcanal
World Discoverer wreck off Guadalcanal
Philjones828, Wikimedia // CC BY-SA 3.0

A cruise ship built in 1974 that once carried passengers to polar regions, MS World Discoverer ran aground in the Solomon Islands in 2000. No lives were lost—all the passengers escaped via ferry after an uncharted rock pierced the ship's hull. Today the wreckage is still a tourist attraction in Roderick Bay in the Nggela Islands, listing heavily against the shore.

3. Peter Iredale, Warrenton, Oregon

The wreck of the Peter Iredale in the Fort Stevens State Park, Oregon, USA, at sunset
The wreck of the Peter Iredale in the Fort Stevens State Park, Oregon, USA, at sunset
ROBERT BRADSHAW, WIKIMEDIA COMMONS // CC BY 2.5

Now a haunting ruin along the Oregon coast, the Peter Iredale was once a four-masted steel barque sailing vessel owned by British shipping firm Iredale & Porter. In September 1906, the ship left Santa Cruz, Mexico, on its way to Portland, Oregon, where it was supposed to pick up wheat bound for the United Kingdom. But a heavy wind and strong current sent her on to the breakers and she ran aground at Clatsop Beach, with three of her masts snapping from the impact, according to the Oregon History Project. The wreckage became an immediate tourist attraction, and despite being buffeted by the wind and waves ever since, it remains so today. It’s now part of Fort Stevens State Park.

4. MV Panagiotis, Zakynthos Island, Greece

The rusty wreck of the Panagiotis on Zakynthos Island
The rusty wreck of the Panagiotis on Zakynthos Island
Simon Dux/iStock/Getty Images Plus

This shipwreck in the Ionian Islands gives its beach its nicknames: Navagio ("shipwreck") Beach and Smugglers Cove. Supposedly, the Panagiotis, which wrecked there in the early 1980s, was smuggling cigarettes and alcohol. The rusting hulk of the boat is far from the only thing to see, however; the beach also attracts visitors for its clear turquoise waters and pristine pale sand. It’s also one of the most popular spots for BASE jumping in the world. The cove can be accessed only by boat. Be careful taking selfies from the cliff, however: At least one tourist fell to their death that way.

5. SS Maheno, Fraser Island, Australia

Fraser Island S.S Maheno Shipwreck
The S.S Maheno Shipwreck on Fraser Island

Once an ocean liner that plied the Tasman Sea between New Zealand and Australia, the SS Maheno was also used as a hospital ship for the New Zealand navy during World War I. She was later sold to a Japanese ship-breaking company for scrap, but broke apart in a cyclone on the journey to Japan in 1935. Since washing ashore on Australia's Fraser Island, the ship has become a major tourist attraction, despite not being particularly safe.

6. SS Oregon, Long Island Sound, New York

Once the fastest liner on the Atlantic, the SS Oregon sunk in 1886 just 18 miles off New York after hitting an unidentified schooner, often thought to be the Charles R. Morse. After an unsuccessful attempt to plug the hole in the hull with canvas, the captain ordered the ship abandoned, even though there were only enough lifeboats for half the ship's 852 passengers. (Fortunately, another ship arrived to save the passengers, and there were no casualties.) Today the wreck is a popular dive site in Long Island Sound. Although the ship's hull and decks have disintegrated over the years, the engine and boilers remain, among other remnants.

7. Uluburun, Bodrum, Turkey

Granted, it's in a museum, but the Uluburun wreck, which sank off the coast of Turkey during the late Bronze Age, is one of the oldest ships ever found—it dates back 3,500 years. A local sponge diver found the wreck of the Uluburun off the southwestern coast of Turkey in the early 1980s. Archeologists then spent 11 years studying the ship, collecting 20 tons of artifacts, including the remains of fruits and nuts, pottery, jewelry, tools, and weapons. No one knows who built the ship or where it was headed, but judging by the amount of gold onboard, someone rich was involved. The remains of the ship and its cargo, as well as a life-sized replica, are kept at the Bodrum Museum of Underwater Archaeology.

8. MV Captayannis, River Clyde, Scotland

Once a Greek sugar-carrying ship, the MV Captayannis has become a de facto home for birds and other wildlife since sinking in Scotland's River Clyde in 1974 during a terrible storm. (The minor collision with a BP oil tanker also didn't help.) The shallow waters around the wreck make it relatively accessible, and the ship seems likely to stay where it is, since its precise ownership is something of a mystery.

9. La Famille Express, Turks And Caicos Islands

The La Famille Express shipwreck anchored in the Turks and Caicos Islands
The La Famille Express shipwreck anchored in the Turks and Caicos Islands
Matthew Straubmuller, Flickr // CC BY-NC-SA 2.0

Built in 1952 in Poland, La Famille Express served a large part of its life in the Soviet Navy (where it was known as Fort Shevchenko), before being sold and re-christened with its new name in 1999. It wrecked under mysterious circumstances around 2004. It now lies in just a few feet of water, an attractive landmark for boaters in the Turks and Caicos.

10. Eduard Bohlen, Namibia

Wreck of the ship Eduard Bohlen that ran aground off Namibia's Skeleton Coast
Wreck of the ship Eduard Bohlen that ran aground off Namibia's Skeleton Coast
Anagoria, Wikimedia // CC BY-SA 3.0

This wreck is unusual for being buried entirely in the sand—it's now stranded about a quarter mile away from shore. A 2272-ton cargo ship that wrecked off Namibia's Skeleton Coast in 1909 in thick fog, the ship has since drifted so far from the water it's now completely land-locked.

This list first ran in 2015 and was republished in 2019.

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