A cesarean delivery is a surgical procedure where the mother's abdomen and uterus is cut open to deliver one or more babies. This type of delivery is also called a c-section. C-sections are occasionally performed to remove a dead baby.
C-sections are typically performed when a normal delivery (vaginal delivery) would put the life of the baby or the mother at risk. In recent years elective cesarean delivery has become a popular choice for women who don't wish to have a vaginal birth and who don't want to experience traditional birthing methods and the pain of labor.
History of Cesareans
C-sections were performed as early as 715 BC but only on mothers who were already dead. It was said that the Roman belief of that time was that mothers not be buried pregnant so a women who died while expecting would have her unborn child surgically removed before she was buried. Although there are records of c-sections being performed in early Rome, there is no connection between the procedure's name and Julius Cesar.
The first recorded child to have survived a cesarean delivery was thought to be the second Mauryan emperor of India, Bindusara. Born in 320 BC, Bindusara was cut from the body of his dead mother by Emperor Chandragupta Maurya's teacher and adviser. It was the only way the adviser could save the child after Bindusara's mother accidently ingested poison and died.
In 1316 a child who later became Robert II of Scotland was delivered by c-section when his mother was considered too far gone to survive. She died which was typical of early c-sections. The first recorded cesarean delivery where the mother survived happened in Switzerland in the 1580s. A pig gelder performed the procedure on his wife after a long and difficult labor.
The procedure continued to be performed but only on women who were on the brink of death. A cesarean delivery guaranteed death of the mother and was only done when there was no other option. There was no such thing as cesarean recovery and in 1865 the mortality rate for c-sections in most of Europe was more than 85 percent. Survival was a pleasant surprise.
Study began on how to reduce the mortality rate of this procedure. Antibiotics were discovered and were used to fight infection. Anesthesia knowledge advanced. The practice of creating a bacteria-free operating area to reduce infection began. In 1882 German obstetrician Max Sanger introduced uterine suturing. The same year what is historically considered the first successful caesarean section was performed.
C-sections in Primitive Cultures
These advancements in the medicine of c-sections was considered cutting edge by the western world. But reports from 19th century travelers suggest that the process of c-sections had been successfully performed for many years in what were considered the primitive cultures in Africa.
In 1879 British traveler R.W. Felkin witnessed a c-section performed by Ugandans. He saw the healer use banana wine to make the women semi-drunk. He then used the wine to cleanse his hands, the woman's abdomen and the surgical tools. He then made a midline incision and cauterized it to reduce the chance of hemorrhaging. He removed the baby and massaged the uterus to help it contract. The wound was pinned with iron needles and dressed with a special healing paste made from roots. The women healed well in the majority of cases without any caesarean delivery complications. Similar reports came from Rwanda.
Modern c-sections are a type of epidural delivery. In most cases the woman is alert through the entire procedure and simply numbed from the waist down with an epidural. The surgeon cut's across the woman's abdomen just above the pubic area. The uterus is opened, the amniotic sac is opened and the baby is delivered. Fluids are cleared from the baby's mouth and nose and the umbilical cord is clamped and cut. The entire process takes no more than 10 minutes.
The doctor then needs to repair the uterus and this process takes between 45 minutes to an hour to complete. Then comes the recovery period of which the first four or five days will be spent in the hospital. The rest of cesarean delivery recovery occurs at home and can take up to six weeks.
Women who go on to have more babies after a c-section can choose to have a vaginal birth. A vaginal birth after c-section (VBAC) delivery is successful up to 80 percent of the time.