Ancient Egyptian folklore contains references to Caesarean section (CS) deliveries going back about 5000 years. Throughout most of history, CS was performed only as a last resort and to save the baby from a dying mother. The mother did almost always die. CS was so dangerous that the mother probably considered herself lucky if she and her baby survived, even if she was rendered infertile, which also often happened.
The popular belief exists that the Roman emperor Julius Caesar was born by CS and gave his name to it. But this is unlikely. Aurelia, Caesar’s mother, survived. This is unusual in itself. Also, under Roman law at the time, CS would not have been performed on her. Of course those attending her may have decided to ignore the law to save the mother and baby. Later, the Roman law governing CS known as lex regia was changed to lex caesarea under subsequent Roman emperors. This is probably how the name came about.
It was not until the 16th century that the first case of a woman giving birth by CS and surviving was verified. However, if Aurelia did give birth by CS, it is even more remarkable since she gave birth to further children.
Ironically, under Roman law, the mother’s husband performed the surgery. In that sense Caesar would have been fortunate. His father was a swineherd. Swineherds often have experience performing similar surgery on pigs. In England and North America, death rates for the mother in CS deliveries were about 75% until the mid-19th century. For the baby, it was only a little better.
Why are there more Caesarean births now?
Although CS is major abdominal surgery, it is generally regarded as being safer now than at any other time in our history. This is due to overcoming post-operative complications including the ability to fight infections.
Prolonged labour and risks to both mother and baby places pressure on childbirth professionals to act quickly. Statistically, in the English-speaking world, women are waiting until later in life to have children. As a consequence, more women experience natural childbirth difficulties due to causes not entirely understood. CS deliveries far exceed the estimated 12% incidence of need. Yet in some areas of the English-speaking world, the CS figure is 30% or more. Beyond this, in Brazil, CS delivery is regarded as the preferred form of delivery and is taught so in medical schools. A team of US doctors in California argues that the recent assertion of ‘a woman’s right to choose’ is a major factor in whether or not a CS is performed.
The World Health Organization estimates that worldwide 15% of childbirth labors have a life-threatening complication. It has been estimated that the “natural” rate of maternal death from childbirth is between 1% and 1.5%. The biggest risk is uncontrolled bleeding.