“History of caesarean section is like history of humanity in back drop of changing women's social status and values imposed on its reproductive function.”
Every obstetrician should keep in mind the various phases of technique and development of caesarean delivery which was the most significant interference of science in mode of delivery of humanity in time of extreme critical situations.
Whenever we take a timely and justified decision to do caesarean and perform technically clean and superb caesarean section, we pay our tribute to all struggles and hard work of our predecessors who have brought us to today's time when caesarean delivery is considered another physiological way of delivering the baby.
Caesarean section is almost certainly one of the oldest operations in surgery, with its origin lost in antiquity and in ancient mythology. Those interested in its history should consult the pages of Fasbender's Geschichteder Geschiclte,1 Pickerell's—An inquiry into history of caesarean section.2 JH Young's—The history of caesarean section.3
WORD CAESAREAN
The word caesarean as applied to the operation was derived sometimes in the middle ages from the Latin Verb Caedere, to cut. An obvious cognate is the word “caesura” a cutting or pause, in a line of verse. This explanation of term caesarean seems most logical but exactly when it was first applied to the operation is uncertain.
It is probability that the term originated from Lex Regia or Lex Caesara as described to Numa Pompetive in 3716 BC. This law dictated the performance of abdominal delivery of fetus from a mother who was dying or dead as an attempt to save the child, for state wishing to increase the population.
It is supposed to be myth that word caesarean origin from birth of Julius Caesar.
Early Age
References in Hindu, Egyptian, Grecian, Roman and European, Chinese Foreklore, Shushruta Samhita.
Middle Age
Postmortem caesarean section in 120 AD has been described. Usually done to retrieve infant from a dead or dying mother. It is age of stagnation in science and medicine.
After Dark Ages
- 1610 AD—performed by Trautman and Seest
- Caesarean delivery of live operation is truly operation of late 1800 and 1900
- Till 19th century women were denied admission to medical school. Women were barred from carrying out caesarean delivery
- 1815–1821 James Miranda Stuart Berry was first women to perform the operation (Fig. 1.1)
- Ether was first used for surgery
- Mortality high as uterus left unsutured
- Eduardo Porro in 1876 advocated hysterectomy with caesarean delivery—mortality decreased but acceptability was low.
Fig. 1.1: A milestone in history of caesarean is being done by a female on a live woman with delivery of alive baby
1882—Kehrer and Sanger—German surgeon introduced adequate method for closure of uterine wound. Contributed greatly in reducing the morbidity of caesarean section.
1911—In Britain, Munro Kerr used lower segment approach in caesarean section—for many years his was a lonely voice in obstetric world.
1949—12th British Congress of Obstetrics and Gynaecology held in London in 1949.
When McIntosh Marshall and others had presented most concerning evidence of an astonishing reduction in death rate from lower segment approach of caesarean section since the first two decade of this century.5
Munro Kerr by that time, was retired from active professional life, was invited to platform and he threw his arms above his head and exclaimed in exaltation—Alleleuro, the strive is over, the battle done.
—Yet the battle continues with life…
New indications, new diagnostic aids, changing position of women in society, evolving and changing needs and expectation of society from obstetrician, development of neonatology, blood transfusion, antibiotic, administrative renewal of medical care facilities, all is changing the roles of medical personal in respect of caesarean section. It is also interesting to note that Step by Step—New Techniques of caesarean delivery reflects the chronological pages of history.
From vertical classical caesarean delivery to transverse mini access of caesarean section, we are again reconsidering vaginal birth after caesarean section.
Let's review the basics of caesarean section as well the rapidly changing overall view of caesarean section as an alternative mean of child birth.
REFERENCES
- Fasbender; Geschichteder Geburtshilfe: JENA 1906;979–1010.
- Pickerell. An enquiry into the history of caesarean section: Bull Soc Med Hist; Chicago: 1935;4:414.
- Young JH. The History of caesarean section, London, 1944.
- Falk. Am J Obstet Gynae 1953;65:707.
- History of caesarean delivery—Ranjit Akolekar Caesarean Birth, Editor—Ranjit Akolekar; Publisher—National Book Depot, Mumbai 11–19.