If you are squeamish, you may want to skip this blog post. For those of you, who love gruesome stories, here you are: Not too long ago I reported on the origins of the C-section in this blog post. Meanwhile, an 18th century mummy kept at the Natural History Museum in Budapest (Hungary) was presented as the oldest direct evidence of a C-section performed on a deceased mother. The incision was made vertically between the umbilical ring and the pubic symphysis and was c. 15 cm long. Cutting the baby out of the womb of the dead mother to baptize the child in time was certainly a Christian motive. In Antiquity, the life of the mother was privileged over that of the child.
Let me introduce you to embryotomy, or, more fittingly, fetotomy. This term refers to cutting a foetus into pieces within the womb so it can be removed. Still used in veteriary medicine, this procedure was carried out in humans when it was foreseeable that a vaginal birth would not be possible and the only way to fit the foetus through the birth canal would be a reduction in size. At that point, the foetus may have already died in the womb due to a long, unsuccessful birth.
Soranus of Ephesus, a Greek physician practicing around AD 100 in Rome described the process as following in his gynaecology (Molleson and Cox 1988: 58):
If the foetus is already dead, one should throw a piece of cloth over it to prevent it slipping and draw it forward slightly. Then, depressing it in order that the ports lying above may become more visible, one should amputate at the shoulder joints… Then one should turn the rest of the body with the fingers and deliver by inserting the hooks… If, however, the impaction is caused by too big a head … one should split it with on embryotome or a knife for removing polypi…. If, however, because of the large size of the whole body, the foetus does not respond even if so pulled … one must plunge the knife into the jugular region until it has penetrated deeply into the foetus. For when the blood is drained off, the body becomes thin. If the foetus is dead and of excessive size, it is dangerous to morcellate it entirely within the uterus. It is better to cut each of the parts as it presents. In theses cases amputations of the joints are indicated, for at their ends even the bones are easily freed from their connections.
Archaeological finds of foetal bones with cut marks from Roman contexts, for instance from Poundbury (Molleson and Cox 1988) and Hambleden in England (Mays et al. 2014) demonstrate that fetotomy was indeed practiced as described.
Really surprising is the recent find of parts of a foetus from Cagny, Département Calvados in France (Corde et al. 2015). It was found in the top layer of a ditch complex near some late Iron Age graves and radiocarbon dating confirmed and age of 399 to 303 cal. BC. The foetus’ age is estimated at 36 to 37 gestational weeks and bore cut marks on the bones as well as signs of inflammatory processes. Most likely, the foetus had died in the womb and was surgically removed. Whether or not the mother survived remains unclear.
This find suggests that fetotomy is several hundred years older than Soranus’ description. It was practiced in a pre- or protohistoric context – far away from contemporary civilisations of the Mediterranean, in a society we usually do not attribute this kind of medical knowledge. Perhaps this ancient case of fetotomy also shows how well-connected societies were in the past. The social networks of antiquity enabled knowledge transfer across wide regions, and proof of this turns up in the most unexpected places.
Corde, D., L. Laquay, A. Augias, J. Poupon, J.-M. Dewitte, and P. Charlier. 2015. “Un cas ancien de foetotomie, La Tène (399-303 av. J.-C.),” in P. Charlier and D. Gourevitch (eds) Colloque international de pathographie – Mai 2013. Paris: De Boccard: 21-31.
Mays, S., K. Robson-Brown, S. Vincent, J. Eyers, H. King, and A. Roberts. 2014. An Infant Femur Bearing Cut Marks from Roman Hambleden, England. International Journal of Osteoarchaeology 24(1): 111-115.
Molleson, T., and M. Cox. 1988. A neonate with cut bones from Poundbury Camp, 4th century AD. Bulletin de la Société royale Belge d’Anthropologie et de Préhistoire 99: 53-60.