There are many records of “cutting open a pregnant mother” to save the baby throughout history around the world. Bindusara, the second emperor of India in 298 BC, was born through a cut-open belly. The Chinese records glean on the births of the six sons of Luzhong, a descendent of the Yellow Emperor, all born through a cut body. The Talmud, an ancient religious Jewish text, also describes a procedure similar to a cesarean section. It is commonly believed that Julius Caesar himself was born by a cesarean section, though it is unlikely because there are no classical records of mothers surviving such procedures before the 12th century. Lex Regia (Regional Law) of Numa Pompilius, later known as Lex Caesarea (Imperial Law) required the excision of the child from a mother dying in late pregnancy. It is believed to have been religiously motivated, prohibiting burial of pregnant women. But the first modern C-section was performed in 1881 by a German gynecologist, Ferdinand Kehrer.
My first C-section was a few days ago. In fact, it was the first birth that I observed. I was on call in Labor & Delivery on the first week of our ObGyn rotation. As soon as I got to Labor & Delivery, the attending physician took us on rounds. There was a grand multiparous Bedouin mother who was giving birth to her 13th child. One mother had well-controlled gestational diabetes and was being monitored. Another mother was 5 cm dilated, with regular contractions and a midwife ready for phase 3 of labor. The mother in room 18 was waiting for a C-section because she had gone through 2 C-sections beforehand. She also had poor prenatal care and ignored physician recommendation to wait 18 months before another pregnancy. She was being rolled out to the OR and the attending asked if anyone wanted to observe. I raised my hand.
I scrubbed in, excited to see my first C-section. The doctor explained to me that this is a complicated C-section because of her previous surgeries. She had adhesions and many fibrotic materials in her abdomen. The doctors carefully separated the fascia from the tissues and found the uterus. I was next to the surgeons and holding the retractor. There was quite a lot of blood but apparently that is normal even in vaginal deliveries. They made an incision and with a rough shove on the fundus, the baby popped out in seconds. The doctor held the baby out in front of me and I hesitated. The baby looked lethargic and grayish. I wasn’t sure if I should take him, but the nurse grabbed him and took him away. I worriedly asked if it was all ok since his Apgar score seemed to be low. The doctor replied, “You have to wait a minute. Apgar score at 1 and 5 minutes, right?”
