From Embryotomy to Cesarean: Changes in Obstetric Operatory Techniques in Nineteenth- and Twentieth-Century Urban Brazil.

This article traces the historical processes by which Brazil became a world leader in cesarean sections. It demonstrates that physicians changed their position toward and use of different obstetric surgeries, in particular embryotomies and cesarean sections, over the course of the nineteenth and twentieth centuries. The authors demonstrate that Catholic obstetricians, building upon both advancements in cesarean section techniques and new civil legislation that gave some personhood to fetuses, began arguing that fetal life was on par with its maternal counterpart in the early twentieth century, a shift that had a lasting impact on obstetric practice for decades to come. In the second half of the twentieth century, cesarean sections proliferated in clinical practice, but abortions remained illegal. Most importantly, women remained patients to be worked on rather than active participants in their reproductive lives.

From the Ancient Myth of the Caesars to the Medieval and Renaissance Tradition: The Practice of Caesarean Section in De universa mulierum medicina by Rodrigo de Castro.

The caesarean section performed on a living woman to save both mother and baby is first considered in gynaecological texts in the late sixteenth century after the treatise by the French physician François Rousset. It is included alongside descriptions of the post-mortem caesarean section, already practised in the Middle Ages in order to save the baby. The early seventeenth-century work by the Lusitanian physician Rodrigo de Castro is often referenced on this subject, seen as critical of Rousset's theory. Castro is cited above all for formulating a new suggestion - operating on a woman in the throes of death - because he was convinced that the post-mortem caesarean section was pointless. This article provides thorough analysis of Castro's work, comparing it to Rousset's treatise and medical texts by other authors to reveal its originality and its real contribution to the interpretation of the two different caesarean sections.

Cesarean section one hundred years 1920-2020: the Good, the Bad and the Ugly.

In present-day obstetrics, cesarean delivery occurs in one in three women in the United States, and in up to four of five women in some regions of the world. The history of cesarean section extends well over four centuries. Up until the end of the nineteenth century, the operation was avoided because of its high mortality rate. In 1926, the Munro Kerr low transverse uterine incision was introduced and became the standard method for the next 50 years. Since the 1970's, newer surgical techniques gradually became the most commonly used method today because of intraoperative and postpartum benefits. Concurrently, despite attempts to encourage vaginal birth after previous cesareans, the cesarean delivery rate increased steadily from 5 to 30-32% over the last 10 years, with a parallel increase in costs as well as short- and long-term maternal, neonatal and childhood complications. Attempts to reduce the rate of cesarean deliveries have been largely unsuccessful because of the perceived safety of the operation, short-term postpartum benefits, the legal climate and maternal request in the absence of indications. In the United States, as the cesarean delivery rate has increased, maternal mortality and morbidity have also risen steadily over the last three decades, disproportionately impacting black women as compared to other races. Extensive data on the prenatal diagnosis and management of cesarean-related abnormal placentation have improved outcomes of affected women. Fewer data are available however for the improvement of outcomes of cesarean-related gynecological conditions. In this review, the authors address the challenges and opportunities to research, educate and change health effects associated with cesarean delivery for all women.

Medical Compromise and Its Limits: Religious Concerns and the Postmortem Caesarean Section in Nineteenth-Century Belgium.

Situated on the intersection of medicine and religion, postmortem caesarean sections exposed ideological boundaries in nineteenth-century medicine. According to clerical guidelines circulating in Catholic territories, Catholics who had not necessarily received medical training had to perform operations on deceased women in the absence of medical staff. Most doctors, on the other hand, objected to surgical interventions by unqualified Catholics. This article uses the Belgian debates about the postmortem caesarean section as a means to investigate methods of negotiation between liberal and Catholic doctors. The article analyzes, first, how doctors incorporated religious concerns such as baptism in the medical profession. Second, physicians' strategies to come to a compromise in ideologically diverse settings are examined. Overall, this article casts light on the dynamics of medical debate in times of both ideological rapprochement and polarization.

Fragmentos da história da cesariana / Fragments of the caesarean history

Relatos da operação cesariana permeiam a saga da humanidade e ilustram a historia da Medicina. Figura em diversas civilizações primevas, feita entre babilônicos, romanos e hindus. Chegou até nós alternado uma historia trágica de morte, até sua banalização nos dias atuais, sempre cercada por polêmicas apaixonadas, essa cirurgia figura entre as mais realizadas em todo o mundo...(AU)

Reports of cesarean section permeate the saga of humanity and illustrate the history of Medicine. It figured in several ancient civilizations, reported between Babylonians, Romans and Hindus. It has come to us altenadoting a tragic death story, until its banalization in the present day, always surround by passionate polemics, this surgery is one of the most performed in the world...(AU)

Por el bien de la nación: discursos científicos en favor de la medicalización del parto en el Perú, 1900-1940 / For the good of the nation: scientific discourses endorsing the medicalization of childbirth in Peru, 1900-1940

Resumen A lo largo del siglo XX se sucedió una serie de cambios en la forma de concebir el parto que pasó de ser un fenómeno reproductivo natural propio del ámbito doméstico y femenino a un asunto médico y profesional del ámbito institucional. A través de procedimientos como el uso de anestesia, la cesárea, el ultrasonido y otras intervenciones técnico-científicas se han generado rápidas e importantes mejoras y cambios para la salud y vida de la sociedad y las mujeres. La medicalización del parto a comienzos del siglo XX fue parte de un proceso más amplio de construcción del Estado e institucionalización del patriarcado común en la región.

Abstract Over the course of the twentieth century, a series of changes occurred in the understanding of childbirth, which went from being a natural reproductive phenomenon belonging to the female, domestic sphere to a professional medical matter handled in an institutional setting. Through procedures like the use of anesthesia, Cesarean sections, ultrasound and other techno-scientific interventions, rapid and significant improvements and changes took place in the health and life of society and of women. The medicalization of childbirth in the early twentieth century was part of a broader process of constructing the state and institutionalizing the patriarchy that was common throughout the region.

La operación cesárea en Cuba / Cesarean session in Cuba

En Cuba, la primera operación cesárea en madre muerta para el sabio bibliógrafo cubano don Carlos M. Trelles Govín (1866-1951), se practicó en La Habana en 1825, pero no se cita quien la realizó ni la fuente bibliográfica, documental o testimonial por la que conoció tan importante información. El presente trabajo tiene como objetivo dar continuidad a la historia de la cesárea. En este momento, la búsqueda se enclavó en nuestro país y los inicios de este tipo de operación. Se realizó un recorrido por las diferentes etapas de la cesárea en Cuba. Sobre todo, en los doctores que, en su tiempo, fueron vanguardias en la ciencia(AU)

In Cuba, the first Cesarean section in a dead mother for the wise Cuban bibliographer, Carlos M. Trelles Govín (1866-1951), was practiced in Havana in 1825, but neither the person who made it nor the bibliographic, documentary or testimonial source was cited. for which he knew such important information. The present work aims to give continuity to the history of cesarean section. At this time, the search was enclaved in our country and the beginnings of this type of operation. A tour of the different stages of caesarean section in Cuba was made. Above all, in the doctors who, in their time, were vanguards in science(AU)

Risk and Reputation: Obstetricians, Cesareans, and Consent.

When physicians performed cesarean sections in the nineteenth century, they customarily sought agreement from all present before proceeding. In contrast, after the introduction of electronic fetal monitoring in the late 1960s, obstetricians obtained permission for a cesarean by offering a choice that ensured consent-give birth by cesarean or give birth vaginally to a damaged or dead baby. This article argues that the manner in which physicians obtained consent for cesareans in the nineteenth century was one factor that kept the cesarean rate low, while the manner in which physicians obtained consent in the late twentieth and early twenty-first centuries was one factor driving up the cesarean rate. The dissimilar approaches to consent did serve a common purpose, however. Each preserved physicians' reputations. With the surgery likely to end in a woman's death in the nineteenth century, consensus ensured that a bad outcome would be a shared burden. And because the fetal monitor, in exaggerating the risks of vaginal birth, changed the nature of the malpractice climate for obstetricians, the late-twentieth-century approach to consent similarly protected physicians. As one early twenty-first-century obstetrician quipped, "You don't get sued for doing a C-section. You get sued for not doing a C-section."

For the good of the nation: scientific discourses endorsing the medicalization of childbirth in Peru, 1900-1940. / Por el bien de la nación: discursos científicos en favor de la medicalización del parto en el Perú, 1900-1940.

Over the course of the twentieth century, a series of changes occurred in the understanding of childbirth, which went from being a natural reproductive phenomenon belonging to the female, domestic sphere to a professional medical matter handled in an institutional setting. Through procedures like the use of anesthesia, Cesarean sections, ultrasound and other techno-scientific interventions, rapid and significant improvements and changes took place in the health and life of society and of women. The medicalization of childbirth in the early twentieth century was part of a broader process of constructing the state and institutionalizing the patriarchy that was common throughout the region.

A lo largo del siglo XX se sucedió una serie de cambios en la forma de concebir el parto que pasó de ser un fenómeno reproductivo natural propio del ámbito doméstico y femenino a un asunto médico y profesional del ámbito institucional. A través de procedimientos como el uso de anestesia, la cesárea, el ultrasonido y otras intervenciones técnico-científicas se han generado rápidas e importantes mejoras y cambios para la salud y vida de la sociedad y las mujeres. La medicalización del parto a comienzos del siglo XX fue parte de un proceso más amplio de construcción del Estado e institucionalización del patriarcado común en la región.

The History of Cesarean Birth From 1900 to 2016.

Nurses struggle with conflicting priorities regarding the care of women during childbirth and the expectations of physicians and employers. Nurses are expected to perform technologically sophisticated interventions that were once performed by physicians, which can affect the perception of comfort that nurses traditionally offered. In this historical overview, I suggest that scientific childbirth advances have contributed to soaring cesarean rates and identify the role of the nurse as a contributor to this trend.

Was Queen Jane Seymour (1509-1537) Delivered by a Cesarean Section?

No direct evidence documents exactly how Jane Seymour gave birth on October 12, 1537. Several later commentators have raised cesarean birth as an option. This paper tries to establish the probable cause of Jane Seymour's death in accordance with present-day knowledge of obstetrics and whether or not a cesarean section could have been actually performed in sixteenth-century England. It appears almost certainly that there were no obstetrical indications that would have led the Queen's physicians to operate on her, a surgeon was not present at her delivery, cesarean section on a living woman was not regularly performed in England in 1537, puerperium events do not support surgery, and the existing pro-cesarean confirmation was politically motivated. Therefore, the most likely mode of Jane Seymour's delivery was vaginal rather than cesarean.

[Outline of the history of caesarean section ­ from ancient times to the end of 17th Century].

Problems with the childbirth accompanied the human civilization since its beginning. From the ancient times, physicians and other people specializing in healing, tried to help women in this special moment of life. At the base of this exceptional meaning of childbirth for humans lies the fact, that if something is going wrong there are two victims - mother and the child. As a result, many times there had been very dramatic attempts of help in this the most difficult journey which in his life every man is undergoing. In this paper a comprehensive review of literature about the history of caesarean section from ancient times to the end of 17th century was done.

Prague 1337, the first successful caesarean section in which both mother and child survived may have occurred in the court of John of Luxembourg, King of Bohemia.

OBJECTIVE: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg. STUDY TYPE: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods. SETTINGS: Department of Obstetrics and Gynecology of the First Faculty of Medicine of Charles University and General University Hospital in Prague. METHODS AND RESULTS: Until the second half of the 19th century, medical knowledge of antiseptics and anesthesia was lacking, and techniques for cleaning wounds and staunching bleeding were primitive.Because no effective anesthetics were known before that time, people did not know how to perform painless abdominal surgery. There are a very few credible reports of caesarean sections performed on living women as early as the 17th century. However, before the 19th century, a caesarean section meant almost certain death for the mother, with related mortality as high as 90%. If the woman did not die of stress from the pain of the abdominal surgery, then she usually died of either bleeding or later of sepsis. However, there is some indirect evidence that the first caesarean section that was survived by both the mother and child was performed in Prague in 1337. The mother was Beatrice of Bourbon (1318-1383), the second wife of the King of Bohemia John of Luxembourg (1296-1346). Beatrice gave birth to the kings son Wenceslaus I (1337-1383), later the duke of Luxembourg, Brabant, and Limburg, and who became the half brother of the later King of Bohemia and Holy Roman Emperor, Charles IV (1316-1378). CONCLUSIONS: From a historical analysis based on the indirect evidence, it is not possible to unequivocally determine whether a caesarean section that was survived by both the mother and child was actually performed in the 14th century. From a medical standpoint in the context of all the known surrounding circumstances, however, this rare event could indeed have taken place.

Cesarean Birth: A Journey in Historical Trends.

Thirty years ago seems like yesterday: a time of immense socioeconomic changes, explosion of an "Internet" computer concept, and identification of human immunodeficiency virus. Like all events of the past, transformations in obstetrics developed over time. Cesarean birth can be better understood in a broader context when one considers how the art of obstetric practice has evolved. Cesarean birth progressed from delivering a fetus perimortem or postmortem to a time of operative births that simultaneously juggle a woman's safety, satisfaction, and freedom of choice concerning birth options. Thirty years of increasing cesarean birth rates have prompted government agencies, national organizations, state-level perinatal collaborative groups, and experts to address these rates and the impact on maternal-child health and healthcare systems. The purpose of this article is to explain cesarean birth's remarkable impact on obstetrics by reviewing key historical periods, current advances, and upcoming trends.