Was Julius Caesar born by Caesarean section? Yes or no? Many depictions over the centuries illustrate his caesarean section. But medical historians deny this. There is evidence that mentions his mother Aurelia 10 years before Caesar’s assassination. She would therefore have had to have survived the caesarean section and that is considered impossible! Nevertheless, there are generals of his time who were almost certainly cut out “a caesare Uteri”, i.e. from the womb. Caesar or emperor means “the cut man”.

The history of the caesarean section is fascinating. That’s why I decided to make my first official YouTube tutorial about it.

Unfortunately it’s a bit long at almost 60 minutes! “Short and sweet” is different. I still have to practise that. But 2000 years of medical history cannot be told in 3 minutes.

The law on Caesarean sections in antiquity.

I think few obstetricians today are aware that since around 700 BC, since the Roman king Pompilius, there was the law lex regia, which forbade the burial of deceased pregnant women together with their baby. This was to rule out the possibility of a living baby being buried in its mother’s body.

This law has endured for almost millennia. Until the 19th century, however, it was a rare sensation when women had a caesarean section and both woman and child survived, even if only for a few days.

From the In the 17th century, the first efforts were made to study obstetrics scientifically, midwives wrote the first textbooks and doctors took up obstetrics. In the 18. and In the 19th century, various forceps were developed to terminate childbirth. In the case of rickets, a disease that was even more common at the time due to vitamin D deficiency, the women’s pelvises were sometimes so severely deformed that the births could not be completed even with forceps. The only gruesome way to end the births and save the mother’s life was to perform “dismembering operations” on the child through the woman’s vagina.

The only indication for a dangerous caesarean section

In order to have alternatives to dismembering operations for these women’s pelvises, which are impossible to deliver, alternatives such as prematurely induced premature births or sawing open the women’s pelvic ring to gain space were developed. Both methods were impractical and a dead end due to the dangers and invalidation of women.

The diagnosis of an “obstructed pelvis” was the only diagnosis that justified a caesarean section.

Complications of caesarean sections

The most common complications from which women died during the rare attempts to perform a caesarean section were: bleeding that could not be stopped or, above all, infections, which were usually unavoidable due to the preceding days of labor with numerous examinations, unhygienic conditions, etc.

The belief that the uterus, the peritoneum and other anatomical structures should not be sutured, the incision method used at the time, etc. further promoted the spread of infections in the abdominal cavity and were almost always the cause of death in the days following the operation.

The first celebrated caesarean section after Porro, which increased the survival rate to 50%, was not a solution either, as the uterus itself and the ovaries were removed with the operation. Young women were thus unable to reproduce and went straight into menopause due to the hormone withdrawal.

It was only the combination of increased knowledge in various disciplines that turned the hopeless operation into an increasingly safe operation towards the end of the 19th century.

The basics of hygiene to save women during childbirth

Milestones included the findings of hygiene in the 19th century: the Viennese doctor Ignatz Semmelweis should definitely be mentioned here. He realized that his student teaching on cadavers and subsequent examinations of women giving birth were responsible for the endemic puerperal fever. His findings were the basis for understanding that diseases were transmitted via hands, instruments, laundry, etc. Antisepsis and asepsis measures were the logical consequence.

Knowledge of anatomy, surgery, better hemostasis and the realization that the incisions on the uterus must be sutured to prevent the otherwise fatal inflammation of the peritoneum were important milestones.

Chloroform anesthesia was developed in England in 1830. The method gained social recognition through the Queen at the time of her 8th birth.