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Each year in the United States, nearly 1.2 million women have their children by cesarean section, or around a third of all deliveries—an increasing trend throughout the country over the past few decades.
This practice has surprisingly old origins—the term “cesarean” may come from the surgical birth of Roman general Julius Caesar, though it’s unlikely he was actually delivered through his procedure. Still, C-sections seem to have been used in the Roman Empire to save children when women in labor were dead or dying in order to expand the state’s population. And in some older contexts, the surgery served the religious purpose of burying the mother and infant separately.
Written records of C-sections didn’t emerge until the 16th century. Around the year 1500, Jacob Nufer, who herded swine in Switzerland, is reported to have surgically removed his wife’s baby during her labor that had spanned several days—he seems to have acquired some know-how from performing surgeries on livestock. But it’s unclear how well the story’s details match reality, as it wasn’t written down until 82 years later.
And on this day in 1794, physician Jesse Bennett carried out the first successful C-section in the U.S. As news of this procedure traveled, it “increased awareness and understanding about successful techniques for cesarean delivery to save the life of both mother and child,” according to a review article published in Academic Medicine & Surgery.
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For centuries, C-sections were mostly done out of necessity. They were more common in rural communities that lacked access to medical professionals and hospitals. People didn’t need to consult with a doctor, and they could be performed in the early stages of challenging labor to help both the mother and child survive. Such surgeries took place on beds and kitchen tables. This was probably a good thing, too: Up until the mid 19th century, infections ran rampant in hospitals, where medical attendants typically operated with unclean hands.
Medical education didn’t often involve hands-on dissection of human cadavers until around this time, a shift that allowed students—mostly men—to improve their surgical skills. (This trend, of course, sidelined the women who had previously worked as attendants in delivery.) Meanwhile, the increasing use of obstetrical forceps became increasingly common: “Men’s claims to authority over such instruments assisted them in establishing professional control over childbirth,” according to the National Library of Medicine.
Today, more recent advances have made C-sections far safer, including ultrasounds to determine the positioning of a fetus, more precise surgical tools, and more effective forms of anesthesia. But some researchers have pointed out that C-sections aren’t always performed when medically necessary, and may be carried out due to “time constraints and perceived convenience,” among other factors not directly tied to medical care—a striking contrast to the procedure’s once-vital role. 
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Lead image: maxim ibragimov / Shutterstock
