Came home from a placental abruption resulting in a horrifying emergency c section and 2 week hospital stay and made a bad choice to watch House of the Dragon where cesareans are a death sentence. I did a bit of research and found out medieval c sections did happen but were only performed if the mother was dying anyway as it was always fatal. I understand that infection would’ve killed any surviving women back then but apparently they died during the operation anyway. So I’m confused about what killed women during the procedure it’s self? As far as I’m aware I did not receive a blood transfusion so it can’t have been blood loss which would’ve been my guess pre my own experience. Did they not have the medical tools necessary to put those women back together afterwards eg stitches? Or did they not know how to make insicions in a non fatal way?
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A caesarian is a major operation in which you are cutting through not just skin but the muscle layer and the protective membrane around the internal organs. Unless you know exactly where to cut and not to cut and you know how to patch it all up in a way that can be healed afterwards, that is a very deadly surgery. And quite frankly it wasn’t until the late 1700s and early 1800s that people started digging up corpses in order to cut them apart and learn those skills.
Even today that is not a surgery that is taken lightly and it has a lot of risks, which is why it is reserved for pretty dangerous conditions.
Even though you didn’t need a blood transfusion you were certainly connected to an IV that helped maintain your fluid volume and the attending professionals also kept your body from going into shock by monitoring your vital signs and management of pain.
Cutting people open is easy.
Cutting people open *and they survive* is harder.
Medieval C-sections usually break the #1 rule of Emergency Medicine: Air goes in and out; Blood goes round and round; deviating from this is Bad.
Such a process can cause lots of blood to go Out if not done carefully, but in medieval times they could not put blood back In.
In Modern Times ™, surgeons are trained to cut people open with Great Skill, and in such a way as to limit blood loss, such as avoiding major blood vessels, clamping them shut if necessary, [scalpels that automatically cauterize incisions](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236379/), tools that are sharp and clean, cutting techniques that minimize collateral damage, and so on.
Also not all blood loss needs to be replaced with blood. Saline (precision salt water) can work up to a certain point to replace blood that has gone Out. They will also have Highly Trained Support Staff to carefully monitor your vitals and put blood back In if it’s really needed.
Fun fact. The blood flow to a pregnant uterus is 700-900ml per minute. There for, once cut to remove a baby, a women can exsanguinate in less than 10 minutes. Even today a normal C Section will loose a liter of blood.
One other thing that other commentors haven’t said – you probably have grown up eating 3 healthy meals a day with all the required nutrients, and drinking a reasonable amount of water, may or may not work out, etc.
your body is different from what a medieval peasant or even queen’s would be like – even if there was a medieval c-section carried out on you and a medieval woman of the same age, you would be more likely to survive (all other things being equal) because your body has had much better nutrition throughout your life, among other factors
The procedure as well is done with much more sophisticated tools, and by people who have experience in the procedure – an ‘average’ medieval surgeon would be a barber by trade, and use the same knives and similar blades for surgery, and may perform around 10 c-sections a year and cut 1,000 people’s hair in between with the same type of tools, but many surgeons today would probably do 10 c-sections in a 6month period or shorter depending on the hospital and use specially designed tools for the process that may be one-use only, rather than have been used to cut peoples hair yesterday and repurposed later for the operation the next day
plus you probably were given drugs during the procedure and afterwards – drugs that no medieval person would know about, they wouldn’t only stop infection, but also stop you from feeling pain (the best painkiller in the medieval world was alcohol, which is problematic for a number of reasons in surgery), a medieval woman wouldn’t have those drugs, so even if the surgery was performed by an experienced person and in some clean environment, the pain of it would often cause shock and complications leading to death
This woman in South America was able to perform a c-section on herself…and she and the baby survived. She sought medical care afterward, though.
[https://www.iflscience.com/woman-performed-a-c-section-on-herself-both-she-and-the-child-survived-68422](https://www.iflscience.com/woman-performed-a-c-section-on-herself-both-she-and-the-child-survived-68422)
The current lower segment caesarean section is relatively new where the cut is made parallel to the pelvis lower on the tummy. This reduces the bleeding and risk if other organ damage.
The intestines and some of the organs in the tummy are wrapped around by a thin layer of tissue called peritoneum. In olden times ( upto even 100 y ago) the cut was made straight through the centre of the tummy. This meant the peritoneum was opened up. That cause a lot of bleeding and also risk of inner organ injury.
The original caesarean sections comes from the fact that the baby was removed so that mother and baby could be buried separately.
TLDR
CUT CRAZY IN TO THE CENTRE – CAUSE INJURY – MOTHER DIE
Edit : I forgot about oxytocin which makes the uterus contract and that stops bleeding. A soft lax uterus will bleed out like crazy.
No anesthesia either, so you’re doing the operation on a fully conscious patient who is screaming in agony. You’re trying to work FAST, especially because babies die in minutes without oxygen. You don’t have the time to use modern surgical techniques to minimize blood loss or injury, even if you knew them.
In reality, the baby would almost always be dead anyway by the time things obviously got to that point. [My great-great-great grandfather](https://en.m.wikisource.org/wiki/American_Medical_Biographies/Atlee,_John_Light) was an OBGYN in the early-mid 1800s — fun fact, he was the first American and second person to remove an ovary and have the patient survive. We have his medical books and kit, which includes some [horrific instruments](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281608/) used to remove dead or undeliverable babies so the mother could be saved.
A factor is that knowing the inevitable result anyway, they probably didn’t even try to to save the mother as it would have amounted to little more but extending the agony. Death by blood poisoning and rotting flesh is a particularly ugly thing, they probably just let the women die of blood loss as comparatively it’s not so bad, over with quickly and without much fuss.
They died from blood loss. You didn’t need a transfusion because we have cautery equipment and clamps that burns vessels shut or clamps them off as the surgeon cuts them. They didn’t have a way to stop the bleeding.
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