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A team of obstetricians perform a caesarean section in a modern hospital. The image shows the very first moment the mother glimpses her new-born child.
A team of obstetricians perform a caesarean section in a modern hospital. The image shows the very first moment the mother glimpses her new-born child.

A caesarean section (AE cesarean section), or c-section, is a form of childbirth in which a surgical incision is made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. Phonology North American English regional phonology In many ways compared to English English, North American English is conservative in its Phonology. Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Cutting is the separation of a physical object or a portion of a physical object into two portions through the application of an acutely directed force In Vertebrates such as Mammals the abdomen (belly constitutes the part of the body between the Thorax (chest and Pelvis. A laparotomy is a surgical procedure involving an incision through the Abdominal wall to gain access into the Abdominal cavity. The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the A hysterotomy is an incision in the Uterus, commonly combined with a Laparotomy during a Caesarean section. It is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk, although in recent times it has been also performed upon request for births that would otherwise have been normal. Caesarean delivery on maternal request (CDMR is medically unnecessary Caesarean section, where the the conduct of a Childbirth via a Caesarean section [1][2][3]

Contents

Etymology

There are three theories about the origin of the name:

  1. In the English language, the name for the procedure is said to derive from a Roman legal code called "Lex Caesarea", which allegedly contained a law prescribing that the baby be cut out of its mother's womb in the case that she dies before giving birth. English is a West Germanic language originating in England and is the First language for most people in the United Kingdom, the United States [4] (The Merriam-Webster dictionary is unable to trace any such law; but "Lex Caesarea" might mean simply "imperial law" rather than a specific statute of Julius Caesar. )
  2. The derivation of the name is also often attributed to an ancient story, told in the first century A. D. by Pliny the Elder, which claims that Caesar's ancestor was delivered thus. Gaius or Caius Plinius Secundus, ( AD 23 – August 25, AD 79 better known as Pliny the Elder, was an ancient Author [5] Whether or not the story is true, it may have been widely enough believed to give its name to the operation. (The reverse view, that the name "Caesar" was derived from the operation, is clearly indefensible, see below. )
  3. An alternative etymology has been proposed, suggesting that the procedure's name derives from the Latin verb caedere (supine stem caesum), "to cut," in which case the term "Caesarean section" is a tautology. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. In Rhetoric, a tautology is an unnecessary (and usually unintentional repetition of meaning using different words that effectively say the same thing twice (often originally Proponents of this view consider the traditional derivation to be a false etymology, though the supposed link with Julius Caesar has clearly influenced the spelling. A false etymology is an assumed or postulated Etymology that current consensus among scholars of Historical linguistics holds to be incorrect The merits of this view must be considered separately from the corollary believed by some, that Caesar himself derived his name from the operation. This is certainly false: the cognomen "Caesar" had been used in the Julii family for centuries before Julius Caesar's birth,[6] and the Historia Augusta cites three possible sources for the name Caesar, none of which have to do with Caesarean sections or the root word caedere. The cognomen (plural cognomina) was originally the third name of an Ancient Roman in the Roman naming convention. Julius (fem Julia) is the Nomen of the gens Julia, an important Patrician family of Ancient Rome supposed to have descended from

The link with Julius Caesar, or with Roman emperors generally, exists in other languages as well. For example, the modern German & Dutch terms are respectively Kaiserschnitt & keizersnede (literally: "Emperor's section"). The German language (de ''Deutsch'') is a West Germanic language and one of the world's major languages. Dutch ( is a West Germanic language spoken by around 24 million people 22 million of which are from the Netherlands, Belgium and Suriname [7] The German term has also been imported into Japanese (帝王切開) and Korean (제왕 절개), both literally meaning "emperor incision. is a language spoken by over 130 million people in Japan and in Japanese emigrant communities This article is mainly about the spoken Korean language See Hangul for details on the native Korean writing system " The South Slavic term is carski rez, which literally means imperial cut.

History

Successful caesarean section performed by indigenous healers in Kahura, Uganda. As observed by R. W. Felkin in 1879.
Successful caesarean section performed by indigenous healers in Kahura, Uganda. The Republic of Uganda is a Landlocked country in East Africa. As observed by R. W. Felkin in 1879.

Pliny the Elder theorized that Julius Caesar's namesake came from an ancestor who was born by Caesarean section, but the truth of this is debated (see here). Gaius or Caius Plinius Secundus, ( AD 23 – August 25, AD 79 better known as Pliny the Elder, was an ancient Author The name Caesar probably originated from a dialect of Latium which did not share the Rhotacism of the Roman dialect The Ancient Roman c-section was first performed to remove a baby from the womb of a mother who died during childbirth. Caesar's mother, Aurelia, lived through childbirth and successfully gave birth to her son, ruling out the possibility that the Roman Dictator and General was a c-section baby. (In fact, she died 45 years later. ) The Catalan saint, Raymond Nonnatus (1204-1240), received his surname — from the Latin non natus ("not born") — because he was born by C-section. Catalonia (Cataluña Catalunya Aranese: Catalonha) is an Autonomous Community in the northeast part of Spain. Saint Raymond Nonnatus (Sant Ramon Nonat San Ramón Nonato Saint Raymond Nonnat San Rajmondo Nonnato (1204—1240 was a Saint from Catalonia in Spain Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. His mother died while giving birth to him. [8]

In 1316 the future Robert II of Scotland was delivered by caesarean section — his mother, Marjorie Bruce, died. Marriages and issue His first wife was Elizabeth Mure, by her he had at least ten children King Robert III of Scotland Marjorie Bruce or Margaret de Bruce (December 1296 &ndash March 2, 1316) was the eldest daughter of Robert the Bruce, King of Scots This may have been the inspiration for Macduff in Shakespeare's play Macbeth". Macduff is a Fictional character in Shakespeare 's play Macbeth. William Shakespeare ( baptised Macbeth is among the best-known of William Shakespeare 's plays, and is his shortest tragedy, believed to have been written some time between (see below).

Caesarean section usually resulted in the death of the mother; the first recorded incidence of a woman surviving a caesarean section was in 1500, in Siegershausen, Switzerland: Jakob Nufer, a pig gelder, is supposed to have performed the operation on his wife after a prolonged labour. Kemmental is a municipality in the district of Kreuzlingen in the canton of Thurgau in Switzerland. Jakob Nufer was a Swiss pig-gelder who in 1500 performed the first Caesarean section in history in which the mother (his wife survived For most of the time since the sixteenth century, the procedure had a high mortality. Death is the termination of the biological functions that define living Organisms It refers both to a specific In Great Britain and Ireland the mortality rate in 1865 was 85%. Key steps in reducing mortality were:

European travelers in the Great Lakes region of Africa during the 19th century observed caeserean sections being performed on a regular basis. The Great Lakes of Africa are a series of Lakes in and around the geographic Great Rift Valley formed by the action of the tectonic East African The expectant mother was normally anesthetized with alcohol, and herbal mixtures were used to encourage healing. From the well-developed nature of the procedures employed, European observers concluded that they had been employed for some time.

On March 5, 2000, Inés Ramírez performed a caesarean section on herself and survived, as did her son, Orlando Ruiz Ramírez. Events 363 - Roman Emperor Julian moves from Antioch with an army of 90000 to attack the Sassanid Empire, in a 2000 ( MM) was a Leap year that started on Saturday of the Common Era, in accordance with the Gregorian calendar. Inés Ramírez Pérez (b1960 is a Mexican woman from the state of Oaxaca who gained media attention after performing a successful Caesarean section on She is believed to be the only woman to have performed a successful caesarean section on herself.

Types

A caesarean section in progress.
A caesarean section in progress.

There are several types of caesarean sections (CS). The differences between them primarily lie in the deep incision made on the uterus, below the skin and subcutaneous tissue, and should be differentiated from the skin incision, such as a Pfannenstiel incision. The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the The skin is the outer covering of living tissue of an animal (or plant A Pfannenstiel incision (ˈpfɑnənʃtiːl is a type of surgical incision that allows access to the Abdomen.

In many hospitals, especially in Argentina, the United States, United Kingdom, Canada, Norway, Australia, and New Zealand the mother's birth partner is encouraged to attend the surgery to support the mother and share the experience. For a topic outline on this subject see List of basic Argentina topics. The United States of America —commonly referred to as the The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page Norway ( Norwegian: Norge ( Bokmål) or Noreg ( Nynorsk) officially the Kingdom of Norway, is a Constitutional For a topic outline on this subject see List of basic Australia topics. New Zealand is an Island country in the south-western Pacific Ocean comprising two main landmasses (the North Island and the South Island The anaesthetist will usually lower the drape temporarily as the child is delivered so the parents can see their newborn. An anaesthetist ( English) or anesthesiologist ( US English) also "anaesthesiologist" is a medical doctor trained to administer

Indications

Caesarean section is recommended when vaginal delivery might pose a risk to the mother or baby. The vagina (from Latin, literally " Sheath " or " Scabbard " is a fibromuscular tubular tract leading from the Uterus Reasons for caesarean delivery include:

However, different providers may disagree about when a caesarean is required. Large for gestational age (LGA babies are those whose Birth weight lies above the 90th percentile for that Gestational age. The placenta is an Ephemeral organ present in placental Vertebrates, such as Eutherial Mammals and Sharks during Gestation Placenta praevia ( placenta previa AE) is an obstetric complication in which the placenta has attached to the uterine wall close to or covering the Placental abruption (Also known as abruptio placentae) is a Complication of pregnancy, wherein the Placental lining has separated from the Uterus Placenta accreta is a severe obstetric complication involving an abnormal superficial attachment of the Placenta to the Myometrium (the middle layer of Vasa praevia ( vasa previa AE) is an obstetric complication defined as "fetal vessels crossing or running in close proximity to the inner Cervical os The pelvis (pl pelvises or pelves) or pelvic girdle is the irregular bony structure located at the base of the spine (properly known A Caesarean section (or Cesarean section in American English) also known as C-section, is a form of Childbirth in which a surgical In Human anatomy, the perineum is generally defined as the surface region in both males and females between the Pubic symphysis and the Coccyx. Crohn's disease is a Disease of the Digestive system which may affect any part of the Gastrointestinal tract from Mouth to Anus For example, while one obstetrician may feel that a woman is too small to deliver her baby, another might well disagree. Similarly, some care providers may be much quicker to cite "failure to progress" than others. Disagreements like this help to explain why caesarean rates for some physicians and hospitals are much higher than are those for others. A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for The medico-legal restrictions on vaginal birth after caesarean (VBAC), have also increased the caesarean rate.

For religious, personal or other reasons, a mother may refuse to undergo caesarean section. In the United Kingdom, the law states that a woman in labour has the absolute right to refuse any medical treatment including caesarean section "for any reason or none", even if that decision may cause her own death, or that of her baby. The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Other countries have different laws.

As scheduled caesarean sections have become a rather safe operation (but see section on Risks), there has been a movement to perform caesarean delivery on maternal request (CDMR). Caesarean delivery on maternal request (CDMR is medically unnecessary Caesarean section, where the the conduct of a Childbirth via a Caesarean section There is also a consumer-driven movement to support VBAC as an alternative for repeat caesareans in the face of increased medico-legal restrictions on vaginal birth.

Risks

Statistics from the 1990s suggest that less than one woman in 2,500 who has a caesarean section will die, compared to a rate of one in 10,000 for a vaginal delivery. [9] However the mortality rate for both continues to drop steadily. Mortality rate is a measure of the number of Deaths (in general or due to a specific cause in some population scaled to the size of that population per unit time The UK National Health Service gives the risk of death for the mother as three times that of a vaginal birth. The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although [10] However, it is misleading to directly compare the mortality rates of vaginal and caesarean deliveries. Women with severe medical disease often require a caesarean section which can distort the mortality figures.

A study published in the 13 February 2007 issue of the Canadian Medical Association Journal found that women that have planned caesareans had an overall rate of severe morbidity of 27. Events 1258 - Baghdad falls to the Mongols, and the Abbasid Caliphate is destroyed Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. 3 per 1000 deliveries compared to an overall rate of severe morbidity of 9. 0 per 1000 planned vaginal deliveries. The planned caesarean group had increased risks of cardiac arrest, wound haematoma, hysterectomy (alt PPH - Post Pregnancy Hysterectomy), major puerperal infection, anaesthetic complications, venous thromboembolism, and haemorrhage requiring hysterectomy over those suffered by the planned vaginal delivery group. [11] Again, these figures can be significantly distorted given that women with severe health conditions are more likely to preschedule births by caesarean.

A study published in the February 2007 issue of the journal Obstetrics and Gynecology found that women who had just one previous caesarean section were more likely to have problems with their second birth. Women who delivered their first child by caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second delivery. Placenta praevia ( placenta previa AE) is an obstetric complication in which the placenta has attached to the uterine wall close to or covering the In Obstetrics, antepartum haemorrhage ( APH) also prepartum hemorrhage, is bleeding from the Vagina during Pregnancy from twenty four Placenta accreta is a severe obstetric complication involving an abnormal superficial attachment of the Placenta to the Myometrium (the middle layer of A stillbirth occurs when a Fetus which has died in the Uterus or during labor or delivery exits a Woman 's body [12]

A study published in the June 2006 issue of the journal Obstetrics and Gynecology found that women who had multiple caesarean sections were more likely to have problems with later pregnancies, and recommended that women who want larger families should not seek caesarean section as an elective. The risk of placenta accreta, a potentially life-threatening condition, is only 0. Placenta accreta is a severe obstetric complication involving an abnormal superficial attachment of the Placenta to the Myometrium (the middle layer of 13% after two c-sections but increases to 2. 13% after four and then to 6. 74% after six or more surgeries. Along with this is a similar rise in the risk of emergency hysterectomies at delivery. The findings were based on outcomes from 30,132 caesarean deliveries. [13] (see also review by WebMD.com)

A caesarean section is a major operation, with all that it entails, including the risk of post-operative adhesions. Adhesions are fibrous bands that form between tissues and organs often as a result of injury during surgery Pain at the incision can be intense, and full recovery of mobility can take several weeks or more. A prior caesarean section increases the risk of uterine rupture during subsequent labour. Uterine rupture is a potentially catastrophic event during Childbirth by which the integrity of the myometrial wall is breached

If a caesarean is performed under emergency situations, the risk of the surgery may be increased due to a number of factors. The patient's stomach may not be empty, increasing the anesthesia risk. [14]

Incidence

The World Health Organization estimates the rate of caesarean sections at between 10% and 15% of all births in developed countries. In 2004, the caesarean rate was about 20% in the United Kingdom, while the Canadian rate was 22. The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page 5% in 2001-2002. [15]

In the United States the caesarean rate has risen 46% since 1996,[16] reaching a level of 30. 2% in 2005. [16] A 2008 report found that fully one-third of babies born in Massachusetts in 2006 were delivered by C-section. In response, the state's Secretary of Health and Human Services, Dr. JudyAnn Bigby, announced the formation of a panel to investigate the reasons for the increase and the implications for public policy. [17]

Among developing countries, Brazil has one of the highest rates of caesarean sections in the world. In the public health network, the rate reaches 35%, while in private hospitals the rate approaches 80%.

Studies have shown that continuity of care with a known carer may significantly decrease the rate of caesarean delivery[18] but that there is also research that appears to show that there is no significant difference in caesarean rates when comparing midwife continuity care to conventional fragmented care. [19]

Elective caesarean sections

Main article: Elective caesarean section

Caesarean sections are in some cases performed for reasons other than medical necessity. Elective caesarean section (AE elective cesarean section refers to a Cesarean section (CS that is performed on a Pregnant woman on the basis of an obstetrical or Medical necessity is a United States Legal doctrine, related to activities which may be justified as reasonable necessary and/or appropriate based on evidence-based Reasons for elective caesareans vary, with a key distinction being between hospital or doctor-centric reasons and mother-centric reasons. Critics of doctor-ordered caesareans worry that caesareans are in some cases performed because they are profitable for the hospital, because a quick caesarean is more convenient for an obstetrician than a lengthy vaginal birth, or because it is easier to perform surgery at a scheduled time than to respond to nature's schedule and deliver a baby at an hour that is not predetermined. [20] Another contributing factor for doctor-ordered procedures may be fear of medical malpractice lawsuits. For example, the failure to perform a caesarean section has been a central point in numerous lawsuits against obstetricians over incidents of cerebral palsy. Cerebral palsy ( CP) is an Umbrella term encompassing a group of non-progressive, non- contagious conditions that cause Physical disability

Studies of US women have indicated that married white women giving birth in private hospitals are more likely to have a caesarean section than poorer women even though they are less likely to have complications that may lead to a caesarean section being required. The United States of America —commonly referred to as the The women in these studies have indicated that their preference for caesarean section is more likely to be partly due to considerations of pain and vaginal tone. [21] in contrast to this, a recent study in the British Medical Journal retrospectively analysed a large number of caesarean sections in England and stratified them by social class. Their finding was that caesarean sections are not more likely in women of higher social class than in women in other classes. [22] While such mother-elected caesareans do occur, the prevalence of them does not appear to be statistically significant, while a much larger number of women wanting to have a vaginal birth find that the lack of support and medico-legal restrictions led to their caesarean.

Anaesthesia

The mother has the option of receiving regional anaesthesia (spinal or epidural) or general anaesthesia for caesarean section. Regional anaesthesia, is Anesthesia affecting only a large part of the body such as a limb Spinal analgesia, (or commonly called spinal anesthesia or sub-arachnoid block (S The term epidural is often short for epidural anesthesia, a form of Regional anesthesia involving injection of drugs through a Catheter placed into the Regional anaesthesia has the advantage of allowing her to remain awake for the delivery and avoids sedation of the newborn. Pain relief after the caesarean is also improved.

General anaesthesia for caesarean section is becoming less common as scientific research has now clearly established the benefits of regional anaesthesia for both the mother and baby. In modern medical practice general anaesthesia ( AmE: anesthesia) is a state of total unconsciousness resulting from General anaesthetic drugs General anaesthesia tends to be reserved for emergencies where the mother or baby's life is immediately threatened or other high-risk cases. The risks of general anaesthesia for mother and baby are still extremely small overall.

If the mother already has an epidural in, this epidural can often be used for the caesarean section. Multiple recent studies have now shown that epidurals in labour do not increase the caesarean section rate (Meta analysis 2005 Anim-Somuah, Cochrane Review) but they may increase the risk of a forceps or instrumental delivery. Epidurals placed after 5 cm dilation is achieved do not affect chance of c-section. Epidurals traditionally have been known to slow down the progress of labour, but recent work has shown that they may actually speed up the labour process (COMET Study, Lancet 2001).

Vaginal birth after caesarean

Main article: Vaginal birth after caesarean

Vaginal birth after caesarean (VBAC) is not uncommon today. Vaginal birth after caesarean (VBAC refers to the practice of delivering a baby vaginally (naturally after a previous baby has been delivered through Caesarean section Vaginal birth after caesarean (VBAC refers to the practice of delivering a baby vaginally (naturally after a previous baby has been delivered through Caesarean section The medical practice until the late 1970s was "once a caesarean, always a caesarean" but a consumer-driven movement supporting VBAC changed the medical practice. Rates of VBAC in the 80s and early 90s soared, but more recently the rates of VBAC have dramatically dropped owing to medico-legal restrictions.

In the past, caesarean sections used a vertical incision which cut the uterine muscle fibres in an up and down direction (a classical caesarean). Modern caesareans typically involve a horizontal incision along the muscle fibres in the lower portion of the uterus (hence the term lower uterine segment caesarean section, LUSCS/LSCS). The uterus then better maintains its integrity and can tolerate the strong contractions of future childbirth. Cosmetically the scar for modern caesareans is below the "bikini line. Bikini Waxing refers to the removal of Hair at the top of the Leg, below the Navel, and in the bikini area, otherwise known as the "

Obstetricians and other caregivers differ on the relative merits of vaginal and caesarean section following a caesarean delivery; some still recommend a caesarean routinely, others do not. What should be emphasised in modern obstetric care is that the decision should be a mutual decision between the obstetrician and the mother/birth partner after assessing the risks and benefits of each type of delivery. As is the case for all surgical procedures a patient signed form relating to informed consent must be obtained prior to surgery attesting the completeness of patient information because of reasonable and viable alternatives to maternal choice CS.

Twenty years of medical research on VBAC support a woman's choice to have a vaginal birth after caesarean. Because the consequences of caesareans include a higher chance of re-hospitalization after birth, infertility, and uterine rupture in the next birth, preventing the first caesarean remains the priority. For women with one or more previous caesareans, as an alternative to major abdominal surgery, some claim that VBAC remains a safer option. [23]

In the United States, the American College of Obstetricians and Gynecologists (ACOG) modified the guidelines on vaginal birth after previous cesarean delivery in 1999 and again in 2004[24]. The American College of Obstetricians and Gynecologists ( ACOG) is a Professional association of Medical doctors specializing in Obstetrics and This modification to the guideline including the addition of following recommendation:

Because uterine rupture may be catastrophic, VBAC should be attempted in institutions equipped to respond to emergencies with physicians immediately available to provide emergency care. [25]

This recommendation has, in some cases, had a major impact on the availability of VBACs to birthing mothers in the United States. For example, a study of the change in frequency of VBAC deliveries in California after the change in guidelines, published in 2006, found that the VBAC rate fell to 13. 5% after the change, compared with 24% VBAC rate before the change[26]. The new recommendation has been interpreted by many hospitals as indicating that a full surgical team must be standing by to perform a caesarean section for the full duration of a VBAC woman's labor. Hospitals that prohibit VBACs entirely are said to have a 'VBAC ban'. In these situations, birthing mothers are forced to choose between having a repeat caesarean section, finding an alternate hospital in which to deliver their baby or attempting delivery outside the hospital setting[27].

Caesareans in fiction

The first caesarean section according to mythology was performed by Apollo on his lover Coronis when he delivered Asklepios, after she had been murdered. The word mythology (from the Greek grc μυθολογία mythología, meaning "a story-telling a legendary lore" There are several characters in Greek mythology by the name Coronis (Κορωνίς -ίδος Asclepius (pronounced /æsˈkliːpiːəs/, Greek, transliterated Asklēpiós; Latin Aesculapius) is the god of Medicine

In Persian mythology, Rudaba's labour of Rostam was prolonged due to the extraordinary size of her baby. By Persian Mythology is meant the myths and sacred narratives of the culturally and linguistically related group of ancient peoples who inhabited the Iranian Plateau Rūdāba or Roodabeh (in Persian رودابه is a Persian mythological female figure in Ferdowsi 's epic Shahnameh. For the historical general who fought at the Battle of al-Qādisiyyah for the Sassanid Empire, also mentioned in the Shahnameh, see Rostam Farrokhzād Zal, her lover and husband, was certain that his wife would die in labour. Zāl (زال in Persian) is a legendary Persian warrior from the old Persian "The Book of Kings" or Rudaba was near death when Zal decided to summon the Simurgh. Simurgh or Simorgh (سیمرغ sometimes spelled Simurg or Simoorg, also known as Angha (عنقا is the modern Persian name for The Simurgh appeared and instructed him upon how to perform a caesarean section, thus saving Rudaba and the child, who later on became one of the greatest Persian heroes.

A caesarean section appears in Shakespeare's play Macbeth. William Shakespeare ( baptised A play, or stageplay, is a form of Literature written by a Playwright, almost always consisting of Dialogue between Fictional characters Macbeth is among the best-known of William Shakespeare 's plays, and is his shortest tragedy, believed to have been written some time between Macbeth hears a prophecy that "none of woman born shall harm Macbeth," an impossibility, but later finds out that Macduff was "from his mother's womb untimely ripp'd," the product of a caesarean section birth (not unlike Robert II of Scotland). Marriages and issue His first wife was Elizabeth Mure, by her he had at least ten children King Robert III of Scotland

The stillborn child of character Katherine Barkley is delivered by caesarean section in the Hemingway novel A Farewell to Arms. Ernest Miller Hemingway (July 21 1899 — July 2 1961 was an American novelist short-story writer, and Journalist. A novel (from Italian novella, Spanish novela, French nouvelle for "new" "news" or "short story A Farewell to Arms is a semi-autobiographical Novel written by Ernest Hemingway, first published in 1929

In the video game Metal Gear Solid 3: Snake Eater, a main character called 'The Boss' exposes a c-section scar to Naked Snake (The player's character). (commonly abbreviated to MGS3) is a stealth action Video game directed by Hideo Kojima. The scar is possibly from a blundered procedure and runs from the abdomen to the breasts, and is in the shape of a snake.

In Alexandra Ripley's "Scarlett", the main character, Scarlett O'Hara, has a caesarean section performed by a so-called "medicine woman". Alexandra Ripley, née Braid ( January 8, 1934 - January 10, 2004) was an American writer best known as the author of Scarlett is a novel written in 1991 by Alexandra Ripley as a sequel to Margaret Mitchell 's Gone with the Wind Scarlett O'Hara (full name Katie Scarlett O'Hara Hamilton Kennedy Butler) is the Protagonist in Margaret Mitchell 's 1936 novel Gone with She almost miraculously recovers after giving birth to a girl.

In the novel, Midwives, by Chris Bohjalian, midwife Sybil Danforth, stranded with a labouring mother in a storm, performs a caesarean section when the mother dies in order to save the child. Midwifery is a Health care profession where providers give Prenatal care to expecting Mothers attend the birth of the Infant Chris Bohjalian is an American novelist A Summa cum laude graduate of Amherst College (where he was a member of the Phi Beta Kappa Society The story revolves around the court case that ensues when doubts are raised as to whether the mother was in fact dead at the time of the surgery or the midwife made a mistake.

In the novel Restoration set in Britain of the 1660's the surgeon protagonist delivers his own daughter by caesarean, but the mother dies shortly thereafter. Restoration is a novel by Rose Tremain, published in 1989. It was short listed for the Booker Prize in 1989 and was the Sunday Express

On the TV show Desperate Housewives the character Edie Britt says she has a C-section scar when she tries to seduce Carlos Solis. Desperate Housewives is an American Television Dramedy series created by Marc Cherry, who also serves as Show runner, and produced Edie Williams (née Britt, previously McLain and Roswell) is a Fictional character on the ABC Television series Carlos Solis ( is a Fictional character on the ABC Television series, Desperate Housewives.

In the novel A Thousand Splendid Suns by Khaled Hosseini, which is set in Afghanistan, the character Laila undergoes a Caesarean section without anaesthesia while giving birth to her son, Zalmai. A Thousand Splendid Suns ( Persian: دو صد خورشیدرو) is a 2007 Novel by Afghan author Khaled Hosseini Khaled Hosseini ( hosejni}} (or ˈhɑlɛd hɔwˈsɛjni by English speakers (born March 4 1965) is a Tajik novelist and physician originally from Afghanistan /æfˈgænɪstæn/ officially the Islamic Republic of Afghanistan ( Pashto: د افغانستان اسلامي جمهوریت, The doctor explains that as the baby is breech, they must perform a Caesarean section or the baby will die. A breech birth (also known as breech presentation) refers to the position of the Baby in the Uterus such that it will be delivered However, as a result of difficulties on the part of the Taliban, the hospital is desperately lacking in basic supplies, and therefore, they literally have no anaesthesia to give Laila for the procedure. The Taliban ( طالبان, also anglicised as Taleban; translation "students" is a Sunni Islamist, predominately Laila nonetheless agrees to go through with it. Which could have good results

References

  1. ^ Fear a factor in surgical births - National - smh.com.au
  2. ^ Kiwi caesarean rate continues to rise - New Zealand news on Stuff.co.nz
  3. ^ Finger (2003). "Caesarean section rates skyrocket in Brazil. Many women are opting for caesareans in the belief that it is a practical solution. ". Lancet 362: 628. PMID 12947949.  
  4. ^ England, Pam and Rob Horowitz, Birthing From Within, p. 149
  5. ^ Pliny the Elder, Historia naturalis 7.47.
  6. ^ About.com
  7. ^ For a summary (in German), of an article (also in German) that deals usefully with many of the relevant historical and linguistic questions raised here, go here.
  8. ^ St. Raymond Nonnatus. Catholic Online. Retrieved on 2006-07-26. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 657 - Battle of Siffin. 811 - Battle of Pliska; Byzantine Emperor Nicephorus
  9. ^ Robin Elise Weiss. Risks of Cesarean Section. childbirth. org. Retrieved on 2006-07-26. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 657 - Battle of Siffin. 811 - Battle of Pliska; Byzantine Emperor Nicephorus
  10. ^ Cesarean Section. NHS Direct. NHS Direct is the name of a 24 hour confidential Telephone, Online and interactive digital TV health advice and information service provided by the National Retrieved on 2006-07-26. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 657 - Battle of Siffin. 811 - Battle of Pliska; Byzantine Emperor Nicephorus
  11. ^ Liu, Shiliange, Maternal mortality and severe morbidity associated with low-risk planned caesarean delivery versus planned vaginal delivery at term Canadian Medical Association Journal, 13 February 2007; 176 (4). Events 1258 - Baghdad falls to the Mongols, and the Abbasid Caliphate is destroyed Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century.
  12. ^ Risks of Adverse Outcomes in the Next Birth After a First Cesarean Delivery Kennare, Robyn Obstetrics and Gynecology, February 2007, vol. 109; pp. 270-276.
  13. ^ Silver, R. M. Obstetrics and Gynecology, June 2006; vol. 107: pp. 1226-1232.
  14. ^ Why are Caesareans Done?. Gynaecworld. Retrieved on 2006-07-26. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 657 - Battle of Siffin. 811 - Battle of Pliska; Byzantine Emperor Nicephorus
  15. ^ "Canada's caesarean section rate highest ever", CTV, April 21, 2004. CTV is a Canadian English language Television network. It is Canada's largest privately owned network the main television asset of CTVglobemedia Events 753 BC - Romulus and Remus found Rome ( traditional date) "MMIV" redirects here For the Modest Mouse album see " Baron von Bullshit Rides Again " Retrieved on 2006-07-26. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 657 - Battle of Siffin. 811 - Battle of Pliska; Byzantine Emperor Nicephorus  
  16. ^ a b Preliminary Births for 2005: Infant and Maternal Health. National Center for Health Statistics. National Center for Health Statistics ( NCHS) is part of the Centers for Disease Control and Prevention (CDC which is part of the United States Department of Retrieved on 2006-11-23. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 800 - Charlemagne arrives at Rome to investigate the alleged crimes of
  17. ^ Stephen Smith, "C-sections leap to 1 in 3 births in Bay State, to outstrip US", Boston Globe, February 14, 2008
  18. ^ Homer Caroline et al. The Boston Globe (and Boston Sunday Globe) is the most widely circulated daily Newspaper in Boston and in New England, Events 842 - Charles the Bald and Louis the German swear the Oaths of Strasbourg in the French and German 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common (2001). "Collaboration in maternity care: a randomized controlled trial comparing community-based continuity of care with standard hospital care.". JBritish Journal of Obstetrics and Gynaecology, 2001 vol 108 p16-22. doi:10.1111/j.1471-0528.2001.00022.x/enhancedabs/. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document.  
  19. ^ Hodnett, E. D. (2000). "Continuity of caregivers for care during pregnancy and childbirth" (PDF, fee may be required). John Wiley & Sons, Ltd. doi:10.1002/14651858.CD000062. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document.  
  20. ^ Mackenzie IZ, Cooke I, Annan B. Indications for caesarean section in a consultant unit over the decades. J Obstet Gynecol 2003;23:233-8
  21. ^ Wagner, Marsden. Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First (registration required), p42.  
  22. ^ "Social class and elective caesareans in the English NHS", British Medical Journal, 2004-06-12. "MMIV" redirects here For the Modest Mouse album see " Baron von Bullshit Rides Again " Events 1381 - Peasants' Revolt: in England, rebels arrive at Blackheath. Retrieved on 2006-10-01. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 331 BC - Alexander the Great defeats Darius III of Persia in the Battle of Gaugamela.  
  23. ^ Vernon, D (2005). David Vernon is the name of David Vernon (writer (born 1965 Australian writer David Vernon (professor, professor at the University of Genoa Having a Great Birth in Australia. Canberra, Australia: Australian College of Midwives. Canberra ( is the capital city of Australia With a population of over 340000 it is Australia's largest inland City. For a topic outline on this subject see List of basic Australia topics. The Australian College of Midwives is the professional organisation representing midwives and Midwifery policy in Australia. ISBN 0-9751674-3-X.  
  24. ^ American College of Obstetricians and Gynecologists (ACOG). Guideline on Vaginal birth after previous cesarean delivery. guideline. gov. Retrieved on 2008-02-09. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 474 - Zeno crowned as co-emperor of the Byzantine Empire.
  25. ^ American College of Obstetricians and Gynecologists (ACOG). Guideline on Vaginal birth after previous cesarean delivery: Major Recommendations. guideline. gov. Retrieved on 2008-02-09. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 474 - Zeno crowned as co-emperor of the Byzantine Empire.
  26. ^ John Zweifler, MD, MPH, Alvaro Garza, MD, MPH, Susan Hughes, MS, Matthew A Stanich, MPH, Anne Hierholzer, and Monica Lau, Vaginal Birth After Cesarean in California: Before and After a Change in Guidelines Annals of Family Medicine, May 2006; 4(3).
  27. ^ Rita Rubin. Battle lines drawn over C-sections. USA Today. Retrieved on 2008-02-09. 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 474 - Zeno crowned as co-emperor of the Byzantine Empire.

External links

Caesarean section at the Open Directory Project

The Open Directory Project ( ODP) also known as dmoz (from directory

Dictionary

Caesarean section

-noun

  1. (UK) Delivery of a baby through an incision in the womb.
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