Julius Caesar almost certainly was not born by caesarean section
The popular story says the operation is named after Julius Caesar's birth. But until modern times the surgery seems always to have killed the mother, and Caesar's mother Aurelia lived for nearly 50 years after he was born. If the name does come from him, it rests on a misconception.
The procedure is ancient. It was carried out at least as early as 715 BC after a mother had died, sometimes saving the baby, and laws and legends about it appear across Europe, the Middle East and Asia. The first recorded case in which mother and child both survived supposedly took place in Switzerland in 1500, performed by the woman's husband, Jacob Nufer, although nobody wrote it down until about eighty years later. Survival for both became far more common only in the 19th century, with the arrival of antiseptics and anaesthesia.
Today the operation usually takes 45 minutes to an hour, often under a spinal block so the mother stays awake. Surgeons typically make a cut of about 15 cm across the lower abdomen, then a second into the uterus to deliver the baby. Common reasons include obstructed labour, breech position, twins, high blood pressure and problems with the placenta or cord. Healing takes around six weeks, longer than after a vaginal birth.
Roughly 23 million caesareans were performed worldwide in 2012, and rates vary enormously: more than 45 countries sit below 7.5%, while over 50 exceed 27%. In the United States about 32% of births were surgical as of 2017. The international health community long treated 10 to 15% as the ideal rate, since rates above that are not linked to fewer maternal or infant deaths, though some evidence suggests 19% may give better results. The World Health Organization recommends the surgery only when medically needed.
For low-risk pregnancies, the difference in bad outcomes is small but real: adverse events follow 8.6% of vaginal births and 9.2% of caesareans. In the developed world the maternal death rate in low-risk cases is 13 per 100,000 for caesareans against 3.5 for vaginal delivery. Efforts to curb unnecessary operations include redefining active labour as beginning at 6 cm of dilation rather than 4 cm, and allowing longer pushing before labour is declared stalled.
Source: Caesarean section
