Wellness

Why Is It Called A 'Cesarean Section' Anyway?

The legend about Julius Caesar seems suspect.
04/05/2018 05:48pm ET
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C-sections account for about 32 percent of births in the U.S., according to the National Center for Health Statistics.

Cesarean sections are a common way to give birth today, accounting for nearly one-third of births in the U.S.

But where on earth did the name “cesarean section” come from?

References to removing babies from their mothers’ abdomens reportedly date back to ancient texts and folklore from Greece, Rome, China, Egypt, India and beyond. Initially, this kind of procedure was an attempt to save the baby when the pregnant mother was either dead or dying ― or a means of separating them for religious burial purposes when neither survived.

The most common explanation for the name cesarean section ― or “caesarian section” as it’s known elsewhere in the English-speaking world ― involves a legend about the birth of famous Roman leader Gaius Julius Caesar. According to 10th-century Byzantine encyclopedia The Suda, “For when his mother [Aurelia] died in the ninth month, they cut her open, took him out and named him thus; for in the Roman tongue dissection is called ‘Caesar.’”

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A 16th-century image depicting the legend of Caesar's birth, printed in Filippion Beroaldo's edition of Suetonius' Lives of the Twelve Caesars.
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An image of a C-section birth in the medieval work Faits des Romains (Acts of the Romans), which chronicles the life of Julius Caesar.

This story seems unlikely, however, given that Caesar’s mother Aurelia survived her son’s birth and even served as a political adviser of sorts when he was an adult.

This misconception about Caesar’s birth may be the result of Pliny the Elder’s Historia Naturalis from the first century. In a section about human birth, he writes about a Caesar (an ancestor of Gaius Julius Caesar) who “was so named, from his having been cut from his mother’s womb.” Thus, the legend about the famous Caesar’s birth likely stemmed from a misreading of this text.

Still, the passage also suggests a more plausible explanation for the origin of “cesarean section.” As Historia Naturalis and The Suda both note, the name “Caesar” seems related to various forms of the Latin word caedere, which means “to cut.” The word caesones referred to babies born via this kind of surgical procedure. So perhaps the term “cesarean section” simply comes directly from the Latin words caedere or caesones, without the Julius Ceasar intermediary.

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Some are concerned about rising C-section rates.

(It’s also worth noting that some sources attribute the Caesar name to the Latin word caesaries, meaning “hair” or “long, flowing hair” ― perhaps because one of Julius Caesar’s ancestors had long, flowing hair.)

Another compelling theory is that the name for the surgical procedure comes from the Roman decree requiring the babies of dead or dying pregnant women to be cut from the womb, which was part of the law known as Lex Caesarea.

Although there’s no definitive answer to the name-origin question, we do know people called the procedure a “caesarean operation” before French surgeon Jacques Guillimeau introduced the term “section” in his 1598 book on midwifery. “Caesarean section” gradually took hold, and the first “a” was dropped in the U.S.

Guillimeau’s book came 17 years after another French surgeon, François Rousset, published his treatise advocating for the procedure ― which he described as “enfantement césarien” or “cesarean birth” ― on living women. His ideas were were controversial, but over time, physicians continued to attempt C-section births, not only as a last-ditch attempt to save the child but also to save the mother.

By the mid-20th century, C-sections had become safer and more common. While there remains much debate around the origin of this procedure, there is also a lot of controversy around the practices of hospitals performing C-sections today, particularly in countries with higher rates like the U.S. and China.

At least we can all agree that Caesar probably wasn’t born via C-section.