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Cesarean delivery is defined as the birth of a fetus through incisions in the abdominal wall (laparotomy) and the uterine wall (hysterotomy). This definition does not include removal of the fetus from the abdominal cavity in the case of rupture of the uterus or in the case of an abdominal pregnancy. In some cases, and most often because of emergent complications such as intractable hemorrhage, abdominal hysterectomy is indicated following delivery. When performed at the time of cesarean delivery, the operation is termed cesarean hysterectomy. If done within a short time after vaginal delivery, it is termed postpartum hysterectomy.

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The origin of the term cesarean is obscure, and three principal explanations have been suggested.

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In the first, according to legend, Julius Caesar was born in this manner, with the result that the procedure became known as the Caesarean operation. Several circumstances weaken this explanation. First, the mother of Julius Caesar lived for many years after his birth in 100 BC, and as late as the 17th century, the operation was almost invariably fatal. Second, the operation, whether performed on the living or the dead, is not mentioned by any medical writer before the Middle Ages. Historical details of the origin of the family name Caesar are found in the monograph by Pickrell (1935).

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The second explanation is that the name of the operation is derived from a Roman law, supposedly created in the 8th century BC by Numa Pompilius, ordering that the procedure be performed upon women dying in the last few weeks of pregnancy in the hope of saving the child. This lex regia—king's rule or law—later became the lex caesarea under the emperors, and the operation itself became known as the caesarean operation. The German term Kaiserschnitt—Kaiser cut—reflects this derivation.

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The third explanation is that the word caesarean was derived sometime in the Middle Ages from the Latin verb caedere, to cut. This explanation seems most logical, but exactly when it was first applied to the operation is uncertain. Because section is derived from the Latin verb seco, which also means cut, the term caesarean section seems tautological—thus cesarean delivery is used. In the United States, the ae in the first syllable of caesarean is replaced with the letter e. In the United Kingdom, Australia, and most commonwealth nations, the ae is retained.

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A more extensive review of the history of cesarean delivery can be found in the 22nd edition of Williams Obstetrics (Cunningham and colleagues, 2005), as well as in works by Boley (1991) and Sewell (1993).

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Frequency

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From 1970 to 2007, the cesarean delivery rate in the United States rose from 4.5 percent of all deliveries to 31.8 percent (Hamilton and colleagues, 2009; MacDorman and associates, 2008). This increase has been steady with the exception of the years ...

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