Postmortem and Perimortem Cesarean Section: Historical, Religious and Ethical Considerations

Abstract

Guillimeau was the first to use the term Cesarean Section (CS) in 1598 but this name became universal only in the twentieth century. The many theories of the origin of this name will be discussed.

This surgery has been reported to be performed in all cultures and from ancient times. In the past it was mainly done to deliver a live baby from a dead mother hence the name Post Mortem CS (PMCS). Many heroes are reported to have been delivered this way.

There have been references to abdominal delivery in old Jewish sacred books. It was especially encouraged and often mandated in Catholicism. There is evidence that the operation was done in Muslim countries in the Middle Ages. Islamic rulings support the performance of PMCS.

Now that most maternal deaths occur in the hospital, perimortem CS (PRMCS) is recommended for the delivery of the pregnant woman with cardiac arrest after 24 weeks. It is believed that emergent delivery within four minutes of initiation of cardiopulmonary resuscitation (CPR) improves the chances of success of maternal resuscitation and survival and increases the chance of delivering a neurologically intact neonate.

It is agreed that physicians are not to be held legally liable for the performance of PMCS and PCS regardless of the outcome. The ethical aspects of these operations are also discussed including a discussion about PMCS for the delivery of women who have been declared brain dead.

DOI: http://dx.doi.org/10.5915/43-3-7099
Video: http://dx.doi.org/10.5915/43-3-7099V