Legend has it that the first successful cesarean section was performed to deliver Julius Caesar; persistence of this legend gave rise to the name of the procedure. However, given the fact that his mother survived his birth, most authorities doubt Caesar really was born in this manner (because surviving cesarean section was virtually unknown until the twentieth century).

By the middle ages, delivery of a baby through an incision in the mother's abdomen was well described-and so was the subsequent death of the mother. In the nineteenth century, the method of cesarean delivery was well-known in medical practice, yet rarely performed. Prior to the mid-nineteenth century, cesarean delivery was associated with an essentially 100% death rate for the mother. Looking back at medical practice at that time, it is not hard to understand why.

First, doctors had no understanding of what today is called the germ theory of disease (the theory that diseases are due to the presence of microorganisms in the body); therefore, they made no attempts to sterilize surgical instruments or wash their hands. Thus, many women acquired serious infections during the birthing process and, since antibiotics were unknown until a century later, these infections resulted in many deaths.

Second, blood transfusions were not performed until the twentieth century, and many women died from blood loss during delivery before this time. Even today, blood transfusions are sometimes necessary as a result of blood loss at the time of cesarean section; in the past, there was no way to help these women.

Finally, until well into the twentieth century, anesthetic techniques were very primitive. This not only made the operation more difficult for the doctor but also made it a horrendous experience for the mother. Undoubtedly, this also increased the rate of complications.

For the most part, these problems have been solved today and death or serious disability resulting from cesarean section is an extremely rare event. On the contrary, cesarean section can be credited with saving the lives of innumerable mothers and infants over the past century, and it can truly be considered one of the major achievements of modern medicine.