The Curious Case of the Pig Farmer and his Wife

The infamous Caesarian Section, so named not because it saved the great politician from an early death (Julius Caesar was born by normal means) but because it was codified into law in the Roman Empire, was, sadly, the option of last resort through the dark and middle ages.

It was common practice to attempt to save the baby in  cases of maternal death in childbirth. It was rarely successful on this count, as generally, by the time the mom died, the fetus was in massive distress. Attempting it prior to maternal death was impossible–it was tantamount to murder.

Without anesthetics, any surgery was painful and traumatic. Nonetheless, surgeries were performed. Amputations were common, as were tumor removals and lithotomy (removing bladder stones). People even occasionally survived these, especially when the surgery was “clean”– no reason, other than chance, for the wound to become infected.

Sections, however, were different. The uterine wall was impossible to suture safely. This massive muscle immediately tore out its own stitches as it clamped down after childbirth. Add to that the other risks of playing with a gravid uterus (amniotic fluid embolism, disseminated intravascular coagulation, puerperal fever), and the women, if they were alive first, weren’t for long after. So it was simply not done.

Enter Jacob Nufer, a Swiss pig-gelder. His beloved wife had already produced a few children, and was in labor with another, when something went wrong.

None of the local midwives could suggest anything more helpful than prayer. He called some local surgeons, who shook their heads.

What is a pig-gelder to do? Well, he had his gelding knives…

Jacob Nufer, a poor pig farmer, performed the first successful C-section in history, in 1500 CE.

We know it was successful because self-same wife was naturally delivered of at least six more children during her 77 year life span, including one set of twins.

So what did Nufer do about the uterine wall?

No one knows. Nufer was illiterate. Someone told the story to someone else, and it was eventually published 82 years later in the appendix of a popular French midwifery book.

It has been suggested, perhaps by those who studied the surgery diligently and attempted to find a way to perform it safely, that Nufer’s wife was delivered not of a uterine pregnancy, but of a full term ectopic. Skeptics point to the V-back and the twins and are quite certain that Nufer never attempted to suture a uterine wall.

We will never know.

But we do know that it was another three hundred plus years before any but the rare anecdotal sections began to make history, as the first wave of the new science of obstetrics began to actually study the problem of the uterine wall.

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