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Coffin birth discovered from over 1000 years ago

Credits: Pasini et al. / World Neurosurgery

An ancient medieval grave, found near Bologna in Italy, contained a woman with head injuries, who had been pregnant, and whose body was found with the bones of a foetus between her legs. Due to the positioning of the bones, researchers concluded that it was a “coffin birth”, when a baby is expelled from the mother’s body after she dies. 

The grave, dating back to the 7th – 8th century AD, was found in Imola, in Northern Italy, in 2010. The archaeologists were able to determine that it was a proper burial, due to the fact that the adult skeleton was found intact and face up. The foetus between its legs and the head injury however, required further study, and the results were recently published in World Neurosurgery by researchers in the universities of Ferrara and Bologna.

Based on the length of the femur, the researchers firstly determined that the foetus was at around 38 weeks gestation. The baby’s head and upper body were below the pelvic cavity, while the legs were still inside it. This means that the baby was almost ready to be born when the mother died. Although it is very rare in contemporary medico-legal literature -and even more rare still in bio-archaeology -it could have been the case of post-mortem foetal expulsion, or “coffin birth”. Bioarchaeologist Sian Halcrow from the University of Otago (in New Zealand) explains that when a pregnant woman has died, the gas produced during normal decomposition of the body can sometimes build up, to the extent that the foetus is forcefully expelled from the body.

Credits: Pasini et al. / World Neurosurgery

This type birth is interesting from an archaeological point of view, but the mother’s health in this instance makes it even more unique: she had a small mark on her forehead and a circular hole in her head 5 mm to the side. According to the researchers, these could be signs of ‘trepanation’, an ancient form of surgery involving drilling a hole in the skull. Not only had the pregnant woman had a trepanation, but she survived for at least a week after this primitive form of surgery. In the article, the Italian researchers suggested a link between the mother’s surgery and her pregnancy: pre-eclampsia. “Since trepanation was once often used in the treatment of hypertension to reduce blood pressure in the skull, we theorised that this lesion may be associated to the treatment of a hypertensive pregnancy disorder such as preeclampsia.” 

Eclampsia is when a pregnant woman suffers convulsions due to high blood pressure linked to pregnancy. And a few centuries ago, this illness was likely to have been a frequent cause of death in pregnant women. A pregnant woman suffering fever, convulsions and headaches at the beginning of the Middle Ages could thus well have been operated on via trepanation. “Given the characteristics of the wound and the late stage of pregnancy, our hypothesis is that the pregnant woman suffered from eclampsia, and was treated with a frontal trepanation to ease the intracranial pressure”, state the researchers.

If the researchers’ conclusions are correct, the mother’s condition unfortunately did not improve, and she was buried while still pregnant, in a grave surrounded by stones. Her body decomposed, the foetus died and was later partially expelled from the body.