Objective: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg.
Study type: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods.
Settings: Department of Obstetrics and Gynecology of the First Faculty of Medicine of Charles University and General University Hospital in Prague.
Methods and results: Until the second half of the 19th century, medical knowledge of antiseptics and anesthesia was lacking, and techniques for cleaning wounds and staunching bleeding were primitive.Because no effective anesthetics were known before that time, people did not know how to perform painless abdominal surgery. There are a very few credible reports of caesarean sections performed on living women as early as the 17th century. However, before the 19th century, a caesarean section meant almost certain death for the mother, with related mortality as high as 90%. If the woman did not die of stress from the pain of the abdominal surgery, then she usually died of either bleeding or later of sepsis. However, there is some indirect evidence that the first caesarean section that was survived by both the mother and child was performed in Prague in 1337. The mother was Beatrice of Bourbon (1318-1383), the second wife of the King of Bohemia John of Luxembourg (1296-1346). Beatrice gave birth to the kings son Wenceslaus I (1337-1383), later the duke of Luxembourg, Brabant, and Limburg, and who became the half brother of the later King of Bohemia and Holy Roman Emperor, Charles IV (1316-1378).
Conclusions: From a historical analysis based on the indirect evidence, it is not possible to unequivocally determine whether a caesarean section that was survived by both the mother and child was actually performed in the 14th century. From a medical standpoint in the context of all the known surrounding circumstances, however, this rare event could indeed have taken place.
Keywords: 1337; Beatrice of Bourbon; John of Luxembourg; Prague; anesthesia; caesarean section; child; first; mortality morbidity.; mother; survived.