Hannah Marsh delves into the story of the Caesarean section, looking at how it weaves its way through myth, folklore and culture, as well as our shared medical and social history.

The knife, the skin, the slice, the pry, the pull, the empty, the delivery, the deliverance.

A cry.

And my son is born by Caesarean section.

This was six years ago, and ever since, I’ve found myself consumed by a fascination with this operation. It’s an interest that has seen me come up against gods and goddesses, mythical heroes (and their mothers), pig gelders and Victorian ‘men of sense’ as I’ve read and scoured and researched. I’ve encountered gloomy, candle-lit theatres in Nineteenth century London, where surgery was a gory and dramatic affair, performed without anaesthetic in front of a roomful of people, (pre-germ theory), as they craned and coughed and chattered in the stuffy, crowded environs. I’ve spoken with women, and wrangled with numbers that tell stories of their own - maternal mortality rates, and gaping gulfs of unfairness; racism, misogyny and prejudice.

The book that I am writing tells a story of the Caesarean Section. It wends its way through myth and folklore, medical history and cultural touchpoints, as well as personal experience and contemporary ideas and issues. I say ‘a story’, because there is no ‘the story’. It is a complex web of developments and experiences that wends its way through and alongside our shared human history

Writing about something so personal to me has been new for me. As a journalist, a job I did for many years, I was used to telling other peoples’ stories. I would sit in armchairs in their living rooms, across from them in cafes or at the other end of a phone, and listen, as they told me theirs. I was a question-asker, a prober, a listen-and-responder, a professional conversation-haver. And then I would gather it all up and spin it into my version of their story. I saw writing a feature as akin somehow to painting a portrait. You have a subject, and you try to represent them in a way that is faithful to its originator, but in your own unique style, and through your interpretation of their words. If you’ve painted it well, with deftness and empathy, your own presence will be faint, ghost-like in the background. Your reader will be caught up in your subject’s story, not particularly giving thought to the way you’ve turned these words to the light so that they shine, or how you’ve cast shadow on others to give them poetry. I’m comfortable in the background, less used to sharing my own experiences, let alone some of the most intimate and vulnerable experiences of my life.

But in a way, the book that I am writing is a telling of other peoples’ stories. At the forefront of my thoughts as I’ve read and written are the millions of women who went before me, whose babies were taken from their womb by knife and hand, many, many of whom didn’t survive the experience. These women’s stories are the beating heart of my book. Although the procedure is now so common as to be almost pedestrian, the Caesarean section is as old as human history, originally a last ditch attempt to save an infant’s life if its mother lay dead or dying. Even then, it was usually for religious or cultural significance - so that the child might be swiftly baptised, or buried separately from its mother. The child wasn’t expected to survive for very long either. Perhaps that is why children born in this way have found themselves associated with supernatural beliefs around their strength and power. From Roman philosophers to Shakespeare, writers have toyed with a folk-belief that Caesarean section babies are gifted with a particular strength, a supernatural fortitude and fortune. It wasn’t until the Nineteenth century, with the advent of anaesthesia and antiseptic that the procedure could be refined, developed and evolve to become the largely safe operation that it is today.

Childbirth turned me inside out. Metaphorically, as I endured a lengthy, complicated labour, hallucinating, tripping and almost out of my mind from the pain and drugs, then literally, as my internal organs were brought from my body so that my son could be extracted. It turned me inside out again as I dug through my memories of that experience, probing and questioning, overlaying them on the many stories I read of women, many far less fortunate than I, who underwent various versions of this procedure over time. Mining for meaning in my own memories of an incredibly traumatic experience has been both vindicating and grief-inducing, and I’ve had moments of elation and empowerment, muddled in with low moods, tears and illumination. Through writing, I’ve made better sense of things, considered what I went through from various new perspectives, and sometimes felt overwhelmed by the emotion that has accompanied my journey. The examples of misogyny and racism I’ve encountered, insidiously weaving their way through medical and surgical developments, has sometimes felt like they are crushing me beneath their centuries of weight. Understanding that so much of the safety that many of us experience in a contemporary medical setting came at a violent, horrific cost to so many women, often the poorest, least supported and most vulnerable women, and in particular enslaved Black women, upon whom many obstetric procedures, including Caesarean sections, were refined and practised, is bleak but necessary.

I have been a magpie during this time. Reading words written by others, gleaning my treasure and assembling them so that they gain collective meaning. Reports written by physicians in the 1800s in medical archives, articles, social media posts, academic reports to decipher and breakdown to see if there is anything there that illuminates something for me, sheds light on the tapestry that I am carefully and painstakingly weaving. And I have also found magic, mystery and beauty in this extraordinary procedure. I’ve found tales of mythical birds with healing feathers, human boldness, bravery and compassion. The Caesarean section represents one of humankind’s greatest triumphs over nature. Shining a light on its story has been humbling.

Gods, gelders, magpies and magic

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