An ancient medieval grave found near Bologna, Italy, contained a pregnant woman injured in the head with a fetus between her legs. Thanks to the positioning of the bones, the researchers concluded that it was a “coffin birth”, when a baby is forcibly expelled from his mother’s body after her death.
The tomb, dating from the 7th-8th century AD, was found in 2010 in Imola, northern Italy. It is because the adult skeleton was found face up and intact that archeologists determined that it was a burial. The fetus between her legs and the head wound, however, called for a thorough investigation, recently published in the journal World Neurosurgery by researchers from the universities of Ferrara and Bologna.
Based on the length of the femur bone, the researchers first determined that the fetus was about 38 weeks of gestation. The baby’s head and upper body were under the pelvic cavity, while the bones of the leg were still inside. That means he was starting to prepare for birth. Although rare in contemporary forensic literature — and even more so in the bioarchaeological file — this could be a case of post-mortem fetal expulsion, or a coffin birth. The bioarchaeologist Siân Halcrow, from the University of Otago, New Zealand, explains that when a pregnant woman dies, the gas produced during the normal decomposition of the body sometimes accumulates to the point that the fetus is expelled by force.
This birth example is interesting from an archaeological point of view, but the mother’s state of health makes it quite unique: she had a small mark on her forehead and a circular hole of 5 mm next to it. It could be, according to the researchers, the signs of a trepanning, an old form of skull surgery. Not only was the pregnant woman trepanned, but she also lived at least a week after the initial surgery. In the article, Italian researchers propose a correlation between maternal surgery and pregnancy: eclampsia. “Because trepanation was formerly used in the treatment of hypertension to reduce blood pressure in the skull,” they write, “we hypothesized that this injury could be associated with the treatment of a hypertensive pregnancy disorder” .
Eclampsia is the appearance of seizures in a pregnant woman suffering from pregnancy-related hypertension. A few centuries ago, this condition was probably a common cause of maternal death. A pregnant woman who has fevers, convulsions and headaches in the early Middle Ages may very well have been trepanned. “Given the characteristics of the wound and the late pregnancy, our hypothesis is that the pregnant woman had eclampsia, and she was then treated with frontal trepanation to relieve intracranial pressure,” the researchers note.
If the researchers’ conclusions are correct, the mother’s condition has unfortunately not improved, and she was buried still pregnant in a tomb lined with stones. Her body decomposing, her dead fetus was then partially expelled.