I’m feeling particularly festive today. So we’re gonna talk about my favorite non-Hitachi power tool originally designed for use directly on a woman’s crotch.
Today’s Moment of Science… The Birth of the Chainsaw.
(Content note: body horror, but you already gathered that, right?)
There are a couple of methods we currently employ to extract a freshly minted human from the womb. There’s obviously a built-in entrance to the world, but for a variety of reasons and complications, sometimes you just have Kool-Aid man this shit and bust a hole in the wall to get the hatchling out.
Anatomy not being so straightforward, there hasn’t always been widespread agreement on how to handle those more difficult births. Instead of constructing a new door, for a time some doctors opted to manually expand the existing one.
In a symphysiotomy, the cartilage that connects the pubic bones is disconnected. This gives a few more precious centimeters of pelvic diameter to squeeze out an extra-stuck baby. Initially proposed in the late 1500s, it could be accomplished slowly using a knife. Which is exactly not the speed you want your anything cut open, especially when in labor with a fetus in distress. So while symphysiotomies were already being performed to various degrees of non-success, a couple of Scottish doctors were like “this problem requires more power.”
Which is all a super nice way to say this really took off when they started cutting open junk with a motherfucking chainsaw.
In the 1780s, Dr. John Aitken and Dr. John Jeffray came up with a hand cranked saw that looked almost nothing like the tool of a semi-fictional Texas-based mass murderer. A few other designs were proposed around the same time but this seems to be the prototype that wasn’t lost to history. Called an osteotome, it had a serrated chain and was just 14 inches long. Which seems goddamn long enough for a starter chainsaw.
It worked marvelously at cutting through cartilage to make way for babies. Given what the name ‘osteotome’ implies, it also started being lent out to surgeons to cut through bones.
For a while, there were two camps of doctors- those who preferred c-sections, and those who preferred the pelvic chainsaw. When this debate got going in the 1800s, most births happened at home and penicillin wouldn’t be widely available for more than a century. I’m not sure exactly how dangerous symphysiotomies were at the time, but c-sections had a mortality rate of about 85% in the UK and Ireland as recently 1865. So… the vadge trimmer 3000 it is, I guess.
From the 1880s to the 1920s, the medical pipeline was awash with new discoveries that made c-sections much safer, including blood transfusions, newer incision and suturing techniques, and antibiotics. But most of the complications that came with the ripping of symphysiotomy were never rectified, so it was almost entirely left behind.
Except for in Ireland. Yes, of course the reason is fucking Catholicism.
The Catholic Church, long the ruler of womens’ rights, “encouraged if not insisted” on the ancient technique. As someone who was raised Catholic and read my Bible and does not remember a verse saying “thou shalt not deliver a baby into the world Kool-Aid Man style,” this left me with some questions. Mainly, fucking why?
Two men, Alex Spain and Arthur Barry. One after the other, they headed Dublin’s National Maternity Hospital through the mid-twentieth century. The Catholic Church generally had a distaste for c-section because of a misguided belief that it could limit total births. Whereas Spain generally wanted the procedure used for emergencies, Barry staked out darker territory. He reportedly wouldn’t even allow Catholic-approved contraception to be discussed, and pushed for the procedure in any case when a woman seemed like she might just be on the small side to give birth.
The procedure came with a 10% fetal death rate. It also severely injured some newborns (sometimes permanently). Then there were those times when it killed the baby and permanently injured the mother, giving her mobility problems, infections, and incontinence. While Spain and Barry both understood this, they were like “hey think of all the other babies you can still make.” So.
Approximately 1,500 women were put through the procedure in Ireland between 1944 and 1987 without anesthesia or informed consent. It took until 2014 for the Irish government to pay out to some of their victims in a redress scheme, but it’s a pittance after decades of suffering.
Symphysiotomy is still used, generally the procedure of last resort in rural areas and developing countries, for an obstructed birth with no option for a c-section. As for if they’re still using chainsaws? If you live in the US, that depends on your insurance.
This has been your Moment of Science, super fucking happy I have no fallopian tubes.
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