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[I have asked a variation of this question already on the Judaism Stack Exchange, but am offering a broader version of it here.]

According to US National Library of Medicine, the first recorded instance of a mother and child surviving a C-section is from 16th century Switzerland, but is a somewhat dubious tale. Maimonides, who for a time served as one of the court physicians to the Sultan Saladin in the 12th century, writes that the possibility of even the mother surviving such a procedure is exceedingly rare (Commentary on the Mishna, Bekhorot 8:2).

I would like to know under what sorts of circumstances surgeons even attempted this procedure in the ancient world. There are explicit references to C-sections in the Mishna (such as the passage on which Maimonides is commenting, above), so I know that it at least happened as early as the 3rd century, but what I don't know is why.

Did surgeons only perform this procedure because the woman was already dying and because they wanted to save the baby? Or were there enough situations in which women survived as to allow surgeons to risk operating on healthy mothers as well, in a case where the baby was not expected to survive normal delivery?

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    There is a third option that you have overlooked due to the cultural change: that the mother's live was secondary in relation to the baby's. That could be the case for a King or similar who still had no male heirs. Posting as a comment because I do not have explicit references to that decission being made, but I think it is a distinct possibility. – SJuan76 Jan 20 '17 at 0:08
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    @Sjuan That seems very likely in terms of ancient cultural values. I would have up-voted that proposition. – Mac Jan 20 '17 at 2:06
  • I would agree with @sJuan76 that the life of the mother was considered less important than the survival of a healthy (male?) heir, particularly as such operations were almost certainly performed in extremis when both mother and child would probably have died otherwise. However, Wikipedia (en.m.wikipedia.org/wiki/Caesarean_section) suggests that Jewish women often survived, even in the Roman era. If not, you could always get another wife.... – TheHonRose Jan 20 '17 at 4:20
  • The Caesarean is called that because it's prurpose is to deliver the next caesar, not to safe the mother. At least that's the story usually given. – mart Jan 20 '17 at 11:17
  • @mart Sorry but I have to disagree with you. It is unclear how the term for the surgical procedure became connected to the Roman Caesar, but this article form the ever-inappropriate Mental Floss. It's a good read if you're interested. mentalfloss.com/article/50179/… – Mac Jan 20 '17 at 19:41
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There are plenty of problems related to childbirth that will kill both mother and child without intervention. This was considerably reduced by the invention of forceps but that did not happen until the 1600s. Low-tech childbirth is dangerous.

If you're reasonably sure that you're going to lose both mother and child without doing a Caesarean, then doing it for decent odds of saving the child and almost certainly losing the mother may be the best option you have.

Without modern equipment, you don't know all that much about the condition of the child.

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