In the early years of the sixteenth century, in the small Swiss village of Siegershausen, a man named Jacob Nufer faced a situation of unimaginable desperation. His wife had been in labour for days. The local midwives had exhausted every known method to deliver the child, but nothing worked. In an age before modern obstetrics, such a prolonged labour almost always ended in tragedy. Yet Nufer, a humble pig-gelder by trade, who was accustomed to performing surgical operations on livestock, refused to give up.
According to later accounts, Nufer begged the town authorities for permission to attempt what no man had ever done before: to operate on his living wife to deliver the baby. It was a radical request, for in those days a caesarean section was typically performed only after the mother’s death, as a last resort to save the infant’s soul through baptism. The idea of cutting open a living woman was nearly unthinkable.
Woodcut by Jonas Arnold made in the 16th century shows a caesarean section being performed.
With permission granted and aided by courageous midwives (only two out of the thirteen he approached finally decided to assist this determined man) Nufer performed the operation himself. He made an incision in his wife’s abdomen, reached the womb, and drew out the child alive. Against all odds, both mother and baby survived. Even more astonishingly, Nufer’s wife is said to have recovered fully and later given birth to several more children, including twins, through natural labour.
If true, the feat was without precedent. In an era when infection and blood loss made caesarean operations almost universally fatal to the mother, Jacob Nufer’s intervention would represent the first recorded case in Europe where both mother and infant survived a caesarean section.
Yet the tale comes to us not from Nufer’s lifetime, but from a report written some eighty years later, recorded by the Basel anatomist Caspar Bauhin in the late 16th century. No contemporary documents, medical notes, or parish records have been found to confirm the event. This long gap has led historians to question whether the story might have grown in the telling.
Some medical historians have proposed that Nufer may not have performed a true uterine caesarean at all. If his wife later bore multiple children naturally, it seems unlikely that her uterus had been opened in the usual sense, since such an injury would almost certainly have ruptured in later pregnancies. It has been suggested that the child might have been developing in the abdomen rather than the womb—an extra-uterine pregnancy—which could explain both her survival and later fertility.
The story first appeared in the appendix of the Latin translation of French medical writer Francois Rousset’s treatise Traitte nouveau de Phystirotomotokie, ou enfantement Caesarien , which was translated by Bauhin. In this extraordinary text, Rousset made a very bold and controversial statement:
The extraction of the child through a lateral incision of the abdomen and uterus of a pregnant woman who cannot otherwise give birth. And that without endangering the life of the one or the other and without preventing subsequent maternal fertility.
Rousset’s optimism about the possibility of both mother and child surviving a caesarean birth was not shared by his contemporaries, nor did it outlive him. Only in the twentieth century did medicine finally achieve what Rousset had envisioned. Caesarean deliveries in which both mother and child survive are now routine.
A baby being removed from its dying mother's womb. Woodcut from 1483. Credit: Wikimedia Commons
The idea of delivering a child by caesarean section was already known to ancient physicians, but for centuries it was performed only on the dead. The procedure was intended to save the infant if there was any chance it was still alive after the mother’s death. In 1310, the Council of Trier (Treves) formalized this practice, declaring:
Should a woman die during childbirth, her body should be opened immediately and the child baptized if it is still alive. If it is already dead, it must be buried outside the cemetery. However, if it can be assumed that the child is already dead in its mother’s body, both should be buried in consecrated ground.
It was François Rousset who first proposed performing the operation on living women. In his 1581 treatise, he argued that a caesarean should be attempted when the child was too large, malformed, or dead, or in cases involving twins or difficult presentation. He also listed conditions affecting the mother — if she was too young, too old, too narrow, or “too hard,” meaning insufficiently elastic — as possible indications for the procedure.
Rousset supported his argument with a series of reported cases in which mothers and infants had both survived caesarean delivery. One woman, Anne Godart, was said to have given birth by caesarean six times in succession.
In another case, Rousset described a young barber who performed the operation on a woman after a prolonged labour. The incision, made “on the right side about one finger below the navel,” was executed with such skill that little blood was lost. The barber extracted the living child and the afterbirth, then closed the wound with five stitches — though he did not suture the uterus. After forty days of bed rest, the woman reportedly recovered fully and later gave birth naturally to a daughter.
The dramatic story of Jacob Nufer did not appear in Rousset’s original treatise but was added by Bauhin when he made a Latin translation of the publication, as already noted.
In 2016, obstetrician and medical historian Dr. Antonin Parizek of Charles University published a paper where he put forward evidence for a case of caesarean birth that predates even Jacob Nufer.
Beatrice of Bourbon (1318–1383) was a French noblewoman, daughter of Louis I, Duke of Bourbon, and wife of John of Luxembourg, King of Bohemia. In 1337, she gave birth to their son Wenceslaus (Wenceslas) — later Duke of Luxembourg and Brabanzon —and according to several chroniclers, the birth was by caesarean section, with both mother and child surviving.
Beatrice of Bourbon
Beatrice was only fourteen years old when she married the widowed King John of Bohemia. King John spent barely two months with his young bride at the Prague court in 1336, long enough, however, to leave her pregnant. On February 25, 1337, Beatrice gave birth to their son, Wenceslaus.
The only contemporary records of the birth that survive are two Latin letters written by Beatrice herself announcing the event. Neither mentions a caesarean section. On the contrary, she makes a striking point of noting that her son was born “salva incolumitate nostri corporis,” which translates literally as “without breaching our body.” This phrasing is highly unusual. In similar birth announcements from the fourteenth century among the Luxembourg and Bourbon dynasties, the mother’s condition is rarely mentioned; the focus is almost exclusively on the newborn heir.
Beatrice’s insistence on her own physical integrity, historian Parízek suggests, was likely a response to rumours that a surgical procedure had been required to deliver the child. At the time, Beatrice had not yet been crowned Queen of Bohemia, and the idea of a ruler’s body, which was seen as a sacred vessel chosen by God and a symbol of the Church, being cut open was theologically troubling. A visible wound through which the king’s son had been “fished out” would have clashed with prevailing notions of royal inviolability and divine order. Her careful wording may therefore have been an effort to protect her dignity and legitimacy in the face of gossip surrounding a difficult birth.
It is only in later sources that the claim appears that Wenceslaus was born by caesarean section. The earliest known reference comes from the early fifteenth-century Flemish rhyming chronicle Brabantsche Yeesten, written by an anonymous author. In its verses, the chronicler recounts that the boy was “taken from his mother’s body” and that her wound healed. He expresses astonishment at the event, remarking that he had previously heard of such an operation only in the story of Julius Caesar.
A 17th century woodcut of a Caesarean section operation, from the works of Johann Schultes, a surgeon.
More than a century later, in 1549, Richard de Wassebourg, archdeacon of Verdun Cathedral, included the episode in his Antiquitez de la Gaule Belgique. He wrote that at Wenceslaus’s birth, “his mother Beatrice was opened up without dying.”
A still later reference appears in 1677, in Mars Moravicus, by Thomas Pesina of Čechorod, Vicar General and Chapter Dean of St. Vitus Cathedral in Prague. Pesina records that “John had a son named Wenceslaus, taken from Queen Beatrice of Bourbon, or rather from the maternal womb, without endangering the mother, a rare and fortunate example of recovery and continued fertility.”
But could such a birth have taken place in the 14th century? Parízek believes it could have.
Prague was a center of education, but also of the medical care of the royal family. In light of the health of John of Bohemia, a number of the most educated physicians of the time were present around the king. It can be presumed that they had the skills for the procedure, that is, cutting out a fetus from a dead or dying pregnant woman. Considering what we know, it can be rejected a priori that it was a case of deliberately saving the mother. In fact, the abdominal removal of the child from an apparently dead mother could partly explain the event described.
If that is indeed what happened, then with likelihood bordering on certainty Beatrice of Bourbon was considered to be dead when the procedure occurred. One explanation could be seizures as a complication of eclampsia. The cut would have had to be made immediately after the onset of such a state. The pain from the operation may have been the reason for a change in consciousness or awakening, and the stress reaction of the mother could also hypothetically explain why she did not bleed to death.
Suturing of wounds, especially of the abdominal wall, was a completely unknown procedure at that time. And that later complications did not arise from the non-sterile environment the operation was performed in push this hypothesis to the edge of reality. On the other hand, there is written evidence that using similar methods, with no anesthesia, surgical hemostasis or antiseptic conditions, the first experiments removing children through the abdomen after labor lasting several days were performed in the 17th to 19th centuries, and almost always in a home setting. It was very rare, but some women survived these operations.
References:
# Blumenfeld-Kosinski, Renate. “Not of Woman Born”
# “Was a 14th c. queen the first to survive a caesarean?”, The History Blog
# A. Pařízek; V. Drška; M. Říhová. “Prague 1337, the first successful caesarean section in which both mother and child survived may have occurred in the court of John of Luxembourg, King of Bohemia”. Czech Gynaecology
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