Coffin Birth

Coffin birth or, more precisely, “postmortem fetal extrusion” is the expulsion of a dead fetus from the decomposing body of a pregnant woman.

How and why it happens

This postmortem birth happens very rarely, but it is historically documented. When someone dies, decomposition begins: tissues are left without oxygen and the anaerobic bacteria in the stomach and intestines multiply, producing gases such as carbon dioxide, methane and hydrogen sulphide.

These bacteria also begin to “digest” the tissues, weakening them. The gases spread through the body, which swells: this usually happens two to five days after death, depending on temperature, humidity and other environmental conditions. As the pressure builds, body fluids begin to seep from all the natural orifices.

These gases press inside the body and, in a woman, can push the uterus downward, even turning it inside out and forcing it out through the vaginal canal.

If the woman who dies is pregnant, the pressure of these gases will push the fetus out of the body, mimicking childbirth: the difference is that instead of contractions it is the gases of the putrefied body that deliver the fetus. It happens more often in women who had already given birth, because their cervix is more elastic.

Documented cases

As I mentioned, it is a rare event, but it has been documented by doctors since the 16th century and observed in various graves at different archaeological digs. Many historical cases are collected in the medical compendium Anomalies and Curiosities of Medicine, published in 1896.

The first documented case dates back to 1551, when a pregnant woman was sentenced to hang by the Spanish Inquisition:

4 hours after her death, with the body still hanging, two dead fetuses were seen falling from the woman’s body.

This is an unusual case given how little time had passed since death, but there may have been conditions that sped up putrefaction, environmental for example, or other factors unknown to us and not described.

Another case occurred in Brussels in 1633.

A pregnant woman died of convulsions and three days later the fetus was spontaneously expelled from her body.

In 1861, in Weissenfels, Germany, a postmortem birth was observed 60 hours after the death of a pregnant woman. Almost all cases happen before burial, with the body still on the deathbed or already in the coffin, and we have only a few accounts of postmortem births discovered after an exhumation.

At the end of the 19th century modern embalming spread, replacing the body’s fluids with preservatives and disinfectants such as formaldehyde and so also removing the bacteria that produce the gases. The phenomenon therefore became even rarer: in 1904 John Whitridge Williams’s obstetrics textbook still devoted a section to it, but it disappeared from editions after 1966.

Coffin birth in archaeology

It was not unusual for a dead newborn and mother to be buried together, so a child’s bones found in an adult coffin are not always a sign of coffin birth.

To tell whether it is this phenomenon you have to look at the position of the child’s bones: if they are entirely inside the mother’s pelvis, the fetus died before birth. If instead they lie just below the pelvis, in line with it, with the head pointing towards the mother’s feet, between her legs, it may be a coffin birth. The clearest sign is a fetus left halfway, with the head outside the pelvis and the legs still inside.

Cases like this have been found in a medieval cemetery at Kings Worthy in England, at a Neolithic site in Germany, in Denmark, in Ireland, in a Roman burial in Hertfordshire and in a 14th-century Black Death cemetery in Genoa.

One of the most famous cases was discovered in 2010 in Imola, Italy, in a Lombard-era grave from the 7th or 8th century. The skeleton of a woman aged between 25 and 35 had the tiny bones of a fetus of about 38 weeks between her thighs, with the head and torso already outside the pelvis and the legs still inside.

The woman also had a 4.6-millimetre hole in her forehead, with early signs of healing: according to researchers from the universities of Ferrara and Bologna, who published the study in 2018, it was the mark of a trepanation, done perhaps a week before her death to treat eclampsia, a serious complication of pregnancy that causes seizures and high blood pressure.

Coffin birth today

Although antibacterial fluids are now used to replace the body’s natural ones and delay putrefaction, a few cases of postmortem birth have still been observed, especially when the body of a pregnant woman lies undiscovered for days.

In 2005 in Hamburg, Germany, a 34-year-old woman eight months pregnant was found dead of an overdose in her apartment, already decomposing. During the autopsy it was found that the head and shoulders of the fetus had been expelled from the body by the gases of decomposition. The woman had given birth twice before. It was the first modern case in which doctors could document the phenomenon while it was happening.

In 2008 the body of a 38-year-old woman, seven months pregnant, who had disappeared from home four days earlier, was found in a field in Panama.

She had been gagged and had a plastic bag over her head, and the case was ruled a homicide. The hot, humid climate had sped up putrefaction and

during the autopsy the fetus was found in the woman’s underwear.

The fetus too was decomposing, but the umbilical cord was found intact and still attached to the placenta inside the uterus. It was the first forensic case in which it could be concluded with certainty that a coffin birth had taken place.

Sources

• Wikipedia, Coffin birth
• Live Science, This Medieval Mother Had a Gruesome ‘Coffin Birth’ After Medieval Brain Surgery
• Smithsonian Magazine, Rare Case of ‘Coffin Birth’ Seen in Medieval Grave
• ScienceAlert, Archaeologists find evidence of a ghastly coffin birth in a medieval grave
• Gizmodo, Dead Medieval Woman ‘Gave Birth’ to Baby in Coffin