The House of the Dragon comes to HBO Max stomping. In the first chapter we have already seen some scenes that show us the harshness with which violence will be presented in the series. Above all, it impacts the delivery of the queen aemmathe wife of King Viserys I. And it is that, although at no time is it named as such, it represents what should have been a Caesarean section in its beginnings. That is, without anesthesia, or hygienic measures, or hardly any knowledge on the subject. But was it really like that in real life?
It is clear that The House of the Dragonlike Game of Thrones, is a fictional story, with many touches of fantasy. But at some points the harsh reality of past times is also represented. In fact, it is said that George R.R. Martin he drew on some actual episodes of history to come up with his famous power struggle plot. In health issues, in fact, you can see some characteristic procedures of the medieval times. For example, in this first chapter we talk about bloodletting or cauterizing wounds. Regarding the caesarean section, it has its real part and its fictitious part.
It is true that the first caesarean sections were performed without anesthesia or hygienic measures. And also that they were possibly as bloody as Queen Aemma’s. However, the big difference is that in the past the first times this intervention was carried out was in the exclusive case that her mother had died during childbirth or even before. Much later she began to get hold of the living mother; but, as in The House of the DragonThey usually died. The first documented case of a caesarean section in which both mother and baby survived took place in 1500. But, curiously, it was not carried out by a doctor, but by a pig farmer. Sometimes reality is stranger than fiction, although that is not necessarily a good thing.
Cesarean section throughout history
In Rome, the 8th century BC, there was a law that prohibited dead pregnant women from being buried without first removing the baby through an abdominal incision. The goal was basically bury them separately. However, in cases where the pregnancy was very advanced, it could happen that the little one was born alive. It would not be the most common, but it could happen. In fact, legend has it that Julius Caesar was born this way, hence his name, although it seems to be nothing more than a myth. What is known is that children delivered by caesarean section were known as Caesons. So there must have been enough live babies born.
But you have to travel much further back in time to find the first documented cases of caesarean section in a living woman. It was precisely the pig castrator Jacob Nuffer who performed this first operation on his wife Isabel, whose delivery after several hours was becoming too complicated. At that time there was still no anesthesia, as we know it today, so, at most, he must have used some mixture of opiate plants. As for the tools, he used a razor he used to shave pigs.
Despite everything, the woman and the child survived and, in fact, she had up to five successful deliveries after. She therefore can also be considered the first woman to deliver vaginally after a cesarean section.
After that successful intervention, some surgeons dared to repeat the procedure in a somewhat more surgical environment, although far removed from today’s operating rooms. However, their very high mortality rateboth immediately and several days later due to sepsis, caused it to fall into disuse and was only used in a few cases in which the delivery was so complicated that the woman would die anyway.
Only in the XVIII century they began to be carried out with some regularity and with a little more success. And especially in the 19th century, when the use of anesthesia was introduced and hygiene measures were further improved, survival rates reached much higher rates. As an anecdote, here it can be noted that one of the first doctors to use anesthesia, although with nothing to do with caesarean section, was the English John Snowwho should not be confused with the lost Targaryen Jon Snow.
The case of ‘The House of the Dragon’
In the first chapter of The House of the Dragonthe maester who is delivering Queen Aemma tells the king about a novel intervention that is beginning to take place in the Citadel. Explains that it consists of taking the baby out for a belly incision. However, she remembers that this means with high probability the death of the mother. Therefore, she makes him choose which of the two he prefers for her to survive.
Without a doubt, this must have been the warning in the first caesarean sections that were performed on living women, since it was very difficult for them to live to tell about it. As for the intervention, anesthesia is not used. Shortly before they begin, however, the maester explains to Viserys that they have been using poppy milk, but if they give more it could be dangerous for the child. This is an opiate substance that appears numerous times in Martin’s novels and that, broadly speaking, would not be far from the herbal mixtures that would be used in the first caesarean sections.
Finally, the gruesome procedure could also resemble caesarean sections performed when there was not yet enough knowledge about it. Therefore, it is not surprising that Queen Aemma, who is caught by surprise by the intervention, ends up dying in the attempt.