The Religious History of Caesarean Surgery and the Abortion Debate

This Women’s History Month marks a sobering historical landmark: According to the Guttmacher Institute, 2021 was “the worst legislative year ever for U.S. abortion rights,” and Roe v. Wade could be overturned at any time.

Efforts to restrict abortion often fixate on slippery questions about when life begins and what constitutes fetal personhood. Catholic authorities arguably led the charge from the mid-18th century to the present, as a long line of popes and their subordinates made the protection of unborn life a cornerstone of the church’s philosophy.

But this was not always the case. In fact, the Catholic Church’s positions on fetal life have changed throughout history. It was actually not until 1869 that Pope Pius IX (1792-1878) removed the long-held distinction between “animated” and “unanimated” fetuses and then declared that abortion merited excommunication. Previously, influential thinkers had accepted the long-standing Aristotelian idea that the unborn first had a plantlike soul, then, by mid-pregnancy, a sentient soul and only after birth did they have a rational human soul.

The Caesarean operation also played a role in shaping these claims about unborn life. Despite their lack of medical training, priests became surgeons during the 18th century. They performed hundreds of Caesarean surgeries as a way to advance the religious notion that the unborn were ensouled early in pregnancy. Pre-modern surgery, colonial violence and theological mandates, therefore, are all at the heart of the fetal personhood debate.

After 1749 and until the end of Spanish colonial rule, authorities throughout the Americas required Catholic priests to perform Caesarean operations on dead and dying women. The Caesarean operation was exceedingly rare at the time, as reliable pain control did not exist, and as antibiotics would not be developed for another century, meaning infection was almost impossible to control. Before this time, surgery was only performed as a last resort when the child could not be born without intervention and the mother’s life was already lost.

Yet, by the 18th century, priests did not primarily aim to save the bodies of unborn babies. Rather, they sought to save their souls. They did so by baptizing the products of conception they extracted via Caesarean surgery. Theological mandates now superseded medical necessity: to save unborn souls, authorities had to argue that the unborn were individuals who had their own souls that needed saving. This quest to baptize the unborn altered the historical trajectory of Caesarean surgery, transforming a rare pre-modern surgery into a commonplace modern one.