Coffin birth
Encyclopedia
Coffin birth, known in academia by the more accurate term postmortem fetal extrusion, is the expulsion of a nonviable fetus
through the vagina
l opening of the decomposing body of a pregnant woman as a result of the increasing pressure of intraabdominal gases. This kind of postmortem delivery occurs very rarely during the decomposition
of a body. The modern practice of embalming
, whereby chemical preservatives and disinfectant solutions are pumped into a body to replace natural body fluids (and the bacteria
that reside therein), have made the occurrence of "coffin birth" so rare that the topic is rarely mentioned in modern medical discourse.
Typically during the decomposition of a human body, naturally occurring bacteria in the organs of the abdominal cavity (such as the stomach
and intestines) generate gases as by-products of metabolism
, which causes the body to swell. In some cases, the confined pressure of the gases can squeeze the uterus
(the womb), even forcing it downward, and it may turn inside-out and be forced out of the body through the vaginal opening (a process called prolapse
). If a fetus is contained within the uterus, it could therefore be expelled from the mother's body through the vaginal opening when the uterus turns inside-out, in a process that, to outward appearances, mimics childbirth
. The main differences lie in the state of the mother and child (whether alive or dead) and the mechanism of delivery: in the event of natural, live childbirth, the mother's contractions encourage the infant to emerge from the womb; in a case of coffin birth, built-up gas pressure within the putrefied
body of a pregnant woman pushes the dead fetus from the body of the mother.
Cases have been recorded by medical authorities since the 16th century, though some archaeological
cases provide evidence for its occurrence in many periods of human history. While cases of postmortem fetal expulsion have always been rare, the phenomenon has been recorded under disparate circumstances and is occasionally seen in a modern forensic context when the body of a pregnant woman lies undisturbed and undiscovered for some time following death. There are numerous examples that have demonstrated that the term "coffin birth" is a misnomer under many circumstances. There are also cases whereby a fetus may become separated from the body of the pregnant woman about the time of death or during decomposition, though because those cases are not consistent with the processes described here, they are not considered true cases of postmortem fetal extrusion.
of postmortem fetal extrusion is not completely understood, as the event is neither predictable nor replicable under experimental conditions. Evidence has accumulated opportunistically and direct observation is serendipitous
. While it is possible that more than one etiology can produce the same result, there is an accepted hypothesis, based on established research in the fields of biochemistry
and forensic taphonomy
, and further supported by observational research, that accounts for the taphonomic mechanisms that would result in the most often encountered cases of postmortem extrusion of a nonviable fetus.
Typically, as a dead body decomposes
, body tissues become depleted of oxygen and the body begins to putrefy
; anaerobic bacteria in the gastrointestinal tract proliferate and as a result of increased metabolic
activity, release gases such as carbon dioxide
, methane
, and hydrogen sulfide
. These bacteria secrete exoenzymes to break down
body cells and protein
s for ingestion which thus weakens organ tissue
s. Increasing pressure forces the diffusion
of excessive gases into the weakened tissues where they enter the circulatory system
and spread to other parts of the body, causing both torso and limbs to become bloated. These decompositional processes weaken the structural integrity of organs by separating necrotizing
tissue layers. Bloating usually begins from two to five days after death, depending on external temperature, humidity, and other environmental conditions. As the volume of gas increases, the pressure begins to force various body fluids to exude from all natural orifices. It is at this point during the decomposition of a pregnant body that amniotic membranes
become stretched and separated, and intraabdominal gas pressure may force the eversion and prolapse
of the uterus
, which would result in the expulsion of the fetus through the vaginal canal. It has been observed that the bodies of multiparous
women are more likely to spontaneously expel the fetus during decomposition than those who died during their first pregnancy
, because of the more elastic nature of the cervix
.
by the courts of the Spanish Inquisition
. Four hours after her death, and while the body still hung by the neck, two dead infants were seen to fall free of the body. This is unusual for the short amount of time elapsed between death and the postmortem delivery. As no information is given regarding other ambient circumstances, it is unclear whether the onset of putrefaction was accelerated, or if other causal factors were at work. In the city of Brussels
, in 1633, a woman died in convulsions and three days later the fetus was spontaneously expelled. In Weissenfels, in 1861, postmortem fetal extrusion was observed sixty hours after the death of a pregnant woman. Other cases are described, though only a few describe the unexpected discovery of fetal remains following exhumation. Most cases occurred prior to burial; in some of these, the body was in the casket while in other cases the body was still on its deathbed or on a bier
.
During the late 19th century, modern embalming
techniques were developed, whereby preservative and disinfectant chemical compounds (such as formaldehyde
) are pumped into a body, flushing out the body's natural fluids, and with them the bacteria that flourish during putrefaction and generate the gases that comprise the active force behind the expulsion of the fetus. However, the phenomenon was still recognized by medical science and in 1904, John Whitridge Williams wrote a textbook on obstetric medicine that included a section on "coffin birth". Although the text has remained an important reference in obstetrics, the subject, whether called "coffin birth" or "postmortem fetal extrusion", was excluded by its 13th edition in 1966, and was not mentioned in the edition published in 2009. The subject was discussed in German medical literature during the 20th century, though more detailed case reports in the forensic literature have been published recently.
In 2005, the body of a 34-year-old woman, eight months pregnant, was discovered in her apartment in Hamburg, Germany. The body was bloated and discolored, and upon initial examination, it was found that the head of the fetus had made its appearance in the vaginal opening. At autopsy
, medical examiners found that both the head and shoulders of the fetus had emerged, and concluded that it was a case of postmortem fetal extrusion in progress. The woman, who had given birth twice before, had died of a heroin overdose. The case was unusual and serendipitous, as few medical practitioners have been able to observe and document the progress of postmortem fetal extrusion.
In 2008, the body of a 38-year-old woman, seven months pregnant, was discovered in an open field four days after she had disappeared from her residence in Panama
. A plastic bag had been left over the head, and she had been gagged; the case was ruled a homicide. The body had suffered from the tropical heat and high humidity, and was bloated and highly discolored. At autopsy, the remains of the fetus were discovered in the woman's undergarments. Although the fetus was in a similar state of decomposition, the umbilical cord
was intact and still attached to the placenta
inside the uterus.
, and bioarchaeologists
are often very cautious in making the assertion. There are numerous cultural reasons why a mother and an infant might be interred together, so the joint presence of neonatal remains and an adult female is not taken as conclusive evidence of postmortem fetal extrusion; however, there have been excavated burials where the position of a set of fetal remains relative to those of an adult female supported the hypothesis
of postmortem fetal extrusion. There are a few general guidelines when an archaeologist is assessing the placement of the fetus and the adult:
In 1975, it was reported that during the excavation of a medieval cemetery in Kings Worthy
, England
, fetal remains appeared to lie within the birth canal of the skeleton of a young woman, with the fetal cranium external to the pelvic outlet and between the two femora
(thigh bones) and the fetal leg bones clearly within the pelvic cavity
. Other cases of coffin birth at archaeological sites have been described, such as in 1978 at a Neolithic
site in Germany, at a medieval site in Denmark
in 1982, and in 2009 at an Early Christian period site at Fingal
, Ireland
.
In archaeology, the study of mortuary context, that is, the interpretation of the postmortem treatment of the dead, whether an individual or as pertains to patterns within a group, has led to the development of hypotheses on social status and/or hierarchy regarding many cultures, ancient and extant. In addition, the determination of whether or not delivery actually occurred prior to death has a bearing on analyses of the mother's population, as the concentration of trace element
s differ markedly between the skeletons of prepartum adult women (before pregnancy) and women who are lactating
; the identification of coffin birth would lead to more accurate analyses of the number of lactating women in a population or the rate of maternal mortality. It is therefore necessary for investigators to be able to recognize postmortem fetal extrusion when encountered in an excavated burial.
In April 2003, the body of Laci Peterson
washed up on a shore near San Francisco Bay
, who was pregnant when she disappeared four months earlier, while the fetus she had been carrying was discovered on a separate beach. When questioned by the media, medical authorities initially speculated that a "coffin birth" may have occurred. However, at autopsy the cervix was found to be in a prepartum condition
. Medical examiners later concluded that while Peterson's body was in the bay, the skin over the abdominal cavity had ruptured due to natural decompositional processes. Seawater entered the abdominal cavity and washed out most of the internal organs, along with the fetus.
In 2007, a 23-year-old woman in India, over eight months pregnant, hanged herself after contractions had begun. A viable infant was spontaneously delivered unassisted from the woman's body, which was suspended by the neck. The healthy infant was found on the floor, still tethered to the body of the mother by the umbilical cord. The primary cause of the delivery was the otherwise normal contractions, which had begun prior to death, and was therefore not related to processes of decomposition. While this is not postmortem fetal extrusion, it may be referred to as a case of postmortem delivery, a term which is applied to a broad range of techniques and phenomena, with a resultant delivery of a live infant.
In 2008, it was reported from Germany that a 23-year-old woman in her third trimester was involved in a motor vehicle accident and died; the nonviable fetus was found between her feet. Following initial impact the vehicle she was in caught fire. The woman was unable to escape due to internal injuries and subsequently burned to death. Investigators came to the conclusion that the extreme heat of the fire burned away epidermal and subcutaneous tissue
around the abdominal cavity, after which the anterior aspect of the uterus ruptured, causing the fetus to spill out of the uterine cavity and land on the floor between the woman's feet. The umbilical cord was still intact, and connected the fetus to the placenta via the ruptured wall of the uterus. Unlike the woman, who suffered fourth-degree burns over her entire body, the body of the fetus was relatively undamaged. As the primary cause of separation from the mother's body was thermally-induced traumatic rupture of the abdominal and uterine cavities; because traumatic separation was not related to normal decompositional processes; and because expulsion of the fetus did not involve passage through the birth canal, this is not considered a case of postmortem fetal extrusion.
Fetus
A fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth.In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization.-Etymology and spelling variations:The...
through the vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
l opening of the decomposing body of a pregnant woman as a result of the increasing pressure of intraabdominal gases. This kind of postmortem delivery occurs very rarely during the decomposition
Decomposition
Decomposition is the process by which organic material is broken down into simpler forms of matter. The process is essential for recycling the finite matter that occupies physical space in the biome. Bodies of living organisms begin to decompose shortly after death...
of a body. The modern practice of embalming
Embalming
Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for public display at a funeral. The three goals of embalming are thus sanitization, presentation and preservation of a corpse to achieve this...
, whereby chemical preservatives and disinfectant solutions are pumped into a body to replace natural body fluids (and the bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
that reside therein), have made the occurrence of "coffin birth" so rare that the topic is rarely mentioned in modern medical discourse.
Typically during the decomposition of a human body, naturally occurring bacteria in the organs of the abdominal cavity (such as the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
and intestines) generate gases as by-products of metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
, which causes the body to swell. In some cases, the confined pressure of the gases can squeeze the uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
(the womb), even forcing it downward, and it may turn inside-out and be forced out of the body through the vaginal opening (a process called prolapse
Prolapse
Prolapse literally means "to fall out of place", from the Latin prolabi meaning "to fall out". In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina or the rectum or for the misalignment of the...
). If a fetus is contained within the uterus, it could therefore be expelled from the mother's body through the vaginal opening when the uterus turns inside-out, in a process that, to outward appearances, mimics childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
. The main differences lie in the state of the mother and child (whether alive or dead) and the mechanism of delivery: in the event of natural, live childbirth, the mother's contractions encourage the infant to emerge from the womb; in a case of coffin birth, built-up gas pressure within the putrefied
Putrefaction
Putrefaction is one of seven stages in the decomposition of the body of a dead animal. It can be viewed, in broad terms, as the decomposition of proteins, in a process that results in the eventual breakdown of cohesion between tissues and the liquefaction of most organs.-Description:In terms of...
body of a pregnant woman pushes the dead fetus from the body of the mother.
Cases have been recorded by medical authorities since the 16th century, though some archaeological
Archaeology
Archaeology, or archeology , is the study of human society, primarily through the recovery and analysis of the material culture and environmental data that they have left behind, which includes artifacts, architecture, biofacts and cultural landscapes...
cases provide evidence for its occurrence in many periods of human history. While cases of postmortem fetal expulsion have always been rare, the phenomenon has been recorded under disparate circumstances and is occasionally seen in a modern forensic context when the body of a pregnant woman lies undisturbed and undiscovered for some time following death. There are numerous examples that have demonstrated that the term "coffin birth" is a misnomer under many circumstances. There are also cases whereby a fetus may become separated from the body of the pregnant woman about the time of death or during decomposition, though because those cases are not consistent with the processes described here, they are not considered true cases of postmortem fetal extrusion.
Causes
The etiologyEtiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of postmortem fetal extrusion is not completely understood, as the event is neither predictable nor replicable under experimental conditions. Evidence has accumulated opportunistically and direct observation is serendipitous
Serendipity
Serendipity means a "happy accident" or "pleasant surprise"; specifically, the accident of finding something good or useful without looking for it. The word has been voted as one of the ten English words hardest to translate in June 2004 by a British translation company. However, due to its...
. While it is possible that more than one etiology can produce the same result, there is an accepted hypothesis, based on established research in the fields of biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...
and forensic taphonomy
Taphonomy
Taphonomy is the study of decaying organisms over time and how they become fossilized . The term taphonomy was introduced to paleontology in 1940 by Russian scientist Ivan Efremov to describe the study of the transition of remains, parts, or products of organisms, from the biosphere, to the...
, and further supported by observational research, that accounts for the taphonomic mechanisms that would result in the most often encountered cases of postmortem extrusion of a nonviable fetus.
Typically, as a dead body decomposes
Decomposition
Decomposition is the process by which organic material is broken down into simpler forms of matter. The process is essential for recycling the finite matter that occupies physical space in the biome. Bodies of living organisms begin to decompose shortly after death...
, body tissues become depleted of oxygen and the body begins to putrefy
Putrefaction
Putrefaction is one of seven stages in the decomposition of the body of a dead animal. It can be viewed, in broad terms, as the decomposition of proteins, in a process that results in the eventual breakdown of cohesion between tissues and the liquefaction of most organs.-Description:In terms of...
; anaerobic bacteria in the gastrointestinal tract proliferate and as a result of increased metabolic
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
activity, release gases such as carbon dioxide
Carbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
, methane
Methane
Methane is a chemical compound with the chemical formula . It is the simplest alkane, the principal component of natural gas, and probably the most abundant organic compound on earth. The relative abundance of methane makes it an attractive fuel...
, and hydrogen sulfide
Hydrogen sulfide
Hydrogen sulfide is the chemical compound with the formula . It is a colorless, very poisonous, flammable gas with the characteristic foul odor of expired eggs perceptible at concentrations as low as 0.00047 parts per million...
. These bacteria secrete exoenzymes to break down
Digestion
Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
body cells and protein
Protein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
s for ingestion which thus weakens organ tissue
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
s. Increasing pressure forces the diffusion
Diffusion
Molecular diffusion, often called simply diffusion, is the thermal motion of all particles at temperatures above absolute zero. The rate of this movement is a function of temperature, viscosity of the fluid and the size of the particles...
of excessive gases into the weakened tissues where they enter the circulatory system
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...
and spread to other parts of the body, causing both torso and limbs to become bloated. These decompositional processes weaken the structural integrity of organs by separating necrotizing
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...
tissue layers. Bloating usually begins from two to five days after death, depending on external temperature, humidity, and other environmental conditions. As the volume of gas increases, the pressure begins to force various body fluids to exude from all natural orifices. It is at this point during the decomposition of a pregnant body that amniotic membranes
Amniotic sac
The amniotic sac is the sac in which the fetus develops in amniotes. It is a tough but thin transparent pair of membranes, which hold a developing embryo until shortly before birth. The inner membrane, the amnion, contains the amniotic fluid and the fetus. The outer membrane, the Chorion,...
become stretched and separated, and intraabdominal gas pressure may force the eversion and prolapse
Prolapse
Prolapse literally means "to fall out of place", from the Latin prolabi meaning "to fall out". In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina or the rectum or for the misalignment of the...
of the uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
, which would result in the expulsion of the fetus through the vaginal canal. It has been observed that the bodies of multiparous
Parity (medicine)
In biology, parity is a technical term that refers to the number of times a female has given birth to a fetus.It can lead to some ambiguity for events occurring between 20 and 24 weeks, and for multiple pregnancies.-Enumeration:...
women are more likely to spontaneously expel the fetus during decomposition than those who died during their first pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
, because of the more elastic nature of the cervix
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
.
History
Numerous documented cases of postmortem fetal extrusion were described in the medical compendium Anomalies and Curiosities of Medicine, first published in 1896. The earliest presented case occurred in the year 1551 when a pregnant woman was tried and hangedHanging
Hanging is the lethal suspension of a person by a ligature. The Oxford English Dictionary states that hanging in this sense is "specifically to put to death by suspension by the neck", though it formerly also referred to crucifixion and death by impalement in which the body would remain...
by the courts of the Spanish Inquisition
Spanish Inquisition
The Tribunal of the Holy Office of the Inquisition , commonly known as the Spanish Inquisition , was a tribunal established in 1480 by Catholic Monarchs Ferdinand II of Aragon and Isabella I of Castile. It was intended to maintain Catholic orthodoxy in their kingdoms, and to replace the Medieval...
. Four hours after her death, and while the body still hung by the neck, two dead infants were seen to fall free of the body. This is unusual for the short amount of time elapsed between death and the postmortem delivery. As no information is given regarding other ambient circumstances, it is unclear whether the onset of putrefaction was accelerated, or if other causal factors were at work. In the city of Brussels
Brussels
Brussels , officially the Brussels Region or Brussels-Capital Region , is the capital of Belgium and the de facto capital of the European Union...
, in 1633, a woman died in convulsions and three days later the fetus was spontaneously expelled. In Weissenfels, in 1861, postmortem fetal extrusion was observed sixty hours after the death of a pregnant woman. Other cases are described, though only a few describe the unexpected discovery of fetal remains following exhumation. Most cases occurred prior to burial; in some of these, the body was in the casket while in other cases the body was still on its deathbed or on a bier
Bier
A bier is a stand on which a corpse, coffin or casket containing a corpse, is placed to lie in state or to be carried to the grave.In Christian burial, the bier is often placed in the centre of the nave with candles surrounding it, and remains in place during the funeral.The bier is a flat frame,...
.
During the late 19th century, modern embalming
Embalming
Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for public display at a funeral. The three goals of embalming are thus sanitization, presentation and preservation of a corpse to achieve this...
techniques were developed, whereby preservative and disinfectant chemical compounds (such as formaldehyde
Formaldehyde
Formaldehyde is an organic compound with the formula CH2O. It is the simplest aldehyde, hence its systematic name methanal.Formaldehyde is a colorless gas with a characteristic pungent odor. It is an important precursor to many other chemical compounds, especially for polymers...
) are pumped into a body, flushing out the body's natural fluids, and with them the bacteria that flourish during putrefaction and generate the gases that comprise the active force behind the expulsion of the fetus. However, the phenomenon was still recognized by medical science and in 1904, John Whitridge Williams wrote a textbook on obstetric medicine that included a section on "coffin birth". Although the text has remained an important reference in obstetrics, the subject, whether called "coffin birth" or "postmortem fetal extrusion", was excluded by its 13th edition in 1966, and was not mentioned in the edition published in 2009. The subject was discussed in German medical literature during the 20th century, though more detailed case reports in the forensic literature have been published recently.
In 2005, the body of a 34-year-old woman, eight months pregnant, was discovered in her apartment in Hamburg, Germany. The body was bloated and discolored, and upon initial examination, it was found that the head of the fetus had made its appearance in the vaginal opening. At autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
, medical examiners found that both the head and shoulders of the fetus had emerged, and concluded that it was a case of postmortem fetal extrusion in progress. The woman, who had given birth twice before, had died of a heroin overdose. The case was unusual and serendipitous, as few medical practitioners have been able to observe and document the progress of postmortem fetal extrusion.
In 2008, the body of a 38-year-old woman, seven months pregnant, was discovered in an open field four days after she had disappeared from her residence in Panama
Panama
Panama , officially the Republic of Panama , is the southernmost country of Central America. Situated on the isthmus connecting North and South America, it is bordered by Costa Rica to the northwest, Colombia to the southeast, the Caribbean Sea to the north and the Pacific Ocean to the south. The...
. A plastic bag had been left over the head, and she had been gagged; the case was ruled a homicide. The body had suffered from the tropical heat and high humidity, and was bloated and highly discolored. At autopsy, the remains of the fetus were discovered in the woman's undergarments. Although the fetus was in a similar state of decomposition, the umbilical cord
Umbilical cord
In placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta...
was intact and still attached to the placenta
Placenta
The placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. "True" placentas are a defining characteristic of eutherian or "placental" mammals, but are also found in some snakes and...
inside the uterus.
Bioarchaeology
Postmortem fetal extrusion can be very difficult to recognize once a body has undergone complete skeletonizationSkeletonization (forensics)
In forensics, skeletonization refers to the complete decomposition of the non-bony tissues of a corpse, leading to a bare skeleton. In a temperate climate, it usually requires three weeks to several years for a body to completely decompose into a skeleton, depending on factors such as temperature,...
, and bioarchaeologists
Bioarchaeology
The term bioarchaeology was first coined by British archaeologist Grahame Clark in 1972 as a reference to zooarchaeology, or the study of animal bones from archaeological sites...
are often very cautious in making the assertion. There are numerous cultural reasons why a mother and an infant might be interred together, so the joint presence of neonatal remains and an adult female is not taken as conclusive evidence of postmortem fetal extrusion; however, there have been excavated burials where the position of a set of fetal remains relative to those of an adult female supported the hypothesis
Hypothesis
A hypothesis is a proposed explanation for a phenomenon. The term derives from the Greek, ὑποτιθέναι – hypotithenai meaning "to put under" or "to suppose". For a hypothesis to be put forward as a scientific hypothesis, the scientific method requires that one can test it...
of postmortem fetal extrusion. There are a few general guidelines when an archaeologist is assessing the placement of the fetus and the adult:
- If the fetal remains are found in a fetal positionFetal positionFetal position is a medical term used to describe the positioning of the body of a prenatal fetus as it develops...
and are wholly within the pelvic cavity of the adult, the fetus died and was interred prior to delivery. The pregnant woman may therefore have died due to labor complicationsDystociaDystocia is an abnormal or difficult childbirth or labour. Approximately one fifth of human labours have dystocia.Dystocia may arise due to incoordinate uterine activity, abnormal fetal lie or presentation, absolute or relative cephalopelvic disproportion, or a massive fetal tumor such as a...
. - If the infant is found alongside the adult, and with the head oriented in the same direction as the adult, then the infant was delivered, whether naturally or by caesarian incision, at about the time of death, and thereafter interred.
- Delivered infants have also been interred between or alongside the tibiaTibiaThe tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....
e (shins), but the infant is still oriented in the same direction as the adult. - If the majority of the fetal remains are in the pelvic cavity of the adult, yet the legs are extended and/or the cranium lies among the ribRibIn vertebrate anatomy, ribs are the long curved bones which form the rib cage. In most vertebrates, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax...
s, then the infant may have been delivered and then placed on top of the mother's torso prior to burial. As both bodies skeletonized, the infant's bones would have settled among the mother's ribs and vertebrae.
- Delivered infants have also been interred between or alongside the tibia
- If the fetal remains are complete and in a position inferior to and in-line with the pelvic outletPelvic outletThe lower circumference of the lesser pelvis is very irregular; the space enclosed by it is named the inferior aperture or pelvic outlet.-Boundaries:It has the following boundaries:* anteriorly: the pubic arch* laterally: the ischial tuberosities...
, with the head oriented opposite to that of the mother (toward the foot of the coffin or grave), then there is the possibility of coffin birth.- Evidence for postmortem fetal extrusion may be less ambiguous when the fetal remains are found to lie within the pelvic outlet of the adult, thus indicating that partial extrusion had occurred during decomposition.
In 1975, it was reported that during the excavation of a medieval cemetery in Kings Worthy
Kings Worthy
Kings Worthy is a village and civil parish in Hampshire, England, approximately two miles north-east of Winchester. Kings Worthy was a tithing of Barton Stacey when the Domesday Book was written....
, England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
, fetal remains appeared to lie within the birth canal of the skeleton of a young woman, with the fetal cranium external to the pelvic outlet and between the two femora
Femur
The femur , or thigh bone, is the most proximal bone of the leg in tetrapod vertebrates capable of walking or jumping, such as most land mammals, birds, many reptiles such as lizards, and amphibians such as frogs. In vertebrates with four legs such as dogs and horses, the femur is found only in...
(thigh bones) and the fetal leg bones clearly within the pelvic cavity
Pelvic cavity
-External links:* * *...
. Other cases of coffin birth at archaeological sites have been described, such as in 1978 at a Neolithic
Neolithic
The Neolithic Age, Era, or Period, or New Stone Age, was a period in the development of human technology, beginning about 9500 BC in some parts of the Middle East, and later in other parts of the world. It is traditionally considered as the last part of the Stone Age...
site in Germany, at a medieval site in Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
in 1982, and in 2009 at an Early Christian period site at Fingal
Fingal
Fingal is a county in Ireland. It is one of three smaller counties into which County Dublin was divided in 1994. With its county seat located in Swords, it has a population of 239,992 according to the 2006 census...
, Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...
.
Applicability of diagnosis
Because postmortem fetal extrusion is so rare, and occurs under highly idiosyncratic conditions regarding the individual and the ambient environment, this phenomenon has not been studied for possible applications to forensic investigation. Even if the study of postmortem fetal extrusion could lead to improved investigative methods, experimental research would be highly problematic. At present, the forensic scientist has at his disposal an array of established techniques and procedures for a death investigation at the stages of decomposition when postmortem fetal extrusion typically occurs.In archaeology, the study of mortuary context, that is, the interpretation of the postmortem treatment of the dead, whether an individual or as pertains to patterns within a group, has led to the development of hypotheses on social status and/or hierarchy regarding many cultures, ancient and extant. In addition, the determination of whether or not delivery actually occurred prior to death has a bearing on analyses of the mother's population, as the concentration of trace element
Trace element
In analytical chemistry, a trace element is an element in a sample that has an average concentration of less than 100 parts per million measured in atomic count, or less than 100 micrograms per gram....
s differ markedly between the skeletons of prepartum adult women (before pregnancy) and women who are lactating
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
; the identification of coffin birth would lead to more accurate analyses of the number of lactating women in a population or the rate of maternal mortality. It is therefore necessary for investigators to be able to recognize postmortem fetal extrusion when encountered in an excavated burial.
Comparable phenomena
There are also many cases where the remains of the fetus are found separate from the body of the mother, but expulsion was not through the birth canal, and separation of the two bodies may have been influenced by external environmental factors. The process of separation is so unusual that a specific term for the phenomenon may not have been proposed to the scientific community. These cases may have comparable results, but they are not cases of postmortem fetal extrusion.In April 2003, the body of Laci Peterson
Laci Peterson
Laci Denise Peterson was an American woman who was the subject of a highly discussed murder case after she went missing while seven and a half months pregnant with her first child. Peterson was reportedly last seen alive on December 24, 2002...
washed up on a shore near San Francisco Bay
San Francisco Bay
San Francisco Bay is a shallow, productive estuary through which water draining from approximately forty percent of California, flowing in the Sacramento and San Joaquin rivers from the Sierra Nevada mountains, enters the Pacific Ocean...
, who was pregnant when she disappeared four months earlier, while the fetus she had been carrying was discovered on a separate beach. When questioned by the media, medical authorities initially speculated that a "coffin birth" may have occurred. However, at autopsy the cervix was found to be in a prepartum condition
External orifice of the uterus
The external orifice of the uterus is a small, depressed, somewhat circular aperture on the rounded extremity of the vaginal portion of the cervix. Through this aperture, the cervical cavity communicates with that of the vagina.The external orifice is bounded by two lips, an anterior and a posterior...
. Medical examiners later concluded that while Peterson's body was in the bay, the skin over the abdominal cavity had ruptured due to natural decompositional processes. Seawater entered the abdominal cavity and washed out most of the internal organs, along with the fetus.
In 2007, a 23-year-old woman in India, over eight months pregnant, hanged herself after contractions had begun. A viable infant was spontaneously delivered unassisted from the woman's body, which was suspended by the neck. The healthy infant was found on the floor, still tethered to the body of the mother by the umbilical cord. The primary cause of the delivery was the otherwise normal contractions, which had begun prior to death, and was therefore not related to processes of decomposition. While this is not postmortem fetal extrusion, it may be referred to as a case of postmortem delivery, a term which is applied to a broad range of techniques and phenomena, with a resultant delivery of a live infant.
In 2008, it was reported from Germany that a 23-year-old woman in her third trimester was involved in a motor vehicle accident and died; the nonviable fetus was found between her feet. Following initial impact the vehicle she was in caught fire. The woman was unable to escape due to internal injuries and subsequently burned to death. Investigators came to the conclusion that the extreme heat of the fire burned away epidermal and subcutaneous tissue
Subcutaneous tissue
The hypodermis, also called the hypoderm, subcutaneous tissue, or superficial fascia is the lowermost layer of the integumentary system in vertebrates. Types of cells that are found in the hypodermis are fibroblasts, adipose cells, and macrophages...
around the abdominal cavity, after which the anterior aspect of the uterus ruptured, causing the fetus to spill out of the uterine cavity and land on the floor between the woman's feet. The umbilical cord was still intact, and connected the fetus to the placenta via the ruptured wall of the uterus. Unlike the woman, who suffered fourth-degree burns over her entire body, the body of the fetus was relatively undamaged. As the primary cause of separation from the mother's body was thermally-induced traumatic rupture of the abdominal and uterine cavities; because traumatic separation was not related to normal decompositional processes; and because expulsion of the fetus did not involve passage through the birth canal, this is not considered a case of postmortem fetal extrusion.
See also
- ChildbirthChildbirthChildbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
- OsteologyOsteologyOsteology is the scientific study of bones. A subdiscipline of anatomy, anthropology, and archeology, osteology is a detailed study of the structure of bones, skeletal elements, teeth, morphology, function, disease, pathology, the process of ossification , the resistance and hardness of bones , etc...
- Posthumous birthPosthumous birthA posthumous birth is a birth of a child after the death of a parent. A person born in these circumstances is called a posthumous child or a posthumously born person...
- StillbirthStillbirthA stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...