Coffin Birth - History

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 hanged 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.Note f Although the fetus was in a similar state of decomposition, the umbilical cord was intact and still attached to the placenta inside the uterus.