Death in childbirth in the past was likely common, archaeologists assume, because of the lack of modern medicine and because women tended to have far more children than they do today. But it is extremely rare for archaeologists to find clear evidence that a person’s cause of death was related to childbirth complications. A new study of the burial of a woman and infant from Neolithic China may provide the clearest evidence yet for death related to childbirth.
Writing in the International Journal of Osteoarchaeology, Chinese and Canadian researchers detail a double burial from the Huigou site in China’s Henan Province. Dating to the 3900-2900 BC Yangshao Culture, the Neolithic grave revealed an adult female buried with the remains of an infant positioned between her lower legs.
The burial intrigued archaeologists initially because young children in this ancient culture were more often interred in urn coffins and were placed in an area outside of the graveyard for adults. To find a baby with an adult meant something else was going on, and further analysis of the skeletons was warranted.
During excavation, the researchers also “noted that the pubic symphysis [of the woman] was wide open.” The pubic bone lies at the very front of the bony pelvis, and the symphysis or joint between the two halves has long been a relevant area of research for archaeologists and anatomists interested in understanding the bony effects of childbearing.
In order to figure out whether the woman died in childbirth, the researchers took precise measurements of her skeleton. She was found to have been around 25-30 years old when she died, and stood about 5’ tall. Her pubic symphysis, however, was “unusually long” according to the researchers, particularly given her short stature. Additionally, there was a large projection of extra bone on her right pubic symphysis.
The infant’s age was estimated using the size and shape of its bones and teeth, putting its gestational age at 36-40 weeks, or full-term. It was found between the woman’s legs, with its head near her knees and its feet in line with hers. “The positioning of the infant remains,” the researchers write, “echoes that of the adult female and others in the cemetery, suggesting careful and intentional placement rather than the effects of decay.” This position also “strongly suggests that the infant was delivered, even if neither mother nor child survived.” Although no DNA work has been done in this case, the researchers assume that the adult female was the infant’s biological mother.
While death during childbirth is not necessarily a remarkable finding, the authors suggest that an analysis of the woman’s bony pelvis could hold clues to the specific reason for her death, shedding light on childbirth complications in the past.
The woman’s abnormally long pubic symphysis may have had ramifications for her ability to deliver children, as that extra length could have increased the depth of the front part of her pelvis, which in turn could have affected the rotation of the fetus’s head during delivery. Long pubic symphyses in contemporary obstetrical medical literature have been found to be a factor in head dystocia – essentially, when the fetal head gets stuck during childbirth.
In a time before C-sections, head dystocia would have led to a prolonged birth process with poor outcomes, such as fetal hypoxia and maternal hemorrhage, threatening the health of both the fetus and the mother. This woman’s long pubic bone may have “increased the risk of delivery,” the researchers conclude, “and may have caused dystocia leading to the death of both mother and child.”
Did the woman leave other children motherless when she died? The extra bone on her pubic symphysis appears to indicate that she did, because “it can occur as a consequence of childbirth” and therefore “may be a scar from a prior delivery. It is possible that this individual had already survived at least one difficult delivery prior to the one causing her death,” the researchers conclude.
Co-author on the study, bioarchaeologist Sandra Garvie-Lok from the University of Alberta, told me that the case affected her emotionally. “If she had had a prior difficult birth, I imagine she would have been scared, and in a lot of pain. As a mother, that made me stop and think a couple times of her and her baby, and the people who buried them,” Garvie-Lok said.
More than a case study, this discovery of a likely death during childbirth has “enormous potential for the study of ancient gender roles within Chinese archaeology,” Elizabeth Berger of the University of California at Riverside, who also studies the bioarchaeology of China, tells me. “It raises all sorts of interesting questions about Neolithic people’s beliefs about personhood, and women and children, which are usually very difficult things to see in the archaeological record,” she notes.
The Huigou Neolithic mother-infant burial is also just one aspect of the larger research program of Zhou Yawei of Zhengzhou University. As the lead researcher on this study, he emphasizes that his university is “doing exciting new things with osteology in the region” and concludes that “there is so much yet to find out about everyday life in China’s past.”