International Journal of Osteoarchaeology

Int. J. Osteoarchaeol. 14: 98–103 (2004)

Published online 10 March 2004 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/oa.714

A Dystocic Childbirth in the Spanish

Bronze Age
A. MALGOSA,a,* A. ALESAN,a S. SAFONT,a M. BALLBÉb
AND M. M. AYALAc
a
Unitat d’Antropologia, Dept. Biologia Animal, Biologia Vegetal i Ecologia,
Universitat Autònoma de Barcelona, Spain
b
Rambla d’Egara 63–65, 08221 Terrassa, Spain
c
Dept. Arqueologı´a, Prehistoria, Historia Antigua e Historia Medieval, Universidad de Murcia,
Spain

ABSTRACT Prehistoric cases of maternal and fetal death during labour are difficult to document.
However, this must have been a frequent cause of death among young women who lived
in hard circumstances and precarious health conditions. In this paper, a case of a Bronze Age
woman who probably died during childbirth due to unavoidable reasons is presented: her
baby was lying transversely with the right fetal arm protracted. Death of both mother and child
was inevitable. Copyright ß 2004 John Wiley & Sons, Ltd.

Key words: pregnancy; dystocia; death during childbirth; burial; Bronze Age

Introduction in a few cases. Even in these cases the cause of

There are a lot of references in anthropological
and palaeopathological literature about the high
mortality rate in young women in ancient times.
Actually, the majority of authors establish a link
between the death of young women and serious
problems related to motherhood: pregnancy,
childbirth, and breast-feeding. This relationship
has been inferred from palaeodemographic data,
ethnographic references, and the bad health con-
ditions attributed to ancient human groups.
Therefore, all considerations about the causes of
death of females during their reproductive years
come from indirect data: the high frequency of
skeletons of young women and perinatal indivi-
duals, extrapolation from ethnographic data, etc.
The most suggestive evidence is the double bur-
ials, which contain a woman and a child, but the
mother-child relationship has only been proved
* Correspondence to: Unitat d’Antropologia, Dept. Biologia Ani-
mal, Biologia Vegetal i Ecologia, Universitat Autònoma de
Barcelona, 08103 Bellaterra-Cerdanyola del Vallès. Spain.
e-mail: assumpcio.malgosa@uab.es
Copyright # 2004 John Wiley & Sons, Ltd.
death could be unrelated to childbirth (but rather
to violence, sacrifice, illness or accidents among
others) or the individuals could even have been
buried at different times. In spite of the lack of real
evidence, all considerations about the high mor-
tality rate of women related to their reproductive
function are based on health and sanitary condi-
tions but are probably reasonably valid.
However, there is not a complete lack of direct
archaeological evidences. A few cases of preg-
nant women with fetus in utero have been reported
(Møller-Christensen, 1958; Hawkes & Wells,
1975; Sjøvold et al., 1974 cited in Wells, 1978;
Wells, 1978; Pounder et al., 1983; White &
Folkens, 1991; Agustı́ & Codina, 1992; Campillo
et al., 1998). There are also other cases related to
obstetric problems but without evidence of fetal
remains inside the mother’s pelvic girdle. This is
the case of a skeleton of a young woman who
suffered a surgical ligature possibly performed
after a laceration of the pubic symphysis and
the rupture of the right sacro-ileal joint after
she gave birth (Capasso et al., 1992).
Received 11 July 2003
Revised 5 August 2003
Accepted 7 October 2003
Ancient Dystocic Childbirth
A completely different question is the possibi-
lity of finding out the cause of death and if there
is a relationship between death and some obste-
tric problem. These archaeological cases are
unusual in spite of the following affirmation:
‘pregnant female skeleton are not exceptionally
rare in ancient burials’ (Wells, 1978). Maybe
these cases are ‘not exceptionally rare’ but they
are not well reported in the literature either,
therefore they are not actually well known. It is
possible that some new cases will appear if
greater attention is paid to more accurate archae-
ological collection of bones during excavations as
well as more accurate recording of archaeological
and anthropological data in recent archaeological
research.
In this paper a clear case of a pregnant woman
is presented. In this case, it has been possible to
link the burial with her death during dystocic
labour due to the advanced state of pregnancy
and the position of the fetal bones. In addition,
the time of burial must be considered as it is the
most ancient case found in palaeopathological
literature so far.
The site
The skeletal remains of the pregnant woman
analysed here comes from the Argaric site of ‘El
Cerro de las Viñas de Coy’ (Lorca, Murcia,
Spain), which is located in southeast Spain. The
prehistoric village was located in a strategically
high place in the confluence of natural routes of
communication. For this reason it was occupied
repeatedly from Neolithic to Middle Ages. The
site under study belongs to the Argaric culture.
This culture existed during the Bronze Age in the
southeast region of the Iberian Peninsula (1500–
1000 BC). There are some ceramic and metal
objects (made of copper, bronze and gold) that
characterize the Argaric culture and therefore
allow archaeologists to date sites. The typical
funerary ritual was individual inhumation, but
some double and, more unusually, triple burials
have been found. Most of these burials were
commonly performed under the houses or inside
their perimeter, but always inside the village
(Ayala, 1991). In the case of Cerro de las Viñas
several inhumations have been found inside the
Copyright # 2004 John Wiley & Sons, Ltd.
99
rooms of the village houses, mainly fetuses and
infants (Ayala et al., 2000). It was in one of these
houses that the double interment of a woman
with a fetus was found during the field season of
1996.
Description of the individuals
CV 96MN-1
The burial CV 96-MN contains an inhumation of
a woman with a fetus inside the pelvic cavity. The
female skeleton was buried in a left lateral posi-
tion, with flexed arms and legs (Figure 1).
Decomposition must have taken place in a com-
pletely filled space as is shown by the integrity of
the articulations: the temporomandibular joint
and other weak articulations (phalangeal, feet,
etc) were conserved.
The preservation index based on the number
of bones (modified from Walker et al., 1988) is
about 100%. All the bones were well preserved
except for the skull. Sex and age were determined
according to skeletal morphological traits
(Ferembach et al., 1980, Krogman & Íşcan,
1986) that suggest a young female individual of
25–26 years of age. The stature of 151 cm was
calculated from the length of the long bones of
both extremities using Pearson formulas (Olivier,
1960).
Incomplete coxal bones and sacrum are
present. Bone reconstruction was not possible,
therefore obstetric measurements were not reli-
able despite the fact that they could have been
important in the interpretation of the individual.
No pathologies related to the pregnancy or
the labour could be diagnosed.
CV 96MN-2
The majority of bone remains of this individual
were found inside the pelvic girdle of CV 96MN-
1. The individual was well preserved (90.48%)
and almost all bones were recovered and could be
analysed (Figure 2).
The fetus was found in a transverse lie, in a
right lateral position. The right arm was
extended and located under the pubic symphysis.
Int. J. Osteoarchaeol. 14: 98–103 (2004)
100
Figure 1. The Argaric woman’s skeleton in situ in the grave.
Therefore the baby’s right arm bones were not
found with the rest but rather outside the
mother’s uterus. Most of the joints were well
preserved which shows that the process of decay
took place in a completely filled space.
From the degree of development and the
measurements of the cranial (Redfield, 1970;
Ohtsuki, 1976; Weaver, 1979) and long bones
(Fazekas & Kósa, 1979; Scheuer et al., 1980) an
age of 37–39 gestational weeks could be attrib-
uted to the fetus. A body length of 48.87 cm was
Copyright # 2004 John Wiley & Sons, Ltd.
A. Malgosa et al.
calculated according to long bone length. There-
fore it can be considered a full term fetus. No
bone pathology could be diagnosed.
Discussion
The archaeological work showed that there had
been no important post depositional movements
of the bones. The bone position and the con-
servation of the joints offer a ‘photograph’ of the
Int. J. Osteoarchaeol. 14: 98–103 (2004)
Ancient Dystocic Childbirth
Figure 2. The skeleton of the fetus CV 96MN-2.
moment of the burial. In this image all the fetal
bones were inside the maternal pelvic girdle lying
in a transverse/oblique position. It is therefore a
clear case of fetus in utero. According to the fetal
maturity (37–39 gestational weeks) and the
degree of the opening of the pubic symphysis,
labour could have started. This incorrect position
Copyright # 2004 John Wiley & Sons, Ltd.
101
of the fetus at the beginning of the labour implies
a dystocic labour (Figure 3). Also, the right arm
outside the maternal uterus shows that it was a
case of prolapse.
The shoulder presentation of the fetus and the
prolapse of its right arm are the sequence of
events that could have taken place when, at the
Int. J. Osteoarchaeol. 14: 98–103 (2004)
102
Figure 3. Drawing of the position of fetus CV 96MN-2 during the
labour (modified from Farabeuf & Varnier,1929).
beginning of labour, the fetus was either in an
oblique or in a transverse lie (in medical practice,
the fetal transverse lie and the oblique one may
be confused because their prognosis and treat-
ment are identical).
The probable cause of death of the mother,
and consequently the death of the fetus, can be
discussed according to modern obstetric practice.
As mentioned above, the position of the fetal
bones reveals that it was lying obliquely or
transversely when labour began. The only way
of overcoming this incorrect position with suc-
cess nowadays is by Caesarean section, mainly in
a term pregnancy. Even with a neglected trans-
verse lie and a dead baby, Caesarean section is
usually preferred, since the uterus is tightly con-
tracted around the baby and spontaneous deliv-
ery is impossible, unless the fetus is very small or
macerated. In this situation and without perform-
ing a Caesarean section, the uterine muscle con-
tinues to contract for a certain period of time
(maybe hours or days) and—eventually—it can
rupture or, more likely, it can not perform its
function because of the impossibility of over-
Copyright # 2004 John Wiley & Sons, Ltd.
A. Malgosa et al.
coming this difficulty (Hellman & Pritchard,
1975; Botella & Clavero, 1976; Käser et al.,
1979; Taber, 1979; Iffy & Charles, 1984).
In the case under study and taking into account
the difficulties of the labour, it is very likely that
hyperthermia arose in the mother, due to infec-
tion of the uterine cavity contents, which, if not
expelled early, cause maternal death from sepsis.
Hyperthermia entails maternal and fetal (if the
fetus is still alive) tachycardia and, eventually,
cardiac arrest. In these circumstances, the mother
eventually dies from exhaustion. Whatever way
she died, exhaustion would be an accompanying
factor.
This scenario could be a possible way of
explaining this fatal labour: mainly sepsis, hae-
morrhage and exhaustion were the cause of the
mother’s death. In this case, it is very clear that
this Argaric woman died during labour. This is
perhaps one of the rare archaeological cases in
which the cause of death can be established.
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