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A Fourteen-Month Pregnancy in Nineteenth-century Cornwall? October 25, 2012

Author: Beach Combing | in : Modern , trackback

Polperro Press is a small publishing house that produces excellent quality monographs on Cornish themes. If every town of this size – Polperro is an idyllic Cornish port – had a book producing company of a third of this quality historians would be able to give up their day jobs: history, at least western history, would have been all but sorted out. One book by PP that has proved a particularly good read is the excellent Doctor by Nature, the life story of Jonathan Couch (by Jeremy Rowett Johns). JC was one of those talented provincial Britons who flourished, in the nineteenth century, off in the long grass, away from metropolitan life. Couch, in fact, spent most of his leisure time observing nature, particularly fish and most of his paid time saving neighbours in the hardy fishing community in which he dwelt. One of several bizarre episodes recorded in Doctor is worth celebrating and wondering over.

One of the strangest medical cases encountered by Jonathan Couch during his career as a surgeon-apothecary and man-midwife concerned Mary George, the 32-year-old wife of farm labourer William George. Mary was already the mother of three children, and visibly pregnant in June 1840 when she felt the first sensation of the baby’s movement in her belly. She was so large that the following month she was unable to continue the sort of work she was accustomed to doing. In November, approaching the time she had been expecting to give birth, she experienced a series of sharp abdominal pains for a day or so. These left her, only to return a fortnight later with even greater severity. Couch, called to examine her, noticed that her arms and legs showed signs of some swelling and that her abdomen was now so distended that she was scarcely able to move. Mary remained in this condition… until April the following year when she finally went into labour, apparently some fourteen months since the start of the pregnancy. Couch attended her again on April 18 when he noted that her cervix was dilated to about three and a half inches in diameter. Some indication of her size can be judged by the fact that he estimated that some five gallons of amniotic fluid was discharged…

The baby was stillborn and severely malformed. Couch who was no fool, in fact who was one of the most observant men in his county, wrote the following in his analysis:

[The baby] ‘had lived close to the period of birth, funis short about a foot in length… The body stout and well formed but the head as if truncated above, the bones apparently loose or rather none, the cavity of the cranium open, spilled with fluid, no neck. The uterus did not contract and a large quantity of liquor amnii was discharged after the birth of the child. The only explanation that can be afforded for this case is that early in the pregnancy the uterus became so distended with liquor anmii as to be inadequately contracted, so that when the period of labour approached it was rendered impossible by the circumstance of distension.

Does this explanation stand up and is it really conceivable that the child could have lived through most of this extended pregnancy: drbeachcombing AT yahoo DOT com Again it is worth repeating that Couch was an experienced doctor who time and time again showed himself to have a fine mind.

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27/10/12: Dr Turkey writes in ‘I find it very difficult to believe a foetus could survive an additional 5 months in utero.  Placenta’s have a lifespan that eventually runs out.  From 37 weeks onwards the stillbirth rate rises, and after 42 completed weeks it rises dramatically (which is why inductions are scheduled for this time).  Rates of stillbirth are about 1 in 633 by 43 weeks increased 7 fold from the rate at 40 weeks and continue to rise sharply.  In addition – the description provided here of a malformed foetus sounds much like a deceased foetus which had slowly been broken down internally.  (Sorry that’s really gross but the best way I could explain it.).  As to explanation of why labour didn’t commence – it is entirely possible that the mother never entered labour because of polyhydramnios (too much water).  Labour is a complex process that we don’t fully understand but we do know that that something (either a head or a bottom) needs to be pressing against a cervix to allow a mother to dilate appropriately.  So that explanation is not too far fetched.  Long term pregnancies were not unheard of prior to modern obstetrics.  Babys and mother’s usually died from it.  There’s another example here on my blog. Thanks Turkey!

31/10/12: Tacitus from Detritus writes: at this far remove you really can’t say much about the onset of the pregnancy described.  Was there some reason to imagine that it must have started that early? Hubby away on a long fishing trip to the Grand Banks, say? But if you have to ponder the implications of long, very long, pregnancies…consider the odd tale of “stone babies“.  Rare indeed, but there have been reported cases of intra abdominal pregnancies that expire and slowly calcify into what appear to be marble statuettes of fetuses. Otto writes ‘from the description the 14 month pregnancy sounds like it might have been a case of holo anencephaly  Use caution opening that link, it has an image of an anencephalactic foetus. And don’t plug the term into a Google image search; too sad. Thanks Otto and Tacitus!