Childbirth and C-Sections in Bioarchaeology

Basically since we started walking upright, childbirth has been difficult for women.  Evolution selected for larger and larger brains in our hominin ancestors such that today our newborns have heads roughly 102% the size of the mother's pelvic inlet width (Rosenberg 1992).

Yes, you read that right. Our babies' heads are actually two percent larger than our skeletal anatomy.

Fetal head and mother's pelvic inlet width
Photo credit: Evolution-of-man.info

Obviously, we've also evolved ways to get those babies out.  Biologically, towards the end of pregnancy, a hormone is released that weakens the cartilage of the pelvic joints, allowing the bones to spread; and the fetus itself goes through a complicated movement to make its way down the pelvic canal, with its skull bones eventually sliding around and overlapping to get through the pelvis.  Culturally, we have another way to deliver these large babies: the so-called caesarean section.

Up until the 20th century, childbirth was dangerous.  Even today, in some less developed countries, roughly 1 maternal death occurs for every 100 live births, most of those related to obstructed labor or hemorrhage (WHO Fact Sheet 2010).  If we project these figures back into the past, millions of women must have died during or just after childbirth over the last several millennia.  You would think, then, that the discovery of childbirth-related burial - that is, of a woman with a fetal skeleton within her pelvis - would be common in the archaeological record.  It's not.

Archaeological Evidence of Death in Childbirth

Two recent articles in the International Journal of Osteoarchaeology start the exact same way, by explaining that "despite this general acceptance of the vulnerability of young females in the past, there are very few cases of pregnant woman (sic) reported from archaeological contexts" (Willis & Oxenham, In Press) and "archaeological evidence for such causes of death is scarce and therefore unlikely to reflect the high incidence of mortality during and after labour" (Cruz & Codinha 2010:491).

The examples of burials of pregnant women that tend to get cited include two from Britain (both published in the 1970s), four from Scandinavia (published in the 1970s and 1980s), three from North America (published in the 1980s), one from Australia (1980s), one from Israel (1990s), six from Spain (1990s and 2000s), one from Portugal (2010), and one from Vietnam (2011) (most of these are cited in Willis & Oxenham).  Additionally, I found some unpublished reports: a skeleton from Egypt, a bog body from England, and a skeleton from England.

The images of these burials are impressive: even more than child skeletons, these tableaux are pathos-triggering, they're snapshots of two lives cut short because of an evolutionary trade-off.

The wide range of dates and geographical areas illustrated in the slideshow demonstrates quite clearly that death of the mother-fetus dyad is a biological consequence of being human.  But what we have from archaeological excavations is still fewer than two dozen examples of possible childbirth-related deaths from all of human history.

Where are all the mother-fetus burials?

As with any bioarchaeological question, there are a number of reasons that we may or may not find evidence of practices we know to have existed in the past.  Some key issues at play in recovering evidence of death in childbirth include:

• Archaeological Theory and Methodology.  From the dates of discovery of maternal-fetal death cited above, it's obvious that these examples weren't discovered until the 1970s.  Why the 70s?  It could be that the rise of feminist archaeology focused new attention on the graves of females, with archaeologists realizing the possibility that they would find maternal-fetal burials.  Or it could be that the methods employed got better around this time: archaeologists began to sift dirt with smaller mesh screens and float it for small particles like seeds and fetal bones.

• Death at Different Times.  Although some women surely perished in the middle of childbirth, along with a fetus that was obstructed, in many cases delivery likely occurred, after which the mother, fetus, or both died.  In modern medical literature, there are direct maternal deaths (complications of pregnancy, delivery, or recovery) and indirect maternal deaths (pregnancy-related death of a woman with preexisting or newly arisen health problems) recorded up to about 42 days postpartum.  An infection related to delivery or severe postpartum hemorraging could easily have killed a woman in antiquity, leaving a viable newborn.  Similarly, newborns can develop infections and other conditions once outside the womb, and infant mortality was high in preindustrial societies.  With a difference between the time of death of the mother and child, a bioarchaeologist can't say for sure that these deaths were related to childbirth.  Even finding a female skeleton with a fetal skeleton inside it is not always a clear example, as there are forensic cases of coffin birth or postmortem fetal extrusion, when the non-viable fetus is spontaneously delivered after the death of the mother.

• Cultural Practices.  Another condition of being human is the ability to modify and mediate our biology through culture.  So the final possibility for the lack of mother-fetus burials is a specific society's cultural practices in terms of childbirth and burial.  In the case of complicated childbirth (called dystocia in the medical literature), this is done through caesarean section (or C-section), a surgical procedure that dates back at least to the origins of ancient Rome.

Cultural Interventions in Childbirth

It's often assumed that the term caesarean/cesarean section comes from the manner of birth of Julius Caesar, but it seems that the Roman author Pliny may have just made this up. The written record of the surgical practice originated as the Lex Regia (royal law) with the second king of Rome, Numa Pompilius (c. 700 BC), and was renamed the Lex Caesarea (imperial law) during the Empire.  The law is passed down through Justinian's Digest (11.8.2) and reads:

Negat lex regia mulierem, quae praegnas mortua sit, humari, antequam partus ei excidatur: qui contra fecerit, spem animantis cum gravida peremisse videtur.

The royal law forbids burying a woman who died pregnant until her offspring has been excised from her; anyone who does otherwise is seen to have killed the hope of the offspring with the pregnant woman. [Translation mine]

Example of Roman gynaecological equipment: speculum
From the House of the Surgeon, Pompeii (1st c AD)
Photo credit: UVa Health Sciences Library

There's discussion as to whether this law was instituted for religious reasons or for the more practical reason of increasing the population of tax-paying citizens.  In spite of this law, though, there isn't much historical evidence of people being born by C-section.  Many articles claim the earliest attested C-section as having produced Gorgias, an orator from Sicily, in 508 BC (e.g., Boley 1991), but Gorgias wasn't actually born until 485 BC and I couldn't find a confirmatory source for this claim.  Pliny, however, noted that Scipio Africanus, a celebrated Roman general in the Second Punic War, was born by C-section (Historia Naturalis VII.7); if this fact is correct, the earliest confirmation that the surgery could produce viable offspring dates to 236 BC.

This practice in the Roman world is not the same as our contemporary idea of C-section.  That is, the mother was not expected to survive and, in fact, most of the C-sections in Roman times were likely carried out following the death of the mother.  Until about the 1500s, when the French physician François Rousset broke with tradition and advocated performing C-sections on living women, the procedure was performed only as a last-ditch effort to save the neonate.  Some women definitely survived C-sections from the 16th to 19th centuries, but it was still a risky procedure that could easily lead to complications like endometritis or other infection.  Following advances in antibiotics around 1940, though, C-sections became more common because, most importantly, they were much more survivable.

Caesarean Sections and Roman Burials

Roman relief showing a birthing scene
Tomb of a Midwife (Tomb 100), Isola Sacra
Photo credit: magistrahf on Flickr

In spite of the Romans' passion for recordkeeping, there's very little evidence of C-sections.  It's unclear how religiously the Lex Regia/Caesarea was followed in Roman times, which means it's unclear how often the practice of C-section occurred.  Would all women have been subject to these laws?  Just the elite or just citizens?  How often did the section result in a viable newborn?  Who performed the surgery?  It probably wasn't a physician (since men didn't generally attend births), but a midwife wouldn't have been trained to do it either (Turfa 1994).

Whereas we can supplement the historical record with bioarchaeological evidence to understand Romans' knowledge of anatomy, their consumption of lead sugar, or the practice of crucifixion, this isn't possible with C-sections - the surgery is done in soft tissue only, meaning we'd have to find a mummy to get conclusive evidence of an ancient C-section.

We can make the hypothesis, though, that because of the Lex Regia/Caesarea, we should find no evidence in the Roman world of a woman buried with a fetus still inside her.  This hypothesis, though, is quickly negated by two reported cases - one from Kent in the Romano-British period and one from Jerusalem in the 4th century AD. The burial from Kent hasn't been published, although there is a photograph in the slide show above.

Interestingly, the Jerusalem find was studied and reported by Joe Zias, who also analyzed the only known case of crucifixion to date.  Zias and colleagues report on the find in Nature (1993) and in an edited volume (1995), but their primary goal was to disseminate information about the presence of cannabis in the tomb (and its supposed role in facilitating childbirth), so there's no picture and the information about the skeletons is severely lacking:

We found the skeletal remains of a girl (sic) aged about 14 at death in an undisturbed family burial tomb in Beit Shemesh, near Jerusalem.  Three bronze coins found in the tomb dating to AD 315-392 indicate that the tomb was in use during the fourth century AD.  We found the skeletal remains of a full-term (40-week) fetus in the pelvic area of the girl, who was lying on her back in an extended position, apparently in the last stages of pregnancy or giving birth at the time of her death... It seems likely that the immature pelvic structure through which the full-term fetus was required to pass was the cause of death in this case, due to rupture of the cervix and eventual haemorrhage (Zias et al. 1993:215).

Both Roman-era examples involve young women, and it is quite interesting that they were already fertile.  Age at menarche in the Roman world depended on health, which in turn depended on status, but it's generally accepted that menarche happened around 14-15 years old and that fertility lagged behind until 16-17, meaning for the majority of the Roman female population, first birth would not occur until at least 17-19 years of age (Hopkins 1965, Amundsen & Diers 1969).  These numbers have led demographers like Tim Parkin (1992:104-5) to note that pregnancy was likely not a major contributor to premature death among Roman women.  But the female pelvis doesn't reach skeletal maturity until the late teens or early 20s, so complications from the incompatibility in pelvis size versus fetal head size are not uncommon in teen pregnancies, even today (Gilbert et al. 2004).

More interesting than the young age at parturition is the fact that both of these young women were likely buried with their fetuses still inside them, in direct violation of the Lex Caesarea.  So it remains unclear whether this law was ever prosecuted, or if the application of the law varied based on location (these young women were both from the provinces), social status (both young women were likely higher status), or time period.  Why wasn't medical intervention, namely C-section, attempted on these young women?  It's possible that further context clues from the cemeteries and associated settlements could give us more information about medical practices in these specific locales, but neither the Zias articles nor the Kent report make this information available.

Childbirth - Biological or Cultural?

Childbirth is both a biological and a cultural process.  While biological variation is consistent across all human populations, the cultural processes that can facilitate childbirth are quite varied.  The evidence that bioarchaeologists use to reconstruct childbirth in the past includes skeletons of mothers and their fetuses; historical records of births, deaths, and interventions; artifacts that facilitate delivery; and context clues from burials.  The brief case study of death in childbirth in the Roman world further shows that history alone is insufficient to understand the process of childbirth, the complications inherent in it, and the form of burial that results.  In order to develop a better understanding of childbirth through time, it's imperative that archaeologists pay close attention when excavating graves, meticulously document their findings, and publish any evidence of death in childbirth.

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Further Reading:

• Coffin Birth, aka Postmortem Fetal Extrusion (Wikipedia)
• Using Votives to Visualize Reproductive Anatomy in Antiquity (Powered by Osteons, 17 Feb 2012)
• The Bioarchaeology of Crucifixion (Powered by Osteons, 4 Nov 2011)

References:

D.W. Amundsen, & C.J. Diers (1969). The age of menarche in Classical Greece and Rome. Human Biology, 41 (1), 125-132. PMID: 4891546.


J.P. Boley (1991). The history of caesarean section. Canadian Medical Association Journal, 145 (4), 319-322. [PDF]

S. Crawford (2007). Companions, co-incidences or chattels? Children in the early Anglo-Saxon multiple burial ritual.  In Children, Childhood & Society, S. Crawford and G. Shepherd, eds.  BAR International Series 1696, Chapter 8. [PDF]

C. Cruz, & S. Codinha (2010). Death of mother and child due to dystocia in 19th century Portugal. International Journal of Osteoarchaeology, 20, 491-496. DOI: 10.1002/oa.1069.

W. Gilbert, D. Jandial, N. Field, P. Bigelow, & B. Danielsen (2004). Birth outcomes in teenage pregnancies. Journal of Maternal-Fetal and Neonatal Medicine, 16 (5), 265-270. DOI: 10.1080/14767050400018064.

K. Hopkins (1965). The age of Roman girls at marriage. Population Studies, 18 (3), 309-327. DOI: 10.2307/2173291.

E. Lasso, M. Santos, A. Rico, J.V. Pachar, & J. Lucena (2009). Postmortem fetal extrusion. Cuadernos de Medicina Forense, 15 (55), 77-81. [HTML - Warning: Graphic images!]

T. Parkin (1992).  Demography and Roman society.  Baltimore: Johns Hopkins University Press.

K. Rosenberg (1992). The evolution of modern human childbirth. American Journal of Physical Anthropology, 35 (S15), 89-124. DOI: 10.1002/ajpa.1330350605.
J.M. Turfa (1994). Anatomical votives and Italian medical traditions. In: Murlo and the Etruscans, edited by R.D. DePuma and J.P. Small. University of Wisconsin Press.

C. Wells (1975). Ancient obstetric hazards and female mortality. Bulletin of the New York Academy of Medicine, 51 (11), 1235-49. PMID: 1101997.

A. Willis, & M. Oxenham (In press). A Case of Maternal and Perinatal Death in Neolithic Southern Vietnam, c. 2100-1050 BCE. International Journal of Osteoarchaeology, 1-9. DOI: 10.1002/oa.1296.

J. Zias, H. Stark, J. Seligman, R. Levy, E. Werker, A. Breuer & R. Mechoulam (1993). Early medical use of cannabis. Nature, 363 (6426), 215-215. DOI: 10.1038/363215a0.

J. Zias (1995). Cannabis sativa (hashish) as an effective medication in antiquity: the anthropological evidence. In: S. Campbell & A. Green, eds., The Archaeology of Death in the Ancient Near East, pp. 232-234.

Note: Thanks to Marta Sobur for helping me gain access to the Zias 1995 article, and thanks to Sarah Bond for helping me track down the Justinian reference.

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Roman Bioarchaeology Carnival XIV

This is a bit late, but here's your now monthly round-up of news in the world of Roman bioarchaeology (broadly defined, as usual)...

New Finds

• The big story out last month was in the area of Montereggi, an Etruscan site.  There is plenty of information at La Repubblica, Nove da Firenze, and Archeorivista, as well as some brief English-language coverage (The Florentine).  Montereggi has been excavated for seven years, with the last phase ending in October of 2011.  This past year, excavators found a human skeleton in a well.  The skeleton was found on top of a number of waterproof jars that seem to have contained wine (although further testing will determine this for sure), then covered with other fragmented jars.  The excavators think it was a purposeful burial (not that, for example, someone fell into the well or was thrown in), but analysis of the skeleton is ongoing at the Archaeological Superintendency of Tuscany.

The Etruscan Skeleton in the Wine Well
(credit: La Repubblica)

• Another big story was on the discovery of around 90 graves that may hold the bones of early Christian martyrs near Milan.  The skeletons were found near the Basilica of St. Ambrose and seem to date to the 4th-5th centuries AD, although it's uncertain because the graves are quite simple (meaning there are few artifacts that can date them).  There's a nice series of photographs with the Corriere della Sera piece, and the find was also covered at Archeorivista.  Sounds like some construction project is being held up for the excavation of the bodies, so I hope the archaeologists are able to recover as much as possible given the time constraints. (See also: The Bones of Martyrs?)

A Christian Martyr?
(credit: Corriere della Sera)

• Archaeologists also found about 30 Lombard tombs in Cividale del Friuli (northeastern Italy, on the border with Austria).  They seem to date from around the Roman period (or at least are positioned near the Roman architecture that remains).  Work has been done at this site in the past, but many of these new Lombard graves were pretty intact and included a lot of interesting artifacts.  One of the graves:

Lombard Grave from Cividale del Friuli
(credit: Archeorivista)

• Two cremated bodies were found in Cawston (near Norfolk, UK) dating to the Roman period.  Not a lot of additional information on them, though.
• Did an Italian archaeologist find the tomb of St. Philip the Apostle, who was martyred in 80 AD, in Hierapolis (Turkey)?  He's certainly suggesting that the Roman-style tomb was indeed that of Philip, but this is the only coverage I saw.
• A Roman cemetery was discovered in Djerba, Tunisia.  There are apparently over 100 graves, but no additional information has been released yet.  Djerba may have been the island of the lotus-eaters referred to in the Odyssey and, in Roman times, produced a lot of murex dye.  This could be a very cool site, especially if they have skeletons from those graves.  I hope more information comes out soon.

Upcoming Excavations and Projects

• And now for a bit of crowd-sourced archaeology... If you live in Kingsholm, Gloucester (UK), you might want to dig up your garden and see what you find - the area used to be a Roman military fort.
• Excavations are resuming at the Etruscan site of Populonia this summer, including its necropolis.  Should be some interesting news coming out of this dig.
• A new archaeological project seeks to answer the question "What have the Romans ever done for us?" - with the "us" being the Irish.  The project will tackle Late Iron Age and Roman Ireland.  Previous work has already been done on human remains (including isotope analyses), but this project will find additional sites and try to figure out what it meant to be "Roman" in Ireland.  This could be quite interesting, as it's likely that Roman influence in Ireland was different than Roman influence in Britain and this difference hasn't been thoroughly researched yet.

Exhibits

• The Roman gladiator skeletons are on tour, spending some time in Durham (UK).  If you need a reminder about who the Roman gladiators are, I covered one of the publications here ("Headless Romans of York"), but it was all over the media back in 2010: National Geographic, CNN, Telegraph.  

New Analysis and New Media

• A recent blog post about a uterus votive in the Wellcome collection inspired me to write about anatomical votives in antiquity.  
• I also wrote about the history of bioarchaeology in Italy, which was drawn in large part from my master's thesis research.
• And my post on Lead Poisoning in Rome: the Skeletal Evidence was syndicated over at Past Horizons.  So go check it out if you haven't already.
• Just wanted to call attention to a blog by Italian anthropologist Moreno Tiziani, who also wrote a book with the same title: Professione Antropologo (Professional Bioanthropologist).

Fun Stuff

• Would you have survived the eruption of Mt. Vesuvius in 79 AD?  Take this quiz at Discovery.com and learn a little about volcanoes!  (I did survive - but only barely.)
• Mike Henderson at the Museum of London laid out a skeleton in proper anatomical position and was stop-motion-captured.  The result is this awesome 40-second video.  (A friend asked me if I could lay out a skeleton that quickly.  I could do it a whole lot faster; it's just a matter of speeding up the video!)

Join me next month for more news from the world of Roman bioarchaeology!

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Women Are Cute, Men Are Geniuses

After looking at some pretty awesome mummies on Monday, I perused the Discovery Place gift shop.  On a table at the front of the store, prominently displayed, were these tshirt-and-hat combos:

They're even specifically labeled: the band on the Genius shirt/hat reads "Men's Cap and Tee" while the band on the Cute shirt/hat reads "Women's Cap and Tee."

Really?

I'm generally ok with the pinkifying of science.  If creating bath salts in a home chemistry kit means more girls and women will get into science, that's great.  But this display pissed me off.  Men display their intelligence (which they are rewarded for), while women display their physical appearance (which we are rewarded for, but only if we make a patriarchal bargain).  Not to mention, the men's display is taller - is it because men are, on average, taller than women, or is it because women's objects / women as objects are inferior to men?  Seriously, there are so many things wrong with this display.

Interestingly, I found a number of similarly styled Genius shirts in a simple web search - this one is unisex, and the copy makes it clear it's for men and women; and this one is cut for and modeled by a woman.  (Not sure what to do with the Cute Genius bracelet I also found, though...)

Discovery Place is a science museum, one aimed at school-aged kids.  Men = geniuses / women = cuties is absolutely the wrong message to send.  Even if the gift shop is run or managed independently, I'm baffled as to why no museum staff questioned this merchandise.  Perhaps, as an anthropologist with a 2.5-year-old daughter who so far loves science, I should write them a letter.

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Update (2/24) - I decided to send Discovery Place an email, through their contact form.  What I wrote follows, but you can also send them an email if this post or the tshirts made you mad.

To Whom It May Concern: 

I'm compelled to write this email in response to a merchandise display I saw in the gift shop this week.  The display had men's tshirts/caps labeled Genius and women's tshirts/caps labeled Cute.  It was baffling to me that, as a self-described "preeminent science education center," Discovery Place doesn't realize that this display is communicating an old and damaging gender bias in science. 

As a biological anthropologist, I greatly enjoyed the Mummies of the World exhibit.  But as a woman, a scientist, and the mother of a 2.5-year-old daughter who loves science, I was chagrined at the idea that she and I can be "cute" but not "geniuses."  I have blogged about both of these topics (my visit to the mummies and the gender-coded tshirts) at Powered by Osteons.  Of course, I'd be happy to include your response as a coda to my "Women Are Cute, Men Are Geniuses" post. 

In closing, I urge you to reconsider selling such blatantly gendered items in your gift shop, as under-representation of women in science is a real problem.

Sincerely,
Kristina Killgrove, PhD

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An Afternoon with Mummies of the World

Flesh and organs are not really my thing; give me dry bones over gooshy bits any day.  So I don't usually go out of my way to see mummies.  If they're on display in a museum, I'll look at them, trying to catch a glimpse of the bones poking through.  But at last year's Paleopathology Association meetings, I heard a talk by Heather Gill-Frerking on the challenges involved in creating a museum exhibit on mummies and in communicating information about mummies to a wider public.  When it was announced that the Mummies of the World exhibit would make its way to Discovery Place in Charlotte, just two hours from me, I figured I needed to check it out, and I brought with me a few interested parties from different disciplines: a Roman historian (my good friend Sarah Bond), a computer scientist (my husband Patrick), and an anthropologist-in-training (my 2.5-year-old daughter Cecilia).  We were also accompanied by Douglas Coler, the coordinator of in-house education for Discovery Place, who helpfully answered our questions about the creation of the exhibit and the mummies themselves.

The exhibit is arranged largely chronologically, starting with the oldest prepared mummies - the Chinchorro mummies from about 5000 BC found in Chile and Peru - and ending with fairly recent natural mummies of the Orlovits family from 18th century Hungary.  In between, there are mummies from Egypt and Peru, as well as a bog body.  Animal mummies are presented as well - naturally preserved rats from Europe, purposefully mummified birds and fish from Egypt, and a spectacular howler monkey wearing a feather skirt and headdress from Argentina.

You can see a nicely done 3-minute preview of the exhibit below:

I liked the organization of the collection very much.  I've been teaching osteology, bioarchaeology, and palaeopathology for six years, and I always give at least one lecture on mummies.  After explaining a bit about normal decomposition, I talk about how processes such as freezing and desiccation, as well as anaerobic environments, can preserve organic remains.  And then I present some examples of mummies chronologically, with a map showing the locations around the world that have given us a variety of mummies.  So it was great to, in effect, see my lecture come alive: I could have dropped my students into this exhibit, and they would have gotten all the information from my lecture in 3-D form.

One of the fascinating individuals on display was the Detmold Child, an 8-10-month old purposefully preserved infant from Peru, who has been carbon dated to 4500-4450 BC.  This child had all kinds of health problems, including a heart defect and growth deficiencies:

Another interesting mummy is this man from the Atacama Desert in pre-Columbian Peru.  Honestly, what intrigued me most is his braid.  How does one create a braid that points in that direction?  When I braid my hair, the Vs point downward, not upward as his does:

Another great thing about this exhibit is the way the mummies are displayed.  Most are laid out on a very thin platform that conforms precisely to the body, making the support very unobtrusive.  There aren't a lot of indications, though, about the other artifacts that might have been in the burial.  Several walls of the exhibit hold shadowboxes with canopic jars, small animal mummies, and other objects that would have accompanied the dead into the afterlife.  But there wasn't a lot of information about the burial styles of most of the mummies - the Atacama man above, for example, was likely wrapped up to create that tightly flexed position, but I don't remember there being an explanation to that effect.  Some of the lack of information, though, may very well be related to the time period in which the mummies were found.  (For example, it was the height of fashion to buy a mummy and have an unwrapping party in 19th century Europe, so many mummies are now devoid of archaeological context.)

The mummy tag on display. (Sarah took this pic of the
tag in the exhibit book.)

The artifacts that were on display, though, were quite cool.  Just one Fayum portrait was loaned for this exhibit, but it was great to see it.  In Roman times, many Egyptians were mummified with a painting covering the face area; whether the painting actually depicts the individual who has been mummified, though, has been in question for a while (with examples of female mummies having a male portrait, and vice versa).  Most people are familiar with high-status mummies from the era of King Tut, and not as many know about the Fayum portraits of the middle and lower classes.  There was also a mummy tag from Egypt - basically the equivalent of the contemporary toe tag you'd see in a morgue.  Sarah was especially pleased by this and attempted to make out the Greek writing.  And there was even a page from the Egyptian Book of the Dead.  So the context of Egyptian mummies was much better explained than was the context of any other culture's mummies, but given the abundance of Egyptian mummies and artifacts as well as the historical records from much of that time period, this was unsurprising.

Halfway through the exhibit, my daughter came running up to me, saying, "Mama!  There's a mummy with a hole in it!" and immediately took off, wending her way through the exhibit to show him to me.  She wanted to know more about him (as she is currently a bit obsessed with holes and discontinuities in general), so Patrick and I explained that the hole was probably made when his internal organs were removed.  Douglas confirmed that that was indeed the case.  I asked if she could name any organs.  "Hmmm.  Intestines."  "Where does your pee come from?"  "My bladder!"  "And where do babies grow?"  "A uterus!  He doesn't have a uterus.  He's a boy."  In addition to the mummy with a hole in him, Cecilia was quite impressed by the double exit sign close to the end of the exhibit.  (When you're 2, you don't really know the difference between what's mundane and what's novel.)

While I admit that I know next to nothing about creating a museum exhibit of this size, there were a few things I would have changed or included.  There was a box of animal mummies, for example, still wrapped, and the different species were listed.  But without an xray or CT scan, it's often impossible to tell a small dog from a large fish.  It would have been nice to see the images that let the researchers figure that information out.  (Perhaps more of this kind of information was contained in the videos on display; I confess I didn't have time to watch them, as we had already lined up lunch plans.)  I also wanted a bit more information on the mummies to be listed directly on the exhibit tags - in particular, at least one of the Peruvian mummies had undergone cranial vault modification, but there was no explanation for the individual's different head shape.  Sarah and I overheard a group of kids wonder why little Johannes Orlovitz was buried in a dress if he was a boy, but there was no explanation for the family's 18th century dress nearby; and I overheard people asking why some mummies were laid out and some were flexed.  Within a tour group, these kinds of questions can be asked and easily answered, but a bit more information about these common questions would have been useful.

The main point I took away from Heather's talk at the PPAs last year was not actually about the process of creating a museum exhibit - it was about the fact that the exhibit company had christened her a Mummyologist(tm).  Yes, they actually trademarked the word.  Hilariously, in the trademark paperwork, the description of the service provided is, "providing information about archaeology, anthropology and forensic science via the internet."  Well, in that case, I guess I'm a Mummyologist(tm) too!  Actually, maybe I can trademark Romanobioarchaeologist?  At any rate, this neologism is super weird to me, since anthropologist (or biological anthropologist) is a perfectly good designation (and, honestly, since it should be Mummiologist by the rules of English).  I think it does a disservice to kids to teach them this made-up word, and it undercuts to a small extent one of the points of the exhibit: to bring anthropological research to a wider public.  We've seen time and time again that the public doesn't really know what anthropologists do, so I question the creation of Mummyology(tm?) and wonder what, if any, effect this will have on the perception of research on ancient humans.

After a long but happy day running around the Mummies of the World exhibit, Discovery Place, and Charlotte, my daughter curled up in bed and we went through our nightly ritual:

"Mama, I want to have a conversation."
"What do you want to talk about?"
"I want to talk about mummies."
"Did you like the mummies?"
"Yes.  There was a mummy with a big hole in him."
"You're right.  Why did he have a hole in him?"
"He doesn't have any organs."
"That's right.  What else do you know about him?"
"He was from Egypt, on the black globe."

Discovery Place in Charlotte
(photo by Sarah Bond)

In spite of my minor critiques of the exhibit, Mummies of the World is an excellent overview of the types of preservation of organic remains.  The specimens include humans and animals, range from South America to Africa to Europe, and represent high and low-status burials of men, women, and children.  The chronological arrangement makes it easy to see that mummies have been created for millennia and aren't restricted to King Tut and his family. Special lighting (used to help preserve the mummies) sets the tone for the exhibit - the dimness is a bit eerie but also suggests a quiet respect for the dead, whose bodies give us a world of information about their lives and the eras in which they lived.  The exhibition catalogue (which I didn't buy, but was priced in the giftshop at a very reasonable $40) is lovely and includes numerous chapters on mummies from around the world, along with additional pictures and information not presented in the exhibit, by such well-known mummy researchers as Albert Zink, Frank Ruhli, Heather Gill-Frerking, and Dario Piombino-Mascali.

Anyone near Charlotte should take the opportunity to spend some time with these mummies before they move on after April 8.

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Using Votives to Visualize Reproductive Anatomy in Antiquity

Shrine to Madonna del Perpetuo Soccorso
in Largo Preneste (Roma) - Photo taken in
2007 by K. Killgrove.

A few blocks from my apartment in Rome was a shrine to the Madonna del Perpetuo Soccorso (Lady of Perpetual Help) in Largo Preneste.  Every day in the summer of 2007, I walked or rode by it on my way to study the skeletons of the ancient Romans.  This is not the home of the original Byzantine icon of the same name - although that does reside in Rome - but rather a roadside shrine, located at a busy intersection near a major public transportation stop in the outskirts of the city.

The shrine to Our Lady of Perpetual Help includes flowers, candles, and dozens of plaques - mostly made out of marble - giving thanks for prayers that have been answered.  Some are simple: Grazie, thanks.  Some are spelled out: Per grazia/e ricevuta/e, For the blessing(s) received.  And some just employ the shorthand: PGR.  Many include a date and a name as well.

Every time I passed this shrine, I was struck by the pathos of one plaque in particular.  It reads PER GRAZIA / RICEVUTA / : SABINA / ROMA, 1972 and is unique to this shrine because it includes a drawing of a stomach:

Detail of the shrine.
Photo by K. Killgrove, 2007.

This tradition of dedicating a body part to a divine figure, however, is not unique to Roman Catholicism.  In fact, the practice may date back quite a long time in Italy and in other parts of the world.  In the Greek world, so-called Asklepions dedicated to the god of healing have produced treasure troves of anatomical offerings from people desperate to be cured of their bodily afflictions.  And there are more than one hundred similar sanctuaries in Italy, just in the area from Etruria to Campania, dating to the 4th-1st centuries BC (Turfa 1994).  These Etruscan and early Roman objects are generally terracotta and are often mold-made, meaning the creation of anatomical votives was a steady business, but others were more crudely fashioned, probably by the individuals themselves.  Offerings of various forms have been found, from swaddled babies to limbs to internal organs.

There's rather a large literature on votives in the Etruscan and Roman worlds, but researchers continue to question the purpose of anatomical votives, to try to suss out the ancient understanding of anatomy through identification of body parts, and to retro-diagnose the population based on the form and abundance of anatomical votives at healing centers (e.g., Cruse 2004).

This week on the blog of the Wellcome Collection, Catherine Walker writes about an object that has been identified as a Roman clay-backed uterus (dating to around 200BC-200AD).  Specifically, she notes:

This observational understanding of medicine provides an interesting perspective when looking at the votives we have in the gallery. The knowledge of what was going on inside the body was limited, so what couldn’t be observed would have been assumed. If we take the votive uterus pictured above as an example, we can see that there was little knowledge of what the organ actually looked like. Autopsies would not have been carried out at this time; there are isolated cases in third-century BCE Alexandria, but these are not the norm. The form of this votive is based on assumptions and what observation could have been made. They would have been aware of the function of the organ and could have observed childbirth, so we see that this understanding has been incorporated into the votive as the wavy lines represent contractions.

The question remains, though, should we assume a lack of knowledge on the part of the ancients, or should we question our assumption about what body part this represents?  Either way, we can arrive at different interpretations of this object.

If the Etruscans and Romans really had no understanding of internal anatomy, can we safely say that this depicts what we know to be the uterus?  That is, in modern anatomical knowledge, we understand the uterus and the vagina to be separate parts of a woman's reproductive anatomy.  The vaginal walls are somewhat ribbed and the vagina terminates in an opening - is our assignment of the anatomical votive above to a uterus simply our assumption that reproduction was the most important gynecological problem for ancient women?

And yet the Etruscans and Romans knew a great deal about childbirth (and depicted it in ceramics), even if their understanding of the internal workings of the female reproductive system was shaky.  Pretty much every woman - and probably lots of men - would have seen or attended a birth and would have been familiar with the delivery of the placenta.  Could this votive object represent the placenta, which can be rather veiny and bag-like?  Or perhaps it's a conflation of the uterus, placenta, and vagina?  In a time before modern medicine and birth control, many women (and female domesticated animals) may have seen their own uterus if they suffered from uterine prolapse, which can look similar to the votive above (I'll let you google-image search that on your own, though).

Even among experts, the assignment of votives to specific parts of the human anatomy is problematic.  In her review of the publication of the votives from Punta della Vipera, Jean Turfa (2004) writes that:

One model type, G11 (83-84, pl. 33,a) has often been identified as a bladder, but it closely resembles models found at Rome and Veii that must represent testicles; the Vipera version does have a different base or backdrop, however. Although they appear extremely stylized, sometimes described as cones or phallic markers, C.'s category G12 are, as she notes (84, pl. 33,b), intended to represent human hearts. 

One category remains problematical to all of us, C.'s G10 (82-84), identified as intestines. I now am convinced that this low-relief, oval model with undulating contours and central, teardrop-shaped organ, is in fact a deflated uterus, perhaps depicted as if just emptied of its fetus and still contracting back to normal shape. As C. notes, I originally identified the type as intestines, based on an example in the British Museum, but later amended the classification. The extra organ could be a vestigial uterus as on "normal" uterus models, or it could be a bladder or other appendage. Some examples seem to show the cervix (pl. 32, e); while the path of the intestines rendered on polyvisceral plaques can be traced, the folds on these smaller plaques are simply decorative and symmetrical.

So even experts disagree about whether something represents a bladder or testicles, whether a votive is a penis or a stylized heart, and whether an object is a uterus or intestines.  That's a lot of disagreement on pairs of organs that really look nothing alike.  Many of these articles on anatomical votives want their explanation both ways: the Etruscans/Romans didn't understand anatomy, so they depicted what they thought it was; we are reaching for the closest analogy to our modern understanding of anatomy, with the assumption that these votives are supposed to be anatomically correct.  The circular reasoning employed is a bit confusing and diminishes the attempt to understand ancient medicine and anatomy.

Figure 1 from Baggieri 1998.

The most convincing bit of evidence for assuming this anatomical votive is a uterus, though, comes from the Etruscan site of Vulci (Cruse 2004).  More than 400 anatomical votives of what appear to be wombs were found - all similarly shaped, but some with an opening and some with a closed end.  Intriguingly, these models were x-rayed, and in nearly all of them, a small clay sphere around 1cm in diameter was found.  These objects have been interpreted as intra-uterine life, connecting the votive wombs with the problems of miscarriage and infertility (Baggieri 1998).

The Vulci votives are quite different looking than the Wellcome Collection example above, but they're also much earlier in date.  With such a lengthy tradition of anatomical votives, it is possible that the slightly more natural-looking wombs of the Etruscans evolved into the more stylized, flattened womb when the votives were mass-produced in Roman times. (It's always possible that they're bladders, though, and that the spheres are, more literally, bladder stones. I'm not sure if this possibility has been investigated.)

It's easy to assume that there is an unbroken tradition in the meaning and practice of anatomical votive dedication - from the 7th century BC Etruscan wombs to the 1st century AD Roman uterus to Sabina's stomach in 20th century Rome - but it's important to question this assumption in light of the growing body of information on health, disease, and ritual in ancient Italy.  I hope the June conference at the British School at Rome will yield some new information about anatomical votives in the ancient world.

---

References:

Baggieri, G. (1998). Etruscan wombs. The Lancet, 352 (9130) DOI: 10.1016/S0140-6736(05)60686-1.

Cruse, A. (2004).  Roman Medicine.  Tempus.

Turfa, J.M.  (1994).  Anatomical votives and Italian medical traditions.  In: Murlo and the Etruscans, edited by R.D. DePuma and J.P. Small.  University of Wisconsin Press.

Turfa, J.M.  (2004).  Review of A. Comella's Il santuario di Punta della Vipera.  Bryn Mawr Classical Review 2004.06.44.

Yeomans, S.K.  (2008).  Medicine in the ancient world.  Biblical Archaeology Review e-feature.

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Anthropo-morphizing Science

In the past month, two neat projects have been started by freelance science communicators in an effort to change the public's perception of science and scientists.

#IAmScience was started by Kevin Zelnio, whose goal was to let scientists explain their personal journey into the subject.  In his original post, Kevin shared the experiences that initially sidelined his pursuit of science and drew on a recent talk at Science Online (which I swear I will go to one of these years).  The hashtag #IAmScience lets tweeters share their stories in 140 characters or fewer; here's mine.  Or you can email him with a longer story, which will appear on the I Am Science tumblr.

This Is What a Scientist Looks Like was started by Allie Wilkinson, whose goal was to change the idea that scientists are all bespectacled, grey-bearded men in white lab coats.  For Valentine's Day, Allie also solicited "Dear Science" love letters, which are all very meet-cute.  Allie's site was picked up by Scientific American today ("What a Scientist Looks Like"), and I was excited to lend her the photograph of me and a little blurb about my love for science.

Only half a dozen of us have contributed to Allie's site, so currently This Is What an Anthropologist Looks Like:

(Top, L to R) - Megan McCullen (archaeologist, ethnohistorian); Josephene & Rebecca (archaeologists); Christopher Schmitt (biological anthropologist); (Bottom, L to R) - Laurie Kauffman (primatologist); Kait G. (biological anthropologist); and me (bioarchaeologist).

Both Kevin's and Allie's projects are great ways for anthropologists to contribute to fixing the public's perception of science and scientists.  So if you haven't already tweeted about #IAmScience, go do it.  And if you haven't sent in a picture to This Is What a Scientist Looks Like, go do it.  Let's anthropo-morphize science and show the many cool things we do!

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An Anthropological Valentine

Author's Note:  I originally wrote this last February, in response to a post at Savage Minds calling for anthropology love letters, but thought I'd reprise it today.  You should also read the whole series of love letters collected last March by Daniel Lende at Neuroanthropology, and you can even contribute your own love note on today's AAA blog post "For the Love of Anthropology."

The Accidental Anthropologist

I’m an accidental anthropologist. Don't get me wrong, I've always known what I wanted to do when I grew up. But I came at anthropology circuitously, sidewinding my way through three of the four fields before realizing just how deep I was in a field of inquiry I'd never really thought twice about.

My love letter to anthropology, though, starts with a prothalamion to my indivisible bond with the classics. One of my earliest memories is poring through every foreign-language board book I could find in our tiny public library, memorizing Spanish words with absolutely no idea how they sounded, and devouring images of the marble elegance of the ancient Greeks. I desperately longed to experience far-away lands filled with colorful tapestries, musical phonemes, spice-laden food, and history much deeper than my native Virginia. Growing up poor, I knew I’d have to travel to Europe vicariously – through old National Geographics with illustrated Roman history timelines, middle school French classes, and used textbooks on Greek architecture.

I was thrilled to enter 9th grade, the first time that Latin was taught in our public school system. Four years of high school Latin later, as well as a course in classical mythology and one in general humanities, I had enormous respect for my teacher, David Larrick. "Doc" gave us the keys to Rome - Cicero, Caesar, and Catullus shared with me their intimate experiences in an Empire that was massive, socially-stratified, and rife with many of the same problems as our modern world. I continued my classical studies at the University of Virginia, with professors like John Miller and Mac Bell as the Vergils to my Dante. At all times, I carried with me a variety of textbooks on the art, architecture, archaeology, and history of the Graeco-Roman world. Although my tenure at UVa was focused primarily on the classical tradition, at least once a semester I would take a class that pushed me outside my comfort zone - Prehistoric Art, Old English, Linguistic Anthropology - with quirky professors whom I had no idea were so influential to the discipline, like Dell Hymes. Without the funds to travel to the classical world or to excavate there but with a great desire to uncover history beneath layers of soil, I enrolled in an archaeological field project at Thomas Jefferson’s Monticello and convinced Jim Deetz to sign off on an independent study at James Madison’s Montpelier.

At the back of my mind, though, were images of graves in the Greek and Roman archaeology books I had pored through as a kid. No one was studying the human skeletons found on classical archaeology digs; nowhere in the textbooks was anything reported about the biological remains of classical civilizations. In approaching graduate school, I realized there wasn’t a name for the sort of research I wanted to do: research that combined a deep understanding of human biology with the archaeological and historical context of ancient Rome and anthropological theories of culture. The main problem with combining these lines of evidence was that anthropology and classics are on opposite sides of a structural divide in the American academic tradition, particularly in regard to archaeology.

As a result of this major academic schism, I struggled to find a university at which I could pursue a course of graduate study that I had been steadily working towards for over a decade. East Carolina University offered me a fellowship to pursue an MA in anthropology, which I graciously accepted, in spite of feeling like an impostor with absolutely no background in the subject. But the freedom that I had at ECU to take courses I was interested in, like human anatomy and disease ecology, and to design my own research project made me realize the importance of an anthropological perspective on the past. Armed with this knowledge, I pursued an MA in classical archaeology at the University of North Carolina, in the hopes of one day being able just to study maps of the Kerameikos or epigrams on Roman columbaria. Thankfully, the archaeologists at UNC not only got along across departments but actively engaged in interdisciplinary research. Even better, between Nic Terrenato's connections in Roman archaeology and Dale Hutchinson's breadth of knowledge of the research potential of human skeletal remains, I managed to draw together skeletal biology, Roman archaeology, geochemistry, and cultural theory for my multidisciplinary dissertation research in pursuit of a PhD in anthropology at UNC.

Ribcage Heart
(shamelessly stolen from Sue Sheridan's Facebook profile,
but I think she got it from this website)

Biological anthropology – or, even more specifically, Roman bioarchaeology – describes perfectly the research questions that I'm interested in. I ended up in anthropology accidentally, but it is the only discipline that takes a biocultural perspective of humans from the deep past to the present. Anthropology finally gave me a name for what I do. Finding a place within an academic family and finding a term - however neologistic - for my research interests convinced me that what I do is real, what I do is important, and what I do is possible.

Dearest anthropology, it was definitely not love at first sight between us. But we kept running into one another and spending time together, so I got to know your strengths and your foibles. It took a while for us to get to where we are, but every morning I look forward to greeting the day with you.

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Blogs as Anthropological Outreach

In the winter 2011 (volume 34, number 4) edition of the Society for Archaeological Sciences Bulletin, Gordon Rakita, a bioarchaeologist at the University of North Florida, wrote a commentary on public outreach and blogging in bioarchaeology.  I'm just going to cut-and-paste it, since it's short and sweet, but you can get the entire volume here (PDF):

Of late, there have been several calls for anthropologists to reach out and engage the public. For example, Jerry Sabloff (2011), in his distinguished lecture at the American Anthropological Association's annual meetings, strongly urged us to actively speak and write to a public audience and develop mechanisms (at least within academia) to reward those who do so. In particular, he suggested (p. 414) that ―One of the most promising areas of outreach—and perhaps the launching pad of the future for public intellectuals in anthropology—is blogging. 

Sabloff is just one such prominent anthropologist to advocate for blogging. Likewise, paleoanthropologist and blogger himself, John Hawks (2010, 2011) has continued to advocate for anthropologists to reach out to the public through blogging or other forms of public discourse. 

Writing as I do from a public university in the state of Florida, I am keenly aware that the public and our elected officials often have a clouded understanding of the nature of our discipline and our contributions to society. Certainly we make such contributions, but we often fail to tout or otherwise advertise these contributions. As a result, we often have to play catch-up when others define who we are and what we do. In the wake of Florida Governor Scott's comments regarding anthropology, many rushed into the public debate to emphasize the scientific aspects of modern anthropology. None were more effective than the presentation developed by Charlotte Noble and other graduate students at the University of South Florida. 

But I can't help but wonder if this entire incident would have happened, or if such a response would have been necessary, had anthropologists been more active in communicating the value and knowledge of our field to the public. This is especially true for scientific archaeologists who both seek public funding and require public laws to preserve the cultural resources that we know are so important to our communities. For this reason, I want to highlight several blogs that are dedicated to bioarchaeology or bioarchaeology themes. 

These are the blogs I've tuned my RSS feed reader to:

• Powered by Osteons by Kristina Killgrove 
• Bones Don't Lie by Katy Meyers 
• These Bones of Mine by David Mennear

Each of these regularly discusses exciting new finds or developments within bioarchaeology. They help me keep up with the literature, make connections between disparate research threads, and (perhaps most importantly) remind me why I decided to be a bioarchaeologist in the first place.  

So if you're interested in the field of bioarchaeology, tune in, and don't drop out. And if you're not interested in bioarchaeology but some other aspect of scientific archaeology, then I guarantee there's probably a blog for it out there. If not, then why not start one yourself.

References Cited

• Hawks, John 2010 Public engagement | john hawks weblog.
• Hawks, John 2011 Blogs, academic discourse in economics | john hawks weblog.
• Sabloff, Jeremy A 2011 Where Have You Gone, Margaret Mead? Anthropology and Public Intellectuals. American Anthropologist 113, no. 3: 408-416.

So, Rakita points out that blogging is a valid and powerful method of public outreach, a way to tell people what it is anthropologists do.  He cites Jerry Sabloff, whose AAA keynote I covered on this blog a little over a year ago, as a prominent anthropologist who thinks blogs are awesome and who thinks that public outreach should be rewarded.  I'm quite honored to be included on Rakita's list, particularly as an example of what Sabloff was talking about.  It's always nice to be recognized by one's peers.

What's interesting about Rakita's list of bioarchaeology bloggers, though, is that not one of us has a tenure-track position.  Katy is a PhD student, David is working on his master's, and I have my PhD but haven't found a permanent position yet.  Don't get me wrong - there are some awesome job-having bio- and archaeo- bloggers out there like John Hawks, Kate Clancy, and Rosemary Joyce.  But many of the heavy-hitters in anthro outreach blogging, like Krystal D'Costa and the Savage Minds crew, are from various levels of academia as well as outside it.

The revolution in public outreach - particularly in bioarchaeology - seems to be coming from the Young Turks.  This is especially interesting, since we (Katy, David, and I, for example) aren't even required to engage in public outreach or in service activities like tenure-track faculty are. Still, there is a growing conversation about the place of blogs in CVs, cover letters, and promotion-and-tenure files, suggesting more of us are starting up blogs and using them as a way to... well, that remains an open question, one that we each answer at an individual level.

I blog because I find it rewarding - there's excitement in knowing that people who probably wouldn't touch my journal articles are reading about my work and about other developments in bioarchaeology; there's joy when I get emails from up-and-coming researchers, as young as middle schoolers, who want advice on how to make bioarchaeology a career; and there's the interaction with my readers that doesn't come across in the unidirectional, static medium of a publication.

Blogging is an exercise in writing for a different public, an exercise in taking all that jargon you learned in your coursework, distilling it, injecting your own ideas, and making it interesting.  Writing a blog has helped me refine my research and my prose, and I think that my public lectures and my successful grant proposals in particular have greatly benefited from the practice.  I always wish I had more time to blog.  There's just so much cool stuff out there to talk about, and so little time to write...

(Thanks to Katy Meyers for the heads-up on Rakita's article!)

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