The dramatic image of a modern, motorized chainsaw being used in childbirth is a misunderstanding rooted in a historical reality involving a surgical tool. The powerful, gas-fueled chainsaws used for logging were never obstetric instruments. The myth originates from an earlier, hand-cranked surgical device that used a continuous, rotating chain with small cutting links. This instrument was developed for a specific procedure in complicated births, long before safe Cesarean sections became widely available.
The Myth Versus the Historical Tool
The surgical device that inspired this popular misconception was a specialized instrument called the osteotome, which translates literally to “bone cutter.” Bernhard Heine, a German orthopedic technician, is credited with inventing an advanced, hand-cranked version in 1830. This instrument was a significant advancement over crude methods previously used for cutting bone, such as the hammer and chisel.
Heine’s osteotome was a delicate, manually operated tool, far removed from the heavy, motorized chainsaws of the 20th century. It featured a chain with small, sharp cutting teeth that ran around a guiding blade, moved by turning a handle. This continuous, controlled movement allowed surgeons to cut through bone with precision, generating less impact and trauma than traditional saws.
The design enabled smooth, controlled bone cutting, which was particularly important in the era before modern anesthesia and antiseptic techniques. This mechanical advantage made it possible to perform intricate surgical procedures more quickly and with less splintering of the bone. The osteotome was essentially the first mechanical bone saw, and its core mechanism later inspired the development of the industrial chainsaws used for woodcutting.
Symphysiotomy and the Context of Its Use
The specialized bone-cutting tool was created to improve the performance of a life-saving procedure known as the symphysiotomy. This operation involved surgically widening the pelvis by cutting through the pubic symphysis, the cartilaginous joint connecting the two pubic bones. The goal was to temporarily enlarge the birth canal to allow a baby to pass through when the mother’s pelvis was too narrow (disproportion).
Before the widespread adoption of safe Cesarean sections, symphysiotomy was considered a less dangerous alternative when a baby was lodged. Earlier versions of the procedure, performed with conventional knives, were slow, painful, and carried a high risk of complications like infection and shock. The surgical chain instrument made the cutting process faster and more precise, reducing trauma and the duration of the operation.
The procedure was a last resort, primarily used to save the lives of both the mother and the child in cases of obstructed labor. In the 18th and 19th centuries, Cesarean sections carried an extremely high risk of maternal death due to infection and hemorrhage. Therefore, a symphysiotomy, despite its brutality and potential for long-term complications like impaired mobility and bladder injury, was often the preferred choice for difficult deliveries.
The Decline of the Procedure
The use of symphysiotomy began to decline significantly in developed nations during the early to mid-20th century. The refinement of surgical techniques, the introduction of antibiotics, and advancements in anesthesia dramatically improved the safety and success rate of the Cesarean section. Cesarean delivery soon became the preferred method for managing obstructed labor, offering a safer outcome for both mother and child than symphysiotomy.
By the 1940s, the lower-section Cesarean section was widely adopted as the standard of care in much of the developed world. Improvements in prenatal care also allowed doctors to identify potential pelvic issues earlier in the pregnancy, reducing the need for emergency interventions during labor. Consequently, the surgical osteotome—the “chainsaw” of the myth—was largely replaced by more modern, specialized bone saws and drills.
Despite its obsolescence in most countries, symphysiotomy continued to be practiced in some regions, most notably Ireland, until the 1980s. This persistence was often driven by a medical culture that sought to avoid Cesarean sections due to concerns about limiting a woman’s ability to have future large families. For the vast majority of the world, the symphysiotomy and the bone-cutting tool used to perform it ceased to be a standard obstetric practice by the mid-1900s.