A possible case of dystocia due to foetal macrosomia at Shuanghuaishu site (3500–2900 BCE), Henan, China

Abstract Childbirth was a significant factor in ancient female mortality, but relatively few cases of death in childbirth have been reported in the bioarchaeological literature due to challenges of recovery and interpretation. Here, we report a possible case of dystocia from the late Neolithic (3500–2900 BCE) settlement of Shuanghuaishu site (Gongyi City, Henan Province, China). An adult female skeleton was discovered in an inhumation burial with the remains of a foetus in the pelvis. The top of the foetal skull has exited the pelvic outlet, but most of the head remains in the pelvic cavity. The face is oriented away from the mother's spine, indicating that the foetus was in persistent occipitoposterior position. In modern deliveries, this atypical positioning is associated with complications including prolonged labour and excessive maternal bleeding. Long bone measurements indicate that the foetus was large compared with full‐term modern infants. This may indicate foetal macrosomia, which is also associated with prolonged and difficult labour. These indicators suggest that this was a case of dystocia, with the large size and positioning of the foetus leading to obstructed labour and the death of both mother and infant. The presence of some cranial remains outside the pelvic outlet could represent either partial delivery of the head or partial post mortem delivery (coffin birth). This paper provides an example of the interpretive challenges facing researchers investigating reproductive mortality in ancient China and in other past societies.