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Caul

Membrane covering the head and face of a newborn at birth


Membrane covering the head and face of a newborn at birth

A caul is a piece of membrane that can cover a newborn's head and face. Birth with a caul is rare, occurring in fewer than 1 in 80,000 births. The caul is harmless and is immediately removed by the attending parent, physician, or midwife upon birth of the child.

An en-caul birth is different from a caul birth in that the infant is born inside the entire amniotic sac (instead of just a portion of it). The sac balloons out at birth, with the amniotic fluid and child remaining inside the unbroken or partially broken membrane.

Types

A child 'born with the caul' has a portion of a birth membrane remaining on the head. There are two types of caul membranes, the first type of membrane is the inner layer called the amnion which is the amniotic sac that contains the fetus and the amniotic fluid; the second membrane is the chorion and is the outermost membrane around the fetus, it contains a complex series of blood vessels that are connected to the endometrium, which together with the chorion forms the placenta, the primary organ responsible for supplying the fetus with oxygen, nutrients and extracting waste.

The most common caul type is a piece of the thin translucent inner lining of the amnion that breaks away and forms tightly against the head during birth. Such a caul typically clings to the head and face but on rarer occasions drapes over the head and partly down the torso.

Removal

The caul is harmless and is immediately removed by the attending parent, physician, or midwife upon birth of the child. If the membrane is of the amniotic tissue, it is removed by easily slipping it away from the child's skin. The removal of the thicker membrane is more complex. First, the attending practitioner will make a small incision in the membrane across the nostrils so that the child can breathe. The loops are then carefully removed from behind the ears. The remainder of the caul is then either peeled back very carefully from the skin or else gently rubbed with a sheet of paper, which is then peeled away. If removed too quickly, the caul can leave wounds on the infant's flesh at the attachment points, which might leave permanent scars.

Epidemiology

Birth with a caul is rare, occurring in fewer than 1 in 80,000 births. This statistic includes en-caul births, which occur more frequently than authentic caul births; therefore, authentic caul births are even more rare than indicated by the raw statistic. Most en-caul births are premature. Research in the 2020s has shown that surgical techniques during cesarean deliveries of severely premature infants that focus on delivering the infant with the caul intact can potentially increase the baby's chances of survival, as it protects the underdeveloped fetus from being harmed by the muscle contractions of the uterus, and from the doctors and nurses accidentally harming the fetus while removing it from the uterus.

Folk traditions

According to the unreliable Historia Augusta, the boy-emperor Diadumenian (208–218) was so named because he was born with a diadem formed by a rolled caul.

In medieval times, the appearance of a caul on a newborn baby was seen as a sign of good luck. It was considered an omen that the child was destined for greatness. Gathering the caul onto paper was considered an important tradition of childbirth: the midwife would rub a sheet of paper across the baby's head and face, pressing the material of the caul onto the paper. The caul would then be presented to the mother, to be kept as an heirloom. Some Early Modern European traditions linked caul birth to the ability to defend fertility and the harvest against the forces of evil, particularly witches and sorcerers.

Folklore developed suggesting that possession of a baby's caul would bring its bearer good luck and protect that person from death by drowning. Cauls were therefore highly prized by sailors. Medieval women often sold them to sailors for large sums of money; a caul was regarded as a valuable talisman.

In Polish the idiom w czepku urodzony/a , in Italian nato/a con la camicia and in French né(e) coiffé(e) all describe a person who is always very lucky.

The Russian phrase родился в рубашке (rodilsya v rubashke ) refers to caul birth and means . It is often applied to someone who is oblivious to an impending disaster that is avoided only through luck, as if the birth caul persists as supernatural armor, and in this sense commonly appears in titles or descriptions of Russian dashcam videos.

Not all cultural beliefs about cauls are positive. In Romanian folklore babies born with a caul are said to become strigoi upon death. It was also believed that "he who is born to be hanged will never drown", i.e. that anyone born with a caul was destined to leave the world in a hangman's hood in place of the caul with which they were born. The belief in cauls as omens persisted well into the 20th century.

The 16th-century Dutch physician Levinus Lemnius, author of The Secret Miracles of Nature, remained skeptical of superstitious claims about preserved cauls. 19th-century comic writer Thomas Hood even ended his poem "The Sea-Spell" with a lament about a drowning sailor's futile reliance on a protection charm: Heaven never heard his cry, Nor did the ocean heed his caul.

Notable people born "in the caul"

  • Barbara Barondess (1907–2000), American actress
  • Edwin Booth (1833–1893), American actor
  • Lord Byron
  • Charles XII of Sweden
  • Gabriele d'Annunzio
  • Andrew Jackson Davis
  • J. G. Farrell, novelist
  • George Formby, English comedian
  • Sigmund Freud
  • Johnny Giles
  • Lillian Gish
  • Charles Haughey, Taoiseach na hÉireann (Prime Minister of Ireland)
  • James VI, King of Scotland and England
  • Liberace
  • Edna St. Vincent Millay
  • Abraham Ribicoff
  • Jonas Salk
  • Cora L. V. Scott (1840 – 1923), American medium
  • Lee Shelton (disputed)
  • Joseph Smith
  • Nancy Wake
  • Kim Woodburn

Notes

References

References

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  2. (2018-04-30). "Extremely Preterm (23 Weeks) Vaginal Cephalic Delivery En Caul and Subsequent Postpartum Intraventricular Hemorrhage and Respiratory Distress: A Teaching Case". Case Reports in Obstetrics and Gynecology.
  3. (23 April 2025). "En Caul Birth: What Is It?". WebMD LLC.
  4. (10 October 2016). "Caul". Encyclopedia Britannica.
  5. (16 November 2018). "Amnion". Encyclopedia Britannica.
  6. (20 July 1998). "Chorion". Encyclopedia Britannica.
  7. (June 1953). "The Social History of the Caul". The Yale Journal of Biology and Medicine.
  8. (2018). "Extremely Preterm (23 Weeks) Vaginal Cephalic Delivery En Caul and Subsequent Postpartum Intraventricular Hemorrhage and Respiratory Distress: A Teaching Case". Case Reports in Obstetrics and Gynecology.
  9. (26 December 2024). "En Caul Cesarean Delivery—A Safer Way to Deliver a Premature Newborn? Narrative Review". Journal of Clinical Medicine.
  10. (February 2022). "Benefits of the «en caul» technique for extremely preterm breech vaginal delivery". Journal of Gynecology Obstetrics and Human Reproduction.
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  21. Giblin, James. (2005). "Good brother, bad brother: The story of Edwin Booth and John Wilkes Booth". Clarion Books.
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  31. Tolchin, Martin. (July 30, 1974). "Ribicoff's Charmed Life: From Poverty to Power". The New York Times.
  32. Jacobs, Charlotte DeCroes. "Dr. Jonas Salk, the Knight in a White Lab Coat: An Interview".
  33. (August 8, 2011). "Nancy Wake dead, aged 98. Extract by Peter Fitzsimons".
  34. (2002). "Nancy Wake: A Biography of Our Greatest War Heroine". HarperCollins Publishers Australia.
  35. Woodburn, Kim. (7 September 2006). "Unbeaten: The Story of My Brutal Childhood". Hodder & Stoughton Ltd..
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