G-section: How a Cork-born doctor delivered a baby gorilla by caesarean

Not many men can claim to have helped impregnate a gorilla or to have delivered a primate by caesarean section, but David Cahill’s CV is fairly unique, even in the radical world of fertility medicine.

G-section: How a Cork-born doctor delivered a baby gorilla by caesarean

So far, so bizarre, particularly as David’s background is one of delivering human babies and treating human couples for fertility problems.

A consultant obstetrician/gynaecologist, originally from Donoughmore, Co Cork, David’s involvement with the largest living primates goes back over a decade.

He studied medicine in University College Cork (UCC) and subsequently worked in the National Maternity Hospital in Dublin where he developed an interest in reproductive medicine, prompted by contact with Colm O’Herlihy, now Professor of Obstetrics and Gynaecology at University College Dublin (UCD) School of Medicine and Medical Science.

David subsequently went to Bristol in the 1990s to study and “never left”. He is now Professor in Reproductive Medicine and Medical Education at Bristol University. His day job takes him to St Michael’s University Hospital where his focus is on gynaecology, specifically fertility treatment.

His day job has also taken him to Bristol Zoo where he was centrally involved in an event which caught the public imagination: the delivery by C-section of a baby gorilla on account of concerns that its mother had pre-eclampsia. On February 10, that baby, named Afia, celebrated her second birthday.

So how does a doctor segue from babies to great apes?

“Vets don’t do IVF,” he says.

David’s involvement with Bristol Zoo goes back to 2004/2005 when the zoo’s efforts to get a gorilla pregnant were unsuccessful. Thinking outside the box, the zoo made contact with David because of his background in reproductive medicine.

“They knew I knew how to get people pregnant so they asked if I could help,” he says.

“It was a bit of a challenge.” It was “practically impossible” to do blood tests to measure the gorilla’s hormones, (try approaching a moody gorilla with a syringe) so they had to depend on urine samples. David still has deep sympathy for the zookeeper whose task it was to retrieve urine samples every day for three months.

“The enclosure was well-designed so that everything flowed into a hole in the middle and he was able to retrieve urine from that point,” David says. The samples were sent to a German laboratory for analysis. It emerged the gorilla, Salome, was not ovulating.

“So we gave her tablets to get her to ovulate, mixed in with her food, and she got pregnant,” David says. She gave birth to a son, Komale.

Afia enjoying her birthday celebrations, with surrogate mother Romina. It is expected Afia will remain with her until she is five.
Afia enjoying her birthday celebrations, with surrogate mother Romina. It is expected Afia will remain with her until she is five.

Having proved his usefulness, David was recalled two years ago when Kera the gorilla showed signs of pre-eclampsia while carrying Komale’s child. David estimates she was “38-39 weeks pregnant, but I can’t be certain, apes don’t have a last period and you can’t ask them”. He says the zoo was concerned about Kera and they got in touch with him on a Tuesday.

“We planned to go and scan the mother on the Friday. There was a chance we might end up delivering the baby. But when I scanned her, it looked like the baby was really in trouble,” he says.

The vets subsequently gave David the go-ahead to deliver, and Kera was taken by stretcher to a van and then to the vets’ working area. She was shaved, David put iodine on her tummy and donned sterile drapes.

So how different was it to delivering a human child?

“The whole thing was very strange and very weird. It was a very different environment and the smells were different. Kera vomited before the operation, a smelly green mess. And there were so many photographs being taken.

“It felt like it went on forever but my junior colleague (another doctor from St Michael’s) said it only took three-quarters of an hour.”

Was there a fear Kera would wake up during the operation?

“I was anxious. The zoo-keepers were holding her arms and feet and occasionally one would say ‘she’s twitching’. She’d clobber me if she woke up and saw the knife,” he says, laughing.

The surgery was trickier than a human delivery because of the different shape of the pelvis and uterus, but he managed it with minimal damage. The upshot was the birth of baby Afia, Ugandan for “born on a Friday”, and membership of an exclusive club of consultant obstetricians/gynaecologists to perform c-sections on gorillas.

“There are reports of 12-15 c-sections worldwide,” he says.

He is thankful he didn’t have to remove Kera’s stitches: “We thought about that — and put in subcuticular stitches — ones that are under the skin, and dissolve by themselves.”

He did undertake follow-up visits, but Kera was in a ‘bad place’ for nine months after the birth. In retrospect, David and the vets believe she may have been suffering from kidney disease, not pre-eclampsia. She was subsequently treated with steroids and recovered.

He did visit Afia once a week for a couple of weeks after the birth, and she was doing well. And he has since taken his two-year-old granddaughter to see Afia but hasn’t yet told her of his role in her existence.

The baby western lowland gorilla Afia, who celebrated her second birthday last Monday.
The baby western lowland gorilla Afia, who celebrated her second birthday last Monday.

Meanwhile, his brothers at home in Ireland, Paul, Declan and Kieran, and his Dad, Pat, are dining out on David’s walk into the gorilla hall of fame.

As for David?

“I really didn’t realise at the time that it was going to be such a big fuss, I was just doing the thing that I do. But in hindsight, it’s brought me into contact with a fairly small and fairly unique, global community of people dedicated to conservation of gorillas. It makes me feel part of that community. There are only 300 gorillas or so in captivity worldwide, so in that sense, what we did was a very big deal.”

More in this section