First application of a puberty estimation method to skeletons of young pregnant females: A case for the reevaluation of maternal-fetal burials

The objective of this study was to evaluate the pubertal status of skeletons belonging to young females who died while pregnant to better understand puberty, the attainment of reproductive capacity, pregnancy, and maternal and fetal mortality in the past. A method to analyze pubertal development in osteological remains was applied to three skeletons of pregnant individuals from different medieval Spanish cemeteries. Pelvic measurements, stature estimates, and pathology studies were also employed. One pregnant individual, determined to have possibly been "at risk" for a complicated delivery, was found to be pubescent having died during the maturation phase of the pubertal growth spurt. Two Hispano-Muslim individuals were both postpubescent, although one had passed this milestone not long before death. This study is the first of its kind to apply puberty determination methodology to the skeletons of pregnant individuals and as such, was able to identify the skeleton of a pregnant, but still pubescent, girl in an archaeological collection. Delays observed in reaching the later pubertal stages prolonged puberty and could have enabled girls to become pregnant before having achieved complete maturity. The authors suggest that this skeleton is not one of a kind and believe it necessary to consider the reevaluation of maternal-fetal burials making use of pubertal status determination methods. In this way, puberty, the early reproductive stages, and motherhood in the past can be better understood.