Illustrated Forensic Case: When the Dead Give Birth: Postmortem Fetal Extrusion (“Coffin Birth”)

Background: Postmortem fetal extrusion, also known as “coffin birth,” is a rare phenomenon resulting from passive expulsion of a fetus during advanced maternal decomposition. Case Presentation: We report the case of a pregnant woman found in an advanced state of decomposition, with a macerated fetus expelled along with the placenta and umbilical cord. No vital obstetrical signs were identified: no active cervical dilation, no perineal or genital injuries, and no evidence of ante-mortem labor. The findings are consistent with passive postmortem fetal extrusion caused by putrefactive gas accumulation and tissue relaxation. The macerated fetus and intact placenta, combined with the absence of vital reactions, strongly support a postmortem mechanism. Conclusion: This case matches the classical descriptions of coffin birth reported in the literature. Distinguishing postmortem expulsion from ante-mortem delivery is crucial to avoid misinterpretation and wrongful suspicion of criminal intervention. This observation contributes to the limited contemporary documentation of this rare phenomenon.