Pregnancy How-to’s from the Middle Ages: Dung Diapers, Barley, and Rabbit’s Blood Cocktails

Get Me Out, by Randi Hutter Epstein, MD, is an insightful history of childbirth exploring the evolution of advice and wisdom in childbirth. The book presents the lineage of childbirth, and helps contextualize the current state of obstetrics. Thomas Forbes once said that the history of obstetrics is “in large part a history of superstition.” Childbirth, then and now, is a “wonderful blend of custom and science.” Perhaps because of the time and space between current day and the Middle Ages, I found Get Me Out‘s chapters on medieval childbirth advice to be, at the very least, captivating. Thus, today we’ll explore advice surrounding birth in the early years in our history: the Medieval Period.

15 pieces of advice for childbirth during the Medieval Period

394px-Eucharius_Rößlin_Rosgarten_Childbirth1. Birth Control: According to the Greek physician, Soranus, who authored the leading text on gynecology for over a thousand years: you could have sex without conceiving if, after your partner ejaculates inside of you, you hold your breath, squeeze forcefully, and then drink ice-cold water. If that fails to work, try the Hippocrates’ abortion method: jump and kick your heels to your bum until the seed simply drops out of you.

2. Looking to get pregnant? France’s 16th century Catherine de Medici had the money and hutzpah to seek out all kids of advice and treatment to get pregnant. After ten years of marriage to the king, she had produced no heir. Her healer told her to drink mare’s urine and to soak her “source of life” (I presume this means her vagina) in a sack of cow manure mixed with ground stag’s antlers. Her husband was never sexually attracted to his wife – no doubt the dung diaper hindered his attraction further. The King was eventually diagnosed with physically defective reproductive organs (aka hypospadias), and recommended specific sexual positions for reproduction. Catherine, so the story goes, had her carpenter drill a hole into the floor to observe her husband having sex with mistress – for educational purposes. Maybe this did the trick, because she went on to have nine children.

3. How conception works: According to Aristotle, a man’s seed shaped menstrual blood into an embryo. Doctors later reconsidered that during pregnancy, menstrual blood flowed upwards and turned into breast milk. In this vein, men produced the life source of what became human. Women were “mere baby-making vessels.” As one sixteenth-century expert eloquently put it, the vagina was an “antechamber to lodge a Man’s Yard.

4. Penis size and getting pregnant: According to Jane Short, a British midwife in the seventeenth century, penis size affects fertility. Too big is just as bad as too small. If the penis is too big (longer than 11 inches), it sprays the womb with seed, thereby rendering conception incredibly difficult. A penis too short (shorter than 1 inch) would not touch the opening of the womb, so male and female seeds would never mix. In cases with an average-sized penis (greater than 1″, smaller than 11″), the vagina acts like spandex. It stretches and shrinks to suit the partner. Or, according to the experts: “the vagina would dilate, contract, extend or abbreviate itself according as it is necessary to bear exact proportion with the bigness or length of the man’s yard.” The clitoris was considered the female equivalent of the penis. Doctors worried about the size of the clitoris – not for fertility – but because women with oversized clitorises were prone to lesbianism.

5. Virginal Conception: According to the monks who wrote Woman’s Secrets, the vagina had powers that lured sperm into it, even without penetration. This explains how virgins become pregnant. The “vagina sucks up sperm like a vacuum”, so a woman could become pregnant if she bathed in a tub where there a man has ejaculated – this “has been attested to by experience.” Woman’s Secrets goes on to assert that, “along the same lines, if a cat ejaculated on sage and then a man ate the sperm-tainted herb, he would grow a cat in his stomach and vomit it out.” So, there’s that.

6. Home pregnancy tests: here’s a do-it-yourself method suggested by Soranus. Women should pee on a bouquet of barley, wheat, dates, and sand. If barley sprouted, you were pregnant. If wheat grew, it’s a boy; if barley, a girl.

7. If you wanted a happy baby, pregnant women were instructed to think happy thoughts. Don’t stare at ugly things, because you’ll get an ugly baby.

8. Most men and women believed that childbirth is a heavenly duty, and women deserved painful labor. This view, of course, stems from the story of Eve. Enticed by that proverbial apple, Eve was cursed with the excruciating pain of childbirth. In 1591, Eufame Maclayne was burned at the stake for asking for pain relief during the birth of her twins.

Sixteenth-century illustrations of fetuses in the womb by Eucharius Rösslin

Sixteenth-century illustrations of fetuses in the womb by Eucharius Rösslin

9. Sex: Sex in moderation is key to successful babymaking. Women were told to have “enough” sex because a “splash of sperm moistens the womb,” but not to have too much sex because “it wears out the baby-making machinery.” Perhaps this is why “whores have so seldom children”: because “satiety gluts that womb.” Too much sex during pregnancy was considered dangerous to the growing fetus, as it drained the vital juices that should flow to the baby. Too much intercourse created children who were “defective in vital and other qualities, ill tempered, sickly, and short-lived.” Smart parents = smart babies, but only if parents didn’t have too much sex. Too little or too much sex would produce smart little ones, but they would die before the age of 10. Too bad nobody ever defined what a moderate amount of sex was.

10. Women have to enjoy sex to get pregnant: Babies are born as a result of a woman’s “voluptuous itch” to copulate. When a woman is in the mood for sex, her womb opens and allows the male seed to enter, which facilitates baby making. Pleasure in sex is explained by four “carruncles” (bumps?) lining the opening of the womb that close more pleasantly around the Man’s Yard, so that the woman is also more delighted. But, if you’re enjoying it, your womb stays closed.

11. If you look at the moon, your child would become either a lunatic or a sleepwalker.

12. Hoping for a baby boy? One guidebook suggests his and hers cocktails to up the odds of having a boy”: red wine tainted with pulverized rabbit’s womb for him; red wine with desiccated rabbit’s testicles for her.” Yes, this seems weird. But when you consider the numerous hormones we shoot ourselves up with today, perhaps dried testicles isn’t as strange as it seems.

13. Bowels: Constipation suffocates the fetus, while diarrhea washes it away. Also from the texts of Soranus, women with chronic bowel issues would never be able to “lay hold of the seed injected into them.”

14. Birth through the Middle Ages was for women only: It was considered obscene for a man to be in the delivery room. While they wrote guidebooks and issued advice, their wisdom drew from “a man-made concoction of myth, herbs, astrology, and superstition.” In 1522, a German doctor – Dr. Wert – was sentenced to death when he was caught dressed up as a woman and sneaking into the delivery room.

15. Forceps: the best kept secret of the 1600’s: The Chamberlen family came to England from France in the 1500s with forceps. Forceps, a medical instrument used to extract babies, were kept secret for over 200 years to preserve steady work and financial success. Nobody saw their instrument, not even the doctors’ closest friends or relatives, not even the women who were receiving their services. Forceps transformed birth from a natural, social event attended by a female midwife to a medical event attended by men. Pre-forceps, midwives would use oils and herbs for the perineum and a birthing stool that allowed gravity to help the baby move down. Post-forceps, doctors didn’t like to use stools, and preferred the patient lying in bed where they could use their tools with ease. Of course, “forceps isn’t the only explanation for why everything changed, but they certainly opened the door for other birthing gadgets.

Randi Hutter Epstein‘s book Get Me Out is not an advice book. Her depiction of the history of childbirth encourages readers to be inquisitive in their health decisions, and portrays the field gynecology as a marriage of medicine and culture.

Read it, and then come talk to me about it.

Doulas Look for Greater Acceptance in Maternal Healthcare System

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Marisa Pizarro’s birth, as described by Anemona Hartocollis of the New York Times, starts out on a busy day in her apartment in Lower Manhattan’s financial district. As Marisa labored alongside her doula, her contractions 10 minutes apart, her husband (a music producer) was able to work on an upcoming release, tend to their young daughter, and catch up on the news on his iPad. With the presence of their doula, Marisa labored until it was time to go to the hospital.

The story of Marisa’s birth highlights the role of doulas in the United States:

Doulas are a growing force in the ever-changing culture of maternity, at once a manifestation of the growing demand for personal service (the doorman, the yoga teacher, Amazon Prime) and a backlash against the perceived overmedicalization of birth, with its high rates of cesarean sections.

Medical professionals can express resistance to doulas, and there is no insurance reimbursement for birth doula services. Despite the growing demand of doulas, they are a small part of the system of maternal healthcare. A recent report estimated that “there are as many as 400 doulas working in New York City who attend about 5,600 births a year, or about 5 percent of all births.”

doula (an antiquated Greek word for a female servant) offers support that complements the support from other birth partners (if others are involved). For many women, the support from their doula is

less-fraught emotional support than do sisters, mothers or husbands. They offer tactics to help women manage the pain of labor, as Lamaze breathing classes did to a previous generation. They are familiar faces and patient advocates in a situation where the patient may be meeting the nurses or the obstetrician on call for the first time during the birth. They also consult on prenatal subjects like nutrition and postpartum challenges like breast-feeding.

“We’re not there to change what the parents get,” said Adele Loux-Turner, a doula based in Brooklyn. “We’re there to help get what they want. If there’s a conversation to be had, we do and can let it be known that we’re there to kind of eliminate the hidden menu items.”

Some providers recognize how doulas support mothers in an otherwise impersonal hospital setting. They may recommend doulas, or – at the very least – feel obliged to allow them to honor their presence at the labor. Other providers work closely alongside doulas, and some hospital programs offer volunteer doula services.

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Doulas continue to seek out more recognition from insurance companies, but “insurance coverage is still rare, according to Choices in Childbirth, a maternal advocacy group that released a report promoting doula care last year.”

“Having a baby in New York City is a very lonely thing,” Dr. Jacques Moritz, an obstetrician at Mount Sinai Roosevelt hospital in Manhattan, said.

Yet the benefits of doula care are significant.

In New York, the By My Side Birth Support Program, which has provided free doula services to more than 400 low-income women in Brooklyn, has found that doulas led to a “definite improvement” in breast-feeding, but only a slight reduction in C-sections, perhaps because doulas could not influence hospital policy, said Mary-Powel Thomas, director of the program, a federal and city partnership.

According to Dr. Jacques Moritz, an obstetrician at Mount Sinai Roosevelt hospital in Manhattan, “a doula is like a personal trainer. Not that you can’t do it yourself; it’s just nicer if you have a personal coach for it.” 

For more information about the role of a birth doula, the growing interest in having doula support in labor, and the current state of recognition of doula care, you can read the entire article here, or check out an earlier post discussing the role of a doula.