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.

Maternal mental illness comes in all shapes and sizes

Pam Belluck of the New York Times published a two-part piece (see part 1, part 2) on the common and varied onset of maternal mental illness. The articles feature a compilation of stories that chillingly portrays the experience and perspective of mothers who encounter diverse manifestations of maternal perinatal depression: depression, anxiety, obsessive-compulsive disorder, and bipolar disorder. Of course, the prevalence of postpartum depression has been well-recognized: the effects of perinatal depression, or depression during the pregnancy or the first year postpartum, is “impressively common and can have devastating consequences” for women, children, and families. However, recent studies challenge the common understanding that symptoms present only in the weeks following delivery. Rather, researchers say that many women begin experiencing depression during pregnancy, and can develop throughout the first year postpartum:

Postpartum depression isn’t always postpartum. It isn’t even always depression. […] In the year after giving birth, studies suggest, at least one in eight and as many as one in five women develop symptoms of depression, anxiety, bipolar disorder, obsessive-compulsive disorder or a combination. In addition, predicting who might develop these illnesses is difficult, scientists say. While studies are revealing clues as to who is most vulnerable, there are often cases that appear to come out of nowhere.

Sometimes cases are mild, resolving themselves without treatment. But a large analysis of 30 studies estimated that about a fifth of women had an episode of depression in the year after giving birth, about half of them with serious symptoms.

Depression in pregnancy can be missed because symptoms like trouble sleeping and moodiness also occur in pregnant women who are not depressed. And doctors have historically been taught in medical school that “women don’t get depressed during pregnancy because they are happy,” said Dr. Katherine L. Wisner, a professor of psychiatry and obstetrics at Northwestern University.


Holding Hands With a Newborn Baby” by Bridget Coila is licensed under CC BY 2.0

The second NYT article focuses on the story of one mother, Cindy Wachenheim, who, despite repeated assurances from her doctors, became obsessed with the notion that she caused her son irrevocable brain damage. Read the whole story, it is worth it.

Experts say such breaks from reality are likely symptoms of postpartum psychosis, which affects only one or two in 1,000 mothers. About 4 percent of those hurt their children; about 5 percent kill themselves. Flagrant cases usually emerge soon after birth; women may hear voices or feel compelled to inflict harm, like Andrea Yates, who drowned her five children in a bathtub in 2001, or Dena Schlosser, who in 2004 cut off her infant’s arms. Both women were ultimately found not guilty by reason of insanity.

Most other maternal mood disorders do not involve such unshakably unrealistic convictions; most women know something is wrong, and although they fear they will harm their children, they rarely do.

Support for mothers experiencing perinatal depression can be found here, here, here, and here.


via NYT