Thursday, December 5, 2013

History of Midwifery in Roman Times

I love reading about the history of midwifery and the role of the midwife in caring for the woman. This article will appeal to midwives and students alike and those who are interested in the history of midwifery. 

Giving birth in the twenty-first century remains potentially hazardous. For Roman women it could be positively deadly. According to Suzanne Dixon, the mortality rates during childbirth slashed young women’s life expectancy compared to their male contemporaries, with female prospects of longevity only increased once they left their fertile years behind them.
Evidence from tombstones confirms this view, with female mortality greatest between ages 15-29, as in the case of Rusticeia Matrona of Mauretania whose husband dedicated the following inscription:
Sacred to the gods of the dead. Rusticeia Matrona lived 25 years. The cause of my death was childbirth and a malignant fate.’ (Inscription from Ain Kebira, cited in Leftkowitz and Fant)
As a result, expectant Roman mothers did everything they could to ensure their deliveries were safe. This ranged from petitioning the gods to more practical ways of ensuring a safe birth for both mother and child.

Roman Gods of Childbirth

Romans summoned a variety of gods to attend upon and aid at births, according to Tertullian. The obscure Diespiter rather vaguely helped as the ‘child accomplishes its birth’ while the goddess Postverta had a more definite role. Tertullian described her as the goddess of breech births. In contrast, Ovid and ancient religion expert George Dumezil both believe Postverta  was actually a fate overseeing the new human life.
Di Nixi, or Nixae, served as the central Roman birth deities. Chief among them was Lucina, an aspect of the goddess Juno who brought the ‘child to the birth and light of day,’ according to Tertullian.  ‘Thanks to you, Lucina!’ praised the poet Ovid in his Fasti. ‘You are named from lucus, ‘grove,’/ Or because you begin life’s lux, its light./ Show Mercy, I ask, kind Lucina, to pregnant girls,/ And gently extract the womb’s ripe burden.’
Women called upon Lucina to aid an easy birth. One of the customs surrounding this goddess was for everything from clothing to the unbinding of hair, as Romans believed knots would inhibit the passage of the child. Even a crossed leg or interlocked finger could dangerously delay a birth. This custom applied not only to the labouring mother but any attendants around her.
Likewise, Dumezil notes that no one entering the temple of Juno Lucina on the Esquiline Hill could have a knot in his or her clothing. It was customary for new parents to visit this sacred spot after a successful birth to deposit a coin into the temple treasury representing the new child.

Juno Lucina was the goddess Juno in her birth goddess guise. In archaic times, it was believed essential to have her favour during childbirth.
Juno Lucina was the goddess Juno in her birth goddess guise. In archaic times, Romans believed her favor was essential during childbirth.

Choosing a Midwife

Doctors such as Soranus may have written about the theories of gynecology. But it was female midwives who attended the birth, supported the mother and ultimately brought a child into the world.
We have no records of birthing techniques written by Roman midwives but Soranus gives us a glimpse into the qualities of the best of them. Ironically, despite the lack of written evidence from their point of view, the doctor believed that a competent midwife was able to read in order to ‘comprehend the art through theory too.’
Soranus’s ideal midwife was sober, discreet and motivated by professional pride rather than financial gain. And despite the plethora of comforting birthing deities available, Soranus also stipulated a midwife should not be reliant on ‘superstition.’ Hygiene was essential and midwives needed  ‘[l]ong and slim fingers with short nails,’ in order to touch ‘deep-lying inflammation without causing too much pain.’

Giving Birth the Roman Way

Soranus recommended a total of three midwives attend a birthing mother: one in charge and two to assist. Essential equipment for the birthing room included: ‘oil for injections and cleansing, hot water…. hot compresses to relieve the labor pains, sponges for sponging off, wool for covering the woman’s body and bandages to swaddle the baby in, a pillow so that the infant may be placed on it below the mother until the afterbirth has been taken away.’
Herbs were also a stock item during childbirth.  Donald Todman records how laboring mothers could be offered a less than appetizing drink consisting of powered sows dung to help manage their labor pains. Soranus’s recommendations were altogether more pleasant and he prescribed: ‘scents such as pennyroyal, sparganium, barley groats and quince and if in season citron or melon….for the recovery of strength.‘
The birthing room was also equipped with two beds.  They were not for the delivery. One, a hard couch, was for lying down between labor pains. The other, made up with soft coverings, was for recovery after the birth. The actual process of birth took place on a birthing stool equipped with a bar at the front for the mother to grip and a crescent-shaped hole cut in the seat to allow the baby to pass through as it was born.
During the process of birth, the main midwife crouched down in front of the mother to supervise the birth while the two assistants stood behind her, supporting her and massaging the belly downwards as necessary to help ease the passage of the child. From this position, the chief midwife would ease or manipulate the child into the world.

Birthing stools were commonly used across the ancient world.
Birthing stools were commonly used across the ancient world. Image by Ad Meskens.

After the Birth

Just as they are today, no visible deformities and a strong pair of lungs were the most obvious signs that a child was fit and healthy. But whereas modern babies receive baths of water or in some cases just get gently wiped down, Soranus recommended cleaning the newborn in salt and honey and bathing its eyes in olive oil to strengthen its eyesight!
Despite limited medical knowledge, the Romans recognized the importance of removing the placenta from the body.  Soranus observed how a retained placenta ‘produces pain in the head and lower abdomen and convulsions or suffocation.’ If the placenta did not evacuate itself naturally, it was for the midwife to remove it by inserting her hand and  gently manipulate it out before the uterus closed.
Even with such care, dangerous postnatal complications could occur. But given the times, the Roman mother had a good chance of surviving childbirth.

Pregnancy and Childbirth Remained Dangerous in Ancient Rome

In spite of the Romans’ attention to careful preparation and following rituals, childbirth remained dangerous. Both mother and child could suffer, but midwives worked hard to reduce the risk.


Dixon, S. The Roman Mother. (1988) Oklahoma University Press: Norman, Oklahoma.
Dumezil, G. Archaic Roman Religion, Volumes 1 and 2. (1996) John Hopkins University Press: Baltimore and London.
Leftkowitz, M R and Fant, M B. Women’s Life in Greece and Rome. (1995). Duckworth: London.
Ovid, translated by A J Boyle and R D Woodard. Fasti. Penguin Books: London.
Ovid, translated by D Raeburn and D Feeney. Metamorphosis. Penguin Books: London.
Translated by Owsei Temkin. Soranus, Gynecology. (1991). The John Hopkins University Press: Baltimore and London.
Tertullian, translated by Q. Howe. Ad Nationes 1. (2007). Faulkner University. Accessed November 22, 2013.
Donald Todman. Childbirth in ancient Rome: from tradition folklore to obstetrics. (2007). Australian & New Zealand Journal of Obstetrics and Gynecology.

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