Conception and Childbirth

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Conception and Childbirth

Fertility. The true purpose of marriage was procreation; in the Classical Period, it was to produce male offspring who would later fight on behalf of the city-state and participate in its governance. In fact, the birth of offspring was considered a right of Athenian wives; the law made it mandatory for the husband of an heiress to consort with her three times a month. Because of the importance of legitimate heirs to the household and the city, female fertility and childbirth were of great concern to the ancient Greeks. Women turned to female deities such as Hera, Artemis, and Eileithuia, the goddess of childbirth, to assist in conception and childbirth. A couple suffering from infertility might consult Apollo’s oracle at Delphi to find a remedy, as did the mythical Athenian king Aegeus, the father of Theseus, or make offerings to the gods. Fertility festivals such as those in honor of the agricultural goddess Demeter ensured women’s reproductive power. In labor and delivery women relied on female family members, neighbors, and midwives for help; male doctors were summoned only for the most difficult cases.

Medical Views. By the Classical Period the new science of medicine addressed concerns about female reproduction and attempted to construct theories of the female body. Many of these theories resulted from speculation rather than scientific observation, partly because dissection of the human body did not occur until the Hellenistic Period. The fact that male doctors normally did not assist women in labor meant that their knowledge of the female body and childbirth was necessarily limited and came mostly from women themselves and their midwives. The writers of the Hippocratic texts therefore put great stock in women’s perceptions of their own bodies:

You cannot disregard what women say about child-bearing. For they are talking about what they know and always inquiring about; they could not be persuaded either by deed or word that they do not know rather more [than you do] about what is happening in their own bodies.

Menstruation. The ancient Greeks viewed the female body as more porous and spongelike in order to explain the process of menstruation. According to Aristotle, a woman’s body draws in moisture, converts it to blood, and then expels it during menstruation. If a woman conceives, this blood goes to nourishing the fetus. Male bodies, by contrast, are only porous in the necessary places, such as the glands. The medical writers also represent the female body as soft because of a life of inactivity indoors, and as cold and wet, in contrast to the dry heat of the male body. Indeed, Aristotle makes a biological argument for the superiority of men by developing a theory of heat in the human body. He thought men’s bodies generated more heat and therefore were capable of concocting the procreative fluid, semen, while women, because colder, could only produce menstrual fluid. Semen has greater value, in Aristotle’s view, because it passes the man’s form on to another generation. By this reasoning, Aristotle comes to the conclusion that a woman is inferior to a man:

A boy actually resembles a woman in physique, and a woman is, as it were an infertile male; the female, in fact, is female on account of inability of a sort, viz. it lacks the power to concoct the semen out of the final state of the nourishment.

Nonetheless, Aristotle maintains that both men and women produce seeds that mingle to produce a child, with women ejaculating seed into their own wombs. This view represents an improvement over one found earlier in Greek tragedy that says the female contributes nothing to the conception of a child:

The mother is no parent of that which is called her child, but only nurse of the new-planted seed that grows. The parent is he who mounts. A stranger, she preserves the stranger’s seed, if no god interfere. I will show you proof of what I have explained. There can be a father without any mother. There she stands, the living witness, daughter of Olympian Zeus, she who was never fostered in the dark of the womb yet such a child as no goddess could bring to birth.

Here the god Apollo argues that the mother’s body serves merely as a vessel or container that nurtures the fetus, while the father provides all of the genetic material. He cites as an example the goddess Athena, who, because

she was born from the head of her father, inherits absolutely no genetic material from her mother. By repeating the word stranger, the god further de-emphasizes the blood tie between mother and fetus. Apollo makes this argument because he wishes to defend Orestes against the charge of matricide by showing that his crime is less heinous than that of his mother.

Productive Process. Many ancient medical theories attempt to account for problems in menstruation. In contrast to other ancient cultures, such as the Judaic tradition represented by Leviticus in the Hebrew Bible, the Greeks did not view menstruation as a form of pollution, although they did consider sexual intercourse, childbirth, and contact with the dead to be polluting. The medical writers portray menstruation as productive of health: an absence of menstruation in a nonpregnant woman was thought to produce clots that could travel outside the womb and block other parts of the body, even bringing about hysteria and suicide in teenage girls:

The girls try to choke themselves because of the pressure on their hearts; their will, distraught and anguished because of the bad condition of the blood, forces evil on itself. In some cases the girl says dreadful things: [the visions] order her to jump up and throw herself into wells and drown, as if this were good for her and served some useful purpose.

The corpus also mentions two case studies of older women who apparently rambled and uttered obscenities as a result of amenorrhea.

Wandering Womb. One ancient conception of the female body strikes modern readers as particularly strange. The Greeks considered the uterus to be almost a thinking creature with a mind of its own, “an animal within an animal,” as one ancient doctor called it. It could “wander” and easily dislocate itself and respond to smells. One philosophical text from the Classical Period provides another example:

[Women] have an animal within them eager for conception, which whenever it goes without issue for a long time beyond its proper season, becomes angry and miserable, and wanders everywhere around the body, blocks the outlets for air and prevents respiration, causing extreme helplessness and bringing on all sorts of other diseases.

This image of the uterus as an animal traveling around the body reinforces the stereotype of women as out of control, irrational, and sexually precocious. The medical writers thought that the uterus, because of its tendency to wander, needed to be anchored down by pregnancy or kept moist by sexual intercourse; otherwise, it would become dry and attracted to the moister organs. For this reason, females not regularly having intercourse were considered susceptible to displacement of the womb. Some remedies for drawing the uterus back to its proper place included “odor” therapies in which foul-smelling vapors were applied to nostrils, on the belief that the nostrils and vagina were connected by a long hollow tube.

Labor and Delivery. Medical treatises also discuss labor and delivery, another important aspect of women’s reproductive health. Because the ancients did not understand that the uterus is a powerful muscle rather than a simple container, they explained the onset of labor as a result of fetal movements tearing the membranes (not until the first dissection had been performed did this view change). A prolonged or nonprogressing labor was thought to indicate a breech birth, multiple birth, or stillbirth. Remedies included vigorous shaking (also prescribed for abortion), drugs to facilitate labor, and, as a last resort, embryotomy, a procedure in which instruments extracted the stillborn fetus. Ancient medical practitioners did not perform caesarian sections, a procedure a woman probably would not have survived, given the state of medical knowledge and the lack of sterile conditions.

Midwives. When it came time for delivery, ancient doctors recommended that women deliver their babies on a birthing chair, or on a hard bed if the woman was weak. Midwives advised their patients to use controlled patterns of breathing to alleviate pain, much like the modern-day practice of Lamaze. Sometimes birth attendants passed strong-smelling titems under the woman’s nostrils and applied warm cloths to her abdomen to make her more comfortable. After the baby was born, the midwife signaled whether it was male or female, then placed it on the ground to assess whether it was healthy enough to survive. Finally, she judged when to cut and tie the umbilical cord, cleaned and swaddled the baby, and put it to bed. Given the dangers of childbirth in antiquity, it is not surprising to find that maternal mortality was high. Women may have died from exhaustion and hemorrhage during difficult deliveries, especially if they were in poor health or young, as many Greek mothers were, or from diseases induced by pregnancy, such as eclampsia. Because of these dangers, the average life expectancy for adult women was around age thirty-five.

Social Ideology. Many of the Greek medical writings on women simply reinforced social ideology. The importance placed on pregnancy as a healthy and natural state supports the social practice of the early marriage of girls. Indeed, the remedy for most female ailments is to conceive a child. Medical theory also corroborates the idea that women needed the guardianship of men because their physiology predisposes them to irrationality and even insanity. Similarly, theories of the wandering womb represent the female body as lacking regulation, out of control and unpredictable, and in need of guidance.

Birth Control and Infanticide. Both men and women in ancient Greece longed for children in marriage, but economic concerns often forced them to limit the size of their families. Infant mortality was high in ancient Greece, and the precariousness of life for a newborn child naturally reduced family size. However, if an unwanted child was born, a Greek might abandon it in a remote spot. The most likely candidates for exposure were the offspring of illicit unions between slaves or from prostitutes, or those with physical infirmities that might affect their ability to contribute to the family estate. There is some evidence that the Greeks were more likely to expose female babies, for whom the added expense of a dowry might make them particularly burdensome for a poor family.

SIGMUND FREUD AND HYSTERIA

Ancient Greek beliefs about the wandering womb and the psychological problems it engendered have parallels in late-nineteenth-century views of hysteria; Sigmund Freud’s work with Jean-Martin Charcot in Paris led to his first full-length study of the subject in a book co-authored with Josef Breuer, Studies in Hysteria (1895). This book attempted to understand the cause of a set of symptoms found in young women that included various physical pains with no apparent cause, such as a choking sensation (also mentioned in the ancient sources). At first Freud looked for a physiological basis for the illness and performed a famous, almost fatal, operation on Emma Eckstein, under the misguided belief that surgery on her nose would cure her hysteria. He later abandoned this approach and turned instead to exploring the underlying psychological causes of this condition. Freud postulated that hysteria resulted from the repression or blocking of traumatic memories; these repressed memories slipped out or made themselves known through bodily symptoms. Freud’s work on hysteria hailed a new era in medicine and inaugurated the new discipline of psychiatry and psychotherapy.

Source: Peter Gay, Freud: A Life for Our Time (New York: Norton, 1988).

Economic Considerations. Normally, the first two children of a marriage would not have been exposed, if they were born healthy, whatever their gender. Beyond the first two children, the economic resources of a given family dictated whether or not to rear additional children. The decision whether to raise or abandon a child resided strictly with the father, except in Sparta, where a tribunal of elders had the final say. The law-court speeches from the Classical Period suggest that the average Athenian family might have had five children, although it is unclear how many siblings may have died in childhood, especially since infant mortality was high. Abandoned male children may have been rescued and raised as the adopted heirs of a childless couple, a practice illustrated by the myth of Oedipus. According to the story, a prophecy foretold that Oedipus was destined to kill his father and marry his mother; his father, the King of Thebes, therefore ordered that the child be left to die on a mountainside. A shepherd took pity on him and brought him to Corinth, where another set of parents reared him. Once he had heard the prophecy, Oedipus fled from Corinth, where he thought his birth parents resided, and, through a sequence of complicated events, unwittingly killed his birth father and married his birth mother. The extent to which the Athenians practiced infanticide is still a source of debate, and possibly they turned to this option only as a last resort. No doubt the babies born of slaves or prostitutes and the products of rape or adultery would have been regularly exposed.

Other Techniques. There were also other means of limiting family size. In the days before reliable infertility treatments became available, natural sterility must have played a part in reducing the number of children born to couples. Breastfeeding, the common practice among ancient Greek mothers, also functioned as a natural contraception and ensured that pregnancies would not be spaced too close together, since nursing suppresses menses. Women could also turn to various medical and folk remedies for preventing conception. Measures include holding one’s breath during coitus, drinking something cold afterward, or smearing the cervix with olive oil, honey, or cedar resin. One recipe calls for equal measures of pine bark and tanning sumac to be mixed with wine and applied to the cervix a few hours before intercourse. Some of the ingredients in these potions, such as white lead, could be quite dangerous. Once pregnant, a woman could turn to abortifacients. The medical writers recommend injections of oil; baths; potions consisting of linseed, fenugreek, mallow, marshmallow, and wormwood; poultices of meal of lupins, ox bile, and absynthium; or violent physical exercise, such as energetic walking or shaking by oxen. One passage in the Hippocratu Corpus advises a woman who wishes to expel the products of conception to jump up and down, kicking her heels to her buttocks! Most of these techniques were probably ineffectual, but some of the herbal therapies indicate an accurate understanding of the science of pharmacology.