13.2 Birth Control in Antiquity

I. BACKGROUND.

Today, women's reproductive rights are a hotly debated issue. The heat of those arguments obscures the long history of birth control and that more sensitive of subjects--abortion. In ancient times, many women practiced birth control with little interference from religious or civil authorities. They did it by using their knowledge of plants.

How was that knowledge obtained and how was it transmitted? Herders of domesticated animals noticed that when animals grazed on certain plants, they failed to reproduce. Trial and error were the next steps and then persons informed others about their experience. In time, plants were chosen on the basis of word-of-mouth information or traditional lore which it was based on cumulative experience and reputation.

Midwives apparently passed on their knowledge by word of mouth. That knowledge could be dangerous; some old women were feared because of their know-how and were branded as witches. With the decline of midwifery, the chain of knowledge was broken.

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II. USE OF SPECIFIC PLANTS FOR BIRTH CONTROL.

The Greeks used Silphium, known commonly as giant fennel. Its pungent sap was good in cough syrups and gave food a rich, distinctive taste. These plants were also known to have contraceptive and abortifacient properties. The plant was honored on a four-drachma Cyrenian coin showing a seated woman touching the plant with one hand while pointing to her genitals with the other hand. The demand for the plant was so great that by the third or fourth centuries, Silphium was extinct. Related plants survived, but were less effective.

The seeds of Queen Anne's Lace (a wild carrot) may have also been effective. Studies in rats show that the seeds inhibit both fetal and ovarian growth. Women in India today chew the dry seeds. A small number of women in rural North Carolina drink a glass of water containing a teaspoon of the seeds immediately after intercourse to prevent pregnancy. Chewing the seeds or deliberately cutting them before ingestion releases the active ingredients. Failure to do so permits the seeds to "go right through you" with no effect.

Another plant used in classical times as contraceptives or abortifacient was pennyroyal. Studies in the 1930s showed that the plant stimulated the production of female sex hormones and reduced fertility in laboratory animals, much as modern contraceptives do.

The ancient Egyptians also practiced birth control. A medical document from 1500 BC lists substances that it claims 'stops pregnancy.' According to the papyrus, unspecified amounts of acacia gum, dates, and an unidentified plant were mixed with plant fiber and honey and formed into a pessary (vaginal suppository). Modern researchers have found acacias to be spermicidal.

How many ancient people actually practiced birth control? Historical demographic studies suggest that pre modern peoples of Europe regulated family size.

Scarring and pitting of bones in the pelvic region provide clues to the number of full-term pregnancies amongst skeletal remains from prehistoric times. Demographic research, laboratory studies, and scrutiny of ancient texts have given us new hints concerning the efficacy of ancient 'family planning.'

We can now understand why the ancient Greeks and Romans valued Silphium and why they tried to develop substitutes when it disappeared from the marketplace. It is more difficult to discover why such herbal birth control agents faded from common usage. Although they are described in medical texts of the early and late Middle Ages, by the onset of the Renaissance, physicians were no longer writing about them. Did doctors no longer know what plants to use, when to use them, or what doses would prevent contraception or end pregnancy? Why was that knowledge passed down through generations of women but not physicians? The research question now becomes not what the ancients knew about birth control, but why that knowledge was lost when it was once so well known.

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III. THE RISE OF MEDICAL TRAINING

By the twelfth century, medical training had moved from apprenticeships to the universities. By the fourteenth century in most of the towns and cities of Europe, guilds required that one be a university graduate in order to practice medicine. The curriculum moved more toward theory and less toward practice. Increasingly, drugs passed from the physicians and into the domain of the pharmacists' guilds.

Although women had studied medicine at some universities in the early Middle Ages, men gradually came to dominate the profession. At the same time, gynecology became more and more the province of midwives who had learned the uses of herbs in the fields. They knew how to identify the necessary plants, how and when to harvest their appropriate parts, how to make extracts and administer them, in what dose, and perhaps most important, when to administer them in relation to the last coitus or missed menstruation. However, such complex knowledge may have slowly faded from common usage simply because, perhaps, it became increasingly difficult to transmit this information orally. Indeed, by the fifteenth and sixteen centuries, physicians were being summoned to women's bedsides only when their medical problems called for drastic or non routine action.

Few physicians knew about birth-control agents since they were not part of their training, nor were there an easy way to learn about them. The chain of learning broke, and the folk knowledge chain was greatly restricted. The ancients learned about herbal agents from people who knew what and how much to take. Physicians of the Renaissance, however, distrusted folk medicine and had no occupational or professional means to acquire this knowledge. In time, Christian church doctrine, canon law, and eventually the laws of states came to restrict women's claims that they should regulate their own reproduction.

In any case, we can now be reasonably certain that many women in antiquity knew what only a few women know today. Many twentieth-century historians still assume that those women relied solely on magic, superstition, and ineffectual folklore to limit their reproductive capacities. That was certainly not the case. Women in antiquity had significant control over their reproductive lives. The evidence is there in the documents where it has been all along.

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IV. THE INTRUSION OF RELIGION

How did religion or the state get involved in reproductive issues? In 1869 Pope Pius IX outlawed abortion among Catholics, declaring that the human soul was born at conception. The decree reflected a very old debate. These issues will be reviewed here.

Greco-Roman, Hebrew, and early medieval sources all contain sophisticated discussions of the issues surrounding contraception and abortion. While there was never uniform opinion among them as to the ethics and medical advisability of birth control practices, Hebrew, Greek, and Roman law generally did not protect the fetus. However, there was a religious distinction made once the fetus had formed recognizable features. Before that point women could abort without fear of reprisal.

(My comment: you reading this paper have a better visualization of the infant before birth than many medical people had fifty years ago. Program such as NOVA on public television with their graphic images of the live fetus in the womb have shaped our views on contraception and abortion probably more than has religious instruction in childhood.)

The most famous medical statement from classical antiquity, the Hippocratic oath, was misinterpreted early on as forbidding physicians to perform abortions. In reading the oath, formulated in the fifth century B.C., initiates swore not to administer an abortive suppository. Scribonious Largus, a Roman physician writing in the first century A.D., was among the first to interpret the Hippocratic injunction against abortive suppositories as a blanket condemnation of abortion.

This misreading survived into modern times. The error became particularly important in the nineteenth century when many American states passed anti abortion laws based in part on this misreading of a doctor's sacred obligations.

Both Plato and Aristotle advocated population control to ensure population stability in the ideal city state.

Hebrew sources give idiosyncratic interpretations of the Biblical directive to "be fruitful and multiply." The Babylonian Talmud records: "A man is commanded concerning the duty of propagation, but not a woman." In other words, men were encouraged to spread their seed, but women, who had to suffer pregnancy, childbirth, and child rearing, were excused by God from the command to be fruitful. Hebrew religious law did not regard a woman as pregnant until 40 days after conception.

Early church fathers were divided about the ethics of abortion. In a sermon around 390, John Chrysostom, the bishop of Constantinople, decried those who used contraceptives, likening the practice to sowing a field in order to destroy fruit, and raising the question whether it was not the same as murder. Jerome (348-420), who revised and translated the Bible into Latin, condemned those who drank potions causing (sterility and murder of those not yet conceived." Augustine (354-430), on the other hand, appears to have been influenced on this subject by pagan authors, principally Aristotle.

We tend to believe that the quandaries over birth control are recent, brought on by the presence of effective contraceptives and safe abortion procedures. In fact, the ethical dilemmas are much the same as they were when Juvenal wrote, almost 2,000 years ago, "we have sure fire contraceptives." Hundreds of generations--saints and sinners, people in distress, kings, queens, merchants, and peasants--have faced many of the same problems we do. The debate over abortion and contraception is indeed old in Western society.

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V. THE MEDICAL SKILLS OF ANCIENT EGYPT/PREGNANCY

The Egyptians recognized some of the procreative relationships among the testes, phallus, semen, and pregnancy. They regarded the man's contribution as a 'seed' that he planted in the fertile ground provided by the uterus. Semen was believed to originate in the spinal cord--a belief derived from veterinary medicine (a bull has retractor muscles that arise from the sacral vertebrae. This lowest extension of the vertebral column was called the os sacrum because it was believed to be a sacred bone.

The maternal contribution to the fetus was not clear to the Egyptians; however, they did regard the mother's nutritional role via the placenta as vitally important.

The duration of pregnancy was estimated variously between 294 days and 182 days. The basic problem then as well as earlier, was probably that no one knew how to determine the exact time of conception.

Egyptians seem to have been more concerned with how to tell if a woman is pregnant. A number of magical methods for making the diagnosis have survived; none is predicated on the cessation of menses as a clue. Several documents from both the Middle and New Kingdoms provide instructions for detecting whether a woman is capable of conceiving a child. One involves examining the "vessels" of her breast. Another states that the likelihood of becoming pregnant is proportional to the number of times the woman vomits while sitting on a floor that has been covered with the sediment of beer and date mash. A third, also found in later Hippocratic writings, specifies that a woman can become pregnant if, on the day after an onion is inserted into her vagina, the onion's characteristic odor can be detected in her breath.

Not all women wanted to become pregnant. The oldest of all the surviving medical papyri, the Kahun Gynecological Papyrus, lists several recipes for contraceptives to be inserted into the vagina. They included pessaries made of honey with a pinch of natron (you will remember natron from our unit on mummies), of crocodile dung in sour milk, of sour milk alone, or of acacia gum. Recently the latter has been recognized as spermicidal in the presence of vaginal lactic acid, and it is conceivable that sour milk, too, might be an effective spermatocide.

Predicting the sex of an unborn child was also done. "Let the woman water Wheat and Spelt (a hardy wheat) with her urine--in two bags. If wheat grows, it will be a boy; if the spelt grows, it will be a girl." The basis for this test was the ancient association of wheat and spelt with male and female divinities. You'll like this: in 1962 the method was tried in a modern botany lab in Cairo. The results were no better than chance.

Women delivered while squatting on two large bricks, or while sitting in a chair from which the center of the seat has been removed. Women in labor were assisted by female birth attendants--midwives.

..... CJ '99

Resources:

Estes, J. "The Medical Skills of Ancient Egypt" in Medicine, a Treasury of Art and Literature Carmichael and Ratzans, eds. New York: Hugh Lauter, 1991.

Jordan, M. "Selling Birth Control to Indian's Poor" Wall Street Journal Sept.21, 1999.

MacCormack, C. Ethnography of Fertility and Birth 2nd ed. Prospect Heights: Waveland Press, 1994.

Peres, J. "Fears keeping 'after sex' pill on the back shelf" Chicago Tribune

Riddle, J. Eve's Herbs Cambridge: Harvard University Press, 1997.

Riddle, Estes, & Russell 'Ever Since Eve---Birth Control in the Ancient World' Annual Editions Archaeology 95/96 Hasten, L ed. Guilford: Dushkin Publishing Group, Inc.,1995.