Fertility, Contraception, and Childbirth in Ancient Rome

On Conception… The aim of Roman matrimony was procreation, rendering theories of procreative potential extremely important. Soranus suggests that women "from the ages of fifteen to forty…not mannish, compact, oversturdy or too flabby and very moist," with uteri as, "neither very moist or dry, not too lax or constricted,"were one's best shot at producer of offspring.1

From a rather negative standpoint, Soranus attempts to identify outward signs of female sterility. These include: importance in the size of head and proportions of eyes and features. Small heads and eyes are always bad signs, however, not all large heads are to be interpreted as good. Protruding foreheads are especially bad.2

According to Soranus, the best time for conception is "when menstruation is ending and abating and when the urge and appetite for coitus are present." The couple should be sober and comfortable. The ingestion of a snack and a good rubdown before coitus further aid conception. A pleasant state is also important during the act.3

Conception leading to the successful birth of a male heir was the goal of many married couples. Therefore, obviously theories would be created regarding the circumstances under which a desired gender might be conceived. Several important ones include the heat theory, and the dominant sperm theory.

The dominant conceptive idea during Roman times was the double-seed theory. Both parents seeming to contribute to the traits of their children were viewed as a result of both producing semen to comingle in the woman's womb, both supposedly at the time of orgasm. The parent with the dominant sperm contributed the more apparent characteristics.4

Soranus also believed women should be "sober during coitus" because the soul becomes "the victim of strange fantasies" during drunkenness and the offspring will resemble the mother in body and soul.

In the logic of Hippocrates, if both parents produced strong sperm, the child was to be male…and if both produced weak semen, a female child would ensue. Should one parent produce strong, and one weak sperm, the gender of the child should be determined the more vivacious sperm.

According to Lucretius (On the Nature of Things 1200-1250) "When the male seed and the female seed are fused, one partner may be dominant, overpower the other in a burst of violence. If this should be the woman then the child shall have her features and qualities. The same if the man assumes the role of dominance, the children will be more like the father." Another author advised (note the incorrect estimation of a woman's ovulatory/fertile period):

"The best time for conception is when the menstrual flow has stopped. It is especially during these days that one should see if a woman is able to conceive, for they are most successful for fertility. If she does not conceive straight away, and everything else is well with her, nothing stops her from going to her husband on other days, for the habit will excite her desire and cause her passages to open. If the ejaculate from the man runs together directly with that of the woman, she will conceive,'5 Thus, even in a context that demanded female seed, the Hippocratics realized that the time of the month was more signifigant for conception. That the heat of lovemaking determined the sex of the offspring is mentioned by Hippocrates, and believed by the Romans.6

The idea is that coitus creates heat and pleasure throughout the female body, reaching its acme with the introduction of sperm. Galen, based on the postulation that both the right ovary and the right testicle, being warmer, produce warmer sperm. This male semen produce a male child.7

First Pregnancy Stage:
Conception Successful conception to the ancient mind was, in its simplest form, the retention by the womb of the male seed. Symptoms of conception included: a shivering sensation after intercourse, swollen breasts, cessation of the menses, and heaviness of the limbs. 8

The woman might at this point, consult the midwife, and when pregnancy seemed likely, the first stage of prenatal care began. This stage focused exclusively on retaining the seed within the womb, which was regarded as tricky business, since many activities were believed to dislodge it. Strong emotions and sudden movements were guarded against, and more specifically, "forced detention of breath, coughing, sneezing, blows and falls...lifting heavy weights, leaping, sitting on hard sedan chairs... want,...drunkenness, ...flow of blood from the nose, etc".9

Soranus continues with the care of a woman through this seed-preservation phase involved anointment with freshly ground oil from unripe olives, confinement to bed for two days, and a light diet of grains. Relaxing activities were to be avoided for a weeks time, such as imbibing wine or enjoying baths, so as to avoid weakening the seed. Gradually, activity and food (still neutral) were to increase, however sexual intercourse was barred, allowing the uterus to rest.10

Second Pregnancy Stage:
Pica Beginning about 40 days after conception, and lasting about four months, this second stage of maternity care was known as the "pica" stage. This stage included the typical symptoms associated with pregnance: nausea, upset stomach, fever, dizziness, and bizarre food cravings for items such as, "earth, charcoal, tendrils of the vine, and unripe and acid fruit".11

With the onset of symptoms, a one day fast was prescribed to ease the stomach and prevent sickness, and an oil rubdown was given. Small portions of easily digestible food were given, such as porridge or soft-boiled eggs, along with cold water. Astringents such as rose oil, myrtle, or unripe olive oil were sometimes applied to relax an extremely upset stomach, along with having a tightly wrapped woolen girdle. Most importantly, unhealthy foods (despite cravings) should be kept at distance.12

Third Pregnancy Stage:
Preparation for Labor Increased exercise, food, and sleep in order to build up the pregnant woman's strength in preparation for labor and childbirth characterized the final stage of pre-natal care. After the seventh month, however, physical exertion was slowed due to the heavier fetus. At this point, linen support bandages were used to help bear the added weight.

Wine and sweet-water baths were enjoyed to calm the woman's mind. The belly was rubbed with oil (to avoid stretch marks), the genitals were anointed with herbs, and the vagina injected with softening oils such as goose fat.13.

Childbirth Once again the finest source of information on obsetretics is Soreanus; his descriptions as always are clear concise derailed and free of superstition. Here, Soranus suggests the items a midwife ought to have in order to attend a normal labor and delivery:

  • olive oil [clean, not previously used in cooking]
  • warm water warm fomentations [ointments applied to the body]
  • soft sea sponges
  • pieces of wool bandages [to swaddle the infant]
  • a pillow [on which to which to place the infant]
  • things to smell [pennyroyal dirt barley groats apples, quinces, lemons, melons, cucumbers; these were used as we use spirits of ammonia to revive someone who has fainted]
  • a midwife's stool or chair [this was the property of the midwife; she brought it with her to the home where the delivery was to take place]
  • two beds [a hard one for use during labor and a soft one for rest after delivery]
  • proper room [of medium size and moderate temperature]."14

The Birthing Stool
A vital piece of equipment was the midwives' stool, designed only to be used in delivery, and not while the woman is in labor. The chair itself was crescent shaped and usually had very strong arms and back against which the mother was to press her hips and buttocks against during delivery.

In the middle of the stool...one must have cut out a crescent-shaped cavity of medium size...and its height medium, for in women of small size a footstool placed beneath makes up the deficiency. Concerning the area below the seat, the sides should be completely closed in with boards, whereas the front and the rear should be open for use in midwifery...Concerning the area above, on the sides there should be two parts shaped like the letter II for the crossbar on which to press the hands in straining. And behind there should be a back, so that both the loins and the hips may meet with resistance to any gradual slipping...To the lower parts of the stool some people...affix a projecting axle which has windlasses on each side and a knob, so that in extraction of the fetus they may places nooses or ropes circularly round the arms or other parts of the fetus, attach the ends to the knob, and effect the extraction by rotation ".15

Portable Medicine Kit
Portable medicine Kit
Size of the orginal Museum 13cm x 7cm Naples

Soranus recommends that the sides of the stool from the seat to the ground be entirely sealed in with boards while the front and the back be left open for the midwife's enterprise. Later in the text, Soranus mentions that if a midwife's stool is not available, the parturient can sit on the lap of another woman, who, must be sufficiently stalwart to bear the mother's weight and hold her still.16 It is not a great challenge to theorize that the children of destitute parents may have been delivered without a midwife's stool at all if the midwives they employed did not have the funds to purchase a birthing stool. Many midwives must have carried only a kit.

It seems quite relevant the amount of time spent focusing on the birthing stool, both midwives and doctors were convinced that delivery was facilitated when the mother sat in an upright position.17 The chair has a has a curved opening in the seat through which the baby would be delivered. The chair had arm-rests, in the shape of the letter "pi," for the mother to grasp during delivery, a sturdy back was also needed which if parturient was to press her hips and buttocks. Some birthing chairs were far more elaborate than others including high arms backs and even padding. The impliction of Soranus's description, is that some midwives' stools did not have backs and that an attendant stood behind the parturient to support her, a less desirable arrangement because of the danger that the parturient might recline or slip backwards, causing danger to everyone involved.18

The midwife finally readied her supplies as labor began in earnest. As labor dragged along, the parturient lay on her back on a hard, low bed with support under her hips. Her thighs were parted with her feet drawn up. Gentle massage was implimented to ease labor agony and the linement used was a cloth soaked in warm olive oil laid over the stomach and genital area. Against the woman's sides were placed hot compresses in the form of warm oil-filled bladders. Soreanus believed, that

as the cervix begins to dilate, the midwife is to encourage the process of dilation by gently rubbing the opening with her left forefinger smeared with olive oil. When the cervix is dilated to the size of an egg, the expectant mother is moved to the midwife's stool, unless she has become very weak; in the latter case, the delivery is to be made on the hard bed.19

According to Soranus' instructions:

..the midwife, after having covered herself properly with an apron above and below, should sit down opposite and below the laboring woman; for the extraction of the fetus must take place from a higher towards a lower plane. Therefore, the midwife, with legs parted and bending the left one forward a little to make it easy to work with the left hand, should sit down...in front of the laboring woman. For the lower sides of the stool...should be blocked in, while the rear is occupied by the assistant for necessary service; for by placing a pledget underneath she must restrain the anus of the gravida because of the prolapses and ruptures which occur in straining. Furthermore it is proper that the face of the gravida should be visible to the midwife who shall allay her anxiety, assuring her that there is nothing to fear and that delivery will be easy.20

In a normal headfirst delivery, the cervical opening must be stretched slightly, and the rest of the body is pulled out. Soranus instructs the midwife to wrap her hands in pieces of cloth or thin papyrus so that the slippery newborn does not slide out of her grasp. Soranus seems to think that if the midwife's hands are so wrapped, she will not inadvertently squeeze the baby too hard in her efforts to maintain a firm hold.21 The midwife was also to take care that the umbilical cord was not distended and to remove gently the placenta immediately after the birth of the baby.

Of course, these methods represent the medical ideal of the time. Part of Soranus' idea of a good midwife includes literacy and lack of superstition. The fact that colloquial methods and superstitious ideas entered the birthing room cannot be ignored. An educated midwife must have been hard to find, even in urban areas.

  1. Soranus Gynaecology 34.
  2. Aline Rousselle. Porneia: On Desire and the Body in Antiquity. (New York: Basil Blackwell Ltd., 1988) 22.
  3. Soranus 36.
  4. Rawson, Beryl, ed. The Family in Ancient Rome: New Perspectives. Ithaca, NY: Cornell University Press, 1986 231; Fantham, Foley, Kampen, Pomeroy, Shapiro Women in the Classical World 186.
  5. On Diseases of Women 1*17: trans Lesley Dean-Jones from Littre (1962) 8:56.
  6. Fantham 186.
  7. Rawson 232.
  8. Soranus 43-44.
  9. Soranus 46.
  10. Soranus 46.
  11. Soranus 48.
  12. Soranus 49-50.
  13. Soranus 56.
  14. Soranus 38.
  15. Soranus 40.
  16. Soranus 41.
  17. Soranus 39.
  18. Soranus 40.
  19. Soranus 43.
  20. Soranus 41.
  21. Soranus 48.

by Laura Colaner