Fertility, Contraception, and Childbirth in Ancient Rome

Vagina specula are among the most complex instruments employed by Greek and Roman physicians

Classical Gynecology

Gynecology, the study of female anatomy and medical womanliness, was used to both understand and cure ailments, as well as firmly entrench the notion of womankind's primary role in society- as that of child bearer. This website intends to focus on the customs and views of the Romans, however, as with topics such as contraception and fertility, older writings are still pertinent. The lack of rapidly increasing technology to spur medical upheaval, widespread folk superstition, and the political convenience of the status quo, acted in conjunction to maintain older, long-accepted beliefs and theories (as absurd as some might be).

There are several main characteristics of ideas, beliefs, and theories on the female physiology and reproductive system. A very limited cannon of information has reached modern historians, and, the information that has survived is mostly conjecture. Even in texts of the great medical writers of the time, comparatively little attention is lent to female physiology. And, out of what is said, very little seems to be in any way based on first-hand examination…the female means of reproduction being the most mysterious.

According to Rouselle, little examination on women was able to be carried out, explaining the inequity of medical information between the genders. Despite the strong moral and societal distaste to human dissection for medicine, those cadavers that fell under the auspices of the anatomist were generally male. The other primary mean for observing the workings of the human body was through tending mangled limbs on the battlefield or the gladiators' barracks, where Galen found his start in Pergamum. Again, the subject was almost always male. Therefore, understanding of the way a female body functioned was extrapolated from understanding of the way female animals (which were dissected) functioned, along with a heavy dose of mental reasoning and conjecture. Rouselle further attributes the physician's lack of solid knowledge from examination to women's secrecy towards men and generally others as well in regard to their personal condition. Throughout the entire Hippocratic cannon, only two examples of doctors carrying out a vaginal examination may be found. All the other information presented was transmitted in a third-hand manner through midwives, whose assistance an ailing or laboring woman would request when desperate 1

Women examined themselves when they were in good health, and were able to discover polyps and callosities which they could be cauterized. Midwives were often consulted, and they would perform an examination themselves in order to be able to answer questions and prescribe treatment. Such problems as displacement, retroversion or anteversion of the uterus and induration, gaping or occlusion of the cervix would have been discovered during the course of routine self-examinations. 2

Then, let us look into the male. If this is a study on gynecology, then why would the male and his anatomy be mentioned? There are several answers. The first of which concerns woman's most important role in middle and upper class society- as producer of offspring, an act impossible without input from the male, especially at a time whence female genetic contribution to offspring was unrecognized. So, if women were largely valued on their fertility and ability to provide legitimate heirs, its only natural to investigate the external circumstances ultimately enabling or disabling her from successfully doing her prescribed duty to her family and society……..the male's ability to impregnate.

The fertility of the male was hinged on something called the "pneuma," or vital essence. What exactly pneuma is is ambiguous and vague. Perhaps it is most easily associated with air and breath. Furthermore, despite observational difficulties, this was an extremely widespread concept that merrily carried on for hundreds of years without contest. Perhaps this concept is best related in Rouselle (from Galen):

a grasp of anatomy which was distorted by preconceived physiological notions. As breath was the most obvious characteristic of life, male sperm which transmitted life must transmit breath, and therefore must contain air. Despite the great emphasis they placed on observation, ancient anatomists could not free themselves from the wholly intellectual concept of the circulation of air in the body, and they believed that the purest air was carried in ever richer blood towards the testicles where it passed it on to in sperm. Anatomical studies confirmed this picture: the aorta and the trachea, first confused had correctly observed similar consistencies, gave rise to the theory that the heart had a respiratory function and the lungs a function related to the blood. When the heart's role in the circulation of blood was discovered, the ancients decided that the blood must carry air to the spinal cord. It was the spinal cord which took this air rich blood towards the testicles. From the vessels situated on the spinal column a spermatic artery and vein ran alongside the convolutions of the epididimus. This vessel led to the neck of the bladder and the penis. Galen stated that in the course of its' journey through these vessels and their convolutions., the blood gradually became white and finally became sperm when it reached the testicles.3

The key to being healthy was to keep ones pneuma in proper balance. Strong, flowing pneuma was necessary to vitality and reproduction, but if unused, it could spoil and throw the bodily humors out of balance, causing irritability and depression. An aerated body had rich pneuma, which in turn yielded rich, potent bodily fluids.4

Diet and Male Fertility
"[I]f the patient had decided to produce an heir; What was required was semen strengthened by a suitable meal. The man should abstain from sexual intercourse for a few days, to intensify desire and increase the supply of semen. He must be careful about what he ate and avoid foods which caused constipation, which were pungent, acid or bitter; he must avoid activities which caused worry or grief, and even avoid excitement or extreme pleasure.

Galen's short chapter on substances which help the production of sperm and those which inhibit it enabled the reader to adjust his diet according to the requirements of his sexual activities. Of all foods, the one which best prepared the body for love making was the chick-pea, and more generally, all nourishing flatulent foods (literally those which produce air): vaccet onions, chick-peas, broad beans, octopus, pine kernals, scrinos, and orchis (whose name in Greek means testicle), flax seeds and rocket. Starchy foods were to be eaten boiled or roasted. Flatulent foods were important because 'sperm is produced from good food…and at the same time contains gas.' As Sperm was thought to carry pneuma it was logical to consider it as a mixture of 'pneuma and a foaming liquid.' The aim moreover is not so much to increase desire by the use of aphrodisiac foods such as chick-peas, rocket or onions, as to produce thick and copius sperm…" 5

Above all, however, one finds warnings against one wasting ones pneuma, resulting in malady, weakness, and languor. If one were to expend one's bodily fluids in excess, one's pneuma would be diluted. Unnecessary loss of sperm or blood must be avoided. According to some, including Soranus, it should be carefully conserved by both sexes, although always more so for the male.

"The testicles are even more important than the heart, since, besides the heat and strength they give to animals, they are responsible for the continuance of the species, for they impart to the whole body a power similar to the sensory and motor power which the brain communicates to the nerves, and to the pulsatory power that the heart communicates to the arteries, and this power causes the male's vigor and virility…When as a result of continual sexual excess, all the sperm has been lost, the testicles draw seminal liquid from the veins immediately above them and so on. This draining process does not stop until it has involved every part of the body, so if it is constantly repeated and if all vessels and all the parts of the body are forced to give up their supplies until the strongest part is finally satisfied, the result will be that all parts of the animal are drained not just of seminal fluid but also of their vital spirit… It is hardly surprising, therefore that those who lead a debauched life will become weak, since the purest part of both substances is removed from their body." 6

It is also important to investigate views of the male physic since that of the female was often primarily identified or defined as an inferior version of the male: "The males of all species are warmer and drier while the females of all species are moister and colder, for the following reasons: originally each sex was born in such things and grows thereby, while after birth males use a more rigorous regimen, so that they are well warmed and dried, but females use a regimen that is moister and less strenuous, besides purging the heat out of their bodies every month…" Galen "The female is less perfect than the male for one, principal reason because she is colder, for if among animals the warm one is the more active, a colder animal would be less perfect than a warmer."

Comparing Male and Female Anatomy
"Male doctors then who had no knowledge of female anatomy or physiology, but fantasies only, used logical reasoning to construct a male science of the human body, incorporating all the facts gathered patiently over the years by women who had built up an empirical science which has never been written down but had grown through oral tradition." 7

Hippocratic corpus on the differences between male and female flesh:

I say that a woman's flesh is softer and more porous and softer than a man's: since this so, the woman's body draws moisture both with more speed and in greater quantity from the belly.

Galen, who based much of his knowledge on his understanding of how animals functioned (which he dissected) and women (which he did not), simply viewed the male and female reproductive system as versions of one another. Every reproductive part of the male was accounted for in physiology of the female, it was merely interior.

The Mysterious Vagina

While it was certainly accessablie, the vagina remained a mystery to many Roman physicians. Soranus felt that dissection would convince roman doctors that a membrane stretching from the neck of the womb to the hymen did not seal a virgin's vagina. Soranus believed that such a membrane would prevent the flow of menstrual blood without the acute pain associated with defloweration. The fact that Greek girls who reached puberty before being married and deflowered did not experience painful menstruation supported Soranus' notion that marriage before puberty was not necessary. Romans felt otherwise, and girls were married at twelve, sometimes even younger, and ere immediately deflowered. Some girls became pregnant before menstruating for the first time. Thus the Romans used a universal anotomical feature to influence their social customs. 8

  1. Aline Rousselle. Porneia: On Desire and the Body in Antiquity. (New York: Basil Blackwell Ltd., 1988) 25, 26.
  2. Rousselle 26.
  3. Rousselle 13.
  4. Rousselle 19.
  5. Rousselle 19.
  6. Rousselle 13-15.
  7. Rousselle 26.
  8. Rousselle 27.
by Laura Colaner