MANAGING FERTILITY
Listen to this page.
Soranus’s Gynecology is noteworthy in another regard: although his book is a manual for the production of heirs, the physician acknowledges that female health could be achieved without childbirth: an unused womb doesn’t necessarily wander. Soranus here departed from some of his Greek predecessors when he asserts that lifelong virginity could be beneficial and that pregnancy depletes the body. Soranus openly recognizes that women might die in childbirth, and indeed a high mortality rate for both mothers and infants is a pervasive finding in the ancient historical record. In Euripides’s play Medea, for example, the title character announces:
“I would rather stand three times with a shield in battle than give birth once.”
While childlessness may have been less common for a Roman woman than it is today, Soranus saw that nonreproducing women could lead healthy lives nonetheless.
Anatomical votive of a uterus. Roman. Terra-cotta. Wellcome Collection: A636107. Photo: Wellcome Collection. CC BY 4.0.
Some childless women may have been infertile, and others may have remained celibate, but there is also evidence that ancient women actively sought to control reproduction. Birth control was a political issue with an ethical dimension, and the general contours of the ancient debate are similar to the positions one encounters in contemporary culture. Some writers argued against contraception and abortion, other thinkers expressed conflicted feelings or recommended limits, and there were those who discussed it as a matter of course. Yet unlike today’s debate, women’s voices are entirely absent in the documented record.
On the spectrum of opinions on family planning, the rationale behind the various positions differed. A number of discussions focused on the entitlements of the father—inheritance laws are of central importance in Roman law—and the prevention of pregnancy was seen as an undesirable hinderance to the production of natural heirs. Other opinions focused on the rights of the unborn, yet there was no consensus in the philosophical or medical literature clearly delineating when life begins: some considered the movement of the fetus in utero to prove its status as an independent being, while others contended that life did not begin until the first breath was drawn, and there was ongoing debate about when and whence a fetus acquires its unique soul. Child abandonment—so-called infant exposure—is also attested in the ancient world, and unwanted children were sometimes left after birth either to die or to be anonymously adopted. Although this can hardly be considered a form of birth control, it was an alternative approach to controlling family size and factored into the discussions about population growth as well.
A number of thinkers, Aristotle and Plato among them, felt that the good of the state ought to be a consideration in reproduction decisions. While they identified situations where limiting birth was preferable, there were other moments where population growth should be incentivized. The Emperor Augustus (r. 31 BCE–14 CE) put this idea into law and created benefits for parents and penalties for bachelors: “If we could survive without a wife . . . all of us would do without that nuisance,” Augustus acknowledged, but “we must plan for our lasting preservation rather than for our temporary pleasure.”
Detail from the Ara Pacis (Altar of Peace), depicting children from the imperial family. Roman, dedicated 9 BCE. Campus Martius, Rome.
But what did ancient Roman women do in practice? Soranus writes about mechanical and surgical forms of abortion. He describes techniques for ending a pregnancy that include enemas, fasting, bloodletting, lifting heavy objects, energetic walking and jumping, riding animals, and more. Because of the risk of uterine perforation, he advises against the use of an instrument to bring about a miscarriage. Gynecological surgical instructions and instruments have come down through time, yet the circumstances under which an abortion operation may have been performed is unclear.
Following the recognized medical wisdom of beginning with the least invasive approach before gradually escalating treatments, Soranus notes that it “is much more advantageous not to conceive than to destroy the embryo,” and his Gynecology also includes information about contraception. Some birth control strategies that work today would have also worked in the past—the rhythm method, for example—but we can also read of plant-based contraceptives and abortion-causing drugs.
Coin (reverse) depicting a plant used to avoid conception. 480–435 BCE. Silver. Minted in Cyrene. Wt. 17.1 g. British Museum: EH,p697.3.Cyr. Photo: © The Trustees of the British Museum. CC BY-NC-SA 4.0.
Soranus identified a difference between these two kinds of birth control: “A contraceptive differs from an abortive, for it does not let conception take place, while the latter destroys what has been conceived.” In practice, it would have been difficult for the ancients to definitively distinguish which mechanism was at play (sometimes the same herb is listed as a contraceptive by one author and an abortifacient by another), but the outcome was clear: these are plants known to bring about menstruation.
Soranus, Dioscorides, and Galen all wrote about these kinds of herbs, and many plant names recur repeatedly in ancient texts—from the pharmacopoeia to comedic plays.
Plant used for birth control. From an Arabic version of Dioscorides, De Materia Medica (Samarkand, 987–990 CE), fol. 22r. Werner Forman Archive, Oriental Collection, State University Library, Leiden. Photo: HIP / Art Resource, NY.
Some remedies were to be taken orally, others administered as suppositories, and a number applied topically in various ways. Recent studies have tested the birth-control properties of a variety of these recipes, and findings suggest that many may have indeed been effective. Yet none of these ancient recipes, all written by male authors, include enough detail about the specific dosage to be used successfully. This has led historians to theorize that knowledge of birth-control herbs likely came from women’s networks, a kind of private medicine.
