MIDWIFERY

Childbirth in the Roman World

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Although the precise details of their actual practice are now obscured, we can gain a sense of a midwife’s practice from Pliny the Elder’s Natural History and Soranus of Ephesus’s Gynecology. Pliny’s writings describe folk childbirth traditions while Soranus, a Methodist physician, wrote from an academic medical perspective. Taken together, these two texts offer a balanced picture of obstetrical practice in the Roman world.

Plaque depicting a midwife attending a birth. 400 BCE–300 CE. Marble. Ostia, Italy. H. 25.0 cm; W. 34.0 cm; D. 6.3 cm. Science Museum, London: A129245. Photo: © The Board of Trustees of the Science Museum. CC BY-NC-SA 4.0.

Pliny’s writings are principally concerned with ways to speed and ease labor, as well as how to bring about the afterbirth. His prescriptions sometimes include herbs or amulets, and frequently involve animal parts or excretions: fumigate with hyena fat; place the right foot of a hyena on the mother (but never the left foot); drink goose semen mixed with water; drink a different mixture sprinkled with powdered sow dung; place a vulture’s feather beneath a woman’s feet; tie a snake’s cast-off skin around the mother’s thigh. (Hyena parts were readily available in Rome, and a different author even reports going out to buy hyena skin “immediately” after reading a good recipe.)

Detail of a hyena with other animals and figures from the “Hunting Scene” mosaic. Late Roman, early 6th century CE. Daphne, Turkey. Worcester Art Museum: Museum purchase, 1936.30. Photo: Artstor.

While readers today may find these recommendations laughable and a potential cause of infection, medical historians note that Pliny’s prescriptions focus a great deal of attention on the mother, and that the constant care and emotional support in fact may have been of genuine help during delivery.

Relief depicting the midwife Scribonia Attica attending a birth. Roman, 140 CE. Terra-cotta. Tomb 100, Necropolis of Isola Sacra, Ostia Antica. H. 28 cm; W. 41.5 cm; D. 5 cm. Museo Ostiense: 5204. Photo: Scala / Art Resource, NY.

Soranus’s text is the only comprehensive academic treatise on gynecology and obstetrics to survive from antiquity. He is familiar with female anatomy, aware of many problems in pregnancy, and also includes instructions for labor and delivery, guidance on newborn care, and descriptions of other gynecological problems.

Positions of the embryo in the uterus. From a 9th century CE manuscript of Soranus of Ephesus (98–138 CE), Gynecology (9th century CE), fol. 28r. Bibliothèque Royale de Belgique: MS 3701–15.

A fair number of his observations and recommendations are correct even by today’s medical standards (although we see fewer hyena parts). While Soranus addresses a primarily male readership, since a male doctor would be called upon to take over in case of complications, the author is fully aware that women will likely provide the kind of care he describes. In fact, Gynecology begins with a description of the characteristics needed to become an ideal midwife. The implication of this discussion is not that there was a problem with the care provided by midwives, but rather reveals debates about who should go into this occupation or at least concern that the selection process should become more rigorous. 

Soranus took the responsibilities of a midwife seriously. He called for intellectual high standards: she should be literate and sharp witted, and have an excellent memory. And she should be physically capable: robust, of sound limb, tidy, and ideally having long, slender fingers with short nails and soft skin (since wool working causes rough hands, it was to be avoided). Soranus understood that midwifery called for a particular temperament too: hardworking and calm—especially since the midwife will need to deal with both a mother and a child—as well as tactful, honest, ungreedy, and not superstitious. He also notes the difference between a midwife capable of performing her duties and a truly accomplished practitioner with a grasp of the theoretical aspects of her trade and broader medical knowledge. While it may seem as if Soranus is shrinking the potential pool, he does, in fact, broaden the field when he remarks that a midwife need not be a mother herself (that is to say, a woman can be a midwife without having given birth personally), as others at the time believed. This account, like other descriptions of the ideal midwife written by male physicians, presents her as being as close to an ideal male doctor as possible.

Relief depicting a midwife attending a birth. Roman, 2nd century CE. Wellcome Collection: M0003964EB. Photo: Wellcome Collection. CC BY 4.0.

In practice, many midwives may have gained experience by witnessing births and through informal women-to-women networks of knowledge, yet such traditions have left no historical record. The social status of the woman was also a factor in the type of midwifery training she may have received and the kinds of births she attended. In addition to Soranus’s call for thorough midwifery training delivered to carefully selected candidates, one also finds scattered anecdotes in other ancient writings that point to a very different kind of practitioner. For example, one may read about a wineshop hostess “skilled in midwifery also,” who paused her daily activities to deliver a baby. And such a waitress/midwife—in this case, in the story of the birth of the 4th century CE philosopher Ablabius—may have been closer to the norm for the average Roman woman.