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21.02.06 Dopfel et al (eds.), Pregnancy and Childbirth in the Premodern World

The Medieval Review

21.02.06 Dopfel et al (eds.), Pregnancy and Childbirth in the Premodern World


The title of this volume reveals its scope, both geographically and chronologically. No one person can be an expert in all these different areas and time periods. With this caveat I will approach these rich and informative essays as a specialist in medieval and Renaissance Western European culture and as an eager learner for other geographical locations and eras. The editors have assembled an impressive international roster of specialists, all leaders in their respective fields. The twelve contributions are divided into three parts: Cultural Exchanges and Transmission of Knowledge; Birth, Death, and Magic; Lying-in and Holy Birth; and Tradition, Iconography, and Political Statement. These terms, many of which are not instinctively associated with the natural functions of pregnancy and childbirth, show the bold approach the editors decided to take with this copiously illustrated volume. Each article is amply documented and most of them draw on extensive manuscript sources and primary texts, making the volume a precious resource for reference and future research.

The first part shows the many ways in which male traditions of the transmission of knowledge moved into or even usurped areas of life that belong to a female domain: conception, pregnancy, childbirth, and midwifery. Francesca Marchetti examines the illustrations in manuscripts of the gynecological manuals of Mustio (or Muscio), dated to the fifth and sixth centuries CE. Her subtle analysis of Mustio's relation to the famous second-century CE gynecological treatise of Soranus of Ephesus, of which no illustrated copies survive, leads her to a wider study of the existence and functions of illustrated early medical manuals. Marchetti analyzes the only surviving manuscript of Apollonius of Citium's (90-15 BCE) collection of orthopedic texts (in a ninth-tenth century Byzantine manuscript) and shows how illustrations were meant to function: as helpful visual aids to treatment. Similarly, Zosimos of Panopolis in the third to fourth centuries CE describes how doctors used illustrated books offering them instructions for the setting of fractures. Marchetti also addresses the changing functions of male physicians and midwives in Soranus's and Mustio's treatises. In the latter, physicians tend to disappear and midwives therefore need clear instructions that could be enhanced by illustrations. Whether medieval midwives actually used these images is an open question, however. In any case, Mustio's illustrations survived and were transmitted to the modern period beginning with the age of printing in volumes like Rösslin's 1513 Rose Garden for Pregnant Women. Focusing on the transmission of knowledge, Paolo Delaini follows the traces of the legendary Doctor Burzoy who was reputed to have been sent to India by the Sasanian King Xusraw. From this tale Delaini suspends an intricate exploration of the pathways by which Indian works were absorbed into Zoroastrian philosophy and religion and how Greek sources were transmitted through Syriac translations. He cites some examples of this knowledge, such as an Iranian work on Primal Creation, the Bundahišn, that sees "the female seed as cold and wet, of red or yellow colour and 'falling' from the hips" while the "male seed originates from the top of the head" (40), thus repeating some traditional tenets that associate the male with the head and reason, while the female is assigned a lower position. This point is expanded on by Kathryn Kueny's study of the male-authored Muslim tradition of gynecological texts which, as she shows convincingly, had as its principal mission to justify the exertion of male control over the female body. Kueny posits that the Koran offered no overarching view on human reproduction but rather "projects brief statements in a kaleidoscopic display of procreative processes and agents of creation in both cosmic and individual realms" (55). Muslim physicians adopted and adapted many of the tenets of Aristotelian and Hippocratic thinking on conception and birth, insisting that a woman's body was responsible if something went wrong during these processes and was even seen as a "hostile barrier" to "male efforts to replicate themselves in their own likeness" (62). But this does not mean that knowledge of and compassion for the difficulties of pregnancy and maternal deaths were absent: Kueny cites a ninth-century text that "recorded how pregnant women who die during childbirth became martyrs" (73). In the last article in this section, conception, pregnancy, and childbirth are completely wrested away from female control by Abraham Ibn Ezra (1089-1167), another tireless traveler across Muslim and Western European lands. Shlomo Sela, the great expert on this intriguing personage, chose one aspect of Ibn Ezra's multifarious works as his focus: the trutina Hermetis ("the balance of Hermes"). In a long and detailed study Sela traces how Ibn Ezra propagated this intricate horoscopic method that depended on finding the precise moments of conception and birth. Sela's mastery of the Hebrew and Arab astrological traditions and Ibn Ezra's place in them make these forty pages an indispensable guide to the trutina Hermetis. Once again, women's knowledge was excluded, this time from the intricate calculations needed to establish a correct horoscope. Fittingly, Sela closes his article with the words of the seventeenth-century philosopher Henry More who supplies the bottom line to all these efforts of learned men to coopt the birthing process by saying of incipient babies, "and if it were known, there is yet no certainty, some coming sooner, some later, as every mother, nurse or midwife knows well" (102).

Part Two connects birth, death, and magic with material culture and the evidence of miracle collections. Archeologists Cécile Chapelain de Seréville-Niel, Raphaëlle Lefebvre, and Armelle Alduc-Le Bagousse show us the opposite of Part One's male thought divorced from female bodies by focusing on the bodies of pregnant women, or rather what remains of them. Excavations of burial sites in Normandy yielded skeletons that permit to gather precious data on funeral customs (such as an area in the cemetery at Courcy that may have been reserved for women who died during pregnancy or childbirth), maternal deaths (women who died while pregnant, stillbirths, but also women with full-term dead fetuses.) The photos of the opened graves and skeletal remains provided here give us pause and a space for mourning. Mary Morse focuses on the time before the birth with her detailed and well-illustrated analysis of English fifteenth- and sixteenth-century birth girdles whose "suspect magical elements" were "mitigated and transformed [...] into an influential affirmation of orthodoxy" (139). Morse argues that the use of birth girdles was in fact one way that "discouraged women from renouncing the Church and converting to Lollardy" (140). In this way the girdles provided not only physical but also spiritual protection. Addressing questions of lay reading in the critical period of Lollardy, Morse's fine analysis of a wide range of manuscript girdles (her bibliography lists thirty-three manuscripts) opens a window on practices that transcend the birthing chamber. Sara Ritchey poses the question "Why did Cistercian confessors consider it appropriate to include birthing charms in a book made for the use of nuns?" (172). Placing the thirteenth-century Cistercian manuscript Brussels, BR MS 8609-20, into the wider context of the "spectrum of healthcare options" (172) of this period in Western Europe, Ritchey gives an overview of the development of midwifery, followed by an analysis of her manuscript's four Latin birthing charms. She speculates that one charm, The Three Kings' Charm, meant to cure epilepsy may reference here "uterine suffocation, a disease considered prevalent among nuns" (175). Finally, Ritchey's consideration of these charms in an oral context leads her to an analysis of the nuns' role in obstetric care of which prayer was an essential part. Alessandra Foscati's work on medieval medicine focuses on France and Italy and exploits one of the great sources in this area: healing miracles, especially those reported in canonization documents from the thirteenth to the sixteenth centuries and in special collections of miracles. In some cases, the findings in these types of sources do not correspond to what historians of medicine found in medical texts, especially with regard to the involvement of male physicians in the birthing process of which Foscati sees little evidence, except in rare cases where a Caesarean or the extraction of a dead fetus was contemplated. Further, prenatal care by male physicians occurred only when the pregnant woman suffered from serious illnesses. Caesareans reappear in the highly interesting section on "Saving the Baby's Soul," dealing with the all-important question of baptism. The resuscitation of still-born babies in order to baptize them is a major component of medical miracles. Here again, Foscati offers a subtle analysis of male and female roles in this process.

Part Three looks at rituals and visual representations surrounding childbirth. Fiona Harris-Stoertz examines the circumstances and meanings of lying-in rituals in England and France from the twelfth to the fourteenth centuries. Clerical authors had a decidedly different view of the significance of lyings-in than did new mothers and their families and communities. Framing her introduction with van Gennep's notion of rites of passage, Harris-Stoertz examines the many contradictory interpretations of this purification ritual, from empowering women to "an instrument of control and marginalization" (229). Her examination of the notions of pollution and impurity clerical authors associated with childbirth, often requiring the ritual of churching before sexual activity could resume--lest husbands contract leprosy or some other sickness--shows that churchmen supported their views "increasingly [with] medical and scientific justifications" (232). Evidence from chronicles and literature (mostly limited to elite women) paints quite a different picture: lyings-in were an occasion for community celebrations that included men in the often lavishly decorated birth chamber and allowed families to assert their social status. Valentina Calzolari takes us to medieval Armenia and the unique pictorial tradition of including Eve (Eve in Eden was still a virgin) in Nativity scenes, a tradition derived from the Armenian Infancy Gospel, possibly related to the second-century Greek Protoevangelium of James that adds a midwife to the scene of Christ's birth. The striking presence of Eve may be an allusion to the ideal of childbirth without pain which would have been possible had Adam and Eve remained in Eden. Eve takes a very active role in Armenian Apocrypha, swaddling the infant Jesus and announcing his birth, shown in many manuscript illuminations many of which, Calzolari argues, "predate the division between canonical and apocryphal texts" (277). The typological implications of this linking Eve and Mary are clearly laid out by Calzolari who never loses sight of the special character of the Armenian tradition. From Armenia we move to the Peloponnese where Antonella Parmeggiani explores the political messages of the Byzantine frescoes in Mystras, "founded by Geoffrey of Villehardouin after the Fourth Crusade" (285). She links her analysis of frescoes in six different churches (with an emphasis on Saint Anne and the birth of Mary who is portrayed as a savior figure) to a number of mixed marriages between the Greeks and Frankish or Italian brides in the Despotate of Morea. These marriages between Greek Orthodox men and Western brides came to signify the union of East and West, and just as Mary gave birth to the Savior, these newly wedded wives were expected to provide a bulwark against the encroaching Turks in the shape of many little saviors. Women as saviors are also a theme in Costanza Gislon Dopfel's final essay on Quattrocento Florence. She considers Renaissance maternal images as a "propaganda instrument supporting such new family practices" (310). Decimated by the plague, the Florentine population was in dire need of growth. Dopfel convincingly argues that the increase in nativity scenes of the Virgin Mary and Saint John the Baptist is not so much related to sacred history as to the civic duty of increasing the population. Noble families star in biblical and hagiographical scenes, such as those of the Cappella Tornabuoni, where richly clothed women glide through lavishly decorated birth chambers, for the most part "completely unaware of or uninterested in the sacred history developing in the background" (314). The abundance celebrated here is an abundance of children. Frequent maternal deaths were played down in this celebratory iconography. The example of a woman who in the first half of the fifteenth century had twenty-one children in twenty-four years is contrasted with evidence of women in the years before the plague-cycles that began in 1348: they married later and produced on average four to six children. The relentless rhythm of post-plague childbearing was also facilitated through the growing custom of wet-nursing, thus freeing new mothers from nursing and making another pregnancy possible. From 1424 to 1430 more women died in childbirth than men from violence. "Only a third of the fourteen-year-olds survived to reach age thirty-four" (335). This is a sobering thought, evoking the skeletons in the graves from Normandy.

This is a very rich, truly interdisciplinary volume and I could do no more here than scratch the surface. Every article brings new facts, new interpretations, and a wealth of evidence. The almost forty illustrations inform and enrich the authors' arguments and add to the pleasure of reading this excellent collection.