Q&A with Tara Mulder, author of "A Womb of One's Own"
In the well-trod history of the Roman Empire, a pivotal moment has long gone unnoticed: It was in ancient Rome that medical men first set their sights on childbirth, the traditional domain of female midwives.
Taking us to the dawn of Western obstetrics, A Womb of One's Own offers a feminist account of how, against a long tradition of midwifery, male doctors began claiming authority in reproductive matters, with an emphasis on theoretical rather than practical knowledge. Their intrusion paved the way for the later criminalization of midwives and the cloaking of childbirth in secrecy and shame.
Yet communities of Roman women continued to help each other through the journey from preconception to postpartum, guided by their own experience and the expertise of midwives. Tara Mulder recovers stories of ancient women living and resisting as they sought autonomy over their bodies and their health. Recounting their experiences in vivid, intimate detail, she reveals how old our modern conflicts about birth truly are.
Tara Mulder is Assistant Professor of Classical and Ancient Near Eastern Studies at the University of Wisconsin–Madison. As the daughter of a homebirth midwife, she has assisted in over two dozen births.
Your book highlights a pivotal shift in ancient Rome when male medical practitioners began asserting authority over childbirth, which was traditionally managed by midwives. What drew you to this turning point? Why do you think it has been overlooked in traditional histories?
I’ve always been aware of the conflict between midwives and doctors. I was raised by a homebirth midwife who was part of the second generation of the homebirth revival movement in the United States during the 1990s. We lived in Michigan, where homebirth was a-legal. That meant that up until 2019 it was not exactly illegal, but not part of the legal apparatus of the state.
When my mom would have transfers—situations where a homebirth patient needed to be moved to the hospital for an emergent medical issue—both she and the birthing person would often be treated terribly by hospital staff. Homebirth midwives were viewed as irresponsible quacks by the medical establishment. This was true even though these midwives were responding to very real issues in the medical system, like obstetrical coercion, violence, and neglect, and even though certified professional midwives—the main type of credentialed homebirth midwife in the US—are well-trained and experienced practitioners.
There has also been a lot of academic and non-academic literature written about this conflict from a historical perspective. Typically, this conflict is described as emerging in the medieval period, when female medical practitioners, sometimes including midwives, were associated with witches. We see this narrative in the writing of people like Barbara Ehrenreich and Deirdre English (Witches, Midwives, and Nurses: A History of Women Healers, 1972) and Adrienne Rich (Of Woman Born: Motherhood as Experience and Institution, 1976). Ancient Greece and Rome, conversely, are popularly imagined as participating in a kind of pre-medicalized, primitive birth culture, where women were cared for by midwives and gave birth in natural, intuitive ways.
But what I was seeing in my research was that the conflict between midwives and doctors was already emerging in Ancient Greece and, especially, Rome around the 2nd century CE. It wasn’t during the Middle Ages. What this shows is that the medicalization of childbirth is baked into the emergence of medical writing. Some of the earliest medical writing on gynecology and obstetrics is from 5th century BCE Greece. This is also the first time we see doctors encroaching on the care of pregnant and birthing women.
So, the powerful narrative of doctors taking over birth from midwives in the Middle Ages, combined with the desire of the homebirth revival movement to locate a kind of pre-take-over utopia in the cultures of Ancient Greece and Rome, led scholars and popular writers alike to overlook the actual origins of this complex and enduring conflict.
In the book you reconstruct intimate stories of pregnancy and birth from historical sources. What were some of the biggest challenges and most rewarding discoveries in recovering these “lost histories” of women’s experiences?
It was certainly challenging and rewarding to take dry historical and medical texts, as well as poorly contextualized and laconic material objects like medical tools, magical amulets, and gravestones, and try to reconstruct real people through them. For instance, the story that forms the frame for Chapter 3 “The Self-Observant Women Get Pregnant,” comes from an incident recounted in the writings of the physician Galen (c. 129-216 CE). He asked “self-observant” but otherwise unidentified women what happens when they have sex and conceive because he was investigating whether a man’s semen has to stay inside a woman’s vagina or uterus after intercourse for conception to take place (that is, could it just touch and *spark* life before draining out?).
It’s an interesting account, but impersonal. To bring it to life I had to consider, who would these self-observant women have been? Where would Galen have talked to them? What sorts of things would they have said to him? What would those women’s relationship to each other have been? To be “self-observant,” which I took to indicate a kind of experience, they would have had to be on the older side, perhaps midwives or women who had given birth many times. They were likely lower class, enslaved or free working women, because it would have been inappropriate for Galen to make such inquiries of his wealthy female clients, whom he often tended to at the requests of their husbands. He probably would have spoken to them in a public place, like an outdoor market, and they were probably a bit raunchy and irreverent if they were willing to speak about their sex lives in detail. And so, my story of Galen’s encounter in marketplace with the middle-aged midwife Claudia and her two middle-aged friends, Flavia, a free vegetable seller, and Helena, an enslaved mother, was born.
What we gain from naming these women and fleshing them out is a much richer, more wholistic view of history. It’s one thing to tell the “big man” narratives around the discoveries of semen, spermatozoa, ova, and the processes of generation and conception. It’s another thing entirely to look at all the people, including many women, behind these narratives. When Galen tells us that he has learned about the function of semen from talking to women, we gain a more accurate—and frankly more interesting and compelling—understanding of historical and scientific discovery if we can make those women as real, detailed, and specific as possible.
A thread running through the whole book that resonates with modern reproductive issues is how patriarchy and misogyny feed systems that privilege fetal and infant life and health over maternal well-being.
—Tara Mulder
Can you give us an example of one of the stories from the book?
One of my favorite stories from the book is the breech birth of Agrippina the Younger. She was almost certainly the most powerful woman in the Roman Empire during her lifetime—the sister of the emperor Caligula, niece and wife of the emperor Claudius, and mother of the emperor Nero. We learn from contemporary historical sources that she wrote an autobiography. Unfortunately, it did not survive. But these other (male) historians used it as a source, and they tell us that she shared the story of her breech delivery of Nero.
So, at the start of Chapter 10 “Difficult Birth,” I reconstruct Agrippina’s lost birth story through these references to it and through descriptions of breech birth from contemporary medical writings. I start the chapter with a dramatization of the birth, which I think is one of the most exciting and immersive parts of the book.
You bring a unique background to this work — as a classicist, a daughter of a homebirth midwife and a trained herbalist. How did your own background influence the way you approached writing this history?
I have had to tread carefully when it comes to my own experience. Just because I have assisted at (and had my own) homebirths and just because I have trained and practiced in herbal medicine doesn’t mean that I am necessarily able to access these practices in ancient Rome.
At the same time, I do think such experiences have allowed me to get closer to what birth was like back then. The have influenced the questions that I have brought to the evidence. For instance, because I run in modern circles where breech birth is generally treated as a variation on normal rather than a medical emergency, I was able to examine, without preformed assumptions, how breech birth was viewed and approached in antiquity. Did the Romans see it as dangerous and unnatural, or did they see it as a quirky variation on normal, cephalic (head-first) birth? I found both perspectives. In popular literature breech birth tended to be treated as problematic—riskier for baby and mother alike. The medical literature, on the other hand, tended to see it as a variation on normal, with its own particular rhythms, movements, and, where needed, manual interventions—just like cephalic birth. I think more than anything this perspective, which comes from the midwifery model of care and conflicts with the medicalized model of care practiced by most people in our culture, allowed me to write a unique history of childbirth in ancient Rome.
While the book focuses on ancient Rome, many of the issues it raises around women’s health, reproductive justice, and the medical field feel very current. What connections do you see between the book and today’s conversations around birth and reproductive autonomy?
Perhaps the most obvious connections between ancient Rome and today emerge in Chapter 5 “Corinna Has an Abortion” and Chapter 11“After Birth,” around the issues of abortion and breastfeeding. This period of Roman history was also the start of significant and widespread condemnation of abortion in what we might call the “west.” We can see some of the very same antiabortion principles and practices at work in imperial Rome and in the modern United States. For instance, we find the eugenicist idea that superior women (free upper class in Rome; white, wealthy in the United States) are having abortions, while the wrong kind of women are having babies. Similarly, parts of Chapter 11 that deal with Ancient Roman debates over breastfeeding one’s own child versus outsourcing that labor to a wet nurse seem like they could be written today about the conflict between breastfeeding versus formula feeding. A thread running through the whole book that resonates with modern reproductive issues is how patriarchy and misogyny feed systems that privilege fetal and infant life and health over maternal well-being.
What is one key insight that you hope readers will take away from the book?
I want readers to be able to look at birth in antiquity without the immediate assumption that it was a horrifying experience. I discuss perceptions of risk and the experience of fear around birth in Chapter 9 “At the Birth” and Chapter 10 “Difficult Birth,” noting that in both ancient Rome and today our perception of birth as dangerous does not always necessarily align with reality. We are hampered in our understanding of childbirth in ancient Rome by cultural perceptions of what modern birth interventions do, as well as our access to powerful methods of pain relief, like epidurals. For instance, the fact that the c-section rate in the United States is more than 30% today might lead us to think that 30% of births in ancient Rome resulted in the death of mother, baby, or both. But c-sections are performed for all kinds of reasons, not only to head off mortal disaster. In fact, it’s more likely that less than 10% of births in ancient Rome would have been considered difficult.
It’s also important to recognize that before the advent of modern pain medications for labor in the 19th century, pain in birth was both a positive sign and a way for birth attendants to track the progress of labor. Throughout the book I show that modern advances in childbirth practices have reduced maternal and infant mortality and pain, but also that certain coping methods and skills—such as those for handling vaginal breech birth—have been lost by most modern obstetrical practitioners. This tradeoff means that we cannot simply sum up childbirth in ancient Rome as terrifying and deadly.