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Tara Mulder, "A Womb of One's Own: Lost Histories of Childbirth in Ancient Rome" (U California Press, 2026)
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Dr. Miranda Melcher
hello, and welcome to another episode on the New Books Network. I'm one of your hosts, Dr. Miranda Melcher, and I'm very pleased today to be speaking with Dr. Tara Mulder about her book titled A Womb of One's Lost Histories of Childbirth in Ancient Rome, published by the University of California Press in 2026. Obviously, as this book subtitle suggests, we are going to ancient Rome to talk about a ton of things you. Childbirth, obviously. Yes. But also lots of things around that.
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Dr. Tara Mulder
Right.
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Dr. Miranda Melcher
Midwives, medical expertise, infertility, all sorts of things that are focused perhaps on childbirth. Certainly that was as we're going to probably discuss very much a concern of ancient Roman society, but lots of aspects about this time that maybe get overlooked if we focus on sort of the male emperors and that side of things. So. So, Tara, thank you so much for joining me on the podcast.
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Dr. Tara Mulder
Thank you so much for having me. I'm delighted to be here.
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Dr. Miranda Melcher
Well, I'm very pleased to have you. Could you start us off by introducing yourself a little bit and tell us why you decided to write this book?
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Dr. Tara Mulder
Yeah. Thank you. I'm currently an assistant professor at the University of Wisconsin, Madison, and I have been. I finished my PhD about 11 years ago now. So I've been traveling around to different, different jobs around North America. I've held. Held temporary positions and teaching positions and that sort of thing. And I have spent that time as well working on this book, which really comes out of my entire life experience. I was raised by a home birth midwife in Northern Michigan, and I have been attending births since I was about seven years old. Initially, my mother would take me along and I would just be there to witness the birth. And then as I got older, I started to assist at births as well. When I did my graduate work at Brown University, I realized that I could combine this lifelong interest and expertise in childbirth with my studies in the ancient world. And that's when I really, really got going on this, on this topic of childbirth in ancient Rome. But like I said, I've been. I've been traveling around for the last 10 years, all these different. All these different places. And very, very slowly over that time, writing this book and the. The fact that I have not been in tenure track positions until this point meant that I was able to take my time on this book and to write exactly the book that I wanted to write. I wasn't writing, you know, to get tenure. I wasn't necessarily writing for an academic audience at first. I just was writing for my mom and her midwife friends and trying to tell this engaging, engrossing story about what childbirth was like in ancient Rome.
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Dr. Miranda Melcher
That's so interesting to hear about as the backstory. I think quite often projects have a combination of, like, academic intellectual goals as well as personal ones. They're always intertwined. So interesting to hear about that in this particular Case. And I think we're going to be discussing, as you said, kind of a lot of things that don't necessarily sound academic. I suppose that doesn't quite make sense. Like, they're things that are obviously heavily researched and academic, but like, also in many senses, in the book, it kind of felt like one was in the room, right. And getting a sense of very much what these sort of key everyday aspects of life more like. But I do want to start with the sort of state view of things because, as I mentioned in the introduction, childbirth was obviously of concern to the people intimately and immediately involved, but it was also a preoccupation of kind of the state and the government as well at this point. So can you maybe tell us a little bit about the Julian laws and how reproduction was viewed by the Roman imperial state to give us sort of some context of the stakes here?
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Dr. Tara Mulder
So I start with the Julian laws because I wanted to tell this birth story from preconception through postpartum. And during that preconception period, what we see is that women, all women in ancient Rome, are viewed as potential mothers, people who could potentially get pregnant and give birth, and they would do so on behalf of their husbands and on behalf of the Roman state, or if they're enslaved women, then on behalf of their enslavers. And so I wanted to paint that picture of what's going on socioculturally, legally, in the first couple centuries of the Empire. And one way I do this is by looking at these Julian laws. These were pieces of legislation that were passed under the rule of the first emperor of Rome, Augustus. And they were passed to incentivize and control childbearing, specifically by the upper classes. They had provisions in them like people of the senatorial class could not marry actors or sex workers. But they also had these incentives to encourage people of this, of these upper classes of the senatorial class to bear children. And one of these is called the US Trium Liberorum, or the Law of Three Children. And it was. It would be four children for freed people, people that had been formerly enslaved. And essentially what it said is, if you are in a legitimate marriage, then within that legitimate marriage, you produce at least three children. You get certain rights and privileges that other people don't have. So if you met that criteria, as spouses, you could inherit from each other. Men earned reprieve from the obligation to provide public works and games. Women got the right to no longer have a male guardian. So we see that childbearing, but not only, not just childbearing, but this particular type of childbearing among the upper classes is incentivized by the state. I then talk a little bit more in those opening chapters about how childbirth was also incentivized among the lower classes as well too. So individual enslavers would make provisions for their slaves that if they produced a certain number of children, then they could earn their freedom. And so we see that this, there is this kind of trickling down of these legal incentives for the upper classes that then also get mirrored in the, you know, the frameworks that are set up for the lower classes as well.
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Dr. Miranda Melcher
Got it. Okay. That's very helpful context. It definitely emphasizes kind of the importance of having children. And following your thread of going from preconception all the way to postpartum before we get then to pregnancy. There's also the kind of territory we want to cover in terms of medical thinking or scientific thinking or philosophical thinking, you know, however we want to call it ideas about how the uterus worked, how it was shaped, how it impacted women's health. Can you give us a sense of that aspect of this time?
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Dr. Tara Mulder
Yeah. So this is another important part of that preconception period. Right. Is, you know, what's going on in terms of medical ideas about women's bodies. And what we see is that, of course, they did not have fetal imaging back then, right. Like we do now, so ultrasound and, you know, related technologies. So they weren't able to see inside of the female body, but they did their own approximation of that by imagining the interior of the body through metaphor and through analogy to female animals. Because the, the interior of female animals was known through sacrifice, through medical dissection, just through simple butchery. Right. So they, they did have access to the interior bodies of female animals, and they used those, they used that, not that information. And they analogized the interior of the animals to the interior of human women. And they also just created different metaphors around the uterus and around conception and gestation as a way to try to make sense of this unseen phenomenon, this unseen interior phenomenon. So a few of the. The main metaphors for the uterus that were floating around at this time. And I think it's important to emphasize that these are both metaphors that are in the medical texts, but also metaphors that were accepted by women themselves. So I think sometimes we get the sense that, oh, these strange ideas about the uterus were like, imposed on women top down by men, or they were imposed on women by the medical text. But we actually see that these metaphors are quite ubiquitous. Right. We See them in, you know, male authored medical texts, and we also see them in material objects that women would have been using and maybe even creating themselves. So one of the metaphors is uterus as cupping vessel. The cupping vessel was one of the key medical instruments of the time. And it was this kind of bulbous cup with a rim on it that was made out of metal or glass. And it was used, you know, just like if you've seen cupping done today, it's still an alternative medical practice that's used today. It would be heated up and then held against the skin. And the idea was that it was drawing fluids and impurities out of the skin. So that was a, you know, a key tool for ancient medicine. And this is what they thought the uterus looked like as well. And this is because as far as they were concerned, the uterus was a vessel for holding and releasing fluids, right? That's how they understood menstruation. That's how they understood lochia, which is the, the out, outflowing of uterine material and blood after childbirth. So that's one metaphor. And then we see this really very different metaphor, which is uterus as octopus. And what this was tapping into was this idea that the uterus was a kind of animal within an animal, an organ that men didn't have, that was unanchored within the interior of the body or loosely anchored within the interior of the body, and that it could move around, it could wander, it could squeeze, it could suffocate other organs. It was even sentient and kind of wily like an octopus. So that's capturing another facet of the uterus, right? One that's different from that cupping vessel image. And, and I think this probably came, this metaphor probably came from the experience of having a uterus, right? If you've ever experienced like uterine cramps or contractions while giving birth, it also came from just simple observation, right? The uterus could prolapse and come down out of the vagina. And when that happened, people could see or feel part of the uterus, and to them it looked and felt like an octopus. So, you know, kind of rubbery, kind of pinkish, that sort of thing. So that's another metaphor. And then you also have this idea of the uterus as a field, so a piece of. A piece of land soil, right? Something that is potentially fertile but in need of management. And you can see kind of where, where this metaphor is heading, right? The. If the, if the uterus or the entire woman's body is a field, then it needs A farmer to cultivate it. And that farmer was imagined as the husband or the doctor who might be overseeing the process of conception and, and gestation. So we get all of these kind of. And these, these metaphors, they contradict each other sometimes they intertwine with one another and they capture all of the different things that the uterus meant for people in ancient Rome.
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Dr. Miranda Melcher
Yeah, there's a really interesting collection of metaphors, and I'd love to pick up the thread you just mentioned there of kind of what these metaphors meant in terms of practice. So what sorts of medicines or medical treatments were seen to be helpful if that was the understanding of what was happening with the uterus?
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Dr. Tara Mulder
Yeah. So a lot of the management of, of women's bodies, particularly for these potential mothers in this preconception phase, was managing the, the, the collection and outflow of fluids, which was primarily the menstrual fluid. You know, women's bodies were seen as being very moist and fleshy and, and leaky. And so menstruation was the mechanism by which women were able to maintain health. Right. Men's bodies were seen as harder and drier and more efficient. Right. So because women were wetter and, and colder, also they had to periodically collect the extra fluid that was in their bodies and then expel it. And so that, that's what menstruation was. And so a lot of medical management in this preconception period was management of menstruation. So using herbs, you know, either ingested orally or inserted vaginally to try to bring on a period that wasn't coming frequently enough or wasn't strong enough, or to, you know, try to curtail a period that, that was too heavy, which, you know, could, could veer into what we call a flux, which is where the, the uterus and the vagina are just kind of leaking a fluid almost constantly. So even either one of those was seen as a problem. Right. Not enough period, not enough menstrual period, or too much. And so trying to manage that largely through the use of herbs, but also through things like bloodletting or through even more intense therapies like inserting metal rods up into the cervix to try to open or reposition a uterus or a cervix that wasn't. That was closed or that was angled in the wrong direction. We even see descriptions of, like, of surgeries where the, you know, the, the cervix, or what they called the mouth of the womb, had been blocked off by a tumor. And so they would need to go in and and cut out the tumor so that menstruation could could proceed normally.
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Dr. Miranda Melcher
Okay, so that's a lot going on, as you said, focused on the menstrual cycle, which is obviously makes sense as a starting point with that assumption you mentioned in terms of kind of all women are potential mothers. In this context, then how might a Roman woman approach the problem of infertility?
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Dr. Tara Mulder
So obviously infertility was a really big deal for Roman women since reproduction was valued so highly and was expected of women at all class levels, all socioeconomic levels. And they really approach the problem through medical, religious and magical means. And women would have used all of these simultaneously. The distinctions between them are really a product of the modern day. And we can see this, we can see how this might have played out, kind of the sort of blending together, for instance, of the religious and the magical in this one section from chapter three. So I'm just going to read this part of the book, and this is about a woman named Turia, who this was probably not actually her name, but this is the name that has been given to her by scholars, and we know about her from this very long funerary inscription that her husband wrote for her after she died. And what makes this inscription unique and what makes their relationship unique is that they were married for about 40 years, right around the time the end of the republic, the beginning of Augustus's reign, and they never had children. And this flew wildly in the, in the face of those Julian laws that I was talking about earlier. It was expected that if, if people, if, if a husband and wife were not having children, that they would divorce each other and marry other people and hopefully be able to have children with their new spouses. But Turia and her husband refused to do that. They seem to have had a very high level of maternal affection and harmony. And so we hear in this inscription about, you know, how, how great of a spouse Turia was and what a sadness it was to her that she was not able to have, have children. And, and we get this oblique mention of all, all the different methods she tried in order to have children, because, of course, infertility was based. Was infertility was blamed on the woman, not the man. Even though, you know, they acknowledge, oh, it could be the man or it could be the woman. When push came to shove, all of the treatments and remedies were aimed at women and women's bodies. So her husband, like I said, very obliquely mentions that she, she tried every means available to cure her infertility. So that's where this, this part picks up. As her repeated prayers to the gods and herbal remedies proved unsuccessful, Turia probably visited soothsayers and fortune tellers, hoping to gain a glimpse into her future and perhaps discover the cause of her infertility. There were many types, knucklebone throwers, animal entrail readers, dream interpreters and more. But their proclamations could be confusing. When a woman dreamed that her womb had been sealed, one interpreter told her that she was barren. Her womb was sealed off to the sperm. But when she sought a second opinion, another told her that she was pregnant. Since quote, it's not customary to seal up something that's empty. End quote. Perhaps secretly and in desperation, Turia sought out more illicit magical cures, amulets, spells or potions because could work as aphrodisiacs to promote sexual desire, fertility and conception, such as a fertility remedy that entailed eating hyena's eye with licorice root and anise. Many of the remedies involved reciting or writing magical spells and formulas to make the ingredients effective. Magic was not just sneered at by doctors. It was actively distrusted and even outlawed. Aphrodisiac potions with the power to promote conception, not just aroused desire were particularly suspect. They were banned under the Cornelian law against murderers and poisoners. Whereas religion was an appeal to the gods, magic was an attempt to force them to do your bidding by example, for example, by using their secret names or to circumvent their authority altogether. But here too, the line was blurred. Two thin lead tablets dated to the first or second century CE were found folded seven times, rolled up and fastened together with a nail in the sanctuary of the goddesses Demeter and Kore in Corinth. The tablets are engraved with a curse against a woman named Carpinibe Babia. In an appeal on behalf of the writer, quote, bring a monthly destruction upon Carpime Babia. Subdue and destroy her soul, heart, mind and wits. Make me fertile. End quote. The bid for fertility includes a string of indecipherable magic letters, appeals to Hermes of the underworld and invokes Euphor, a powerful name for opening a mouth here, the mouth of the womb. The writer's bid for her own fertility is paired with a request for destruction of another woman's fertility, an interference with her menstrual period. The tablets are located in a religious space, the sanctuary of Demeter and Kore, but involve a kind of religion adjacent magical activity. Perhaps Turia was desperate enough to resort to such measures.
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Dr. Miranda Melcher
Yeah, that definitely establishes the stakes and what those sorts of societal expectations and legal incentives mean for the individual, which is really quite important to understand kind of how those different scales interact with each other and also the kind of medical ideas around what should and should not be done. So if we move from how one gets pregnant to then pregnancy itself, you talk about a few different kind of key medical figures in the book in terms of the interventions they made of ideas of pregnancy. Can we talk about some of those and the longer and shorter term impacts of them?
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Dr. Tara Mulder
Yes. So I'm, like I said, this book is set in the first few centuries of the Roman Empire. I dip into, you know, dip back into the first century bce. I go as late as, you know, into the second and third century ce. A little bit later than that, if I'm looking at the legal texts, because the, the legal texts that we actually have are, are from the 6th century CE, though, recording laws from earlier times. But in any case, so in this period in the Roman Empire, something really significant happens in terms of gynecology and obstetrics. Up until this point, the main medical understanding of the female body had been supplied by the Hippocratic corpus. And so the Hippocratic corpus This collection of texts from the 5th and 4th centuries BCE, written in Greek, had started to systematize and write down gynecological knowledge. And the key principle of this group of physicians and their texts was that pregnancy was healthy or healthful for female bodies. If menstruation was a regulating principle for female bodies, childbirth was even more so regulating for them. And that had to do with the way that being pregnant expanded and opened up the channels within the body, but also with that lochia, which was the, what they saw as, you know, a very heavy kind of menstrual period following birth. A cleansing, a cleaning, the ultimate cleaning of the female body. So pregnancy was seen as this thing that was really good for maintaining the health of female bodies. In the second century we get this gynecological and obstetrical text by a man named Serenus, and he's coming from Ephesus on the. In Ionia, which is now the western coast of modern day Turkey. He was writing in Greek, but, but living and practicing at Rome. And he completely upended this philosophy of female bodies. He said pregnancy is not healthy for women. Pregnancy is actually detrimental to their health. That doesn't mean they shouldn't become pregnant. It, you know, it's, it, they need to be pregnant. It's, it's, it's their duty, right? It's the expectation, it's why people get married. But it's in, it's, it's natural, but it's not good for women. And so this, this massive change in philosophy, and I will. The reason this matters so much is that Serenus goes on and, you know, the later translations and adaptations of Serenus go on to be the main gynecological and obstetrical texts well into the Middle Ages, you know, you know, up until the 14th century, really. So he has this just enormous impact on all, all of the places that were under the aegis of the Roman Empire in the second century ce. And he. So this, this new idea about women's bodies, that pregnancy is not healthy, it's not good for them, has wide ranging impacts, right? If pregnancy is normal and it's necessary, but it's not healthy, then it requires medical intervention. And that medical intervention can be midwives or male doctors or husbands who are following the advice of these male medical writers. And so we start to see childbirth being, being pregnancy and childbirth being pathologized and then also starting to come under
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Dr. Miranda Melcher
medical control and with quite long lasting impacts, as you mentioned. So, yeah, a pretty big change indeed. What does this mean then for ideas and practices of abortion in this period?
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Dr. Tara Mulder
Yes. So this is a kind of parallel track to childbirth, right? I, I debated whether or not to have an abortion chapter in the book since I don't think that people always associate abortion with childbirth. It's, you know, it's a, the childbirth process cut short or cut off. But I decided that it was important because like the experience of being a potential mother or like the experience of infertility, right? Abortion was a just an important facet of being a woman. Being a female bodied person in ancient Rome was an important part of their fertility story. Right? And so what I, I'm looking at in, in chapter five in the book is what's going on with abortion, right? How did, how did the Romans feel about it? Was it happening? If so, how was it happening? How widespread read was it? There's been a debate among scholars going back to the early 20th century as to whether there was a lot of abortion happening in ancient Rome or really no abortion happening at all. And, and the reason that this debate arose is that we, we see a real ramping up of anti abortion sentiment at this time period, at the time that Serenus is writing his gynecology, you know, we're talking like 100 years or so after the Julian Laws from Augustus. And so scholars have been like, does this ramping up of anti abortion sentiment mean that there was an abortion epidemic, that, that people were responding to, right? Women were having so many abortions that these male writers had to speak out against it? Or does this indicate that there was really no abortion going on because, because there was such strong moral and social opposition to it. Unsurprisingly, I kind of take a middle road between the two. I think both of those are just untenable arguments. Right? The idea of an abortion epidemic is fundamentally a very misogynistic idea. And then the idea that there's no abortion happening is, is fairly naive in my perspective because I, I, I take the tact that anywhere in the world at any time that people have been having babies, there has been abortion to some extent, right? The, the amount of it varies, the, the methods of it might vary, but, but people are always interested in managing, managing their reproductive lives or for a variety of different reasons. So what I try to do in that chapter of the book is really look at like who would be having abortions, like what, what kind of women would be interested in having abortions and then how would they go about doing it? And we, we have a lot of evidence for how to have an abortion. Right. The medical texts contain physical, mechanical and, and herbal abortifacient methods. Physical being like jumping up and down to try to dislodge the fetus. Mechanical like using sharp objects, taking hot baths, that kind of thing. Again, to try to dislodge the fetus. And then just a lot of herbal remedies, again, things to be taken, drinks to be taken orally or pessaries to be inserted vaginally to bring on the menstrual period. And of course, in the, in the pre modern world, there's a great blurring of the line between some and a metagogue. Right. Something that is intended to bring on the menstrual period versus an abortive fashion. Right. Which we might say is something to, that's designed to kill or expel a fetus. So there's, there is always this question of, you know, what exactly were people trying to do when they, when they used these methods? Were they knowingly in instigating an abortion or were they just trying to regulate their menstruation? And I think it's, it's just always, always some combination of those, those things for different people due to their own idiosyncratic reasons.
- [35:02]
Dr. Miranda Melcher
Yeah, we can't read their minds. So we, we can make guesses, but not more than that. So that, that's helpful to understand kind of what's happening in that aspect of reproductive care. Another one I want to talk about is prenatal care. What was and wasn't there in terms of that aspect?
- [35:22]
Dr. Tara Mulder
Yeah. So like with infertility treatments, we see combinations of, of the things that women did for themselves versus what the medical texts were advising that women should do. And I, I think it's important to not see these as separate routes of treatment. We should understand women as caring for themselves or being cared for by people in their lives in, in a variety of different ways. Right. Some of which we might call magical or religious and others that we might call medical. So one thing that was really important during the prenatal period was the sort of ritual or, you know, religio medical or. Sorry, religio magical management of knots. So what do I mean by that? Well, there's this, this kind of sense that during pregnancy it's important for the uterus to stay closed up and to hold in the fetus so that it can develop fully and properly. And so one way to manage that closing of the uterus, closing of the cervix was to tie knots around the body. Right. Where different kinds of like knotted or tied on amulets to wear belts, like binding on the body was thought to impart a sort of binding power to the uterus as well. And then once the pregnant woman had reached full term, it then it became a management of the knots being untied and coming off of the body. So we see descriptions of, you know, amulets that are supposed to be tied on the arm during the course of pregnancy to hold the fetus in and then untied, taken off the arm at the appropriate time so that labor could ensue and the. The baby could come out. And this kind of like not management knowledge as I call it, this would have been the purview of midwives and experienced women who were helping. Helping other women. One of my favorite amulets or a class of amulets, because we have, we have a few of these, is called the Omphale amulet. And it shows. So the onay was the queen that kept Hercules imprisoned for, for a year as a kind of willing sex slave. And on these amulets, on one side of them we see Hercules wrestling with the Ninian lion. And then on the other side we see a pregnant Omphale holding a club. She's naked, she's holding a club and she's squatting over this donkey that's lying on its back that has a large erect phallus. And it's sort of. It's unclear whether she's like about to like lower down, lower her vagina down onto this donkey phallus or whether she's like warding off the donkey with her club. But the way that scholars have interpreted this amulet is that she is defending and protecting herself from miscarriage. So these amulets come out of kind of Greco Egyptian tradition, religio magical tradition. And so the donkey is. Is supposed to be the God Set or Seth, who. It menaces pregnant women and, and causes miscarriage during the prenatal period. And so I love this idea that Onfil A is like this strong pregnant woman with a club who's like defending herself against miscarriage. So women could have worn these amulets on their body, these onflay amulets on their body while they were pregnant in order to protect themselves from miscarriage. So that's how we see women kind of managing it themselves. And then we also have this kind of parallel tradition going on in the medical text. So we turn again to Serenus. He is our main medical source for this period. Period. And one thing that's really interesting there is that he divides the prenatal period into three trimesters which is still, that's how we think of it today. But that's not how everyone in antiquity or in, even in the pre modern world thought of pregnancy. We can compare that kind of trimester framework to a different framework that sees pregnancy as being divided between pre and post quickening. So before the first movements of the fetus and after the first movements of the fetus, which is the, the main way that people understand pregnancy up until the modern period. So it's kind of, kind of interesting that Serenus had like sketched out this trimester period, that this trimester framework that doesn't, you know, really become popular again until, until the, the modern era. But he, so he recommended different, or he, you know, he had different lifestyle and diet recommendations for these different trimesters. And the overwhelming message is that his text is really aimed at upper class women, right? He, he has this absolutely impressive list of the kind of nutritious and, and modern mild foods that pregnant women are supposed to eat to ensure their health, the health of their fetus and to, you know, mild foods because strong foods could cause miscarriage. So he says like women should be eating like wild duck and blackbird and thrush and pigeon and chicken and all kinds of seafood, red mullet and crayfish and shrimp and then this huge variety of fruit, fruits and vegetables and nuts, endives and plantain and olives and pears and grapes and almonds. And so you have to pause and think to yourself, what sort of woman would have actually had access to all of this food, right? And the answer is not very many. And that's where I like to bring in the bioarchaeological data, right? So the people that have examined skeletal remains from the ancient world have examined teeth and bones and so been able to identify, you know, what people were actually eating. And the reality is that most women in ancient Rome were eating mostly cereals, so spelt, wheat, barley, oats, right? So they had these, you know, very simple diets that would have led to different kinds of nutritional deficiencies. In particular, like eating a lot of cereals can impact the intestinal absorption of iron and lead to anemia, which is a serious concern even today for people in the prenatal period. Even people today who have access to, you know, varied and nutritious diets.
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- [44:26]
Dr. Miranda Melcher
Yeah, some of this definitely sounds quite familiar. Moving then, in terms of forward in the sort of pregnancy story, you've given us some really intricate details there which are great, right? The assumption might be that, like, oh, it's too long ago, we can't know that level of specificity. But clearly, as you've just demonstrated, we do know in some instances, some nice specific things that really kind of, as I mentioned earlier, like let us feel like we're in the room. How much can we know about ancient Roman birth stories? Do we have a sense of how dangerous or difficult this generally was?
- [45:02]
Dr. Tara Mulder
One of the things I am trying to do in the book is acknowledge the risks and the dangers of birth, but also continually, repeatedly point out that we have in many cases overemphasized the dangers of ancient childbirth. The risks of ancient childbirth and not the other aspects of the story of ancient birth, but to look at some of those risks and dangers. Of course, young age at pregnancy was a problem, right? The medical writers acknowledge this. They advise waiting several years after the onset of menstruation to get pregnant for the first time. We don't know if the recommendations were followed, that we have records in the literary texts and inscriptions of women, girls getting married very young, right. Either, you know, right before or around the onset of menstruation. There were also, like I started to mention earlier, nutritional deficiencies that could cause problems. So, for instance, vitamin D deficiencies could lead to rickets and something called rashidic pelvis, which is where the pelvic opening, the bones of the pelvis, are so deformed that the pelvic opening becomes too narrow to admit the fetal head. And that is obviously an intractable problem, right? For giving birth in antiquity, the way that started to be dealt with in the modern period is with caesarean section, which they did not have recourse to in terms of, you know, at the birth moment itself. In addition to, you know, malformations of the pelvis causing problems, there could also be malposition of the fetus as it, at it, as it's coming out of the uterus and through the cervix and down the birth canal. So if the fetus is positioned obliquely, so kind of, you know, lying on its side in some way, if it's breech, so coming down feet first or butt first instead of head first, if you have something like a nuchal hand or a cord, so a hand up by the face or a cord wrapped around the neck many times, you know, if the head is slightly tilted. These are all things that could cause labor to be difficult, some of which could be managed and, and, and result in a living mother and a living baby. And, and some of which could not, right? And then the, the only recourse there would be embryotomy, which is just, you know, the really gruesome practice of the doctor using scalpels and hooks to go, you know, reach up manually inside the birth canal or even all the way up into the uterus and dismembering the fetus and pulling it out to try to save the life of the mother. Before things got that far right, midwives would have managed these difficult births by, you know, manual repro repositionings of the fetus, so using hands to go up into the birth canal and physically reposition the fetus. But, but even before that, just, you know, having, having the woman Change positions, having her walk up and down stairs, having her be on her knees, leaning forward to try to reposition the fetus. They did a lot of like moving and shaking and jiggling of the body all in attempts to reposition, reposition these, these malpositioned fetuses. So they, they had a lot. And we can, we read about these in the, in the medical texts. They had a lot of means of dealing with difficult perth at various levels before things got really extreme. In terms of numbers, we're looking, you know, these are entirely estimates. We really don't have numbers for ancient Rome, but we're looking at things like 5 to 20 maternal deaths per a thousand live births and then a slightly different number which is the rate of difficult birth. Right. And difficult birth doesn't always necessarily end in maternal or fetal death. It just means a birth that, you know, needs some kind of management in order to, to proceed, probably around 10% or less. So that's alarming, I think from a modern perspective, right, that we would have 10% of births be difficult, that 5 to 20 women would be dying per thousand live births. But another way of looking at it is that for the most part birth would have proceeded normally and, and that they did have a lot of means of dealing with difficult or dangerous labors.
- [50:12]
Dr. Miranda Melcher
Yeah, I mean, if we're comparing those numbers to today, that might sound, as you said, alarming, but perhaps comparing to what some of our assumptions might be about the numbers from ancient Rome, actually that maybe is a bit of a different perspective. So thank you for giving us a sense of that aspect. Of course, though, birth stories is not the end. Right. You mentioned at the beginning, we're going from pre pregnancy all the way to postpartum. So if we're talking and sort of concluding our discussion on the book, looking at the postpartum period, what were seen to be the risks there and you know, picking up from what you've just said, what were some of the mitigation and management techniques available?
- [50:48]
Dr. Tara Mulder
It's interesting because I started writing this book before I had a baby and then I finished writing it after I had a baby. And also in that period of time I had about half a manuscript finished and some, some folks here in the US and Canada held a first book workshop for me, right. So they, I had two, two scholars read my half finished manuscript and give me extensive, extensive notes on it and, and help sort of guide it, the manuscript as it went forward. And one of those readers had just had a baby and she said you have to have a Chapter about the postpartum period. Like, I had not intended to include that. Right. I was gonna, it was a birth story. I've, I've seen a lot of birth in my life. So I was gonna just, you know, take it, take it through that birth moment and that was going to be it. And she was like, she, you know, going through postpartum herself. As she was giving me this feedback on my manuscript, she said, you have to include the postpartum period. And then as soon as I had my own child the next year, I was like, I have to include the postpartum period. Because I think, you know, it's, people don't really prepare you for that, that like fourth trimester, how much that is a part of the birth story and how much you are still kind of giving of your body to this, this new life. So, you know, thanks to Jane Dracott. She was, she was the, the scholar who told me I had to put this, this final chapter in. And I think it ended up being sort of one of the, the richest and most complex chapter chapters in the book. But to get back to your question, yeah. What were some of the risks in that immediate postpartum period? Of course, there's getting the placenta out. That's, you know, concern number one. Got to get the placenta out, got to get all the pieces of it out. Cutting the umbilical cord. And I, I, I put the placenta first because interestingly enough, in antiquity it seems, seems like they did wait for the placenta to come out before they cut the umbilical cord, which is not standard practice today. But one of the reasons they did that is a, one of the means of getting the placenta out was to lay the baby down. So the baby is still attached to the placenta by the umbilical cord. To lay the baby down on a bladder that's full of air, like a pig bladder that's full of air with a tiny pin prick hole in it. And so the weight of the baby would compress the bladder. And as the baby's weight compressed the bladder, it would provide gentle traction to pull the placenta out. Which seems like very complicated and elaborate, but presumably they felt like this was safer than just having someone apply manual traction to the umbilical cord. So then there was concern about cutting the cord. And this is where we see denigration of midwives in the, in the male authored medical texts. Because they're like, midwives can mess this up, right? They can cut the, the umbilical cord too close and and cause the baby to die, or they can pull on it too hard and then they can cause pieces of the placenta to get stuck inside the birthing woman. And what, you know, we can see, they even suggest sometimes that the midwives are doing these things maliciously, that they've been bribed to do these things. So that's one of the points at which, like this distrust between medical men and the female midwives who are managing the birth starts to crop up. There's the management of the lochia, the bathing and feeding of the infant. And here, interestingly too, is where we see some risks introduced in the medical texts that wouldn't necessarily be there if people were not following the medical text. So what I mean by that is, in the texts that survive, the ones that went on to have influence for hundreds and hundreds of years, the recommendation is babies should not be fed their mother's milk immediately after birth. They should be fed hydromel. So honey, honey, water, essentially. Um, and anyone who's cared for a baby in the modern day knows that we do not. You do not give honey to an infant under 1 year of age because of the risks of botulism. So there, you know, there's that slight risk that's introduced, but even more so the risk of. Of contaminated water. Right. Being mixed with the honey. So not only with that, if, if people were following that medical recommendation, not only are infants getting this risky hydromel, but they're also being denied colostrum, which is the first type of milk that's produced by the breasts. It's this kind of thick, yellowish, very, very nutritive substance that's really, really good for newborn babies. So that's a kind of interesting tension in the text as well, that we see the ways that they try to mitigate risks, sometimes introduce new risks that wouldn't have been there otherwise.
- [56:45]
Dr. Miranda Melcher
Yeah, that's definitely interesting to think about from the perspective of how we approach medicine now. And definitely, I think, speaks to that advice you got in terms of why it's important to include this chapter. So we've now kind of covered, in many senses, the whole journey, the whole book, obviously. Is there anything you want to leave us with in terms of what you might be up to next now that this book is out in the world?
- [57:07]
Dr. Tara Mulder
So my next project, I'm. I'm going to go more in depth into abortion. I did birth and now I'm going to do abortion. I just got a fellowship from the American Council of Learned Societies to. To undertake this project that I'm calling the invention of abortion in ancient Rome, where I'm really going to drill down into what's happening with this ramping up of anti abortion sentiment during this time period. You know, where does that come from and what are its lasting impacts, particularly here in the United States, where antiquity, Greco Roman antiquity in particular, has played such an important role in the legal, legal framework around abortion in this, in this country. So kind of looking at the ancient and modern, looking at the, you know, abortion in ancient Rome and then the impacts of ideas from Rome on our society today.
- [58:17]
Dr. Miranda Melcher
Well, plenty there to get into. So good luck with that investigation. And of course, while you are pursuing that, listeners can read the book we've been discussing titled A Womb of One's Lost Histories of Childbirth in Ancient Rome, published by the University of California Press in 2026. Tara, thank you so much for joining me on the podcast.
- [58:36]
Dr. Tara Mulder
Thank you so much for having me. This has been delightful.
- [58:40]
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