Contraception and Abortion in the Middle Ages

Were contraceptives and other means of family limitation such as abortion, infanticide, and child abandonment practised in medieval Western Europe? If so, what remedies and methods of contraception were used, to what extent, and were they successful? Early research into the topic concluded that contraception was virtually unknown in the Middle Ages and that medieval people did not have a ‘contraceptive mentality’.

However, more recent investigations have produced a plethora of writing which clearly demonstrates that medieval society not only knew about various forms of contraception and abortifacients; they used them to such a degree that medical texts, church doctrine and the common literature of the time are strewn with references to their use. Documents are littered with contraceptive recipes and methods and contain warnings and prohibitions against certain herbs, many of these originating in antiquity.

Contemporary research into the history of human fertility control has therefore ceased to ask when contraception became common place and effective, and instead questions how family limitation was practised prior to the eighteenth century.

The idea and practice of controlling the number of children conceived and born has been employed across all cultures through time, although the methods and efficacy vary.

Starting in antiquity, there is indisputable evidence that family planning methods were used in Ancient Greece, Rome, Persia and Egypt.

Aristotle’s History of Animals and Pliny’s Natural History were both works used extensively by Roman and Greek society as medical texts from the fourth century B.C. and contain references to the biological, reproductive and scientific understandings of the time. From the fifth century B.C The Hippocratic school produced the earliest medical texts which focused on female health such as The Nature of Women and Diseases of Women and mention the use of a potion (misy) which induced temporary sterility.

Dioscorides of Cilicia’s Materia Medicais a compilation of Greek medical information which included gynaecological knowledge, similar to Pliny’s work, and was available from the first century A.D. His work includesa number of contraceptive and abortifacient recipes including potions that women could drink (willow leaves in water, ground barrenwort in wine) as well as pessaries to impede conception (peppermint juice, cedar gum).

Soranus of Ephesus, a second century A.D Roman medico, wrote the Gynecology which became the main guide for contraceptive and gynaecological information in the Roman Empire and was disseminated and used in the East and then later again in medieval Europe.

In his Gynecology under, ‘Whether One Ought to Make Use of Abortion and Contraceptives and How?’, Soranus noted the difference between the two:

A contraceptive differs from an abortive, for the first does not let conception take place, while the latter destroys what has been conceived. Let us, therefore call the one ‘abortive’ (phthorion) and the other ‘contraceptive’ (atokion). And an ‘expulsive’ (ekbolion) some people say is synonymous with an abortive; others, however, say that there is a difference because an explusive does not mean drugs but shaking and leaping. And since it is safer to prevent conception from taking place than to destroy the fetus, we shall now first discourse upon such prevention’.

 

Soranus also advised that to prevent conception from taking place,that during critical moment in coitus a woman should hold her breath and draw herself away a little so that ‘the seed may not be hurled too deeply into the cavity of the uterus’.[

His medical treatise also warns that the treatments to induce an abortion may cause congestion of the head, stomach upsets and vomiting.

One method for abortion includes ‘violent’ exercise, carrying things which are too heavy, diuretic potions, hot baths of linseed, fenugreek, wormwood and marshmallow and internal douching with rue juice, honey or iris oil.

 

Later works such as Oribaso’s Books for Eunapius and Medicine by Aëtios of Amdia, are medical texts which are heavily based on Soranus and Dioscorides’ texts and are evidence that contraceptive and gynaecological knowledge was passed on and updated throughout the ages.

Oribaso lists potions of fern root and willow leaf as contraceptives to be used after coitus and the description also indicates that it may also have been taken as an abortifacient, as well as vaginal concoctions to take such as the juice of wild mint.

Aëtios’ work recommends gallnut, pomegranate and alum mixed with vinegar or brine as a spermicidal recipe for preventing conception and mentions the use of contraceptive amulets.[

The reintroduction of this ancient information from Arabic to Latin led to an increase in gynaecological knowledge in the high middle ages in Western Europe.

When looking at whether medieval society had effective population control methods, Karras and Riddle argue that the use of restraint and celibacy does not fully explain the low birth replacement rate and progressive population decline. The fluctuations in population levels (exclusive of food supply issues, war and plague) cannot be understood simply in terms of individuals restricting their sexual activity or the age at marriage increasing. Further, it can be argued that as the low births rates and population figures do not correspond with the introduction of Christianity and prohibitions on sexual behaviour, effective methods of population control such as contraception and abortifacients must have been used by medieval societies to reduce the birth rate.

J.C Russell notes that the birth rate in Western Europe during the eleventh to thirteenth centuries was 4.2 per cent with a death rate of 3.6 per cent, but that during the fourteenth to fifteenth centuries the birth rate was 3.9, with a death rate of 4.1 per cent.[

This figure would produce an increase in population with the first figure and a decline in the second figure but also indicates that there was no major alteration in the birth rate.

This may be due to the use of family planning methods. Non-procreative intercourse such as anal or oral sex has also been suggested as a possible reason for the lower birth rate in some demographic studies.

It has long been presumed that ancient and medieval women had special knowledge of controlling their fertility and limiting the number of children they bore.

Women were therefore the main targets of campaigns to cease and prohibit the use of contraceptives and abortifacients. Whilst husbands were chastised by St Bernadino for sexual behaviour ‘against nature and against the proper mode of matrimony’ ie. contraceptive practices, he made clear that the worst offenders were the women who practised contraception:

And I say this to the women who are the cause that the children that they have conceived are destroyed; worse, who also are among those who arrange that they cannot conceive; and if they have conceived, they destroy them in the body. You (to whom this touches, I speak) are more evil than murderers.

Fertility control was therefore viewed by the church as a ‘female question’ as it was generally women who were required to take the potions, pessaries, amulets and herbs to prevent conception from taking place and it was therefore assumed that it was taken at their initiative.

In 1150 Clemence, wife of Robert II, the Count of Flanders, having produced three children, chose to not to have any more and reportedly used the ‘arte muliebri’ to prevent further pregnancies.

The De secretis mulierum, an anonymous medical text covering female gynecological issues, is therefore one example of the ‘secret’ fertility information that women were supposed to know (despite it usually being attributed to a male writer). The experience and knowledge of women in regards to contraception and childbirth was also tentatively acknowledged by Albertus Magnus who wrote that ‘much belief should be given to trustworthy women who have borne many children’.

In the thirteenth century, Michael Scot’s The Secrets of Nature also said that there were many things a woman could take which would prevent conception and that pregnant women should avoid those things.

Other writers, including an author of a thirteenth century confessor’s manual, Thomas of Chobham, also asserted that women had many ways to conceal the result of illicit affairs and to spare themselves the rigours and danger of pregnancy and childbirth.

Although written by men, these ‘secret’ books indicate that there was a belief that women had superior knowledge and access to methods of limiting pregnancies and their family size during the medieval period.

Women’s health and gynaecological care prior to the early modern period has mostly been perceived as ‘women’s business’ until recently.

Monica Green asserts that women and female midwives have generally been assumed to be the main providers of medical care and advice to female patients and in particular focused on contraception, abortion and pregnancy related issues.

She states that although the majority of medieval medical texts were written by men and for men, female experience and collective knowledge of gynaecological information remained and was transmitted informally between women.

Her study makes a distinction between female medical practitioners (who cared for all aspects of health) and midwives whose focus was on reproduction and pregnancy. Green finds that although women were underrepresented in the medical profession during the Middle Ages, there were female physicians, surgeons, barber-surgeons, apothecaries and any number of unrecorded empirical healers who treated both men and women.

The research conducted by Danielle Jacquart and Ernest Wickersheimer, which focused on the 7,647 medical practitioners recorded in France from the twelfth to fifteenth centuries, found that 121 of them were female. Of this number, 44 were categorised in terms which translate to ‘midwife’ and whose occupation was gynaecologically based.

The evidence of recorded female medical practitioners in England is considerably less, although Robert Gottfried claims that there were about 28 women medical practitioners in his survey of doctors in England from 1340-1530.

Green notes that this particular research doesn’t include midwives, however another study conducted by C.H Talbot and E.A Hammond found 8 female medical workers from the Anglo-Saxon times to the beginning of the sixteenth century.

Again, it must be recognised that many female healers and midwives were not legitimated by formal licensing, yet continued to practise.

The case of the French female doctor, Perretta Petone, who in 1410 was jailed on charges of practising medicine without a license is an example of this. Petone questioned why she was being singled out for review and examination in regards to her qualifications when there were already many female medical practitioners in Paris ‘of whom nobody demands anything’ ie licensing.

There were no legal requirements to be licensed until this time and there is evidence that women continued to practice medicine without it. It was not until the later medieval period that there was a focus on licensing ‘women’s work’ or midwifery (as opposed to general medical practitioners who happened to be female) and it appears to focus primarily on the midwives moral character, rather than their medical skills.[35]

The licensing of women healers also provides weight to the argument that not only were there likely many unrecorded medieval female empirics who provided gynaecological advice but also that women (though to a much lesser number) became medico professionals.

A study of medical licenses in Naples from 1273 to 1410 show that 24 were granted to female surgeons, 13 of which were licensed to practise on women exclusively, and treatment was not just limited to gynaecological issues.

 

The most famous female medical practitioners of the medieval period are the muliers Salernitanae of Salerno.

These women are reported to not only practise medicine but also wrote their own treatises and the most controversial and debated female medical writer and doctor was Trota or Trotula. She is said to have existed in the eleventh or twelfth century and there is considerable debate as to whether the works ascribed to her were written by a female or were simply dictated or even were a collection of work written by a man (or men) for the purpose of medical practise.

There are several versions of Trota’s treatise available. Monica Green’s translation of the Trotula also states that the reason the manual was written (according to the author/s) because:

…women are by nature weaker than men and because they are most frequently afflicted in childbirth, diseases very often abound in them especially around the organs devoted to the work of Nature. Moreover, women, from the condition of their fragility, out of shame and embarrassment do not dare reveal their anguish over their diseases (which happen in a private place) to a physician.

The implication of the passage being that Trota wrote her medical treatise for women due to their natural modesty in presenting to a male physician with their female gynaecological issues. In some versions she claims to also have written the treatise so that if women are:

…ashamed for fear of reproof in times to come and of exposure by discourteous men who love women only for physical pleasure and for evil gratification…. And so, to assist women, I intend to write of how to help their secret maladies so that one woman may aid another in her illness and not divulge her secrets to discourteous men.

 

In Rowland’s translation (from the Sloane manuscript 2463), the treatise is specifically directed at English women and the reason for writing it in the vernacular is stated;

Because whomen of oure tonge donne bettyr rede and undyrstande thys langage than eny other and eury whoman lettyrde rede hit to other unlettryd and help hem and conceyle hem in her maledyes, withowtyn shewyng here dysese to man, I have thys drauyn and wryttyn in englysh.

These translations indicate that there may have been a strong presence of female knowledge and wisdom in gynacolgical practises. The works included information about abortifacients and emmenogogues and are an indication that female information on family limitation was present, although formally recorded to a much lesser extent.

In regards to other methods of contraception in the medieval period, a variety of approaches have been recorded.
Amulets

There is evidence to suggest magical amulets were used to prevent conception, although the medical texts vary on their effectiveness.

Soranus does not put much store in their use, however, even as late as the sixth century A.D, Aëtios listed using the tooth of a child, henbane seed diluted in mare’s milk and carried in stags skin as special contraceptive charms.

He also advocated using the testicles of cats in a container attached to the navel and parts of a lioness to be carried in an ivory receptacle as efficacious contraceptive methods.

The ‘magical’ element of these items shows that ancient and medieval society still followed folklore in choosing to limit family size and that church doctrine on contraception (though important), was not always followed in family planning.
Coitus Interruptus

The extent and use of coitus interruptus or onanism as a contraceptive practise has caused much debate amongst historians. The literal translation of onanism from the Bible relates to Onan arousing God’s displeasure by disobeying his commandments. It has also been incorrectly interpreted to mean Onan’s sin was his use of contraception (coitus interruptus) or masturbation.

Coitus interruptus was referred to in 813 by Theodolphus, Bishop of Orleans, who described it as ‘Irrational Fornication’, and wrote ‘Not to have relations with a woman in a natural way is called uncleanness or a detestable sin whence we read that Onan, the son of Juda, was struck by after entering into his wife and spilling his seed on the ground’.

It should be noted that there are only limited references to the use of coitus interruptus in pre-Roman medical and literary texts and none at all in the penitentials.

Medical writers in antiquity such as Galen, Soranus and the Hippocratics do not mention the practice and it has been described as being virtually unheard of (apart from Jewish literature) in medieval times.

Riddle therefore believes that this method of contraception would not have been popularly used as it requires a great deal of cooperation from the male.

However, P.P.A. Biller disagrees and cites several early fourteenth century church writings which discuss coitus interruptus in regards to preventing conception with married couples. The reasons stated for the use of this method of contraception include preventing the pain of childbirth, the poverty of the family and inability to feed a new child, and the preservation of a wife’s beauty.

It has also been argued that coitus interruptus was such a self evident and common contraceptive practise that it was unnecessary to record it in the same manner as herbal contraceptives and abortifacient recipes.

Biller also posits that coitus interruptus would have been the simplest and most natural form of preventing pregnancy and would not have required written dissemination of the information from generation to generation.

 

Riddle’s arguments against the use of coitus interruptus as a contraceptive practise (i.e. the requirement of male cooperation, lack of written sources) is contradicted by Aëtios, who listed a spermicidal ointment specifically for male use before coitus.

The ointment’s main ingredient was pomegranate, and he also mentioned rubbing the male organ with a salt solution which prevented conception. Both of these methods of contraception would require a high degree of male cooperation and some basic medical knowledge of conception. This indicates that coitus interruptus and coitus reservatus may have been a more popular method of contraception than previously thought.

In regards to other male contraceptive practices there is very little evidence of the use of sheaths or condoms in this period, however we know that male condoms had been used by a number of ancient civilisations.

Primitive cave paintings depicting men wearing sheaths in Grotte des Combarelles and Egyptian tomb artefacts indicate that some form of male protection was available in early civilisation, although it has been argued that they were mostly used to prevent transmission of sexually transmitted diseases and not for contraceptive purposes.

Evidence from about 1000 BC shows that linen sheaths were used, specifically to prevent diseases like bilharzia and that Egyptian men wore coloured condoms to display their social status.

While Roman society does not acknowledge the contraceptive aspect of the use of sheaths, they did take keen interest public health and the prevention of sexually transmitted diseases such as syphilis.

Both Ancient Greece and Rome used hand sewn animal skins or gut such as lamb or goat for health reasons, however the contraceptive effect of the does not appear to be commented on.

One of the earliest reports of an early modern condom was in Gabriel Fallopio’s De Morbo gallico, written in 1563.

Fallopio, a sixteenth century Italian anatomist, described a linen sheath soaked in lotion for prevention of the spread of syphilis. Fallopio conducted trials on1100 men using condoms, none of whom had been infected by the disease. A further example of early condom use can be found at Dudley Castle, England. Sheaths made from fish, cattle and sheep intestines and dating from the early-mid seventeenth century have been uncovered at the site, and were likely used during the English Civil War to prevent the armies contracting syphilis from the use of prostitutes.

In both of these examples the primary use of condoms was for the prevention of venereal disease and not contraception. This may indicate that during the medieval period that the use of sheaths may have been limited to health reasons, not for family limitation. It was not until the invention of vulcanised rubber in the mid nineteenth century that condoms became cheaply and readily available and were used for contraception on a wide scale.
Rhythm method

Other methods of contraception which have been dismissed as being used irregularly within medieval society include the rhythm method. The discussion of the fertile and non-fertile times of the month for women in medical terms indicates a level of awareness of the fertility cycle and that contraceptive measures were taken in ancient and medieval times. Riddle again cites the lack of references to the practise in ancient and medieval sources as evidence that it was not popularly used as a contraceptive practise by medieval couples.

However, when the practise is mentioned, the gynaecological texts such as Soranus’s Gynecology, Hippocrates On the Diseases of Women, state that the most fertile period for intercourse was near the end or just after the menstrual period.

The lack of knowledge and misunderstanding of the most fertile times for a woman to conceive would have impacted on its failure and success rate as a contraceptive practice, yet again we can see that there was knowledge of methods to prevent conception in this period.
Oral contraceptives and abortifacients

There are numerous accounts of medical, canonical and anecdotal texts which reference the use of oral contraceptives and abortifacients.

The origins of this can be found in antiquity and the knowledge was passed down in medieval medical texts. As early as 100 AD Soranus noted the distinction between contraceptives and abortifacients stating and made recommendations for their use.

While the difference between a contraceptive and abortifacient was known, the use of emmenagogues (menstrua provocata – agents which bring on menstruation) as potential early-term abortifacients was often given the distinction of simply assisting in relieving amenorrhoea or other gynaecological conditions.[64] This enabled medical writers to discuss contraceptive and abortifacient herbals and to disseminate information on female reproductive issues without having to confront the thorny issue of morality or church theology on contraception.

An example of an emmenagogue is found in Rowland’s version of Trota’s work the Medieval Woman’s Guide to Health. The writer states that to rid the uterus of suffocation (amenorrhea) and to bring on a ‘purgation’ (menses) that;

…the matter may be brought down with sweet-smelling things, take the oil of musk and do thus: take 2 ½ gallons of good, suitable oil that is very sweet and add to it 1 pound of pennyroyal, half a pound each of rosemary, costmary, camomile, lavender, balm, woodruff, hyssop, savory, shaving of cypress, 12 drachms of calamint, feverfew, fennel, wormwood, sage, rue, orginanum, southernwood, mugwort of St-John’s… wash them first in water, then boil in malmsey, grind them up, put them in the previously mentioned oil, add to the mixture a quart of wine…. let them boil right down…pass them through a good, new, wide-meshed canvas to clean them…For this oil is good for all kinds of sickness that occur, especially for cold and for the suffocation of the womb.

Many of the herbal ingredients listed in medieval literature as oral contraceptives, emmenagogues and abortifacients remain the same as, or are very similar to ancient medical texts. Ferula (the giant fennel), pomegranate (which was used orally and as a vaginal pessary), rue, silphium, myrrh, parsley, pepper, juniper, pennyroyal, squirting cucumber, and Queen Anne’s Lace (wild carrot) are all discussed in ancient and medieval texts.

One recipe states that to reduce the female ‘seed’ (and therefore the likelihood of conception), a woman should stay awake, and have heat inducing herbs such as hyssop, rue and cumin and then partake of ‘cold herbs’ such as St. John’s Wort and water lilies to dry the ‘seed’ out.

Vaginal suppositories, fumigations and douches are frequently mentioned in ancient and medieval medical texts, both for contraceptive and abortifacient reasons.

Some of the suppositories could also be taken orally and then were used internally as an ‘intensive’ treatment if the oral contraceptives or arbortifacients failed to work. It has been argued that the suppositories were successful as the resins in the concoctions coagulated to block the mouth of the cervix, and/or altered the pH of the vaginal canal which acted as a spermicide and thus prevented conception.

The extent of writing on suppositories, their recipes and instructions for use, seem to indicate that they may have been one of the most popular methods of family planning in this time.

Medieval medical writers not only used ancient sources on herbal contraceptives and abortifacients but also added their own findings. In the fourteenth century, Peter of Padua included arum as a fertility agent in the gloss beside the Latin translation of the Alphabetical Dioscorides (an ancient medical text).

While not specifically stated as a contraceptive he describes it as being taken by ‘uniformed people’ before coitus.[71] Hildegarde of Bingen (1098 – 1179) was one of the first western writers to discuss the use of tansy as an emmenogogue, which is still considered an effective abortifacient today.

She was clear that certain plants such as oleaster were harmful to pregnant women and causes abortion. Riddle contends that Hildegard’s treatises on abortifacients, emmenagogues and potential contraceptives show that folk usage of herbs was still in use and undergoing adaptation during this time.

Additionally, the future Pope John XXI (1226-1277) in his Drugs for Poor People (Thesaurus Pauperum), provided 26 prescriptions relating to contraception and a further 56 recipes for fertility.

These references show that not only was there knowledge of fertility control in the Middle Ages, but that it was also increasingly sophisticated. It also demonstrates that the majority of the written work was documented by the church and medical practitioners in formal medical texts, which were summaries of medical information.

The expansion in medical knowledge of contraceptives and abortifacients in this period may be due to the introduction of translated Arabic medical texts, originally based on Ancient Greek and Roman medical writings. During the twelfth century several Arabic medical texts were transcribed into Latin and were disseminated in Western Europe. These include Constantine’s translation of the ‘Provision of the Voyager’, which was known in the West as the Viaticum, a well known medical text.

Gerard of Cremona translated the works of Rhazes into Latin as well as ‘The Simple Medicines’ by Serapion the Elder. The Canon of Medicine by Avicenna was also a treatise translated by Gerard, and it became a pre-eminent and important medical text for centuries to come. William of Saliceto’s Summa conservationis et curationis was in part derived from the Canon but also included a chapter on ‘Those Things That Prohibit Conception and [Cause] Abortion. He wrote;

Although this chapter may not be according to the strict rules of law [demandato legis], nevertheless [it is necessary] for the ordinary course of medical science on account of the danger that comes to a woman because of a dangerous risk of conceiving on account of her health, debilities, or the extremity of her youth.

This passage demonstrates that some medical practitioners recognised the need for contraceptive knowledge, and that church doctrine and secular law was circumvented in the interests of the female patient in some instances. Many of the herbals were described as emmenogogues or abortifacients and were included not to prevent conception but to advise pregnant women to avoid such herbs or ingredients, in alignment with church theology, although this information, as shown above, could be used for alternative purposes.

In re-examining medieval contraceptive and family planning practices we should be mindful that contemporary medieval literature was hampered by social and religious taboos and that a vocabulary for sexual health did not formally exist until the nineteenth century.
Abortion

Abortion has always been viewed as homicide and the church proscribed against it as early as the second century.

This was reiterated in the canon doctrine written by Regino in 830 which stated ‘If someone [Si aliquis] to satisfy his lust or in deliberate hatred does something to a man or woman so that no children be born of him or her, or gives them to drink, so that he cannot generate or she conceive, let it be held as homicide’.

Abortion as homicide stems from the erroneously translated and misunderstood Hippocratic Oath which does not prohibit physicians from administering an abortion, only the use of abortifacient pessaries.

Medical texts in the medieval period both support the Hippocractic belief, ‘Nor will I contemplate administering any pessary which may cause abortion’[81], and the incorrectly translated statement that ‘Neither [will I give] to a pregnant woman a protacted drink [potio] for killing a conceived fetus [conceptum fetum]’.

There are many recipes listed for causing abortion in the medieval period which may have been the main method used as mechanical and surgical abortions were recognised as dangerous.

Following the dictates of St Augustine, medieval theologians and canonists made a distinction between the abortion of a foetus which was less than forty days old (for male children) or 80 days for a female.

If abortion took place after the ‘ensoulment’ or ‘animation’ of the foetus then it was considered homicide.

This canonical view was further enshrined in secular laws. During Edward I’s reign the English law stated that;

He who oppresses a pregnant woman, or gives to her a poison, or delivers to her a blow [strong enough] so as to cause an abortion, or who gives to her [something] that she will not conceive, if the fetus is formed and animated [foetus erat formatus et animatus], is guilty of homicide…. Item: A woman commits homicide who so devastates an animated child through a drink [potationem] or similar things in the stomach.

 

The distinction between the stages of a pregnancy and how a foetus was viewed can be found in the Irish Penitentials of 800 AD which list the varying penance for abortion before and after forty days;

(5.6) A woman who causes miscarriage of that which she has conceived after it has become established in the womb, three and a half years of penance. If the flesh has formed, it is seven years. If the soul has entered it, fourteen years penance. If the woman die of the miscarriage, that is, the death of body and soul, fourteen cumals [are offered] to God as the price of her soul, of fourteen years’ penance.

(5.7) Anyone who gives drugs or makes a bogey or gives a poisonous drink so that someone dies of it, seven years’ penance, as for homicide. If no one dies of it, three years’ penance.[86]

Thus there were many ways to end a pregnancy and to prevent conception from taking place although abortion, and according to the church doctrine, contraception, was considered a homicide. It appears therefore that by providing a list of penances for the ‘crime’ of family planning indicates that family limitation methods were practised in medieval Western Europe, despite church and legal prohibitions.

Examples of mechanical abortions can be found in Avicenna’s eleventh century tome, Canon of Medicine, which discussed forceful physical exercise, leaping and jumping to dislodge a foetus. Rowland states that the earliest medical treatises on abortion required great physical agility from the patients and that one recommends:

that the woman on the sixth day of her pregnancy should perform a number of mighty leaps, making her heals touch her buttocks. After the seventh day the ‘seed’ would fall out of her with a clatter.

 

Thus, the consensus of most modern historians is that late term abortions (especially using mechanical or surgical means) were to be avoided, however the amount of literature on the topic show that early term abortions and abortifacients were administered.
Infanticide and Child abandonment

Infanticide has been a popular explanation by some historians and demographists in accounting for population movements and birth rates in the medieval period, although there are a number of arguments which contradict this theory.

The increased male to female ratio during the time does suggest that unwanted male children were more likely to be accepted into the family or abandoned, while unwanted female children were disposed of.

However some demographists argue that if infanticide was a systemic practice that it would have caused major short term problems with the birth replacement rate (due to a lack of female partners) and would have been remarked upon in medieval texts. Further, medieval church and secular law protected not only the foetus but also the newborn child and prohibited infanticide. Certain letters of remission granted to women who committed infanticide in France in the thirteenth and fourteenth centuries’ state that the reasons for their actions were due to their fear of disgrace and momentary terror.

The expression ‘because of fear and disgrace’ seems to appear in most of these letters or remission. The women were of the peasantry andincluded unmarried women, wives and widows alike.

This suggests that while infanticide still occurred, it was not acceptable as a family limitation method in Western Europe during this time.

The more socially acceptable form of family planning in the medieval period may have been child abandonment. This practice was semi-regulated by the church in the form of exposition and oblation of unwanted infants and children.

It has been suggested that the likelihood of a parent abandoning their offspring increased depending on the financial circumstances of the parents (poverty was a major factor), gender, social status and the relationship between the parents and how the conception came about.

Single mothers, separated parents, or parents with difficult relationships were more likely to abandon or expose their children. It has also been posited that there would have been higher rates of abandonment for handicapped or deformed children, and those born as the result of incest or rape.

When looking at exposition we should note that the Latin exposition does not directly translate to ‘exposure’ of infants (although this would happen), but refers to the ‘putting out’ or ‘offering’ of the child to strangers, the church or public welfare.

In this sense, expositio differed from infanticide in that it offered an ambiguous alternative to directly killing the child.

While death was always a possibility of expositio, it was not always the case and there is evidence that some parents hoped that their abandoned offspring would be adopted, cared for, and possibly enjoy a more prosperous life than the one they were able to offer.

Expositio, while still considered morally repugnant, was therefore distinct from infanticide and in comparison could be considered closer to abandonment than infanticide.

A lesser known and infrequently used method of child abandonment was the presentation of children to the church as oblatios (“offerings” or donations). Oblates were children given by their family to the church, which assumed all parental rights and authority, and educated the children for a monastic career.

Seven seems to be the standard age for acceptance into a monastery or nunnery, however on the rare occasion, children as young as three or four were also recorded as taking vows.

Oblation required the permanent surrender of the child by the parents whose parental rights were subsumed by the church.

Initially it was the supernumerary children of wealthy families who were donated as oblates, as they were able to provide a monetary gift to the church, in compensation for raising and training the child. Later, children of poorer and destitute families were accepted despite the parents’ inability to provide financial incentives.

The number of children presented at monasteries increased during periods of economic hardship and from this we can surmise that the church was seen as a last resort by some parents who wished to limit their families or were unable to provide for additional children.

In contrast, the church also had to make specific prohibitions against the donation of extraneous children from wealthier families when its sole purpose was to prevent the division of an estate or family wealth.

However, it should be noted that some parents may have donated their offspring purely for spiritual reasons even when superfluous children were involved.

The church also prevented the donated child from leaving the monastic life as an adult and the act of oblation was considered binding and irrevocable, particularly by St Bernard.

This rule was relaxed in the thirteenth and fourteenth centuries as the problems it created with unwilling and impious clergy became evident and the practise came under increasing attack.

Contraception and other methods of varying family limitation have therefore been present in society from antiquity to the present day, including the medieval period. Researcher Norman Himes found in his study, A Medical History of Contraception, that ‘the desire for control is neither time nor space bound. It is a universal characteristic of social life’.

In revisiting the sources on medieval contraception we can therefore see that a variety of family planning methods were available to women and men the time. First hand document documents from antiquity onwards show that medieval people were sophisticated enough to differentiate between contraceptive and abortifacient drugs, which had specific uses and instructions. A litany of plant and herbal remedies were cultivated to reduce the likelihood of conception, to act as emmenogogues and antiabortionists.

These medicinal treatments were clearly documented and practised by a wide variety of the population, including female physicians and midwives. Additionally, new research into ancient and medieval contraceptive remedies has found that many ingredients contain high dosages of estrogen, which disrupts the regular fertility cycle and may explain the effectiveness of the potions.

This result suggests that the recommended treatments were successful if followed correctly and supports the supposition that contraceptives and abortifacients were used on a wider scale than previously thought. We can also find clear evidence that contraceptive knowledge was expanded onand medical texts were disseminated from the East to Western Europe from the twelfth century onwards.

Mechanical and surgical abortions were performed, though likely to a lesser extent than early-term abortions via emmenogogues due to the increased risk to the mother. When re-examining child abandonment as a family planning method, we find that both wealthy and poor families engaged in the practise, though sometimes for different reasons.

Non-medicinal contraceptive practises such as coitus interruptus have sometimes been dismissed non-existent, however, there is convincing evidence that it was practised despite the need for male cooperation and sensitivity. Although infanticide has been the fashionable explanation for the reduction in birth rates, there is conflicting information which indicates that it was not likely to be a popular method of family planning during the medieval period.

Medieval medical, canonical and literary texts contain a remarkable amount of direct and incidental information which show that medieval women were knowledgeable about contraception and abortion. Moreover, medieval women were able to use family planning methods successfully and relied on ancient (and updated) gynaecological information which was passed on through the generations.

Author: letjamz

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