Here is the script from which I (roughly speaking) gave my panel talk at the Historical Novel Society Convention in Denver 2015 along with Diana Gabaldon as moderator and presenters Sam Thomas, Lisa Yarde and Kim Rendfeld. You can click on their names to find out about midwifery in each of their periods (Early Modern England, Moorish Spain, 8th Century Francia)
Historical fiction is part accurate history and a lot, telling a good story. The tensions, danger and suspense inherent in birthing scenes make them a good narrative element for page-turning fiction. While giving birth in the modern world doesn’t generally offer, thank goodness, nail-biting danger, death lurked everywhere around ancient, medieval and early modern deliveries. Besides this built-in emotional richness, the midwife herself offers the historic novelist another huge advantage: an especially concentrated lens into the role of women, their relative power and social respect at any given period and place. And then there are those quirky details that enchant readers of historical fiction: midwifery offers a good world-building store of those also.
So here’s an opening True or False question to set the stage: A responsible Hittite midwife brought along to a delivery a ewe, that is a female sheep, to swing around the head of the mother.
It’s true. Bring your livestock to get that baby and mom through safely in the 13th Century BCE in what is now Turkey, then the Hittite Empire.
The reality of Hittite midwifery is that the available documents reveal a heavy dependence on magic and religious practices and a minimum of what we’d call medical obstetrical techniques.
By documents I mean clay tablets, written in cuneiform script, which looks like bird tracks on a busy day at the beach.
We now have hundreds of thousands of such tablets excavated from archaeological sites in Turkey and gradually being translated.
The tablets were meant for court use, so these rites probably reflect more about royal birth procedures than peasant births. Also we have to assume that some practical procedures were passed on orally since there is little in these that would actually deliver a baby. The court tablets were maintained for the esoteric fancy stuff. Let’s hope anyway.
As I said in my intro, the role of a midwife tells a reader a lot about how women are viewed in a particular culture—an organic way to get at this topic that intrigues a lot of readers. My main character in Hand of Fire, Briseis, serves her city of Lyrnessos as the hasawa, which I chose to translate as healing priestess. A big portion of the healing priestess’s job according to the tablets was as a midwife. I’ve given Briseis this job on my own initiative. The legendary bits from Homer and elsewhere that we do know about Briseis simply tell us she was a princess who was captured by Achilles during one of his side raids on surrounding cities during the Trojan War.
So why did I choose to make her a midwife and healing priestess? Partly because that made some excellent connections with the legends surrounding Achilles and I was looking for reasons they might bond and love each other as human beings. But also because I found this full blown job description in the tablets and it was the most direct way I could express the surprising finding that in the Hittite culture, women held a lot of power and influence, despite an overall patriarchal structure. This discovery, which I had not expected based on the role of Greek women at the same Late Bronze Age time period, was just too much fun not to integrate into the novel.
So my Briseis is a midwife, a healer also in a more general doctoring way, and the person her city looked to for keeping their crops, herds and women fertile and flourishing. She was responsible for the harmony between the divine and mortal worlds. No stress job, right?
Fertility and successful delivery of human children reflected to the Hittite mind that the correct balance between the gods and man had been achieved. It was the central reality and metaphor for the right state of life. In the great religious festivals that mark the Hittite calendar, we see repeated this correlation of female fertility with overall societal well-being. So the priestess who oversaw all this birthing and sacred balance held immense respect within her society and she held wide-ranging responsibilities branching out from the core of midwifery.
This cultural expansion of the midwife’s role is somewhat less true in the later periods of the midwives of the other authors on this panel, although Sam Thomas, for example, has created a midwife with some important other legal duties also and Kim Rendfeld’s midwife has one key religious privilege.
So what did my Hittite midwife do—the juicy details that bring fiction to life? I have to confess, by the way, that both the extended birthing scenes originally part of Hand of Fire got cut along the way of tightening the novel, so there’s way less of this in the novel that this sounds like. Fortunately I can make good use of it in the sequel. A Hittite midwife oversaw a purification process long before the delivery. She assisted with cleansing rituals during the birth. She also followed up once the baby was born with divinations that determined the fate of the child and she called on the Mother goddess to bring the child a long healthy life.
Her recognizably useful tools are few. She brought a receiving blanket and two cushions for catching the baby and comforting the mom. She had a birthing stool that seems to have involved a bowl on or over which the mother sat, pegs the mother grasped during delivery and boards—unclear where or what the boards did but presumably they held up the mom. The midwife has a knife. We do once hear about cutting the umbilical cord, but more often she uses her knife to cut red strips of wool that were tied on the mother and various scapegoat substitutions—for example, a goat, a lamb, a pitcher of wine or a collection of wooden pegs—that were then either burnt or sent away to rid the mother and child of any evil that would interfere with the safe delivery and future health of the child once born.
There was also an “Incantation of Crying Out” that the midwife recited. Maybe this was the Hittite version of Lamaze coaching?
But my favorite intervention, which we are told happens while the “mother is still crying out,” involves the ewe—either a pregnant ewe or not, doesn’t seem to matter. Someone drove the ewe into the “inner chamber” where the delivery was going on and then swung the ewe over the head of the mother three times while the midwife said these words, “What evils afflict this woman, may they release this woman!” It must be admitted the Hittites are not the only ancient culture that thought swinging animals over heads was productive.
Another procedure—while a bit obscure—seems to be designed to help turn a baby inside the mother in the case of a breech birth. Instead of manually intervening, the Hittite midwife followed these commands, which I’m giving here in translation straight from the tablet:
“Let her take the tarpatarpa plant of the field (an onion perhaps?). And as the tarpatarpa bulb turns so let the child in his mother likewise turn. And as the door in the socket turns, let the child in his mother likewise turn.”
This is analogical magic at work, an essential element of Hittite medicine. The Hittite priestess would describe in words a parallel process like the one she wants to cause to occur and then say that like this I have described, so let it happen in this situation right here in front of me. Words were viewed as powerful in Hittite culture. Words were considered literally transformative. There is a Hittite saying, “The tongue is the bridge to the gods.” And the priestess was the tongue.
So that is my offering of an ancient midwife and what her role in historical fiction and history can bring to a novel. Next up we jump forward in time to Francia in the eighth century CE. Kim Rendfeld’s novel is placed more squarely in the peasant world but her midwife also has a powerful religious role along with practical procedures on behalf of the delivering mom. No more swinging ewes, I promise.
In case anyone would like the sources from each of the presenters, here’s the handout I put together from each panelist:
Hittite Midwifery from Judith Starkston
Beckman, Gary. Hittite Birth Rituals. Wiesbaden : O. Harrassowitz, 1983, Studien zu den Boğazköy-Texten 29
Bryce, Trevor. Life and Society in the Hittite World. Oxford: Oxford University Press, 2002
Collins, Billie Jean. The Hittites and Their World. Atlanta: Society of Biblical Literature, 2007
Midwifery in early medieval times (Christian) from Kim Rendfeld
Daily Life in Medieval Times by Frances and Joseph Gies
“Capturing the Wandering Womb” by Kate Phillips, The Haverford Journal, April 2007
“The History of Cesarean Technique” by Samuel Lurie, MD, and Marek Glezerman, MD, AJOG Reviews, December 2003
“Limbo” by Patrick Toner. The Catholic Encyclopedia, Vol. 9, 1910. [http://www.newadvent.org/cathen/09256a.htm]
Saint Augustine’s On Merit and the Forgiveness of Sins, and the Baptism of Infants (Book I) [http://www.newadvent.org/fathers/15011.htm]
Islamic Practice of Midwifery from Lisa Yarde
Muslim Midwives – The Craft of Birthing in the Premodern Middle East by Avner Giladi
Arab Women in the Middle Ages: Private Lives and Public Roles by Shirley Guthrie
The Muqadimmah: An Introduction to History by Ibn Khaldun, translated by Franz Rosenthal
Midwifery in Early Modern England from Sam Thomas
Evenden, Doreen. The Midwives of Seventeenth-Century London. Cambridge: Cambridge University Press, 2000.
Harley, David. “Historians as Demonologists: The Myth of the Midwife-Witch.” Social History of Medicine 3, no. 1 (1990): 1–26.
Marland, Hilary, ed. The Art of Midwifery: Early Modern Midwives in Europe. London: Routledge, 1993.
Thomas, Samuel S. “Midwifery and Society in Restoration York.”Social History of Medicine 16, no. 1 (2003): 1–16.