Throughout the ages, abortion has been a crucial feature of women’s lives. So argues John M. Riddle, a distinguished specialist in the history of medicine, who has spent a long career uncovering information nearly lost in the mists of time. His work shows that people going all the way back to ancient Egypt relied on a variety of herbal abortifacients (abortion-inducing substances) and contraceptives to control fertility and continued doing so well into the Middle Ages. What’s more, he argues that contrary to what many historians and demographers have maintained, these ancient drugs actually worked.
In “Eve’s Herbs: A History of Contraception and Abortion in the West,” Riddle posits that while we may think of ancient and medieval people as superstitious and prone to rely on useless remedies, when it came to abortion, many knew what they were doing.
The historian illustrates how their methods, most commonly drugs taken orally, were developed through careful observation of nature (noticing, for example, which plants caused livestock to bear fewer offspring), experimentation, and the accumulation of botanical knowledge passed down by word-of-mouth, and also occasionally in written form, including a text by a thirteenth-century physician, Peter of Spain, who later became Pope John XXI!
These botanical substances blocked or stimulated hormones, caused contractions, or otherwise acted on the body to prevent or end pregnancies, thus enabling women and their families to make reproductive choices in their best interest. Riddle points out that it wasn’t just elites who knew the secrets of which herbs to use and how—common people knew and purposefully regulated family size for a variety of reasons, including the desire to space out children, economic pressures, and the health of the mother.
As Riddle details, the Egyptians listed abortifacients in medical texts. The Greeks were so accustomed to abortion drugs that the playwright Aristophanes joked about them, describing in Lysistrata a desirable young woman “trimmed and spruced with pennyroyal,” a well-known abortion drug. Riddle holds that the plant silphium (related to giant fennel / Ferula family) was popular with the Greeks and Romans primarily because it was used to terminate pregnancies – so much so that the city-state of Cyrene (in modern-day Libya) based its whole economy on the plant until it was overharvested to extinction. His research reveals that in the Middle Ages, abortion drugs were also integral to economies. The typical European village would have available a “wise woman” or midwife, and later, an apothecary, who knew exactly what herbal remedies to give women who did not wish to be pregnant and could produce reliable results. Through such fertility intervention, he says, family size was managed in ways that may well have impacted whole populations, causing some government officials associating large families with economic prosperity to view women who controlled fertility as potential enemies of the state.
Riddle shows that what was once widely known and tolerated came under increased scrutiny as the Middle Ages gave way to the Early Modern period. Eventually, he explains, female experts in botanicals fell under suspicion of witchcraft, and their persecution served to eliminate or dilute knowledge of herbal abortifacients. As these women were pushed out of reproductive healthcare, those remaining, along with physicians and apothecaries who competed with them for business (and often knew far less about abortion and contraception), began to deal with abortifacient drugs through circumlocutions and evasions, noting that a particular drug “brought down the courses” or “aired the womb,” expecting female clients to know what they meant. In time, Riddle argues, knowledge of effective antifertility agents was lost through centuries of laws, religious doctrine, changing social mores, and witch hunts. By the late nineteenth century, a woman in New York or London might have to rely on purchasing nostrums advertised by unknown parties in newspapers rather than going to a trusted family member or midwife for assistance. Yet before the pill and legalized abortion, and even after, Riddle describes how women in many parts of the word, including Appalachia, continued to use botanicals to control fertility.
Riddle is convinced by his research that drugs that check fertility have shaped human history in ways that are not fully appreciated. Today, as women in America and elsewhere fall under attack for trying to do what their foremothers were long able to do, some in favor of restrictions argue that they are following ancient precepts, such as the Hippocratic oath. But according to Riddle and others, they are engaging in revisionist history, often unknowingly.
Riddle recently spoke to the Institute for New Economic Thinking about what we know of abortion in ancient societies and how we know it.
Lynn Parramore: Your work shows that abortifacient plants were fundamental to ancient economies. Why were they so important? And how do we know these herbal treatments worked?
John Riddle: Why shouldn’t they be important? There’s nothing more fundamental to human society than reproduction — or lack thereof.
How do we know they worked? Let me tell you about a sixth-century man whose Latin name was Germanus, a Gallo Roman in central France who became a saint. He became bishop of Paris and is buried at the abbey Saint-Germain-des-Prés, named after him. His biography, recorded in a life of saints, states that his mother had a number of children, and when she became pregnant again, decided that she didn’t want another one just then. It was a matter of spacing with her. So she got a “poison” and she took it. After she took it her insides were in turmoil and she had pain, which extended for a period of time. But finally Germanus was born, and seeing such a lovely baby and so forth, she said she had made a mistake. There is a question with saints that you can’t be one unless you produce miracles. Well, his miracle happened when he was a fetus – the first fetal miracle!
To me, this story of Saint Germain challenges people who have said that ancient abortions couldn’t have worked. It’s actually the reverse – it took a miracle to prevent them from working! People were accustomed to abortifacients being effective.
LP: Let’s talk about Cyrene, the Greek city-state. You have argued that its economy was based entirely on an abortifacient plant called silphium, so highly coveted that it was eventually over-harvested and went extinct. What’s the evidence, in your view, that its popularity was based on its use as an abortion-inducing drug?
JR: Silphium was very basic in its association to the city of Cyrene. After I got interested in the plant, I started researching beyond the literary accounts, of which there are a number. I found a big volume on ancient Greek coins in the British Museum, and the coins of Cyrene take up a big section. Virtually every one of them has silphium – this extended for three centuries. I found no reference to it as a food. There’s a plant that’s related to it botanically that gives Worcestershire sauce its distinctive aroma, but that’s modern.
LP: And the high demand was because so many sought to use it to manage fertility?
JR: I’m as certain of it as anything one can be certain of in the ancient world. In one play, Aristophanes talks about its high price, and much later, Pliny notes that silphium is worth its weight in silver – a span of 300 years. Others referenced its use as an abortifacient. There’s no other purpose for it. They didn’t have Worcestershire sauce, and it’s too expensive to be used as a food.
LP: Just recently, an article in the Washington Times asked if health professionals who follow the Hippocratic oath should have to perform abortions. Let’s talk about this oath, which contains a prohibition on using a pessary (a vaginal insert) to induce abortion. You observe that translators often changed the meaning to suggest a prohibition against all methods of abortion, not just pessaries, and note that in the modern era, people have misunderstood who wrote the oath and how it was used. How did the oath come to be taken by modern physicians as a moral charge not to perform abortions?
JR: I learned a lot tracing that down. The Hippocratic oath was not taken as an oath by most physicians in antiquity. There’s no reference to it and there are few copies. Copies in the Middle Ages developed the notion that ancient physicians had to abide by it. Actually, it was not until the late nineteenth century that some medical schools required it. Classical scholars then did not know that ancient people had effective birth control methods other than pessaries – that they used drugs. A friend of mine at the University of Pittsburgh and another colleague found that 100% of medical schools use the oath today; some pass around a printed copy at graduation and say that students are bound to it while others make the students stand up and take the oath. But that’s a modern development.
When Roe v. Wade was first argued, the question of the oath came up. This is where it gets intriguing to me: [Dallas County District Attorney] Wade said we can’t allow abortions because physicians are bound to the oath and the oath doesn’t allow it. But someone at the Supreme Court, directly or indirectly, asked classicist Ludwig Edelstein at Johns Hopkins if that was true. He wrote an article, which was published, arguing that it wasn’t an oath in antiquity.
LP: You note that the oath wasn’t even written by Hippocrates, nor were medical texts generally ascribed to him.
JR: Yes, we’ve given up on finding the “real” Hippocrates — he’s like Santa Claus. I think what happened, and this is conjectural, is that the librarians at Alexandria made a concerted effort to get anything that had been written in Greek. Treatises came from all over, and anything medical was ascribed to Hippocrates. So at that point, medical treatises become associated with Hippocrates.
LP: The oath referred only to a prohibition on pessaries to induce abortion, but you point out that this was not the most common way of ending a pregnancy. Does that imply that the more common form of abortion, induced by drugs, would have been permitted?
JR: Abortion by pessary was absolutely not the most common method. The part about pessaries was not stated for ethical reasons, but for medical reasons, because pessaries could cause ulcerations and didn’t work that well. Translations later change the meaning to a total ban. Even Edelstein messed up on that. He used a more general term, something like “abortative remedy,” instead of “pessary.”
LP: So we ended up with the misguided idea that the Greeks prohibited abortion, which has fueled restrictive attitudes in the present day.
JR: That’s right.
LP: You do note that the Greeks and even more so, the Romans, had some misgivings about abortion as it concerned male property rights since the fetus was assumed to be the property of the father. You show that later, Christian theologians began building on the male property-rights anxiety and adding concern about when the soul entered the fetus and promoting prohibitions against abortion after “quickening.” Physicians, lawmakers, and theologians began to demand restrictions, but what about ordinary people? How did they view it?
JR: They absolutely had a much higher degree of tolerance for contraception and abortion. Keep in mind, it all gets murky, but early-term abortion was not really considered to impact a living fetus, even among theologians. There was the concept of quickening, which was thought to occur when a woman could feel the fetus kicking.
LP: Let’s say I’m a thirteenth-century English peasant woman who is pregnant but doesn’t want to carry the pregnancy to term because I have too many kids to feed already. How do I go about this? Who do I consult?
JR: You would have talked to people you trusted—a mother, an aunt, women in the village, and above all, the midwife. The transmission of the knowledge, I think, is more oral than it is written. I found very few cases in the Middle Ages or the early modern period where they go and consult a book.
LP: And I would have a pretty high expectation that the remedies indicated would work?
LP: If, as you argue, the limiting of family size through abortion drugs was common, how do demographers view the role of abortion in populations?
JR: Therein is a swamp. Two demographers of good standing said that abortions could not have worked to the level that affected gross population. However, since then, I found two demographers with different findings. One of them wrote a long article on demography in Spain in the nineteenth and early twentieth century, when Spain’s population is going down. He goes into the reasons, one by one, as to what could have caused it. Economic depression? No, Spain was not different from other places that were reasonably prosperous, and there were no widespread famines, which will reduce populations. So he concludes that the only possible reason for a steady, century-old decline was birth control (which includes the use of abortifacients). The thing that is so logical to me is that the placebo effect just doesn’t work in the case of pregnancy. If your peasant woman in the village is given a remedy to restart her menstrual cycle so that she will not have a baby – if she has the baby, then she knows the remedy doesn’t work in a very, very real way. It’s self-correcting. The midwife giving the abortion remedy that didn’t work wouldn’t be able to stay in business — not very long in that village. She might get by with one failure, but not two.
LP: We’ve talked about how important abortifacients were to ancient economies, what about the medieval period? How do we know they were fundamental?
JR: In the late Middle Ages, German towns forbade the growing or possession of juniper, which was used by midwives to control fertility. To have the knowledge of using juniper for that purpose would make you suspected to be a witch. I wrote to several people when I was researching juniper in the history of pharmacy and asked if they could think of any other time period where a government agency had prohibited possession of a substance, and they couldn’t. So it must have been very important.
Two German researchers published work concluding that whenever there was an area where there were virulent witch hunts, that area had big increases in population. They concluded that the burning of what were often called “wise women,” who were midwives, had something to do with this rise in population.
LP: The common wisdom was that abortion was not a criminal offense, despite theologians and the bishops sometimes pushing for it, right?
JR: That’s right. I’ve read two recent works – one is by a researcher at Ohio State who just got through studying legal assizes in England where there was an abortion case, and like me, she never found a jury that convicted a woman. The jury found all kinds of excuses. One was where the baby was born but died five days later, which was attributed to poison the mother had taken. She was up for homicide, but the jury wouldn’t do it.
LP: If you were a medieval woman operating as an herbalist, consulting on abortions and contraception, you might have a thriving business and some economic independence. In times of economic turmoil, was the persecution of women for witchcraft a convenient way to bring the economy back into the hands of men?
JR: It’s terrible to think of men doing that, but they do. Men have the notion that they have the power to reproduce, and they don’t want that power taken away from them. They associate that power with the economy and the well-being of the community.
LP: And yet prohibiting the management of fertility actually has negative consequences to the community.
JR: Yes, that is correct.
LP: Do you see the motivations of women to control fertility consistent throughout history?
JR: There’s no way to deal with it statistically. You just have to extrapolate the factors that you think would be at work, other than the occasional individual. Spacing has to account for some of it – just like Germanus’s mother. We’re dealing with human nature here. The motives should the same in antiquity, the Middle Ages, and the present.
Why is it that in the United States that it tends to become associated with politics? Some states outlawing abortion and others not? From the point of view of jurisprudence, the thing that comes into play in Roe v. Wade was that she (Roe) wanted an abortion but couldn’t get one because she couldn’t afford it. Why should one person have a right in a state and another not? The question becomes economic.
On the question of when life begins, there is so much that isn’t measurable. If you’re going to talk about life beginning at conception, well, is it when the sperm enters the egg? One of the various stages after that? Implantation? Would Queen Anne’s lace, the seeds of which women have used after coitus to control fertility, be considered an abortifacient?
LP: We know from history that women desperate to end a pregnancy will try anything. Do you see vitamin supplement hawkers and dubious vendors on the internet capitalizing on the new restrictions and the distrust of mainstream medicine to promote botanical abortions? You note that a person today would be ill-advised to try this because there are so many factors involved in the efficacy of plants for this purpose — when they’re harvested, how extracted, the dosage, the frequency, etc., and that without precise knowledge of toxicity levels, they can be dangerous.
JR: I don’t doubt that people will try to sell herbal remedies for fertility control. A vendor in California had a website and it began with a quote, “Dr. Riddle says…” It was a quote lifted out of context which purported to show that whatever herb they were promoting worked. I’m a Ph.D. in history, not an MD. I ask legal consultants if I had any legal remedy, and they said that because the quote was accurate, I didn’t.
The first book I published was on the Greek physician Dioscorides’ herbal treatise, and I decided I’d put in the frontispiece a warning that the discussions about the medical use of plants and other substances are purely for historical examination. The same goes for my book on contraceptives and abortion in history. Some people think that they need “natural remedies,” but the body doesn’t know whether it’s natural or not. All it knows are molecules. And it doesn’t make any difference where the molecule comes from.
I don’t know if the lawmakers in Texas, or the people who support them, have thought through the implications of what they’re doing. It’s obvious to me that the educators of the general public are going to have to be journalists.
LP: Does it surprise you, given your historical perspective, where we are today on this topic? It would seem that history is not linear.
JR: Yes I am surprised. I thought Roe v. Wade was rightly decided, and I didn’t think it would be reversed. You could have a district attorney, a prosecutor responsible for a large area, marshaling a whole force of law enforcement on this.
As you say, history is not linear. We can regress, and we do, in so many different ways.