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Contraception

Contraception refers to methods or practices meant to allow heterosexual activity yet avoid production of offspring.  The line between contraception (preventing conception from occurring in the first place) and abortion (the termination of a pregnancy that had already begun) was less clear-cut in the Middle Ages than it is now, largely because the conceptus was not really considered a fetus until it “quickened” or was “ensouled” (that is, until the woman perceived the movement of the fetus).  Whether the methods and practices used to prevent pregnancy in the Middle Ages were fully effective is less important than evidence of the desire to separate the sex act from reproduction.  Three criteria are therefore relevant to understanding medieval contraception:  (1) whether there is evidence of the intent to prevent pregnancy and how it was viewed by religion and law; (2) what kinds of contraceptive knowledge were available; and (3) whether contraception was the concern of women only or also of men.

Islamic and Jewish Attitudes
The different religious traditions of medieval Europe had differing attitudes toward contraception and early abortion.  In the Islamic world, contraception was permissible, and abortion was tolerated, though physicians were often more uncomfortable with the latter than were religious jurists.  Because sexual relations between a male master and a female slave were considered licit (that is, in the eyes of the law they did not make the man adulterous vis-à-vis his wife or wives) yet produced other problems if she conceived (once she had borne him children she could not subsequently be sold), males often had reason to use contraception.  Contraceptive methods might also be motivated, for both men and women, out of fear of the dangers of childbirth or to preserve the woman’s beauty.  Coitus interruptus (the man’s withdrawal of his penis prior to ejaculation) was a favored method, though medical texts offer numerous chemical means of contraception.  Woman-controlled methods (such as vaginal suppositories, which offered physical, as well as chemical, barriers to the man’s semen) outnumber male-controlled methods by about four to one.  Muslim jurists debated whether men or women could practice contraception without their partners’ consent.

Among Jewish communities, use of a contraceptive sponge was permitted during lactation lest a new pregnancy rob the nursing child of its nourishment.  There seems to have been no stigma attached to this practice, and it is referred to openly in rabbinical literature.  Coitus interruptus, on the other hand, and other forms of “destruction of the seed” were prohibited.

Christian Attitudes
In Byzantium, Christian orthodox views equated abortion with murder, though some considered contraception more egregious because it killed many potential fetuses rather than just one.   Among Latin Christians, views on contraception and abortion were primarily influenced by Saint Augustine of Hippo (d. 430), who had defined offspring as the second of three “goods of marriage” (the others being sexual fidelity and the sacrament that bound the husband and wife to God).  Thus, any attempt to thwart the purpose of marriage was condemned.  Canon law pronounced that it was more sinful for a man to impede conception when having intercourse with his wife than to engage in adultery with another woman.

In the early Middle Ages, religious writers spoke exclusively of “procuring poisons of sterility” (venena sterilitatis procurare), which has generally been interpreted as use of oral abortifacients; terminology for contraception per se is entirely absent from penitentials prior to the ninth century.  In the early twelfth century, theologians and canon lawyers began to speak of “avoidance of offspring” (vitatio prolis), a more general concept that seems to have included such practices as coitus interruptus and anal intercourse.

Contraceptives
Contraceptives and abortifacients were never suppressed from early medieval Latin gynecological texts (which derived largely from pagan Greek and Roman traditions), and some elements of Muslim attitudes and practices were adopted when Arabic medical writings were translated in the eleventh and twelfth centuries.  The Benedictine monk Constantine the African (died before 1098/99) did not translate a chapter on abortion from an Arabic text he was rendering into Latin, yet he openly supported the use of contraceptives on the belief that regular heterosexual activity was necessary for women’s health, even if pregnancy should sometimes be avoided.  This view was adopted by some other Latin medical writers, although, aside from Italian writers, it was rare for them to devote a separate chapter to the subject.

On Constantine’s authority, the anonymous author of a twelfth-century Salernitan text, On the Conditions of Women, listed several contraceptive amulets—substances to be worn around the neck or carried in the hand to prevent pregnancy which, from our modern perspective, could not possibly have had anything more than a placebo effect.  Nevertheless, a thesis proposed in the 1990s argued that medieval women had ample knowledge of chemically effective pharmaceutical agents to “provoke the menses” or “expel the fetus,” thereby regularly maintaining control of their fertility.  The flaw with this argument is that while certain herbal substances could be used to limit reproduction, not every attempt to provoke the menses was motivated by the desire to contracept, nor was every attempt to expel a fetus done because the child had been unwanted. 

“Retained menses” (what we would call amenorrhea) was a major concern in medieval gynecology and it was recognized that women could not conceive unless they were menstruating regularly.  As the twelfth-century medical writer Trota of Salerno put it, emmenagogues (drugs or agents used to bring on or quicken menstruation). were “for provoking the menses because of whose retention the woman is unable to conceive.”  And “expelling the fetus” was a frequently necessary obstetrical intervention when the fetus had died in utero and did not emerge spontaneously.  In other words, both practices could be motivated by pronatalistic concerns, not the desire to limit fertility. 

Trota herself includes neither contraceptives nor abortifacients in her medical writings, and those medical authors who did so usually justified the inclusion on the grounds of preserving the woman’s health.  In fact, the widespread modern belief that medieval midwives were all experts in the knowledge of contracepting and aborting has never been documented.  The belief may reflect an overly literal reading of the 1496 Dominican witch-hunters’ manual, The Hammer of Witches, which made wild claims that “witch-midwives” regularly inhibited fertility.  It is clear that magical practices were indeed associated with the placenta and other products of birth, and curses of sterility or impotence were common elements of witchcraft accusations.  Yet midwives’ contraceptive knowledge or practices are never mentioned by medical writers.  Rather, it was more common for male writers to focus on prostitutes, whose low fertility was a commonplace, though even here they credited the nature of prostitution (for example, the belief that  prostitutes did not experience pleasure in intercourse and therefore did not emit their own “seed”) as much as prostitutes’ own active contraceptive knowledge.

Whether women beyond those trained in the arts of prostitution were generally aware of contraceptive techniques is less clear.  Beatrice de Planissoles, a suspected heretic in early fourteenth-century Montaillou (southern France), recounts how her male lover, a priest, brought to their trysts a contraceptive amulet which he had her wear when they made love; he was always sure to take it back from her when he left, lest she take another lover.  Clearly, control over contraceptive knowledge in this situation lay with the man, who was concerned not only with avoiding pregnancy but also with controlling his partner’s sexuality.  Coitus interruptus, which Biller suggests may have been the main method of “avoiding offspring” from the thirteenth century, likewise gave the male partner control over contraception. 

Christian medical writers became increasingly cautious about how they shared contraceptive knowledge toward the end of the Middle Ages.  In Latin gynecological texts contraceptive instructions were sometimes put into cipher; in vernacular gynecological texts addressed to women they were deleted entirely.  Even “legitimate” remedies to expel the dead fetus were hedged with warnings that they should not be shared with suspect women.  Statements about “womanly arts” of limiting fertility suggest that there existed an “underground” female culture where contraceptive and abortifacient knowledge circulated freely.  If so, historians have yet to find adequate evidence to prove it.

Monica Green

References and Further Reading

Barratt, Alexandra, ed.  The Knowing of Woman’s Kind in Childing:  A Middle English Version of Material Derived from the ‘Trotula’ and Other Sources.  Medieval Women:  Texts and Contexts, 4. Turnhout:  Brepols, 2001.

Baumgarten, Elisheva.  Mothers and Children:  Jewish Family Life in Medieval Europe. Princeton, NJ:  Princeton University Press, 2004.

Biller, Peter.  The Measure of Multitude:  Population in Medieval Thought.  Oxford: Oxford University Press, 2000.

Boswell, John E.  The Kindness of Strangers:  The Abandonment of Children in Western Europe from Late Antiquity to the Renaissance.  New York:  Pantheon Books, 1988.

Brundage, James A.  Law, Sex, and Christian Society in Medieval Europe.  Chicago: University of Chicago Press, 1987.

Elsakkers, Marianne.  “Abortion, Poisoning, Magic, and Contraception in Eckhardt’s Pactus Legis Salicae.” Amsterdamer Beiträge zur älteren Germanistik 57 (2003), 233-267.

Fournier, Jacques. “Inquisition Records.”  In Readings in Medieval History. Volume II. The Later Middle Ages. Ed. Patrick J. Geary. Peterborough: Broadview Press, 1999, 524-44.  Includes the testimony of Beatrice de Planissoles.

Green, Monica H.  “Constantinus Africanus and the Conflict Between Religion and Science.”  In The Human Embryo:  Aristotle and the Arabic and European Traditions.  Ed. G. R. Dunstan. Exeter:  Exeter University Press, 1990.  pp. 47-69.

———.  review of John Riddle, Eve’s Herbs:  A History of Contraception and Abortion in the West (Cambridge, MA:  Harvard University Press, 1997).  In Bulletin of the History of Medicine 73 (1999): 308-11.

Green, Monica H., ed. and trans.  The ‘Trotula’:  A Medieval Compendium of Women’s Medicine.  Philadelphia:  University of Pennsylvania Press, 2001.

Green, Monica H. and Linne R. Mooney.  “The Sickness of Women.”  In Sex, Aging, and Death in a Medieval Medical Compendium:  Trinity College Cambridge MS R.14.52, Its Language, Scribe and Text.  Ed. M. Teresa Tavormina.  Medieval and Renaissance Texts and Studies. Tempe, AZ:  Arizona State University Press, 2005.

Musallam, B. F.  Sex and Society in Islam:  Birth Control Before the Nineteenth Century. Cambridge:  Cambridge University Press, 1983.

McClanan, Anne. “‘Weapons to Probe the Womb’:  The Material Culture of Abortion and Contraception in the Early Byzantine Period.”  In The Material Culture of Sex, Procreation, and Marriage in Premodern Europe. Ed. Anne L. McClanan and Karen Rosoff Encarnación.  New York: Palgrave, 2002.  pp. 33-57.

Noonan, John T.  Contraception:  A History of Its Treatment by the Catholic Theologians and Canonists.  Enlarged edition.  Cambridge, Mass.:  Belknap Press of Harvard University Press, 1986.

Patlagean, Evelyne.  “Birth Control in the Early Byzantine Empire.”  In Biology of Man in History:  Selections from the Annales, économies, sociétés, civilisations.  Baltimore:  The Johns Hopkins University Press, 1975.  pp. 1-22.

See also: Abortion; Breast Feeding and Wet Nursing; Gynecology; Infertility; Menstruation; Penitentials and Pastoral Manuals; Pregnancy and Childbirth: Christian Women; Pregnancy and Childbirth: Jewish Women; Prostitutes; Secrets of Women; Sexuality; Trota of Salerno.
 

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