Left in the Shadows
Cover image of a peacock flower by Nasim Uddin via Unsplash
Approximately 8 minute read
If you’ve been reading the Quick Bites blog and newsletter for a while, it will not surprise you that I’m a sucker for primary sources. Thus, I have slowly and thoughtfully been making my way through the 200+ pages of the Dobbs vs Jackson Women’s Health Organization decision from the US Supreme Court. This decision has likely made many women much more acutely aware of their bodies, and the rights we do (or now do not) wield over them. Prior to medicine becoming the venue of men and hospitals, it was the venue of women and home, and sometimes nuns and monks in monasteries.
This post was originally going to be about the historical connection between herbs and abortion, but the more I read the herbal history of abortion, the more I noticed the theme of women holding knowledge and agency over health - both their own and others.
In the article “Exotic Abortifacients and Lost Knowledge,” Schienbinger explains how for enslaved Amerindians, Africans, and Caribbeans, abortion was as much a political act as a physical act, and women held the “how to” knowledge of it all.
Although many women miscarried spontaneously as a result of the hard work, poor food, and extreme corporeal cruelty, some at least induced abortion as a deliberate, desperate act of resistance of vanquished against victor. In an economy where planters sought to breed “Negroes” as well as horses and cattle, refusal to breed became a political act.
These women were agents of their own bodies, using herbal knowledge and a network of women to end their pregnancies. Schienbinger discusses the peacock flower, an oft-used abortifacient, that was brought to and established in Europe, but the knowledge of its most common use did not accompany the plant on its travels.
It wasn’t due to laws or restrictions, as laws criminalizing abortion weren’t passed in Europe until the 19th century, but instead the author explains the reason the plant’s virtues didn’t migrate along with the plant itself:
“The shift in the management of birthing in this period away from midwives to newly minted obstetricians curtailed women's reproductive freedoms. Abortion had traditionally been practised by midwives as well as women themselves. As female practitioners lost ground to obstetricians (men trained primarily as surgeons) over the course of the 18th century, herbal remedies gave way to surgical procedures designed to induce abortion. As midwives were run out of the high-end of their profession (there was always work for them among the poor), abortifacients gradually disappeared from mainstream medicine.”
Schienbinger describes this loss of knowledge as an example of “culturally cultivated ignorance—the unspoken but distinct configuration of events that converge to leave certain forms of knowledge unplucked from the tree of life.”
Speaking of the arrival of male obstetricians, National Geographic published an article in 2020 about how behavior distinctions between male obstetricians and midwives led to the understanding of the importance of hand-washing in medical care.
“In Europe in the 1840s, many new mothers were dying from an ailment known as puerperal fever, or childbed fever. Even under the finest medical care available, women would fall ill and die shortly after giving birth. Hungarian physician Ignaz Semmelweis was intrigued by the problem and sought its origins.”
Semmelweis worked in a hospital with two maternity wards, one staffed by female midwives and the other staffed by male doctors. He quickly noticed the mortality rate from the fevers was twice as high in the male-run ward.
Like any good scientist he tested hypotheses, investigating everything from body position to “embarrassment,” and then he adjusted for variables. And what he discovered was that male doctors spent the morning doing autopsies, then spent the afternoons examining pregnant women and delivery babies, while midwives stuck solely to the maternity ward. His realization of the germ transmission from cadaver to pregnant patient (germ theory was not yet popularized, so instead of the term “germ,” he used the phrase “decomposing animal organic matter”) led Semmelweis to institute a mandatory hand-washing policy for all the doctors and students who worked for him. His policy led to a drastic reduction in the mortality rate in the male-run maternity wards. Unfortunately hand-washing was an unpopular belief at the time and Semmelweis was mocked and rejected by the medical community.
Would the midwives have washed their hands instinctually prior to examining patients if they’d also been allowed to perform autopsies? I have no clue, I just find the story fascinating!
From Semmelweis, let’s jump back about 700 years to Hildegard von Bingen, the medieval German nun who aided women with medical care, including abortions.
In 2021, Olivia Campbell wrote an engaging article, posted on the JSTOR Daily website, titled “Abortion Remedies From A Medieval Catholic Nun (!): Hildegard von Bingen wrote medical texts describing how to prepare abortifacients.”
Hildegard was likely one in a long line of women who benefited from medical knowledge - including that of contraception and abortifacients - being passed down orally through generations of women, but she was one of few women to codify this information into medical texts. She wasn’t an outlier when it came to understanding how to terminate a pregnancy tho as,
“Birth control and abortion agents were well known in both books and oral knowledge during the medieval times. Recipes from the 1st century Greece were even disseminated in medieval Europe: The first century pharmaceutical text De Materia Medica, by the Greek physician Pedanius Dioscorides, lists 959 substances, 141 of which are noted to bring on menstruation, 49 to expel an embryo, 18 to terminate an embryo, and six to “cause abortion.” Such recipes regularly appeared in medical books throughout the medieval era, which suggests that abortion was considered a routine healthcare procedure.”
Campbell makes an interesting statement about the home, thus women, being the arena of medicine and healthcare:
“Outside of monasteries, medicine was primarily practiced in the domestic realm, most often by the women of the house or by lay folk healers. Knowledge of basic medical treatments was an essential element of women’s household management. Most midwives were women, so their work faced less oversight than that of university-trained male physicians. The relative invisibility of women practitioners and patients rendered regulation of their interactions virtually impossible.”
Apparently, much work was done in the shadows, and the shadows are where the invisible are forced to live.
And in addition to the medical agency of women, Campbell goes on to clarify another theme that continued to show up in my readings; the unequal access to healthcare based on one’s economic status:
And just like in modern times, wealth and power meant greater access to abortions. Ladies of the court had storied apothecaries at their disposal, while the poor had to do with whatever they could glean or procure from folk healers.
I just purchased the book “Eve’s Herbs: A history of contraception and abortion in the west” by John M. Riddle. The book is comprehensive, and the print is small, and as a lover of non-fiction I consider this the perfect Summer Read ha!
In April of 2022, Lynn Parramore wrote an article titled “Abortion Drugs Fundamental to Ancient Economies, Argues Historian” about “Eves Herbs,” and conducted an interview with Riddle for The Institute for New Economic Thinking. Campbell explains the transition of women’s healthcare from women to men as laid out in “Eve’s Herbs,”
“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.”
The interview ends with Riddle saying, “As you say, history is not linear. We can regress, and we do, in so many different. ways.”
Once you remove women from the equation of bodily decision-making, you have an unequal and burdensome system of healthcare. Since the Dobbs decision, the Internet has been awash in DIY reproductive healthcare, but many home or herbal remedies, both of the past and present, carry significant health risks. We live in an age where women shouldn’t have to practice their own healthcare in the shadows with potentially dangerous remedies. But if States refuse to pass evidence-based and equal laws, in place of the frankly insane shit they’re proposing, we are putting half our population back in the shadows.
References:
“19-1392 Dobbs v. Jackson Women’s Health Organization (06/24/2022),” 2022, 213.
Schiebinger, Londa. “Exotic Abortifacients and Lost Knowledge.” The Lancet 371, no. 9614 (March 1, 2008): 718–19. https://doi.org/10.1016/S0140-6736(08)60330-X
‘Wash Your Hands’ Was Once Controversial Medical Advice,” March 6, 2020. https://www.nationalgeographic.com/history/article/handwashing-once-controversial-medical-advice.
Campbell, Olivia. “Abortion Remedies from a Medieval Catholic Nun(!).” JSTOR Daily, October 13, 2021. https://daily.jstor.org/abortion-remedies-medieval-catholic-nun/.
“Eve’s Herbs — John M. Riddle.” Accessed July 2, 2022. https://www.hup.harvard.edu/catalog.php?isbn=9780674270268.
Parramore, Lynn. “Abortion Drugs Fundamental to Ancient Economies, Argues Historian.” Institute for New Economic Thinking. Accessed July 2, 2022. https://www.ineteconomics.org/perspectives/blog/abortion-drugs-fundamental-to-ancient-economies-argues-historian.