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2004 124: 284The Journal of the Royal Society for the Promotion of HealthGeoffrey Chamberlain

Historical perspectives on health : Childbirth in Ancient Egypt  

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JRSH The Journal of The Royal Society for the Promotion of Health November 2004 Vol 124 No 6

JRSH 2004;124(6):284-286

AuthorGGeeooffffrreeyy CChhaammbbeerrllaaiinn,, MMDD,,

FFRRCCSS,, FFRRCCOOGG, Department of

the History of Medicine,

Clinical Medical School,

University of Wales Swansea

Received 28 January 2003,

revised and accepted 4 May

2004

Key wordsAncient Egypt; birth mortality;

childbirth; Gods in obstetrics;

mammisi

INTRODUCTIONIn all cultures birth is an important time; so it wasin Ancient Egypt where it was thought to be an ‘Actof the Gods’ and proper respect had to be paid tothem. This recognition, however, only covered theduration of labour itself, for it was only a centuryago that antenatal care started. The months of preg-nancy leading up to the birth process were notthought to have any importance in earlier times.

It must also be remembered that much of what isrecorded of the history of Ancient Egypt refers tothe upper classes; the rest of the population wereonly referred to peripherally in either papyri ortomb decorations. Women were equal to men in thefamily, sharing the work in the fields as well asdoing most of the hard work in the householdincluding cooking, weaving and bringing up thefamily.

Most Egyptians lived along the narrow strip ofgreen land on either side of the river Nile thatprovided both their water supply and their sewer.The river flooded every summer bringing nitrogen-rich mud onto the fields, often resulting in twocrops a year. The same methods of farming are stillemployed today. Irrigation was usual, with mechan-ical equipment worked by man or animal to raisethe water from the river to the fields. For the poor,particularly in the rural areas, life in Egypt was hardbut healthy. Diet was adequate, tending towardsvegetables, grain, bread, onions and beer. Meat orfish were available to all classes but they were expen-sive and had to be cultivated or caught.

Women married soon after puberty and, sincethere was no effective contraception, families werelarge. Up to a third of babies died of water-trans-mitted diseases and only a handful reached adult-hood. The life expectancy for women was not much

beyond 30.Ancient Egyptian medicine was well advanced

compared with the rest of their contemporaryworld. They had specialists in many subjects butnowhere are there any records of obstetricians ormidwives. Birth was considered to be a normalevent not requiring medical help. It took place inthe home and in the presence of a local womanfrom the village who had experience of attendingdeliveries but had no formal training. If anythingwent wrong during labour, there was nothing thatcould be done about it so there were no specialists:nature had to take its course. The first temple togive formal instruction in midwifery was on theDelta, at Sais, which was not built until 700 BC.

GODDESSESAs was usual in primitive societies, the lack ofmedical knowledge was compensated by a profusionof divinities that guarded the mother and baby inchildbirth. Some of these included: Isis, the seniorgoddess, who was in charge of all the healing arts(Figure 1); Ta-wrt, a pregnant hippopotamus, whoprotected women throughout pregnancy, labour andbreast-feeding ; Meskhenet, the goddess of labour,who was in charge of safe deliveries and who gaveher name to the pair of ‘birth bricks’ squatted onduring delivery; Bes was there to frighten awaydemons that might interfere with the mother orbaby; Hathor, known as the ‘mother of mothers’ andwho is usually shown as either a cow or a womanwith cow’s ears, gave overall protection to the baby.At the moment of birth, some believed that themother cried out to Hathor and briefly became adivine creature, so that it was not the woman givingbirth but Hathor herself.

Women often prayed to these goddesses in

Historical perspectives on health

Childbirth in Ancient Egypt

284 HISTORICAL PERSPECTIVES Childbirth in Ancient Egypt

Abstract

Medicine in ancient Egypt was much more advanced than the rest of the Biblical world, especially intrauma surgery. Care at the time of childbirth was however virtually non-existent. There were no trainedobstetricians or midwives but a galaxy of gods were at hand.

This article traces what we can piece together about pregnancy of childbirth from the evidence wehave in tombs and papyri of Egypt.

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November 2004 Vol 124 No 6 The Journal of The Royal Society for the Promotion of Health JRSH

Childbirth in Ancient Egypt HISTORICAL PERSPECTIVES 285

temples and usually left votive offerings.Statues of the goddesses were also kept inthe home and sometimes other localdivinities were called in for second opin-ions.

CONCEPTIONMedical notes on papyri from AncientEgypt constitute one of the main sourcesof medical information from this period.The largest collection of these waspurchased in 1873 by George Ebers and isnow in Leipzig. These were probablywritten by a doctor and date from 1534BC. Facsimiles exist and there is an Englishtranslation.

If there were difficulties in conceiving,the god Amen was prayed to. There werealso treatments to keep the baby in theuterus. According to Ebers’ papyrus:

“To prevent miscarriage: the dried liver ofa swallow with a sticky liquid from ferment-ed drink to be placed on the breasts,abdomen and all other parts of the body of awoman.”

Other therapies were used to release thechild from the belly of the mother whenher time had come:

“Ground tortoiseshell, turpentine, pine oiland Hekun beetle. Grind together and rubon abdomen.”

BIRTHWhen the woman felt that the time for herbaby’s birth had come, she retired into abirth room which had been set aside in herfamily mud hut, often raised above theother rooms. The birth itself usually tookplace with the woman lying back support-ed by her friends or squatting (Figures 2and 3). These are positions that are stillwidely used in Africa today. If the motherwas squatting or kneeling, this wouldcommonly be on two bricks to allow spacefor the baby to descend to the floor. A bowlof hot water placed underneath wasbelieved to allow warm vapours to rise andease passage. This was sufficientlycommon to appear in several of the bas-reliefs, and the phrase ‘two bricks’ wasoften used as a synonym for giving birth.These bricks would often be decoratedwith the images of the birth gods and werekept as family treasures, passing from onegeneration to the next.

Nature took its course and the baby wasusually born alive. After birth the babywas separated from the placenta by cutting

the umbilical cord after it had been ligated.The birth attendants may have used aspecial fishtail-shaped knife called a ‘psS-kf ’ (pesesh-kaf) that would hold the slip-pery umbilical cord steady, allowing it tobe cut. The symbolic head-dress of thegoddess Meskhemet includes a pss-kf. Themagic of birth mirrored that of death. Thepss-kf is the same tool used for the openingof the mouth ceremony before a mummi-fied body was entombed. Placentas werecommonly buried under the threshold ofthe house to bring good fortune in thenext pregnancy.

The birth rooms found in some temples(mammisi) were not for the women of the

village to use but were reserved for thegods and goddesses. Women may havevisited such mammisi during the course ofpregnancy to make votive offerings to theright goddesses but they actually had theirbabies in more domestic circumstances.Victorian Egyptologists were misled bycarvings and drawings of what the godsand pharaohs’ wives did in their labours.The use of a birth chair by ordinary folkwas not common (Figure 2); they used thebricks. Many of the objects labelled now inmuseums as birth chairs were actuallycommodes.

Little pharmacological pain relief wasused despite knowledge of the anaesthetic

Figure 1: The senior goddess Isis with her son Horus

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JRSH The Journal of The Royal Society for the Promotion of Health November 2004 Vol 124 No 6

286 HISTORICAL PERSPECTIVES Childbirth in Ancient Egypt

properties of opium from poppies andalcohol from wine. Distraction therapywas relied on. This consisted of a largecrowd of women from the village. Theyfilled the birth room and, shrieking loudlyin sympathy with the woman during hercontractions, made much noise to keepaway demons (and men). This stillhappens today and in villages acrossmodern Egypt you can clearly hear, from aquarter of a mile away, when a woman isin labour.

AFTER THE BIRTHThe babies were breast-fed, ideally forthree years. If milk did not come through,there were spells and potions to help, butnone of them seemed to be very lacto-genic. For example, Ebers’ papyrusadvises:

“To induce milk in the woman breast-feeding a child, the backbone of a fish to bebaked in oil and rubbed on her back.”

The mother would be recommended notto rise from her bed, nor leave the birthroom, until after 14 days. She would oftenbe back in the fields two weeks later. Therewas little effective contraception available,and prolonged breast-feeding was proba-bly the most used method to ward off thenext pregnancy. Most of the artificialmethods of contraception involved variousunpleasant unguents (e.g. honey mixedwith crocodile dung) placed in the vagina.This perhaps worked better by putting offthe husband from having intercourserather than from any biochemical action,but no follow-up records exist of familyplanning efficiency so no idea of its effec-tiveness can be derived.

BIRTH MORTALITYThere is no population-based data of thenumbers of babies and mothers lost inchildbirth during this time. It was certainlymuch higher than occurs in modern Egyptwith its planned antenatal and deliveryservice. There is, however, no reason tobelieve maternal or baby death rates wereany worse than those in the rest of Africa.The loss of mothers was probably aboutthree to four times that of the Westernworld (i.e. approximately 40 to 70 perthousand total births) but still the vastmajority survived. Again, most of thebabies lived through the process of birth(about 800-900 per 1,000 total births) butchild mortality rates afterwards, particu-

Selected reading

1 Ebers’ Papyrus (1555 BC). University Library,Leipzig, Germany

2 Ghalioungui P, Dawakhly Z. Health andHealing in Ancient Egypt: A Pictoral Essay.Cairo: The Organisation for Authorship andTranslation, 1965

3 Jordan P. The Black Land. Oxford: PhaidonPress, 1976

4 Nunn J. Ancient Egyptian Medicine. London:British Museum Press, 1996

5 Roth A. The PsS-kf and the opening of themouth ceremony. J Egyptian Archaeol1992;78:113-20

Figure 2: Giving birth in the seated position

Figure 3: Giving birth in the squatting position

larly from diarrhoeal diseases, were high,with as many as a third of those survivingbirth dying whilst infants. These estimatesare based on the last century’s data and arevery approximate estimates.

CONCLUSIONThis account of childbirth in AncientEgypt is based upon many sources. Most ofthem are secondary interpretations oftemple paintings or carvings, and ofpapyri, with some extrapolations fromwhat went on in middle Africa.

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