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Historical perspectives on health : Childbirth in Ancient Egypt

Geoffrey Chamberlain
The Journal of the Royal Society for the Promotion of Health 2004 124: 284
DOI: 10.1177/146642400412400618
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284 HISTORICAL PERSPECTIVES Childbirth in Ancient Egypt

Historical perspectives on health

Childbirth in Ancient Egypt

Author
Geoffrey Chamberlain, MD,
FRCS, FRCOG, Department of
the History of Medicine,
Clinical Medical School,
University of Wales Swansea
Received 28 January 2003,
revised and accepted 4 May
2004

Abstract
Medicine in ancient Egypt was much more advanced than the rest of the Biblical world, especially in
trauma surgery. Care at the time of childbirth was however virtually non-existent. There were no trained
obstetricians 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 we
have in tombs and papyri of Egypt.

Key words
Ancient Egypt; birth mortality;
childbirth; Gods in obstetrics;
mammisi

INTRODUCTION
In all cultures birth is an important time; so it was
in Ancient Egypt where it was thought to be an Act
of the Gods and proper respect had to be paid to
them. This recognition, however, only covered the
duration of labour itself, for it was only a century
ago that antenatal care started. The months of pregnancy leading up to the birth process were not
thought to have any importance in earlier times.
It must also be remembered that much of what is
recorded of the history of Ancient Egypt refers to
the upper classes; the rest of the population were
only referred to peripherally in either papyri or
tomb decorations. Women were equal to men in the
family, sharing the work in the fields as well as
doing most of the hard work in the household
including cooking, weaving and bringing up the
family.
Most Egyptians lived along the narrow strip of
green land on either side of the river Nile that
provided both their water supply and their sewer.
The river flooded every summer bringing nitrogenrich mud onto the fields, often resulting in two
crops a year. The same methods of farming are still
employed today. Irrigation was usual, with mechanical equipment worked by man or animal to raise
the water from the river to the fields. For the poor,
particularly in the rural areas, life in Egypt was hard
but healthy. Diet was adequate, tending towards
vegetables, grain, bread, onions and beer. Meat or
fish were available to all classes but they were expensive and had to be cultivated or caught.
Women married soon after puberty and, since
there was no effective contraception, families were
large. Up to a third of babies died of water-transmitted diseases and only a handful reached adulthood. The life expectancy for women was not much

beyond 30.
Ancient Egyptian medicine was well advanced
compared with the rest of their contemporary
world. They had specialists in many subjects but
nowhere are there any records of obstetricians or
midwives. Birth was considered to be a normal
event not requiring medical help. It took place in
the home and in the presence of a local woman
from the village who had experience of attending
deliveries but had no formal training. If anything
went wrong during labour, there was nothing that
could be done about it so there were no specialists:
nature had to take its course. The first temple to
give formal instruction in midwifery was on the
Delta, at Sais, which was not built until 700 BC.

GODDESSES
As was usual in primitive societies, the lack of
medical knowledge was compensated by a profusion
of divinities that guarded the mother and baby in
childbirth. Some of these included: Isis, the senior
goddess, who was in charge of all the healing arts
(Figure 1); Ta-wrt, a pregnant hippopotamus, who
protected women throughout pregnancy, labour and
breast-feeding ; Meskhenet, the goddess of labour,
who was in charge of safe deliveries and who gave
her name to the pair of birth bricks squatted on
during delivery; Bes was there to frighten away
demons that might interfere with the mother or
baby; Hathor, known as the mother of mothers and
who is usually shown as either a cow or a woman
with cows ears, gave overall protection to the baby.
At the moment of birth, some believed that the
mother cried out to Hathor and briefly became a
divine creature, so that it was not the woman giving
birth but Hathor herself.
Women often prayed to these goddesses in

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Childbirth in Ancient Egypt HISTORICAL PERSPECTIVES 285

temples and usually left votive offerings.

Statues of the goddesses were also kept in
the home and sometimes other local
divinities were called in for second opinions.

Figure 1: The senior goddess Isis with her son Horus

CONCEPTION
Medical notes on papyri from Ancient
Egypt constitute one of the main sources
of medical information from this period.
The largest collection of these was
purchased in 1873 by George Ebers and is
now in Leipzig. These were probably
written by a doctor and date from 1534
BC. Facsimiles exist and there is an English
translation.
If there were difficulties in conceiving,
the god Amen was prayed to. There were
also treatments to keep the baby in the
uterus. According to Ebers papyrus:
To prevent miscarriage: the dried liver of
a swallow with a sticky liquid from fermented drink to be placed on the breasts,
abdomen and all other parts of the body of a
woman.
Other therapies were used to release the
child from the belly of the mother when
her time had come:
Ground tortoiseshell, turpentine, pine oil
and Hekun beetle. Grind together and rub
on abdomen.

BIRTH
When the woman felt that the time for her
babys birth had come, she retired into a
birth room which had been set aside in her
family mud hut, often raised above the
other rooms. The birth itself usually took
place with the woman lying back supported by her friends or squatting (Figures 2
and 3). These are positions that are still
widely used in Africa today. If the mother
was squatting or kneeling, this would
commonly be on two bricks to allow space
for the baby to descend to the floor. A bowl
of hot water placed underneath was
believed to allow warm vapours to rise and
ease passage. This was sufficiently
common to appear in several of the basreliefs, and the phrase two bricks was
often used as a synonym for giving birth.
These bricks would often be decorated
with the images of the birth gods and were
kept as family treasures, passing from one
generation to the next.
Nature took its course and the baby was
usually born alive. After birth the baby
was separated from the placenta by cutting

November 2004 Vol 124 No 6

the umbilical cord after it had been ligated.

The birth attendants may have used a
special fishtail-shaped knife called a psSkf (pesesh-kaf) that would hold the slippery umbilical cord steady, allowing it to
be cut. The symbolic head-dress of the
goddess Meskhemet includes a pss-kf. The
magic of birth mirrored that of death. The
pss-kf is the same tool used for the opening
of the mouth ceremony before a mummified body was entombed. Placentas were
commonly buried under the threshold of
the house to bring good fortune in the
next pregnancy.
The birth rooms found in some temples
(mammisi) were not for the women of the

village to use but were reserved for the

gods and goddesses. Women may have
visited such mammisi during the course of
pregnancy to make votive offerings to the
right goddesses but they actually had their
babies in more domestic circumstances.
Victorian Egyptologists were misled by
carvings and drawings of what the gods
and pharaohs wives did in their labours.
The use of a birth chair by ordinary folk
was not common (Figure 2); they used the
bricks. Many of the objects labelled now in
museums as birth chairs were actually
commodes.
Little pharmacological pain relief was
used despite knowledge of the anaesthetic

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286 HISTORICAL PERSPECTIVES Childbirth in Ancient Egypt

properties of opium from poppies and

alcohol from wine. Distraction therapy
was relied on. This consisted of a large
crowd of women from the village. They
filled the birth room and, shrieking loudly
in sympathy with the woman during her
contractions, made much noise to keep
away demons (and men). This still
happens today and in villages across
modern Egypt you can clearly hear, from a
quarter of a mile away, when a woman is
in labour.

Figure 2: Giving birth in the seated position

AFTER THE BIRTH

The babies were breast-fed, ideally for
three years. If milk did not come through,
there were spells and potions to help, but
none of them seemed to be very lactogenic. For example, Ebers papyrus
advises:
To induce milk in the woman breastfeeding a child, the backbone of a fish to be
baked in oil and rubbed on her back.
The mother would be recommended not
to rise from her bed, nor leave the birth
room, until after 14 days. She would often
be back in the fields two weeks later. There
was little effective contraception available,
and prolonged breast-feeding was probably the most used method to ward off the
next pregnancy. Most of the artificial
methods of contraception involved various
unpleasant unguents (e.g. honey mixed
with crocodile dung) placed in the vagina.
This perhaps worked better by putting off
the husband from having intercourse
rather than from any biochemical action,
but no follow-up records exist of family
planning efficiency so no idea of its effectiveness can be derived.

Figure 3: Giving birth in the squatting position

BIRTH MORTALITY
There is no population-based data of the
numbers of babies and mothers lost in
childbirth during this time. It was certainly
much higher than occurs in modern Egypt
with its planned antenatal and delivery
service. There is, however, no reason to
believe maternal or baby death rates were
any worse than those in the rest of Africa.
The loss of mothers was probably about
three to four times that of the Western
world (i.e. approximately 40 to 70 per
thousand total births) but still the vast
majority survived. Again, most of the
babies lived through the process of birth
(about 800-900 per 1,000 total births) but
child mortality rates afterwards, particu-

larly from diarrhoeal diseases, were high,

with as many as a third of those surviving
birth dying whilst infants. These estimates
are based on the last centurys data and are
very approximate estimates.

CONCLUSION
This account of childbirth in Ancient
Egypt is based upon many sources. Most of
them are secondary interpretations of
temple paintings or carvings, and of
papyri, with some extrapolations from
what went on in middle Africa.

Selected reading
1 Ebers Papyrus (1555 BC). University Library,
Leipzig, Germany
2 Ghalioungui P, Dawakhly Z. Health and
Healing in Ancient Egypt: A Pictoral Essay.
Cairo: The Organisation for Authorship and
Translation, 1965

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3 Jordan P. The Black Land. Oxford: Phaidon

Press, 1976
4 Nunn J. Ancient Egyptian Medicine. London:
British Museum Press, 1996
5 Roth A. The PsS-kf and the opening of the
mouth ceremony. J Egyptian Archaeol
1992;78:113-20

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