Nancy Demand, Birth, Death, and Motherhood in Classical Greece. Baltimore: Johns Hopkins University Press, 1994. Pp. xx + 276. $39.95. ISBN 0-8018-4762-1.
Reviewed by Mark Golden, University of Winnipeg.
Nancy Demand's thesis is straightforward: Greek women bore children early and often, this was unhealthy and known to be so by the men who controlled them, "at least in the extreme patriarchal form that it took in Athens and many other poleis, the Greek polis was detrimental to the interests of both women and polis" (154). Its presentation starts from a useful summary chapter on the lives of Greek women. Most important for Demand's argument are the tendency of medical writings to incorporate cultural constructions of gender -- the Hippocratics viewed women as essentially passive in childbirth despite observing birth contractions (19) -- the high reproductive rate, estimated at over six births per woman (21), and men's concern to guarantee the legitimacy of their children (22). The following two chapters characterize the Hippocratic Epidemics and sketch their evidence for attitudes towards and treatments of female patients. Here as elsewhere in the Hippocratic Corpus there is much material developed by and derived from women, but shaped by "the value-laden conceptual screen of traditional Greek male assumptions" (65). And as men appropriated women's knowledge, so too they took over the care of pregnant women, raising the status of female midwives who worked along with them and lowering that of those without such links. Doctors' belief that women's wombs were prone to wander without the moisture and fullness provided by intercourse, and pregnancy supplied a medical justification for what fathers and husbands wanted, early marriage and regular parturition. The interests of kyrioi also influenced the Hippocratic outlook on abortion, a procedure doctors undertook rarely and then only with the consent of a husband or owner.1 The "medicalization" of childbirth had little effect on obstetric risk, which remained high. Demand finds the symptoms of puerperal infection in Epidemics (though few cases of toxemia, another common cause of maternal mortality before the antibiotic age, and none of hemorrhage), and persuasively explicates the role of pregnancy in reducing immunity to endemic diseases, especially malaria (chapter 4). Nor was it the only model of care: women's first recourse for "female problems" remained the gods, Artemis in particular, and often enough the manteis, women among them, whose religious quackery so threatened and enraged the Hippocratics (chapter 5).
If early marriage had important advantages in the eyes of Greek males, seized as they were with the need to safeguard the honor of the oikos by guaranteeing the chastity of its women and the authority of its men, how were women reconciled to it ? Chapter 6 discusses three means of acculturation: the theory of the wandering womb, understood here as a cure for girls' anxiety about marriage; the arkteia and similar coming-of-age ceremonies (Demand accepts the usual view that Athenian arktoi were ten and older, and suggests that only an elite few served at Brauron itself); and the Thesmophoria. Here the myth of Demeter and Persephone delivered "a powerful message of reconciliation to female losses in marriage" (115). One inducement to motherhood Demand denies (chapter 7): despite the current consensus, Greeks did not equate the death of a childbearing woman to that of a man in battle, either as a matter of public policy (Sparta) or in private life (Athens). On the contrary, the iconography of Attic and Atticizing tombstones distinguishes such women, passive and pitiable, from the heroized men shown as warriors in action. (And some stones taken to depict women who died in childbirth probably commemorate midwives.) Indeed, far from glorifying motherhood, Greek men denigrated women's role, going so far as to deny them a significant share in reproduction, and appropriated their procreativity through the metaphor of male pregnancy (Socrates the midwife of ideas) and the representation of pederasty as a means of completing the necessary masculinization of males. "For the Greeks, giving birth to actual infants, very likely ephemeral creatures ... did not compare in importance with giving birth to 'real men' (or to poems, laws or philosophical truths, all accomplishments of men)" (140). This lack of interest in young children is reflected in the failure to develop a pediatrics; children of all ages are underrepresented among patients in Epidemics, and those who feature in the cases the doctors report are usually older, often already at work (chapter 8). Their medical care was usually left to women. The main text of the book is followed by twelve plates of tombstones and funerary lekythoi, an appendix setting out the data on female and pregnancy-related cases in Epidemics, another translating cases involving pregnancy -- very valuable, this, in view of the difficulty of many of the texts Demand discusses --, fifty-something pages of notes, a glossary of medical terms, a bibliography, a general index and a Hippocratic index locorum. There are more typos and slips than in other volumes of the series Ancient Society and History I've seen; a few may confuse, such as the ascription to M.B. Wallace of a view he refutes (220 n. 2).
This book contains much that is true; but it is not always the whole truth or nothing but the truth. The treatment of the male appropriation of birth seems particularly partial. Demand notes, but does not sufficiently stress, that Hippocratic writers tend to reject the "incubator" theory and to acknowledge women's contribution to the makeup of the child; she omits any mention of Pericles' Citizenship Law in this context -- where it might reflect a community preference for the Hippocratic view -- and cites it instead as evidence for a supposed increase in male anxiety over the control of women during "the Hippocratic period" (148); and she ignores women's role in readmitting those given up for dead into society through a process of rebirth, a practice which may motivate Odysseus's mysterious appeal to Queen Arete in Odyssey 7.2 This whole section puts too much weight on the initiatory character of Greek pederasty and its New Guinea analogues and too little on those anthropological studies of sex-segregated societies which read childbirth rituals as "a form of psychological warfare ... used when opportunities for more direct forms of conflict and more explicit bargaining are restricted."3 Nor is it true that Epidemics reveal changes over time in the percentages of female and pregnancy-related cases the doctors report (48). There is no statistically significant difference in the proportion of female cases in the three groups into which Epidemics is generally divided, Books I and III (410-400 BCE), Books II, IV and VI (400-375) and Books V and VII (375/360-350). The incidence of pregnancy-related cases does differ, but is almost identical in the first two groups -- only the third is anomalous. Besides, even if the rate of reporting were significantly different, Demand's perceptive account of the nature of Epidemics -- the products of at least three authors and probably more, who chose both which cases to take and which to write up -- reveals that time is only one possible variable. In general, Demand is less successful in solving some problems of method than her sound grasp of the difficulties would suggest. She confronts the problems the distribution of her evidence poses for a book on classical Greece as a whole, yet writes that a woman divorced as unfaithful would lose her dowry (12) without any indication that such penalties are reliably attested only for Ephesus, and no earlier than the third century BCE at that. She recognizes the pitfalls of comparisons with modern Greek village life (186 n. 24, 187 n. 8) and warns of regional variation in pre-industrial populations (206 n. 4), yet seems at times to invoke such villages and their customs at random and in neglect of crucial differences. (How relevant can it be to classical Greece, where there was ready access to slaves and most citizens owned some land, that modern Greeks pay a dowry premium to avoid farm work and marry into town ?) Such slackness surprises in so good a scholar. It is perhaps signalled already in the historiographical introduction, where the pattern of fifth-century Greek history is said to confirm "the larger hypothesis of a connection between state formation and the subordination of women," and the takeover of female lore about childbearing by Hippocratic gynecology to have had effects that extend to the present day (xx). The book itself, however, has nothing to say about state formation (which surely must antedate the classical period); and the charge that the misogyny and marginalization of women which marks so much of modern medicine is to be laid against the Greeks hides from history the women who worked as physicians and surgeons as late as the fifteenth century in Italy and elsewhere and, as midwives, controlled childbirth and introduced their methods into medical practice two thousand years after that "crucial point in women's history ... in the formative days of Western medicine and culture" (69).4
Nancy Demand has written three books: Thebes in the Fifth Century: Heracles Resurgent (l982), Urban Relocation in Archaic and Classical Greece: Flight and Consolidation (l990), and now this one -- an admirable range of subjects which testifies to her energy and learning. Birth, Death, and Motherhood further differs from its predecessors in appearing without the usual signs of professional pregnancy, journal articles. Environmental friendliness? (After all, it is not only philosophers who wonder about the fate of trees falling in the forest these days.) A product of the culture of American history departments, notorious (among Canadian classicists anyway) as the natural habitat of the People of the Book? At any rate, while this latest book is both welcome and helpful, it might have become still more so through the debate and development ideally prompted by a body of accessible work on her theme. Some of Birth, Death, and Motherhood in Classical Greece -- the discussions of abortion, of the iconography of death, of the arkteia, comments on miraculous cures credited to Asclepius (93-94), on the subjectivity of judgements on rates of maternal mortality (206 n. 4) -- meets the high standard set by her earlier work. The book as a whole does not.
 This excellent account [57-63] would have been strengthened by reference to J.S. Murray, "The Alleged Prohibition of Abortion in the Hippocratic Oath," EMC 35 (1991) 293-311.  Plut. Mor. 264F-265A, Hsch. s. deuteropotmos; R.M. Newton, "The Rebirth of Odysseus," GRBS 25 (1984) 5-20.  K.E. and J.M. Paige, The Politics of Reproductive Ritual (Berkeley 1981) 48, cf. now S.S. Sered, "Husbands, Wives, and Childbirth Rituals," Ethos 22 (1994) 187-208.  See, e.g., T.G. Benedek, "The Roles of Medieval Women in the Healing Arts," in D. Radcliff-Umstead, ed., The Roles and Images of Women in the Middle Ages and the Renaissance (University of Pittsburgh Publications on the Middle Ages and the Renaissance 3 ) 145-159; S. Shahar, The Fourth Estate. A History of Women in the Middle Ages (trans. C. Galai: London and New York 1983) 201-203; M.E. Wiesner, "Women's Defense of their Public Role," in M.B. Rose, ed., Women in the Middle Ages and the Renaissance (Syracuse 1986) 1-27; H. Lemay, "Women and the Literature of Obstetrics and Gynecology," in J.T. Rosenthal, ed., Medieval Women and the Sources of Medieval History (Athens, GA and London 1990) 189-209.