Abortion in the Ancient Near East and Greco-Roman World

Abortion in Mesopotamian Medical Texts

Ancient methods for ridding oneself of a pregnancy included remedies meant to be rubbed, ingested, or inserted into the body. Such recipes, however, generally do not explain why a person would decide to use these remedies.^[1]

The Babylonian and Assyrian Medical Texts include a recipe for a potion that begins with the following notation:

^{BAM 3 246} A pregnant woman, so that her fruit [i.e., the fetus] is expelled...^[2]

It requires crushing eight plants, only some of which have been identified. These plants include:^[3]

azupirânu, possibly saffron, known to cause uterine contractions if consumed in large quantities;

wêdu, identified as Asafoetida, a sulfurous plant resin known colloquially as Devil’s dung;

buṣinnu, probably referring to mullein (Verbascum), a flowering plant used medicinally in many cultures;^[4] and

ankinutu, or lotus (Nelumbo nucifera), another commonly used medicinal plant.

The patient is to drink these with wine on an empty stomach.^[5] Another medical text mentions an unnamed plant, which presumably was known to medical practitioners, “to make the fetus drop” (BAM 422 iii 5).^[6]

Abortion in an Egyptian Medical Papyrus

The Ebers Papyrus (ca. 1550 B.C.E.), the most extensively preserved Egyptian medical text, includes remedies for everything from acne and wrinkles to intestinal disease, tumors, and teeth issues. The text also covers gynecological issues, including abortion.

Some remedies were intended for the early stages of pregnancy, but the first concoction in this section of the text could apparently be used during any trimester:

^{Ebers 783} The beginning of recipes that are made for women to cause a woman to stop [abort] pregnancy in the first, second, or third period. Unripe fruit of acacia, colocynth, dates, triturate with 6/7 pint of honey; moisten a pessary of plant fiber and place it in vagina.^[7]

Acacia and colocynth are known today to have abortifacient properties; too much of these items can also be toxic, even fatal, for the mother. The solid ingredients were ground into a fine powder and mixed with honey to form a sticky substance. This was then placed into a plant fiber, maybe a leaf, and presumably rolled into a pessary, which was used like a tampon.

One non-organic approach seems intended to create an irritant to expel the embryo:

^{Ebers 798} Another for inducing that everything which is in a woman’s abdomen is expelled. Potsherd of a new earthen pot; it is ground in oil/fat, it is warmed, and it is placed in her genital.^[8]

The heading “for loosening the child” (Ebers 800) introduces another set of abortion remedies:

^{Ebers 801} Another. One-part fresh beans and one part honey are pressed together and drunk for one day.^[9]

The list continues with recipes using a variety of ingredients, including onions, beans, juniper berries, pine products, beer, wine, bird dung, and oils, which could be combined and made into a rub, salve for the belly, ointment, suppository, or drink (Ebers 802–807).

Some of the combinations of plants and other organic materials sound unusual and may even be dangerous, and the efficacy of these Egyptian and Mesopotamian medical recipes is unknown. Given that spontaneous miscarriage is known to occur in one out of every six pregnancies, it might have only appeared that the remedies were working, when in reality the end of the pregnancy was caused by natural means.^[10]

Causing Miscarriage in ANE Law

Ancient Near Eastern legal texts generally do not directly address the permissibility or morality of abortion. They do, however, impose penalties in cases where someone outside the family causes a woman to miscarry.^[11]

Bible

The Covenant Collection requires compensation to the head of the household for the loss of a potential child if a mother is struck and miscarries:

‏^{שׁמות כא:כב} וְכִי יִנָּצוּ אֲנָשִׁים וְנָגְפוּ אִשָּׁה הָרָה וְיָצְאוּ יְלָדֶיהָ וְלֹא יִהְיֶה אָסוֹן עָנוֹשׁ יֵעָנֵשׁ כַּאֲשֶׁר יָשִׁית עָלָיו בַּעַל הָאִשָּׁה וְנָתַן בִּפְלִלִים.

^{Exod 21:22} When people who are fighting injure a pregnant woman so that there is a miscarriage and yet no further harm follows, the one responsible shall be fined what the woman’s husband demands, paying as much as the judges determine.^[12]

In the ancient Near East, men needed children, especially sons, for a variety of reasons—e.g., to inherit, work in the fields, carry on the family name, provide elder care, and carry out the duties associated with their cult of the dead. It is noteworthy that the father is allowed to make demands about the penalty, suggesting how seriously the law treats this case, but the law is otherwise consistent with other ancient Near Eastern law collections.^[13]

Hammurabi

In the Laws of Hammurabi (ca. 1750 B.C.E.), the penalty is a fine based on social class of the woman:

^{LH 209} If a member of the awīlu (free, elite class) strikes a woman of the awīlu-class, and thereby causes her to miscarry her fetus (ša libbiša uštaddīši, “who causes her womb to be dropped”), he shall weigh and deliver 10 shekels of silver for her fetus.^[14]

The fines are reduced if the woman is a commoner (5 shekels) or a slave (2 shekels).^[15]

Hittite

The Hittite Laws (ca. 1650–1500 B.C.E.) from Anatolia (Turkey) establish penalties for causing a miscarriage based on the status of the woman and how long she was pregnant, i.e., the age of the fetus:^[16]

^{HL 17} If anyone causes a free woman to miscarry [abort], if it is her tenth month, he shall pay 10 shekels of silver, if it is her fifth month, he shall pay 5 shekels of silver.^[17]

The penalties are halved if the woman is a slave:

^{HL 18} If anyone causes a female slave to miscarry [abort], if it is her tenth month, he shall pay 5 shekels of silver.^[18]

Middle Assyrian

The Middle Assyrian Laws (MAL; ca. 14^th c. B.C.E.) in most cases also impose a financial penalty for causing a miscarriage.^[19] If the fetus is male and the woman’s husband has no other sons, however, the assailant is executed:

^{MAL A 50} …And if there is no son of that woman’s husband, and his wife whom he struck aborted her fetus, they shall kill the assailant for her fetus. If her fetus was a female, he shall make full payment of a life only.

The loss of a potential heir for the woman’s husband was apparently so egregious that it justified the death penalty.

The MAL also legislate the case of the prostitute:^[20]

^{MAL A 52} If a man strikes a prostitute causing her to abort her fetus, they shall assess him blow for blow, he shall make full payment of a life.

In a patriarchal society, without a man to provide for her, the law compensates the woman for the loss of a child to care for her in old her age.^[21]

Abortion

Among the Mesopotamian and Hittite material, only the MAL explicitly address the possibility that a pregnant woman might strike or harm herself to intentionally end a pregnancy:

^{MAL A 53} If a woman aborts her fetus by her own action and they then prove the charges against her and find her guilty, they shall impale her, they shall not bury her. If she dies as a result of aborting her fetus, they shall impale her, they shall not bury her.^[22]

As in the previous cases, the law presumably focuses on the concerns of the father, since the mother’s action would deprive him of a potential child. The brutal public impalement and non-burial of the woman serve to make an example of her.

Abortion in the Greco-Roman Literature

The section of the Hippocratic oath in which the physician swears not to do harm to a patient includes the following commitment:

Neither will I give a woman a suppository (pessary) to cause an abortion.^[23]

Though this statement has traditionally been interpreted as a general prohibition against abortion, the oath only specifically prohibits pessaries, which carried a known risk of harm to the mother.^[24] In any case, it appears that ancient physicians generally did not follow the oath, and it is clear from other ancient sources that abortion was practiced in the Greco-Roman world.^[25]

In Medical Texts

The Greek text On the Diseases of Women, attributed to Hippocrates (460–370 B.C.E.) but likely representing a compilation of materials from multiple authors, includes a variety of abortifacient remedies, many of which use methods and ingredients similar to those found in the Egyptian papyri.^[26]

The text contains numerous recipes for purgatives or emetics, which were meant to weaken the embryo, including:

1. Potent uterine abortifacient, the roots of sweet earth-almond, that is like a bulb, small like an olive, and let her drink it. If small, two are needed; if not, one will do. Mix together some seeds of Ethiopian cumin, Massilian hartwort, dried Lybian leaves [possibly Silphium] with three cotyls of wine; boil down to a half and let her drink this.
2. Fruit of the chaste tree, hartwort likeness, myrtle, ground and given as a drink in water.
3. A small handful of mint [possibly Pennyroyal], rue, coriander, juniper or cyperus chips, boiled down in sweet wine and drunk.^[27]

These recipes appear to include plants such as Silphium and Pennyroyal, which were known and used for their abortive properties throughout the Greco-Roman world. Also mentioned is the chaste tree (Vitex agnus-castus L.), a native Mediterranean shrub whose modern English name suggests that it was associated with reducing sexual desire. Several studies have indicated that it has antifertility and abortifacient qualities.^[28]

Many of the remedies take the form of pessaries, which were intended to place pressure on the uterus, loosening or opening the womb and expelling the pregnancy. Some examples include:

1. Ecbolic (abortive) suppository: Egyptian salt, mouse dung, wild colocynth; pour in a fourth-part honey, boiled to a half; take a drachma of resin and put into the honey and mouse dung, grind all together well. Make suppositories, insert in the uterus, until the proper time.
2. Elaterium (squirting cucumber) in double amounts, honey and wine on linen pad.
3. Butter and alum on coarse flax.^[29]

Hippocrates’s Commentary on the Nature of The Child also describes inducing abortion by having the pregnant woman engage in excessive physical activity, such as carrying heavy loads, jumping up and down, or shaking items. The text specifically mentions a practice, attributed to the Spartans, called the Lacedemonian leap, which involved a woman jumping up and kicking her buttocks with her heels. If performed correctly, the leap would expel the pregnancy in its very early days.^[30]

In Greek Philosophy

References to abortion are also found among the Greek philosophers. For example, Plato (ca. 428–348 B.C.E.) includes abortion among the practices of midwives:

The midwives, by means of drugs and incantations, are able to arouse the pangs of labour and, if they wish, to make them milder, and to cause to bear those who have difficulty in bearing, and they cause abortions at an early stage if they think them desirable.^[31]

The key for Aristotle (384–322 B.C.E.) is that abortion should happen before life is established:

Abortion must be practiced on it (the embryo) before it has developed sensation and life. For the line between lawful and unlawful abortion will be marked by having sensation and being alive.^[32]

Under Roman Law

The first state laws that directly address abortion in Classical Antiquity appeared during the Roman period, during the reigns of Septimius Severus (r. 193–211 C.E.) and Antonius Caracalla (r. 211–217 C.E.). The two case laws establish limits for abortion, but neither outlaws the practice.

The first case deals with a woman who sought an abortion after her divorce, against the wishes of the ex-husband. Her punishment, exile, is motivated by the rights of her husband, whom she has deprived of an heir: “for it may seem unworthy that she should have cheated her husband of her children with impunity.”^[33]

The second case concerns those who have given abortion inducing drugs to a woman. Its stated motive suggests that the law is not concerned about abortion per se, but about setting a precedent that a person could not give dangerous drugs to a patient with impunity: “They give an abortion or an amorous cup, even if they do not do it with guile, but because it is a matter of bad example.”^[34] If the patient dies, the person administering or providing the abortifacient is put to death as punishment for her death.^[35]

Abortion: Unlegislated

The ancient legal sources—both Near Eastern and Greco-Roman—seem to share common general approach that is more about compensating the head of a household for the loss of a potential child than it is a commentary on the rights of women or perceptions of when life began. In most cases, the head of a household would be the woman’s husband, but the right to compensation apparently could shift to the woman if she were not under the authority of a male.

Implicitly, the absence of broad prohibitions against the practice suggests that abortion decisions would have been a family matter. In addition, the existence of numerous recipes and procedures for inducing an abortion in these cultures seems to indicate an ongoing desire for such remedies.