Well-Born: The Ancient History of Making the Best Babies
This article is part of a five-part series on childbirth in antiquity
Two teams of Chinese scientists recently published studies reporting that they successfully used the CRISPR genome-editing technique to alter the DNA of non-viable human embryos. As Yurie Hong discusses in her article from this childbirth series, these reports raised concerns about the possibility of future non-therapeutic applications of the technique, tapping into longstanding fears (however misguided) about “designer babies” and other variations on the dystopian public imaginary.
Most accounts of these CRISPR-induced anxieties have focused on a time horizon from the recent past to the far future. The specter of a generation of children surpassing all others in intelligence, beauty, and health reaches back to the heyday of eugenics in the early-twentieth century. And indeed, the state-sponsored eugenic programs of a century ago are a logical point of reflection, given the shape of science funding and government involvement in health care and personal data that characterize the twenty-first century. (There are a number of great books on the field of twentieth-century eugenics and its legacies, including those by Daniel Kevles, Alexandra Minna Stern, and Nathaniel Comfort).
But these are not the only historical resources available as we seek to understand our present moment. I hear echoes of the hopes and anxieties of our own age in sources from the Greco-Roman world. Here, I want to look at one medical text known as the Gynecology, written by a Greek doctor named Soranus in the second century CE. This was a time of relative prosperity in which elite Roman families often employed Greek doctors to aid in health-related matters, including childbearing.
Soranus’ Gynecology (which you may have encountered already in Tara Mulder’s article from this childbirth series), covers a wide range of issues relating to reproduction. The work is split into four “books”: books one and two cover routine aspects of pregnancy, birth, and infant care, including how to pick the best midwife and wet nurse; books three and four deal with gynecological and obstetrical problems, especially disease and difficult birth. Not only is the Gynecology one of the most important texts on women’s health from antiquity, but Soranus’ ideas continued to circulate through adaptations, especially Mustio’s Gynaecia (c. 500 CE). The influence of the Gynaecia ebbed and flowed in unexpected ways for over 1,000 years after its composition (Monica Green is the expert on this history).
The Gynecology is essentially advertising an approach to enhancing reproductive outcomes, probably pitched to husbands nervous about ensuring their wives’ health and fertility, as well as the best future for their children. It is this focus on improvement that makes Soranus’ Gynecology a useful mirror for thinking about more recent efforts to alter the nature and future of human children, as well as preparation of the pregnant body to those ends. The text provides advice, unparalleled in other sources from the period, on how to produce the best possible offspring.
Soranus’ treatise emphasizes care of the pregnant body — and regulation of women’s behavior — as central to the formation of healthy, strong, virtuous children. Embedded in his recommendations is an understanding of social privilege as rooted in the physical body. This configuration is worth exploring, both for what it says about Soranus’ particular historical context and for its place in a longer history of approaches to the reproductive body.
According to Soranus, a pregnant woman may miscarry as a result of a wide and varied set of factors, which range from sneezing to sitting on a hard sedan chair. These factors may be “bodily” or “psychic.” He singles out, for example, “fright” and “sudden joy” (Gyn. 1.46 Ilberg). Danger is lurking everywhere throughout the pregnancy.
A pregnant woman must adhere to a rigorous schedule of bathing, massage, food, and exercise. These practices put enormous pressure on the female reproductive body and imply a high level of surveillance of her everyday habits. In this regard, Soranus is drawing on a long tradition of what is called “regimen” (a set of prescribed habits) and “dietetics” (precise dietary instructions), designed both to heal and improve an individual’s constitution.
On the second day after conception, Soranus explains that women should engage in some “passive” exercise, such as riding on a (presumably, soft) sedan chair. They should also eat fish that does not give off a lot of grease and avoid “pungent” foods such as leeks and garlic (Gyn. 1.46 Ilberg). This kind of advice suggests access to resources, including sedan chairs, massage, and high-status foods. Only the most privileged could afford this type of regimen, let alone the acquisition of a caretaker (such as a midwife) who would have the skill to read, understand, and implement Soranus’ prescriptions.
Caring for a woman throughout her pregnancy was intended to ensure that her fetus receives the best possible nutriment, which derives from what a woman herself consumes, and to prepare her to give birth — strengthening, relaxing, and preparing her body and mind. A woman’s body, in Soranus’ view, is like the earth, which can bring forth clear or foul moisture to nurture seeds into plants (Gyn. 1.53 Ilberg). A fetus, Soranus explains, is also like a house. You have to build on good foundations, and a key part of this process is providing appropriate material, that is, nourishment. In its early stages of construction, a house may fall apart “at the slightest provocation,” and the same goes for a fetus (Gyn. 1.47 Ilberg). Soranus’ prescriptions are meant to ensure the fetus receives suitable, pure nourishment, providing the most auspicious environment for growth.
At the end of his prescriptions for women who have just conceived, Soranus provides the following warning:
Even if a woman transgresses some or all of the rules mentioned and yet miscarriage of the fetus does not take place, let no one therefore assume that the fetus has not been injured at all. For it has been harmed: it is weakened, becomes retarded in growth, less well nourished, and, in general, more easily injured and susceptible to harmful agents; it becomes misshapen and of an ignoble soul.
— Soranus, Gyn. 1.47 Ilberg; tr. Owsei Temkin 1992
In this passage, Soranus provides, in the most definitive terms, an explanation for the frailty of some children after birth or later in life. He also embeds future risks in the child’s body, in the form of susceptibility “to harmful agents.” In one sense, this offers an explanation for high infant mortality; but the rhetoric also suggests a more expansive interpretation. Soranus clearly wants to frighten his audience into following his rules. In essence, he seems to say, you’ll regret it if you don’t listen to me!
There’s a more sinister way to read this passage. In addition to the elites who may choose not to abide by his prescriptions, what about all the people who simply cannot? If you’re working in the fields, toiling in a bakery, pushing a vegetable cart, it would be well-nigh impossible to follow Soranus’ rules. Taking this interpretation to its logical conclusion, we realize that Soranus’ understanding of gestational growth is embedded in a broader conceptualization of the differences between — and possibilities for — those with access to certain knowledge and resources (the aristocracy) and everyone else. His view embeds status difference in the bodies of those he treats (or doesn’t).
When I puzzled through this passage in the Gynecology, I was taken aback by its implications. The anxieties one can infer from Soranus’ proposed solutions have much later echoes in what modern historians call “positive eugenics” — the “science” of improving a population by encouraging the reproduction of certain individuals, as opposed to “negative eugenics,” the elimination of individuals with traits deemed undesirable. (Plato’s Republic, by the way, and his analogy of human breeding with animal husbandry in his ideal state, is often a place people start when discussing eugenics.) Of course, Soranus doesn’t think about these matters the way we do, instead relying on an understanding of difference rooted in visible, controllable bodily behaviors. This is not to say he would deny that parents’ traits are passed down to their children, but in his particular medical/philosophical context, he places a great deal of emphasis on the impact of nutriment and the uterine environment.
Still, there is something to these tragic echoes of the ancient medical tradition. Today, the idea of eugenics is inseparable from the development of “social Darwinism” and the catastrophic legacy of related ideas in the twentieth century. Roughly 2,000 years ago, Soranus was engaging in his own particular “eugenic” project, if we understand eugenic as it relates to its ancient roots, eu (“well”) and genos (“race, stock”) — or perhaps more pointedly, the Greek adjective eugenes, meaning, literally, “well-born,” which is also used to mean “noble.” The cultural practices that reproduce inequality (not to mention the anxieties that give rise to them and by which they are entrenched) have a very ancient history.
Fears of genetically engineered cyborg babies make sense, but such prospects can also be seen as extensions of a stratification of medical resources that already exists. In the United States today, class, wealth, and especially race (as Khiara Bridges shows) determine a great deal about the kind of treatment and counseling a pregnant woman will receive — how she will be judged, measured, and cared for in a clinical setting. Indeed, countless studies have shown the extent to which women’s control over their bodies is eroded during pregnancy, and this is especially true for women of color. Overwhelmingly, women bear the lion’s share of responsibility and blame when things go wrong.
Women are all too often made to feel it’s their behavior and choices that have prevented the formation of the strongest, fittest, smartest child. This impulse can easily transform into an explanation — and then justification — for social stratification and prejudice, facilitating judgments about women’s bodies and their offspring that are still there, just beneath the surface, in Soranus’ Gynecology and in the hopes and fears associated with CRISPR and other technologies today.
Anna Bonnell-Freidin is a PhD candidate in Classics and the Program in the Ancient World at Princeton University, as well as a certificate candidate in Gender and Sexuality Studies.
Other articles in this series:
