by Randall S. Frederick

To a great extent, any discussion of abortion is truly a discussion of women’s rights. There are many masks – religious conviction, sentiment, morality – but each are facades. The root concern is, ultimately, the rights a woman has over her own body, her reproductive health, and her potential to have or avoid having children.

Today, a woman in America must meet certain criteria to have the surgical procedure of tubal ligation or “having her tubes tied” and requesting the procedure could trigger a mental health evaluation. In some states, federally-funded insurance plans such as Medicaid require a woman be at least 21 years old and not “mentally incompetent.” Further, the procedure must take place at least 30 days after the patient has been “voluntarily given informed consent” regarding the process. For those familiar with this language, “Informed consent” could mean a spectrum of things. In sexual education materials, it means explicit consent to every step of a process (ex: “enthusiastic consent” to sexual activities). In conservative states like Louisiana, “informed consent” at a Women’s Resource Center (which are not required to employ medical professionals, certifications, or even trained volunteers) means a woman seeking an abortion will be given pamphlets discouraging abortion for moral or religious reasons. Seeking help for her circumstances, she is shamed and pointed to a local church where she is told even thinking about an abortion is a sin that could send her to Hell.

In other words, “informed consent” is not standardized. It could mean a woman is given the full attention of a medical professional. It could mean she’s given pamphlets and pointed to a church to get her life right. These kinds of double standards are not surprising since women’s health and thorough information is routinely less comprehensive than medical information for men.

The double standard of treatment even exists whether a woman is a patient or a physician. My mother is the director of a mental health facility and today over lunch, she said that there was a situation last month where she ordered a client undergo a particular kind of treatment. One of her male employees asked, “Are you sure?” and began to explain why he disagreed with her decision. She outranks him, has more certifications than he does, more licenses than him, and has a more advanced degree than he does. Yes. She was sure. “And the kicker is, he wasn’t even correct in what he was saying the state required! It was ridiculous and offensive to me as a professional.”

Specifically as it relates to tubal ligation, “informed consent” with a medical professional often means any member of a medical facility – such a nurse, not a doctor – speaks with a woman and “shares” their personal experience, worst case scenarios, or graphic recall of procedures gone wrong. A woman I once dated had previously been married and, by her thirties, had given birth to two children when she decided she wanted to have her tubes tied. She said that, in Baton Rouge, “you have to have at least two children and the signed consent from your husband. No one in Louisiana, at least not in Baton Rouge, will consider it unless your husband gives you permission.”

If the state of women’s health today sounds “Medieval, there’s a good reason for that.

In the last entry on abortion, I discussed ancient history. Let’s jump ahead.

In 1469, Margery Paston, daughter of a wealthy Norfolk family, was secretly engaged to the overseer of her family’s property, Richard Calle. The family had hoped to marry her to a noble family and increase their standing, but Richard came from a family of shopkeepers. When the engagement was announced to the Paston family, their anger is laid bare in a letter between Margery’s mother and brother, recalled in Martyn Whittock’s The Pastons in Medieval Britain (1993).

On Friday the bishop sent for her and he spoke to her clearly and reminded her of her position in society and who were her family and friends. And that she would have more friends if she followed their advice. And if she did not, what rebuke and shame and loss she would suffer. And she said again what she had promised [to Richard Calle] and she said boldly that if these words did not make it final then she would make it quite clear before she left! These shameless words shocked me and her grandmother… I ordered my servants that she should be banned from my house… I beg you that you do not take this too badly. For I know well that it goes to your heart and it is the same to me and to others. But remember, as I do, that all we have lost is a worthless person. For if she had been good, then this would never have happened. Even if he [Calle] were to die at this very hour, I would not take her back!

Despite all this, Margery eventually married Richard and the Paston family was forced to accept it. Their romance and the Paston letters reveal the intricacies and nuances of the still developing constraints facing Medieval women, as much as the changing attitude toward and understanding of the fundamental role and character of “woman” in society. This understanding was affected by the Norman Conquest but went much deeper than this and event and its social repercussions.

Whittock explains in his Life in the Middle Ages (2009).

The position of women in society suffered a setback in 1066. While female land ownership occurred to a significant extent in Anglo-Saxon society, the Norman preoccupation with linking land to military obligations reduced the role of women as landowners. Moreover, developments within Canon (Church) law also reduced the status of women. Whether this would have happened if the Conquest had not occurred is a matter of debate. What is clear is that women had a complex image in the Middle Ages. Eve was a woman; the Virgin Mary was a women. On the one hand it was a woman who was blamed for the Fall and origin of the sinful nature of humanity (along with Adam of course). On the other hand it was a woman whom God had honored by making the mother of Christ. And in medieval Catholic theology, Mary was a woman exalted far beyond the relatively limited information provided by the New Testament. Yet it was this very Church which greatly emphasized the particular responsibility of Woman in the fall and whose male-dominated celibate clergy could sometimes be highly misogynistic in the way they described and related to women.

The medieval legal definition of women, outlined in 1180, was that ‘every woman is a sort of infant’. As a result, even adult married women had few rights since, in most circumstances, the existence of a male (whether father or husband or brother) mean that he was in control. Consequently, when a woman married, her property automatically belonged to her husband for as long as he lived. Furthermore, Canon Law permitted a man to beat his wife if he considered her lazy or disobedient.

This seems far from the discussion of abortion, but note the casual way that Whittock discusses the demotion of women. As a result of the Norman Conquest, women lose the right of inheritance, right the own land (since they are not under military obligations), become the property of men (who are under military obligation and, following the Conquest, to be continually observed for their loyalty to the vacillating crowns), and are constrained by their exaltation as much as responsibility for global damnation. Finally, if a woman is “lazy” or “disobedient” (veiled language for refusal to consent to sex upon demand), she can be beaten. After all, according to the teachings of the Church, she is a child. Not a man.

One more noteworthy side rail.

In 1945, the apocryphal Coptic text The Gospel of Thomas was found near Nag Hammadi. Records of The Gospel of Thomas, it is believed, were buried and hidden away at the order of Athanasius (d. 373 A.D.) because of the strange and confusing treatment of women in the scripture, culminating in this bizarre conversation between St. Peter and Jesus

Simon Peter said to him, “Let Mary leave us, for women are not worthy of life.”

Then Jesus said, “I myself shall lead her in order to make her male, so that she too may become a living spirit resembling you males. For every woman who will make herself male will enter the kingdom of heaven.”

While both Protestants and Catholics reject the Gospel of Thomas from inclusion in the Bible, it provides evidence that the sentiment that women “are not worthy of life” (and must be “made male” to reach Heaven, an expression that baffles theologians) predates the Norman Conquest and provides evidence that there were lines of thought that surely affected Catholic Canon and culture – including the Normans, descendants of the “barbarian” people the Franks, Gallo-Romans, and Norse Vikings. If a woman’s life meant anything, which is say that her accomplishments eclipsed those of every man around her, the greatest praise one could laud her with would be that she was mannish. Conversely, the greatest reproach to a man was that he was womanish, effeminate or feminine, as was the case with Edward II and his favorites at court, namely Piers Gaveston, who were criticized and attacked for their supposed liaisons outside of Edward’s marriage to Isabella of France. Whatever the nature of their relationship, Edward II was overthrown and murdered at Berkley Castle (Glouchestershire) in 1327, in part, for his failure to behave like a man.

Women were frequently regarded as being less rational and intelligent as men, more easily tempted into sexual sin. Repressed societies often project onto women the blame for “inflaming” sexual desire which men feel, especially when men are celibate or prohibited from freedom of sexual expression. In such circumstances, it is invariably the woman who is blamed for tempting men rather than the man being blamed for natural sexual desire. Despite these so-called characteristics of women, there were of course women who prospered in male-dominated communities and did not conform to stereotype. The countess of Hawisa, wife of the Earl of Essex in 1180, was described by a monastic chronicler as “almost a man to whom nothing masculine is lacking save virility.” In exceptional cases, such characteristics might be reluctantly admired, but they were not to be emulated by women as a general rule. It should come as no surprise, then, that women could not normally hold responsible roles in government, the law, or attend university. They also, with the rise of medicine, could not learn about surgery or examine the body. Writing for the American Journal of Public Health in February, 1992, Dr. William Minkowski explains that women, when they were allowed to participate in “healing” at all, were often seen as witches – not only for their use of medicinal herbs, but for violating their “place” in society.

Healing has always been regarded as the natural responsibility of mothers and wives. With techniques leamed from family and friends or from observation of other healers, women have always succored the whimpering, feverish child and mended the wounded worker – warrior hunter husband. But because they were excluded from academic institutions, female healers of the Middle Ages had little opportunity to contribute to the science of medicine. Rather, they served as herbalists, midwives, surgeons, barber-surgeons, nurses, and empirics, the traditional healers. As women of lower or higher birth, as nuns in convents or members of secular orders, these healers were notable for their devotion to the sick under the most stressful circumstances. Untutored in medicine, they used therapies based on botanicals, traditional home remedies, purges, bloodletting, and native intelligence. Their medications were compounded of plant materials, some superstition, and a dash of charlatanism…

Early in the 13th century, female health workers, long accustomed to the trust and respect of their patients, began to face opposition. Barred from most European universities because of their gender and thus denied academic training in medicine, they were considered ineligible as healers, and those who persisted often met with capricious, even harsh punishment. Yet they stood their ground against the inimical decrees of secular and clerical authorities, and in doing so, they risked heavy fines, flagellation, excommunication, and exile. Then, in the last four centuries of the Middle Ages, female healers became the target of witch-hunting, a program of ruthless persecution that was promoted by the church and supported by both clerical and civil authorities.

Minkowski continues, pointing out that nursing began during the Crusades, in the absence of

curative, medical, or surgical therapies, nursing care was the preeminent service, one that offered little more than comfort in its provision of bed, board, bath, and prayer. A remarkable outburst of intellectual and socially directed energy found expression in secular nursing groups in the 12th and 13th centuries. In an age still superstitious and capable of great cruelty, nursing appealed to women’s piety and compassion as well as to their striving for some measure of independence from a constricting social system. As some women entered into nursing orders that provided in-patient care in the rapidly proliferating hospitals of Europe, others chose to wet-nurse the newborn and to care for the sick in homes and for the children in orphanages. Even aristocratic women were caught up in the spirit of charitable works. French women, for example, studied medicine with private physician tutors to become Good Samaritans. Spurred by religious zeal, they offered their healing skills in distant Spain and North Africa, where the gravely ill, the wounded, and the pregnant sought their care.

Women were increasingly given liberty to perform medical procedures, so long as they remained in their “place” as nurses, secondary to men who may or may not know what they were doing. Women, observing hundreds and increasingly thousands of cases over their lifetime, became experts in all manner of health and were afforded a freedom they could not find inside the home. In a very real sense, the hospital replaced the cloister for women to congregate and exercise some manner of control in their limited sphere, with one caveat: nurses (women), unlike men (doctors) were also responsible for the maintenance and cleaning of their ward. Janitorial duties and “domestic concerns” were a given.

At the Hotel Dieu of Paris, as well as virtually every other hospital that followed the Crusades until shortly before the European migration to America,

Obstetrical patients were in the charge of a midwife. A nurse assistant admitted them and often had to dispose of their stillborn by cremation. Maternal death at birth occurred quite often. Hospital policy recognized the special needs of pregnant women by urging them to remain for 3 weeks beyond delivery. Their nursing care included baths three times weekly and abundant rations of meat and fish. Yet, not infrequently, poor mothers wittingly forfeited their infants. In such cases, the hospital was compelled by statute to provide 7 years’ care for such children, as well as for infants surviving mothers who died in childbirth and for babies deserted at the hospital door and left as prey to foraging pigs and dogs. Responsibility for pediatric care fell heavily on the sisters, who harbored 60 to 70 infants in normal years and often twice that number during epidemics of plague or other infectious disease… Clearly, however, women did perform varied medical functions beyond those of empiric and midwife; they served as physicians, apothecaries, surgeons, and barber-surgeons, although far fewer of them acted in these capacities than in the more traditional ones. Evidence for their involvement in these more specialized areas of medical practice comes from the feminine endings of nouns descriptive of their healing work, from guild societies to which they belonged, and from legislation regulating their professional activities.

Together with knowing more than a man, practicing medicine and attending to more patients than a man, women were expected to take on the caring, feeding, bathing, and cleaning after of patients as well as taking on the responsibility for infants and children born or accompanied by their patients, nurses were also responsible for any abandoned wards left to them – meaning their education or training.

By this point, if it feels like there should be an outer limit on the growing influence of women followed by restrictions and limitations to their social capital, then censorship of their experience, you would be correct. My dear Reader, how correct you are.

Medieval medical licensure had been introduced in 1140 by King Roger II in Sicily. In major Italian cities like Rome, Naples, Florence, and Venice, women were active practitioners of medicine without judicial restraint or prohibition, but Roger begins a precedent. According to D. Jacquart’s Le milieu medical en France du II au XV Siecle. En annexe 2e supplement au “Dictionnair d’Emest Wckersheimer” (1981) there were only 84 university trained physicians between 1310 and 1329. It was then that medical faulty renewed their campaign to banish untrained healers, and specifically women, from medical practice. In England, King Henry V decreed in 1421 that women were to be banned from practicing medicine or surgery altogether.

With the growing power of university medical faculties, laws against female health workers were more consistently enforced. But undaunted by threats of expulsion from the city, imprisonment, or excommunication, women and men refused to sacrifice their practices to male academics and persisted successfully in their healing work. They accepted poorer patients unwanted by licensed physicians, charged smaller fees, and sometimes offered free services referred to as work “for the love of God.”

Contemporary surveyors of history are afforded a safe vantage from what the women of this period experienced. Women who continued to offer healing services and who has been called “physicians” in the 13th Century were branded as charlatans and witches in the 14th and 15th Centuries. “Love of God” was not an acceptable practice during the contentious, decidedly violent Reformation.

While Martin Luther tried to find new language for the equality of the sexes he saw Jesus instructing in the New Testament, insisting that women leave the cloister and celebrate marriage (for where had Jesus prescribed widespread chastity?), the followers of John Calvin broke from the teachings of both Luther and bastardized (or perhaps fulfilled) the teachings of John Calvin to insist that women return to their domestic sphere and produce children. Women who practiced medicine or, broadly, did not return to their “place” and obey their husbands by adhering to the Medieval practice of submission and restricted rights were labeled as witches.

The pursuit and punishment of witchcraft had a long pre-Christian history that was deeply embedded in biblical injunctions such as “Thou shalt not suffer a witch to live,” a credo that justified death by stoning. Although the extent of healer involvement in witchcraft is debatable because records are either unavailable or unreliable, its existence seems incontestable, if only in the context of church and municipal rulings about the practice of witchcraft among health practitioners. Moreover, Christianity had long held that disease had its origins in sin, in possession by Satan, or in witchcraft and that its most effective treatments lay in prayer, penitence, and saintly assistance.

The unquestioned power and authority of the medieval church were threatened by the tenacious hold of superstition on both its educated and untutored members. The heretics had to be rooted out because the very souls of men and women were at stake. Thus, both secular and clerical authorities joined in prosecuting and persecuting those predominantly peasant women-alleged to be in league with the Devil. Thousands were tortured and executed, many of them falsely charged and convicted on the basis of coerced confessions. So satanic were the instruments of torture used that arrested women, contemplating what lay ahead, often chose suicide. The European campaign of repression against the witch gathered momentum between 1230 and 1430.

From superstition to belief in sorcery and witchcraft entails but a small leap in imagination, especially for the untutored and impoverished women healers of the Middle Ages. Many peasant healers believed that admitted witches possessed the skills of sorcery, a widely held view of the witch, and they denied holding membership in the occult sorority and applying witchcraft to their healing practices. The church, however, rejected their protestations of innocence and severely condemned a host of alleged practices of sorcery by midwives during and after
delivery. Even an innocent midwife whose patient had an unwanted result, such as a stillborn or a malformed infant, was at risk of being accused of witchcraft. Hiltprand’s Textbook of Midwifery, published toward the close of the 16th century, unabashedly stated that “many midwives were witches and offered infants to Satan after killing them by thrusting a bodkin into their brains.”

It is not difficult to understand why women healers and midwives were prime targets of such virulent attacks. Their therapies reflected superstition and hearsay as well as personal experiences. Any multiparous woman was automatically endowed with midwifery expertise.

Moreover, with poverty as their constant companion, female healers were of such low social status that their sons might be denied entry into a trade guild. Faced with so wretched an existence, they might easily have found witchcraft too tempting to spurn. Despite great punitive risk to themselves, sorcery offered opportunities for gaining prestige and added earnings for their esoteric skills. Perhaps the lure of promised pleasures in consorting with the Devil might have been irresistible to those leading rigorous and colorless lives.

We now have in place the architecture necessary to make yet another leap forward and I am sure that an astute reader has already begun to detect familiar patterns of social “othering” for those who do not conform with strict and patriarchal readings of holy texts. However, indulge  one last plank in the platform.

As the world woke up from the Dark Ages and entered the Medieval period, there is evidence that women were afforded a measure of social mobility and freedom in Europe that soon became eclipsed. Because so much of the discussion of rights comes down to gender, we often forget that issues of gender and sex(uality) would not truly be distinguished and articulated until much later. It was sufficient that a child was born either male or female – their sexuality was an entirely different matter and was often concealed by the family and social propriety. However, in this milieu, we should recall that impotence was a ground for marital separation. In 1522, Martin Luther, the man who originates Protestant Christianity and redefines the Church’s teachings on marriage and gender, writes a letter on The Estate of Marriage. There, he places a high priority on marriage for the purposes of procreation. Given Luther’s jovial and teasing language on other concerns such as beer making and of course the sobriety and seriousness with which he approaches faithfulness to the teachings of scripture instead of the teachings of the Church, we can see the otherwise witty Luther is very serious when he writes

For this word which God speaks, “Be fruitful and multiply,” is not a command. It is more than a command, namely, a divine ordinance which it is not our prerogative to hinder or ignore… just as God does not command anyone to be a man or a woman but creates them the way they have to be, so he does not command them to multiply but creates them so that they have to multiply. And wherever men try to resist this, it remains irresistible nonetheless and goes its way through fornication, adultery, and secret sins, for this is a matter of nature and not of choice. (emphasis added)

The divine ordinance to have children is so important, Luther writes, that

What I said was this: if a woman who is fit for marriage has a husband who is not, and she is unable openly to take unto herself another and unwilling, too, to do anything dishonorable since the pope in such a case demands without cause abundant testimony and evidence, she should say to her husband, “Look, my dear husband, you are unable to fulfil your conjugal duty toward me; you have cheated me out of my maidenhood and even imperilled my honor and my soul’s salvation; in the sight of God there is no real marriage between us. Grant me the privilege of contracting a secret marriage with your brother or closest relative, and you retain the title of husband so that your property will not fall to strangers. Consent to being betrayed voluntarily by me, as you have betrayed me without my consent.”

I stated further that the husband is obligated to consent to such an arrangement and thus to provide for her the conjugal duty and children, and that if he refuses to do so she should secretly flee from him to some other country and there contract a marriage. I gave this advice at a time when I was still timid. However, I should like now to give sounder advice in the matter, and take a firmer grip on the wool of a man who thus makes a fool of his wife. The same principle would apply if the circumstances were reversed, although this happens less frequently in the case of wives than of husbands. It will not do to lead one’s fellow-man around by the nose so wantonly in matters of such great import involving his body, goods, honour, and salvation. He has to be told to make it right.

Luther places such a high priority on childmaking that “forsaking of all others” in marriage not only can but should be suspended so that a woman may have a child. This is a tame English translation, however. Directly from the German, Luther’s words are better translated as “Husband, you are unable to give me my pleasure… Consent to my pleasure and allow…” The wife’s pleasure is important here, and translators often approach this letter with the same caution that previous translators approach the canonical Song of Songs (or Song of Solomon). A woman’s desire here, in the original German of Luther, is a double entendre meaning both the desire or pleasure of her marriage (notice how translators assume a woman’s pleasure is having children) as much as her sexual pleasure. Commentators shy away from the original translation of “pleasure” because, as should be obvious, the sexual tone here would indicate that if a woman’s sexual desires outpace her husband, the husband should consent to being cuckolded.

Lest we reject this premise, Luther’s next two paragraphs are explicitly about sex and sexual capacity.

The second category, those who Christ says “some have been made eunuchs by men” [Matt. 19:12], the castrates, are an unhappy lot, for though they are not equipped for marriage, they are nevertheless not free from evil desire’. They seek the company of women more than before and are quite effeminate. It is with them as the proverb says, “He who cannot sing always insists upon singing”. Thus, they are plagued with a desire for women, but are unable to consummate their desire. Let us pass them by also; for they too are set apart from the natural ordinance to be fruitful and multiply, though only by an act of violence.

The third category consists of those spiritually rich and exalted persons, bridled by the grace of God, who are equipped for marriage by nature and physical capacity and nevertheless voluntarily remain celibate. These put it this way, “I could marry if I wish, I am capable of it But it does not attract me. I would rather work on the kingdom of heaven, i.e., the gospel, and beget spiritual children.” Such persons are rare, not one in a thousand, for they are a special miracle of God. No one should venture on such a life unless he be especially called by God, like Jeremiah [16:2], or unless he finds God’s grace to be so powerful within him that the divine injunction, “Be fruitful and multiply,” has no place in him.

In that same letter, Luther reverses the genders to expand the consideration, creating an equitable consideration, rather than making a rule based on gender. Which is to say, Luther does not privilege male or female. Instead, he asserts that if either partner is unable to perform sexually or provide children (whatever the reason), they should refrain from asserting exclusive “control” of their partner’s body and “consent” to circumstances that would allow a child to be born “of” the marriage. 

Here, Luther is speaking of divorce

…in which one of the parties deprives and avoids the other, refusing to fulfil the conjugal duty or to live with the other person. For example, one finds many a stubborn wife like that who will not give in, and who cares not a whit whether her husband falls into the sin of unchastity ten times over. Here it is time for the husband to say, “If you will not, another will; the maid will come if the wife will not.” Only first the husband should admonish and warn his wife two or three times, and let the situation be known to others so that her stubbornness becomes a matter of common knowledge and is rebuked before the congregation. If she still refuses, get rid of her; take an Esther and let Vashti go, as King Ahasuerus did [Esther 1:1 :17]. Here you should be guided by the words of St. Paul, I Corinthians 7 [:4-5], “The husband does not rule over his own body, but the wife does; likewise the wife does not rule over her own body, but the husband does. Do not deprive each other, except by agreement,” etc.

Notice that St. Paul forbids either party to deprive the other, for by the marriage vow each submits his body to the other in conjugal duty. When one resists the other and refuses the conjugal duty, she is robbing the other of the body she had bestowed upon him.

Again, Luther is saying sex does not have to be exclusive to the married parties, so long as a child is born, accepted, and adopted within the marriage. Rather, Luther is saying sex or the “conjugal duty” is not to be avoided. If a spouse cannot sexually perform, or refuses sexual advances (assuming a heterosexual relationship, as Luther does at this time), the reluctant partner is not to continue denying their partner, but allow them the liberty – as Paul said, “do not deprive each other, except by agreement” – to seek out a partner who can keep the matter private and provide children.

Luther would, obviously, have been aware of the birth narratives in Genesis where a then-infertile Sarah agrees and even encourages her husband, Abraham, to have sex with the woman Hagar. This story informs Luther’s prescriptions. Later, Sarah has a child of her own and it is only then that she insists the woman Hagar leave their home.

This is not added here to offend, but instead to highlight the priority placed on the ability of sexual partners to produce children coming out of the Reformation. As I emphasize to my American Literature class, the origins of our nationalist loyalty to the idea of America and the American way of life were built on the teachings of Europe. The first settlers, the Puritans, were deeply entrenched in the teachings of Martin Luther and John Calvin. That they now had a mandate to procreate for survival would have only solidified their prioritization of giving birth. But this must also be held in tandem with legal proceedings like the one recorded in Benjamin Franklin’s The Speech of Polly Baker. Women were supposed to have children, as many as possible, but only as they remained in their “place.”

Further Reading

A Brief History of Life in the Middle Ages (2009) by Martyn Whittock