Journal of Obstetrics and Gynaecology, August 2014; 34: 547

2014 Informa UK, Ltd.

ISSN 0144-3615 print/ISSN 1364-6893 online

LETTER TO THE EDITOR

Midwifery in ancient Greece, midwife or gynaecologist-obstetrician?

G. Tsoucalas1,2, M. Karamanou1 & M. Sgantzos2,3
1History of Medicine Department, Medical School, University of Athens, Athens, 2History of Medicine, Medical School, University of Thessaly

and 3Department of Anatomy, Medical School, University of Thessaly, Larisa, Greece

Dear Sir
Midwifery is one of the oldest medical professions in the world.
In ancient civilisations, the midwife was a woman with personal
experience that originally received a little practical training from
experienced colleagues, able to bear children of her own, usually
within her village or community (Drabkin 1944; Karamanou
2013). There was definitely a family training tradition, either from
mother-to-daughter or in some cases, from the lady of the house
to female slaves (French 1987). Although many consider all midwives as auxiliary medical personnel, Soranus of Ephesus classified them into three categories: (i) those that had only empirical
education; (ii) those that apart from their experiences, had theoretical training in obstetrics and gynaecology; and (iii) those with
a higher education, training and skills, ranked as equals between
men physicians (Soranus 1927). Midwifery had opened the door
for women to enter a male world of physicians and enjoy the
respect of society (Fantham 1994).
In his work Gynaecology, Soranus provided us with a unique
description of the essential characteristics and skills of a midwife
of the era. He had rhetorically asked first, What is a midwife?,
giving the answer, A woman learned in all the causes of female
diseases, and also skilled in general medical practice. The midwives in Ancient Greece should have been able to read and write,
have a thorough knowledge of the theory and practice of obstetrics and have experience in all branches of medicine, so as to give
dietetic as well as surgical and pharmacological prescriptions.
The midwifes nails should be trimmed and rounded so that they
will not wound the organs. They had to have soft hands and long
thin fingers; have a good memory, great perception and be hard
working. They had to know all kinds of treatment and complications of childbirth, have an adequate knowledge of pharmacology and maintain their composure, as it would be imperative to
simultaneously provide psychological support. They had to be
discreet, as often, various family secrets were revealed during a
childbirth; irreproachable; not bribed to execute illegal abortions
and finally, spiritually healthy always committed on duty away
from superstitions, the midwife should be no believer in spirits.
When the delivery was completed, it was necessary for midwives
to explore the uterine cavity and remove, with the hooked finger,
any adherent blood clots. The midwives had to announce the sex
of the newborn, to clean it, to care for its health on the first steps
of its life, and above all, to inform the mother about aftercare and
the upbringing of the child (Soranus 1927). The midwife was
also called the obstetrician (Greek: maietria) omfalotomos (the
person who cuts the umbilical cord) or healer (Ancient Greek:
striV). The more capable midwives, perhaps those with the

higher education, were called iatrenes (Greek: traineV) of

womens diseases, meaning female physician on gynaecological
diseases (Tsoucalas 2012).
The description of the education, skills and personality of the
midwives, testified the qualifications of a gynaecologist-obstetrician, even for a modern era physician (Tsoucalas 2012). Rare
reports of midwives, only a total of 16 had been referred in Corpus
Inscriptionum Latinarum, probably indicate that most midwives
were female slaves. On the contrary, those that they have been
named as iatrenes, had probably belonged to a higher social class
(Jackson 1988). It is almost a certainty that most of the known
midwives, iatrenes: Fainareti (5th century bc) (mother of Hippocrates or Socrates, two or maybe the same person); Fanostrati
(4th century bc); Elephantis (1st century bc); Olympias of Thebes
(1st century ad); Sotira (1st century ad); Salpi (1st century ad);
Lais (2nd century ad); Aspasia (2nd century ad); Phavilla (2nd
century ad); Maia (2nd century ad); Cleopatra the gynaecologist
(4th century ad); Metrodora Cleopatra (7th or 2nd century ad),
all with exceptional medical legacy in gynaecology, obstetrics,
surgery, genetics, oncology, pathology, aphrodisiology, physiology, pharmacology, votanology, should be classified as expert
gynaecologist-obstetricians of the antiquity (Tsoucalas 2012) and
should be addressed as such.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing
of the paper.

References
Drabkin IE. 1944. On medical education in Greece and Rome. Bulletin of the
History of Medicine 15:333351.
Fantham E, Peet Foley H, Boymel Kampen N, Pomeroy SB, Shapiro HA.
1994. Women in the classical world. Image and text. New York: Oxford
University Press. p 68.
French V. 1987. Midwives and maternity care in the Greco-Roman world. In:
M. Skinner, editor. Rescuing Creusa: new methodological approaches to
women in antiquity. Texas: Lubbock. p 72.
Jackson R. 1988. Doctors and diseases in the Roman Republic. London: University of Oklahoma. p 97.
Karamanou M, Tsoucalas G, Creatsas G, Androutsos G. 2013. The eect of
Soranus of Ephesus (98138) on the work of midwives. Women Birth
26:226228.
Soranus. 1927. Gynaeciorum libri IV. Ilberg, J, editor. Sorani Gynaeciorum
libri IV, de signis fracturarum, de fasciis, vita Hippocratis secundum
Soranum. [Corpus medicorum Graecorum. Vol. 4]. Leipzig: Teubner. pp
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Tsoucalas G. 2012. Women physicians in Ancient Greece and Byzantine
Empire. Athens: Thesis, History of Medicine Department, Medical History, University of Athens, Greece. pp 1387.

Correspondence: G. Tsoucalas, History of Medicine Department, Medical School, University of Athens, and History of Medicine, Medical School, University
of Thessaly, 6264 str. kononos, Pagrati, 11633 Athens, Greece. E-mail: gregorytsoucalas@yahoo.gr
DOI: 10.3109/01443615.2014.911834

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