For most of human history, babies were delivered at home with the help of female attendants, using techniques that relied on gravity, manual skill, herbal remedies, and ritual. There were no hospitals, no anesthesia as we know it, and no surgical options for living mothers. Despite the dangers, ancient civilizations developed surprisingly sophisticated approaches to managing labor, handling complications, and caring for newborns.
Midwives Led Nearly Every Birth
Childbirth was almost exclusively a woman’s domain in the ancient world. Midwives attended deliveries across Egyptian, Greek, Roman, and Mesopotamian cultures, and they were expected to bring real expertise to the task. Soranus of Ephesus, a Greek physician practicing in Rome around 100 AD, wrote the most detailed surviving account of what a qualified midwife should know. He outlined specific skills including knowledge of anatomy, the ability to assess labor progress, and competence in managing complications. His writings shaped midwifery education and obstetric practice well into the Middle Ages.
Male physicians were rarely present at a normal delivery. They were typically called in only when something went seriously wrong, such as a baby stuck in the birth canal or uncontrollable bleeding. Even then, the midwife remained central to the process.
Laboring Upright, Not Lying Down
The flat-on-your-back delivery position is a relatively modern invention. Ancient women labored in upright positions that used gravity to help move the baby down. Squatting, kneeling, and sitting were all common. Soranus is credited with introducing the birth chair, a specialized seat with an open bottom that supported the mother in an upright or semi-reclined position while giving the midwife access from below. Birth chairs and stools appeared across many ancient cultures and remained in widespread use for centuries.
Women in labor often gripped ropes, poles, or the hands of attendants for support during contractions. The birth environment was typically a private room in the home, attended by the midwife and experienced female relatives.
Handling Breech Babies and Obstructed Labor
Ancient practitioners understood that a baby’s position in the womb could make delivery dangerous or impossible. When a baby presented feet-first or sideways, midwives attempted to reposition it manually. Soranus described a technique later known as “podalic version,” which involved reaching into the uterus and turning the baby by its feet so it could be delivered in a more favorable position. Vaginal delivery of breech babies was the standard approach from at least the first century AD, and it remained so for well over a thousand years.
Mesopotamian medical texts from ancient Assyria and Babylon specifically addressed difficult deliveries as a recognized category of obstetric problem. Clay tablets describe treatments for prolonged labor, including vaginal suppositories, salves, lotions, bandages, and fumigations (medicated smoke directed upward from below the laboring woman). These treatments combined practical medicine with incantations, reflecting a worldview where physical and spiritual causes of complications were inseparable.
When Deliveries Turned Fatal
When all attempts to deliver a living baby failed, ancient practitioners had grim tools at their disposal. Roman surgical instruments included obstetrical hooks, both blunt and sharp, used to extract a baby that had died in the birth canal. Soranus described a procedure for a baby whose head became fatally impacted: the skull could be opened with a sharp instrument and the bone fragments removed with forceps. These procedures, known collectively as embryotomy, were a last resort meant to save the mother’s life when the baby could not survive.
Cesarean sections existed in the ancient world, but not for living mothers. Roman law, the Lex Caesarea, required that a baby be cut from the womb of any woman who died during labor. Initially this was a religious rule: Roman custom forbade burying a pregnant woman. Over time, the motivation shifted toward trying to save the child. The first documented cesarean performed on a living woman did not occur until 1610, and she died 25 days later. For ancient women, a birth that could not proceed vaginally was often a death sentence for mother, child, or both.
Pain Relief Through Opium and Herbs
Opium and its derivatives are the oldest known effective pain relievers, and they were used during childbirth for thousands of years. Various cultures supplemented opium with local herbal remedies, teas, and poultices, though the specific plants varied by region. Egyptian papyri mention herbal preparations to speed labor. Greek and Roman texts reference botanical mixtures applied as drinks or compresses.
The effectiveness of these remedies ranged widely. Some herbs used in ancient labor, like certain members of the nightshade family, contain compounds that genuinely relax smooth muscle or dull pain. Others likely worked through placebo effect or simply gave the laboring woman something to focus on. There was no way to standardize doses, so the line between helpful sedation and dangerous overdose was thin.
Managing Bleeding and Delivering the Placenta
Postpartum hemorrhage was one of the most feared complications, and ancient practitioners developed both medical and ritual responses to it. Mesopotamian texts describe the urgency vividly. One incantation compares a hemorrhaging womb to “a fermenting vessel whose stopper does not block the outflow” and “a waterskin whose knot is not strong.” These poetic metaphors accompanied practical treatments: tampons soaked in medicinal substances were inserted vaginally, and various herbal preparations were applied externally.
Delivering the placenta, the third stage of labor, required its own set of techniques. Traditional birth attendants across cultures used abdominal compression, pressing down firmly with both hands to help expel the afterbirth. Other methods included having the mother blow forcefully into a bottle to build abdominal pressure, or inducing vomiting to contract the abdominal muscles. Some attendants would wrap the umbilical cord around a stick of grass and apply gentle traction while calling to the placenta with whistling sounds.
Inspecting the placenta after delivery was considered essential. Attendants rinsed it in clean water repeatedly, then examined it for completeness, checking that it looked intact in shape and color (typically compared to a liver). A ragged or incomplete placenta meant tissue had been retained inside the mother, which could cause deadly infection.
Cutting the Cord and Early Newborn Care
Soranus provided what may be the earliest systematic newborn assessment, examining the baby immediately after birth for signs of health and viability. The umbilical cord was tied and cut, though the tools and rituals surrounding this step varied by culture. Trotula, a medieval author drawing on ancient traditions, specified that the cord should be tied, a charm spoken during cutting, and then wrapped with the string of a musical instrument. The choice of binding material and the words spoken over the cut cord carried deep symbolic weight in many cultures, linking the newborn to protection, fortune, or spiritual identity.
After the cord was cut, newborns were typically washed, rubbed with salt or oil, and swaddled tightly. Swaddling was nearly universal in the ancient world, believed to keep the baby’s limbs straight and protect its fragile body. The baby was then placed at the breast, though in wealthy Roman families, wet nurses often took over feeding within days.
The Toll on Mothers and Babies
Childbirth in the ancient world was genuinely dangerous. In ancient Rome, both maternal and infant mortality were high, though exact numbers are difficult to pin down from archaeological evidence. Estimates from skeletal analysis and historical records suggest that somewhere between 1 in 4 and 1 in 3 infants did not survive their first year, with many dying during or shortly after delivery. Maternal death during childbirth was common enough that Roman tombstones frequently reference it, and Egyptian prayers for safe delivery reflect the same pervasive anxiety.
The risks were highest for first-time mothers, very young mothers (girls were often married and pregnant by 13 or 14 in some ancient cultures), and any delivery involving abnormal fetal positioning or prolonged labor. Without antibiotics, even a delivery that initially went well could turn fatal within days if infection set in. The combination of skilled midwifery, herbal medicine, manual techniques, and spiritual ritual represented the best response ancient people could muster against a process that remained unpredictable and often lethal until well into the modern era.