I Hebrew Bible/Old Testament
The major Hebrew root pertinent to the topic of labor or childbearing is y–l–d, originally derived from the Semitic root *w–l–d. The bulk of the occurrences of the term are found in Genesis and 1 Chronicles, due to the inclusion of lengthy genealogies in said books where one person bears/begets (yālad) a child (TDOT: 6:76). The subject of yld ranges from women to men, YHWH, animals, and nations (DCH: 4:213–20). For obvious reasons, however, translators opt for “bear” or “give birth to,” when a woman or female figure is in view, and “beget” when a male figure is in view (ibid).
YHWH’s punishment of Eve is the first time childbirth is mentioned in the canonical arrangement of the Hebrew Bible (Gen 3:16). Wessel suggests the punishment that is given to Eve in Gen 3:16 is not “pain” (ʿiṣṣābôn/ʿeṣeb), as most have understood the term – see, for instance, the rabbis discussion of the ten curses of Eve in bEr 100b – but rather “toil” or “labor” (29). Similarly, Carol L. Meyers suggest the verse should be translated, “I will greatly increase your toil and your pregnancies; (Along) with travail shall you beget children” (Meyers 1985: 118). And indeed, this interpretation is substantiated by examples of the term found elsewhere in the HB, which suggests the meaning “strenuous work” (HALOT: 865). The use of ʿeṣeb/ʿiṣṣābôn to describe childbirth thus likely indicates the strenuousness of labor, which is to be understood – along with Adam’s strenuous working of the land (ʿiṣṣābôn; Gen 3:17) – as a punishment from YHWH for the couple’s disobedience.
Regardless, throughout the HB/OT, childbirth is depicted as a joyous occasion and a blessing, not a curse. Twice in the early chapters of Genesis humanity is commanded by God to “be fruitful, multiply, and fill the earth” (Gen 1:28; 9:1). Multiplication through birth is also crucial to the fulfillment of the Abrahamic covenant: “(God) brought him outside and said, ‘Look at the sky and count the stars if you are able to count them. So shall your descendants be’” (Gen 15:5; cf. 12:1–3; Wenham: 33). The requirements of this covenant produce an obvious tension in the narrative of Genesis because the wives of Abraham, Isaac, and Jacob are either too old to bear children or are infertile (e.g., Gen 29:31; 30:22; cf. Gen 18; 21:2). Yet, God’s “opening the womb” of these women only underscores the biblical portrayal of childbirth as a miraculous blessing. This aspect of the Abrahamic covenant is prominent through the Pentateuch and into the historical books, where the covenant is represented as fulfilled under the reign of Solomon, when Israel was said to be “as numerous as the sand which is by the sea” (1 Kgs 4:19). The positive valuation of childbirth would continue through Greco-Roman times and, according to Solevag, eventually merge with salvation discourses, resulting in the idea that childbirth was a form of salvation for women (e.g., 1 Tim; Acts Andr.; Martyrdom of Perpetua and Felicitas; Solevag, passim). This is mostly true, but there is at least some association of procreation and salvation even in the texts of the HB/OT, for instance, in the book of Exodus, where the multiplication of Israel – seen as a threat to Pharaoh – is represented as one of the reasons Israel was able to escape Egypt (see esp. Exod 1).
The story hidden by the grand narrative of childbirth and blessing, however, tells another tale, one of social exclusion. First, there is the social exclusion of a woman who gave birth to a child, who, because of the birth process, is considered unclean and thus excluded from the cultic community for a set period of time (Lev 12:2). If she gives birth to a male child, she has to wait seven days to become clean and then an additional thirty-three after that, for safe measure. During this time the woman may not eat of anything holy or enter the sanctuary (Lev 12:4; Olyan 2000: 43–44). The exclusion lasts even longer if she gives birth to a female child: fourteen days to become clean and an additional sixty-six days thereafter, for safe measure. Second, there is the social exclusion of the infertile woman, ostracization to which the story of Hannah and Elkanah, for example, points (1 Sam 1, esp. 1:5–8, 10–11, 15–16; Moss/Baden: passim). Because of her barrenness, Hannah is said to be taunted; often without appetite; regularly weeping; deeply distressed; miserable; deeply troubled; anxious; and vexed (1 Sam 1:5–16; Moss/Baden: passim). Whether this biblical story is historical or not, it at least points to how some in ancient Israel thought it best to represent a infertile woman, which ultimately connects to some form of historical reality. Third, what the biblical text says about women and childbirth has only led to further societal oppression throughout history, as women continued to be pressured to procreate and remain restricted to a domestic role (see, e.g., the discussion of Martin Luther, John Chrysostom, Ayaka Siomura, among others, in Moss/Baden: 1–20).
Other forms of childbirth could be considered – e.g., adoption (e.g., Ps 2:7), metaphorical childbirth (e.g., Ps 7:14; Hos 13:13; see Bergmann; Doyle), and childbearing men (Jer 30:6). The idea of labor is also used metaphorically, as for instance in Isa 42:14 wher YHWH is compared to a woman in labor (“now, like a woman in labor, I will cry and groan and pant”), an image to announce the re-creation of Israel as YHWH’s child.
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II New Testament
Just as Gen 3:16 (LXX) names pain (λύπη) and groaning (στεναγμός) as the fundamental experience of a woman in labor, NT texts also associate birth with pain and labor (ὠδίν κτλ.). However, in the NT, these aspects of the birth process are only addressed by way of analogies and metaphors (as they are in Greek and Roman Literature, cf. Bertram: 668–69). The narratives about the births of John the Baptist and Jesus (Matt 1; Luke 1–2) report the fact of their births solely from an authorial perspective, limited to the verb τίκτειν (Matt 1:21, 23, 25; Luke 1:31 et passim) or γεννᾶν (Luke 1:13, 57). This fact inspired later interpretations that Mary gave birth without labor pain.
All of the imagery texts view the event of labor from the perspective of the woman giving birth. Although there are OT/HB examples of imagery of labor in the prophetic tradition (see above), the imagery in the NT can draw directly on everyday knowledge of the birth process, which was commonly known and not only to the woman giving birth and her attendants (see Gerber: 475). The imagery always emphasizes birth as a strenuous process oriented towards an end. However, different aspects of the birthing process are emphasized by the context and are therefore significant for the text’s message, as an overview of the texts will show:
The metaphor in Gal 4:19, with which Paul represents himself as a parturient mother of the addressees, is unusual: “My children, for whom I am again in the labor of childbirth until Christ is formed in you.” Paul does not emphasize the pain here, but rather the fact that he has to repeat the strenuous effort of labor, which in itself is nonsensical. He points out that in their endeavor to subordinate themselves to the requirement of circumcision and thus the law, the addressees “regress” and abandon the state of salvation already attained (3:1–5), namely their Christ-like form (see 4:19b). The metaphor works with the fact that labor is strenuous, that it actually does not need to be repeated, and that the infant is formed during pregnancy, according to ancient biology (see Gerber: 473–89).
In other birth metaphors, the pain of a woman’s labor is explicitly mentioned and taken center stage. In John 16:12–22, Jesus puts the pain of parting with the disciples into perspective by comparing it with the situation of a woman giving birth (whose affliction is described with τίκτειν and λύπη, as it is in Gen 3:16, as well as with θλῖψις): the woman suffers the pain of giving birth “because her hour has come,” but she does not think about these pains after the birth, “because of the joy of having brought a human being into the world.” Thus, mourning is interpreted as a necessary phase followed by great joy which no one can take away (16:22).
In apocalyptic contexts, the metaphor “labor” (ὠδίνω κτλ.) is already attested in the HB as well as in extrabiblical texts (cf. Isa 13:8; 4 Ezra 4:40–42; 1 En. 62:4; cf. 1 QH 3:7).
In the eschatological discourse in Mark 13:8 (par. Matt 24:8), Jesus describes increasing tribulation as wars, earthquakes, and famines: “This is the beginning of the birth pangs” (ἀρχὴ ὠδίνων ταῦτα). The metaphor captures the plight of the woman in labor and her helplessness, but, moreover, it characterizes time: in the same way that labor hurts a little at the beginning but increases toward the end of the birth, affliction will continue to increase.
First Thessalonians 5:2–3 describes how the coming of the day of the Lord will catch those who think themselves safe: It will come unexpectedly like a thief in the night and “then sudden destruction will come upon them, as labor pains come upon a pregnant woman, and there will be no escape!” (NRSV). There is a traditional link between the judgment motif and the labor metaphor (cf. Isa 13:8; Jer 4:31 et passim), and the process of birth stands for terrible tribulations as it does elsewhere (here ὄλεθρος). But the comparison particularly emphasizes that labor begins unpredictably and suddenly and that it is inevitable for the woman giving birth. A favorable outcome of the birth is not in sight.
In Rom 8:19–22, the situation of a woman in labor becomes a metaphorical source domain which transfers aspects of labor to the phenomenon of creation. Present suffering and future glory stand in contrast to one another (see v. 18). In this passage, κτίσις refers to non-human creation (with Wolter: 508). It is personified as waiting eagerly (v. 19). It shares in the suffering of believers in the present and longs for their deliverance from the present slavery of transience, and for the day when the children of God will be glorified (v. 21). But, for now, “creation in its entirety groans (συστενάζει) and lies in labor pains (συνωδίνει).” This description refers specifically to the last phase of birth, the so-called final contractions (cf. Isa 26:17; Sutter: 92). It potentially alludes to the idea that labor pains (like mortality) signify the unredeemed world since the loss of paradise (Gen 3:16–19). Here the birth metaphor, on the one hand, symbolizes involuntary subjection to present suffering (v. 20), and on the other hand, the hope of imminent redemption (v. 21–22).
In a visionary account, Rev 12:1–6 describes the plight of the “woman with the crown of stars,” who appears in heaven as a sign. She cries out as the birth is imminent (v. 2). Attention is drawn to her painful contractions, which lead to the emergence of the child. But the unborn child is also in danger: the dragon waits where the midwife usually stands in order to devour the child (v. 4); the mother cannot protect it. In this desperate situation, God intervenes and carries the child away (v. 5); the mother escapes as a result of God’s protection, but is still pursued by the dragon (12:13–17). Regardless of the open question as to who is symbolized in this passage (Mary, Zion, Israel, the church, etc.) and whether associations with HB/OT themes (e.g., Isa 26:17–18; 66:7–8, cf. Dochhorn) or myths are underlying, one should take note of the special character of this story of a woman in labor giving birth. Her plight and powerlessness are developed dramatically through an external threat, to an extend where she and the child require divine deliverance.
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Childbirth was an especially difficult time in a woman’s life in antiquity due to the pain and risk to her life. A woman’s birth pain(s), ḥevel (ḥavalim), was considered punishment for Eve’s sin in the garden of Eden (Gen 3:16). Still, childbirth is associated more often in the Bible with blessing than pain (Gen 30:1; 1 Sam 1:6–20; Ps 127:3; John 16:21). It was an exciting time since children were considered a blessing from the Lord, and a woman’s primary role in antiquity was to bear and raise them. Indeed, the first commandment in Scripture is to be fruitful and multiply (Gen 1:28).
Aborting a baby during pregnancy was not favored in Jewish tradition. According to Josephus, a woman was prohibited from destroying a foetus within her body: “a woman who does so shall be judged a murderess of children for she has caused a soul to be lost and the family of man to be diminished” (Ag. Ap. 2.202; cf. also Philo, Spec. Laws 3.108). The Talmud considers a man who has sexual relations with his wife causing harm to the baby during pregnancy as “a shedder of blood” (bYev 62b; bNid 13a, 31a). A late tradition in the Zohar ties the prohibition against abortion to the biblical narrative of the baby Israelite boys slated for destruction by the Pharaoh but rescued by midwives who feared God: “There was found no single person to kill the foetus in the womb of the woman, much less after its birth. By virtue of this Israel went out of bondage” (Zohar, Exodus, ed. Warsaw, 3b; cf. Exod 1:17). Nevertheless, according to the halakhah, abortion is permitted if the mother’s life is in danger (mOhal 7:6). In the case of two men fighting and accidentally hurting a pregnant woman so that she miscarries a child, the Torah decrees, “If any harm follow, then you shall give life for life “ (Exod 21:22–23; cf. Josephus, Ant. 4.278, which commutes this penalty by monetary compensation). The Talmud interprets the “harm” here as that which befalls the woman, not the foetus (MekhSh, ed. Epstein-Melamed: 126; Targ. Exod 21:22–23; bBQ 42a; but cf. Exod 21:23 [LXX]). The sages also discuss the age of the foetus, whether it is of completed shape or not. The halakhah does not consider abortion a sin if the foetus is not yet viable (mNid 5:3). By contrast, in Christian Europe, abortion could result in excommunication from the church whether the foetus was viable or not.
Labor was usually done in the crouching or squatting position (cf. 1 Sam 4:19, where the mother “bows and gives birth”). Midwives, respected women of the community known for their experience in matters of birth and delivery, often assisted during the birthing process. Protective rituals during the labor process abounded as the family anticipated the newborn child and hoped for its health as well as that of the mother; these included wearing amulets, tying red string around the wrist or ankle of the baby (cf. Gen 38:28), and keeping a light on in the birthing room to avert the “evil eye.” Other rituals included utilizing herbs and oils to facilitate delivery, placing a Torah scroll in the woman’s vicinity, and blowing a shofar to rid the room of evil elements. Sometimes rooms and cabinet doors were opened in order to facilitate the opening of the womb. Prayer was critical. The assisting women chanted Scriptures and even the husband recited Psalms during childbirth. Directly after birth, the infant’s umbilical cord was cut, the baby was salted in order to harden the skin and swaddled (cf. Luke 2:7) to give it proper form.
A woman who has just borne a child is considered by the Bible and Jewish law to be impure because of the blood which flows out with the baby. This effluvium is treated like menstrual blood for one week if the child is male and two weeks if female (Lev 12:1–6). Scripture does not provide any rules concerning the contagion of a parturient’s impurity to others, but it does compare her impurity to that of a menstruant (Lev 12:3). This implies that the woman may not go to the sanctuary or come into contact with any sancta or with anyone in a state of ritual purity. She may not have sexual relations during this period, and her bed and seat pollute anyone who touches them (Lev 15:20–24; 18:19). Subsequently, she enters a second level impurity, for thirthy-three days if the child is male and sixty-six if female, which still bars her from contact with the sacred but allows her to make contact within the profane sphere, i.e. she may go about ordinary duties and handle food and other items which are not sancta. In the time of the temple, the parturient offered a burnt offering and a purification offering at the sanctuary (Lev 12:6–7; cf. Luke 2:22–24).
Second Temple and rabbinic literature reveal great concern for the impurity resulting from childbirth. The contagion produced by a woman’s flow of blood is discussed in the DSS (cf. 4Q274). According to the Temple Scroll, a pregnant woman who miscarries becomes impure like a grave as long as the dead foetus remains within her (11Q19 L, 10–11). Other texts extend the impurity of childbirth to the first pair, Adam and Eve. Accordingly, Adam did not enter the sacred garden of Eden until forty days after his creation and Eve not until eighty days afterward (Jub. 3:12; 1QHa 16:10–13; 4Q265 11–13). The rabbis analyze the contagion of this type of impurity meticulously in the Mishnah, tractate Zavim.
Labor is also used metaphorically in Jewish tradition. In the NT, Paul uses the term to describe his patient work with the Galatians, “My children, with whom I am again in labor until Christ is formed in you” (Gal 4:19). On another occasion he refers to a woman’s labor pains to illustrate the plight of the world as a whole as a result of the fall, “For we know that the whole creation groans and suffers the pains of childbirth together until now” (Rom 8:22). In rabbinic tradition, labor pains can refer to the suffering and seemingly interminable wait of the Jewish people for the Messiah to emerge, (ḥevlo shel Mashiaḥ, the travail of the Messiah [bShab 118a; bPes 118a; bSan 98b], which in later medieval sources morphed into the more common term ḥevlei mashiaḥ [e.g., LeqT Song 1.8] “the birth pains of the Messiah”).
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A Greek and Latin Patristics and Orthodox Churches
Patristic interpretation follows both OT and NT in being somewhat cagey about references to labor and childbirth, understanding it as a bloodless, idealized event, even though this obscures women’s actual experience. This kind of interpretation needs to be understood within the frame of ancient historical assumptions and the limitations of a philosophical tradition that privileged mind over body, idea over matter, and word over flesh. The biological assumptions of classical medical theories (woman as cold, spongy, defective, and irrational) underpin the perspectives on women found in writers like Hippolytus in the west and Dionysius in the east. Over against the pure body of Christ and the church, the new Christian community, stands the stigmatized female body, which popular ideology regarded as dangerous and ritually impure (Shultz: 115–16).
The medieval rite of “churching” had deep roots in the early church, arising from the notion that childbirth temporarily placed a woman outside the spiritual community, despite her baptism. Although no outline of such a rite has been found, a crossover from the Hebraic notion of cultic purity appears in a homily of Origen treating the instructions of Lev 12:2 on purifying women who give birth (Hom. Lev. 8). Later, the canons of Hippolytus on the prescriptions for purification (no. 18) include the attending midwife, which suggests that birth itself was perceived as defilement.
John Chrysostom sees the birth pangs of death loosed in John 16:21, where Jesus compares the coming joy of the disciples at his resurrection to a woman’s joy at her child’s birth. For Chrysostom, Jesus describes his paschal departure as a “passing from the womb into the light of day”; he speaks mystically of how a new person is born from the pain of birth (Hom. Jo. 79.1). Augustine compares the pangs of parturition to sorrow, while birth brings joy “which is usually all the greater when it is not a girl but a boy that is born” (Tract. Ev. Jo. 101.3). The Venerable Bede likewise sees the church as a woman laboring to give birth (Hom. Ev. 2.13).
Prophetic imagery of the Daughter of Zion (Isa 66:7–9) giving birth before any birth pangs occur is linked with the Virgin Mary’s painless labor. The birth of Jesus surpasses natural birth (cf. John of Damascus, Orthodox Faith, 4.14; Methodius, Oration Concerning Simeon and Anna 3). Zion in labor (Isa 66:8) represents the remnant of Israel and the faith of the apostles giving birth to the Savior (Jerome, Comm. Isa. 18.23; cf. Cyril of Alexandria, Comm. Isa. 220.127.116.11–9).
Interpretations of Gen 3:16 need to be set against the importance that the church fathers gave to the early chapters of Gen. Of particular importance is their frequent invocation of the parallel between Adam and Christ. The Greek fathers’ cosmic understanding of the human person led them to see the sin of Adam as affecting all his descendants (ancestral sin), while Augustine’s view that Adam’s sin and guilt are inherited by all (original sin) became dominant in the Latin church (Div. quaest. Simpl. 1.10–11; Conf. 5.9.16).
The painless creation of Eve (Gen 2:21–22) from unfallen Adam (John Chrysostom, Hom. Gen. 15.7) contrasts with fallen Eve’s pain in giving birth. For Jerome, God formed (aedificavit) Eve from Adam’s rib as a symbol of the church being formed (aedificatur) from the side of the second Adam (John 19:34); the church is built up from the baptism of water and the blood of martyrs (Hom. Matt. 66). Birthing pain is a consequence of the disorder and inequality caused by carnal desire. For Chrysostom, this pain is a result of her neglect of God’s command and lingering sin (Hom. Gen. 17.30–31, 36). He envisions God addressing the woman, saying that although she was created equal in esteem to her husband, now she is subject to him (17.36).
Jesus explains that being “born again” is a spiritual rather than a physical act (John 3:3–6). Accordingly patristic commentators often regard the church as a new mother, and baptism as new birth, a recreation (Gregory of Nazianzus, Or. 5.28; John Chrysostom, Hom. Jo. 25.1–2), as well as an image of resurrection (Theodore of Mopsuestia, Comm. Jo. 2.3.3).
The fathers link the pierced side of Jesus bringing forth blood in John 19:34 to the blood of the grape, and to the sacramental fruit of the vine (Theodoret of Cyrus, Dialogue 1). For Cyril of Jerusalem, the signs of blood and water commencing with Moses (Exod 4:9) culminate with Christ’s pierced side. “First Moses changed the river into blood. Jesus at the last gave forth from his side water with blood” (Cat. Lect. 13.21). For Augustine, Noah opening the door of the ark (Gen 6:16) points to Christ in death “opening his side” to pour forth the sacraments wherein the church finds life; that in turn fulfills the prophecy of the sleeping Adam from whom God brought forth Eve (Gen 2:21–22), “the mother of all the living” (Gen 3:20) (Tract. Ev. Jo. 120.2). Augustine also writes of women bringing forth children in pain as a picture of the soul struggling to bring forth virtue (Gen. Man. 2.19.29).
The typological identity of Christ as the new Adam has cosmological significance (Sawyer: 138). Birth from the side of Christ in John 19:34 is read in terms of creation. God used Adam as material to create Eve, and the two together would create the human race. So God uses the second Adam as material to create the new humanity. According to the Greek fathers, who tended to read the Genesis creation stories in terms of Plato’s Timaeus, the human being is a microcosm that is integral to the cosmos (Louth: xlix). After the sin of humanity, the whole cosmic order was subjected to corruption and death. Paul's use of eschatological birth imagery (“the whole of creation has been groaning in labor pains until now”; Rom 8:22) means that the fall of humankind has cosmic consequences. For Origen, this should be understood in the light of Paul’s groaning in labor pains on account of the gospel in Gal 4:19 (Comm. Rom. 4.6.9).
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B Medieval Times and Reformation Era
Childbirth is mentioned directly (Gen 25:16–20, 38:27–30 and 1 Sam 4:19–22) and indirectly (Gen 4:17, Gen 25:22–26, Ezek 16:4) several times in various books in the Bible. Gen 3:16 is especially important. These passages figure significantly in medieval and Reformation Christianity.
In Summa theologiae (2a2ae. q. 164, a. 2), Thomas Aquinas (d. 1274) argued that all women were punished for Eve’s transgression:
As regards the begetting of children, she was punished in two ways: first in the weariness to which she is subject while carrying the child after conceptions, and this is indicated in the words (Gen 3:16), “I will multiply your sorrow and your conceptions”; secondly, in the pain which she suffers in giving birth, and this is indicated by the words “In sorrow shalt thou bring forth.”
The universal female suffering in childbirth did not, however, include the Virgin who gave birth to Christ “from the closed womb” and “consequently there was no pain in that birth, as neither was there any corruption.” Aquinas cites Isa 35:1–2 to support this assertion (Summa theologiae III q. 28, a. 2).
The description of Mary standing below the cross in John 19:25–27 was interpreted as the Virgin experiencing deferred labor pains. Rupert (d. ca. 1135), Benedictine abbot of Deutz, wrote in his commentary on this verse and John 16:21–22: Mary “is truly a woman and truly a mother and at this hour, she truly suffers the pains of childbirth. When [Jesus] was born, she did not suffer like other mothers: now, however, she suffers, she is tormented and full of sorrow, because her hour has come. … In the Passion of her only Son, the Blessed Virgin gave birth to the salvation of all mankind: in effect, she is the mother of all mankind” (cited in Neff: 256). Albertus Magnus (d. 1280) and Saint Anthony of Padua (d. 1231) relied on Isa 66:7 when discussing Mary’s labor pains at the foot of the cross.
Perhaps indicative of the popular association of childbirth and the Virgin’s own miraculous labor is the practice of inscribing the Magnificat (taken from Luke 1:46–55) on prayer rolls worn by women while giving birth. During the Reformation, the focus of women’s prayers during pregnancy and in childbirth shifted. In The Estate of Marriage written in 1522, Martin Luther encouraged women giving birth to “gloriously suffer and even die in the performance of God’s work and will” (Luther: 40). According to Thomas Raynalde’s prayer book published in 1548, Christ rather than the Virgin or a saint should be thanked for a successful delivery. According to Fissell, “women were to connect their suffering in childbirth not with the Virgin Mary but with Eve. … the speaker tells the Lord that she acknowledges that he has ‘justly’ increased the pain and sorrow with which women bring forth children because of Eve’s ‘original transgression’” (66), a reference to Gen 3:16. Similarly, Lutheran writers understood labor pains as redemptive and analogous to Christ’s suffering on the cross (Crowther-Heyck: 926).
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C Modern Europe and America
In order to understand childbirth, its pains and its rewards, Christians have utilized various interpretations of biblical texts. Childbirth was both women’s curse and their chance at redemption. In the late 17th century a woman’s suffering during pregnancy was understood as her gift of grace promised in 1 Tim 2:15: “Yet she shall be saved through childbearing, provided they continue in faith and love and holiness, with modesty.” A woman’s suffering in childbirth also allowed her to empathize with Christ’s suffering and with the suffering of Mary at the foot of the cross. The New England minister, Cotton Mather (d. 1728), preached on the topic in “Elizabeth in Her Holy Retirement” (1710), stressing both the joy and danger of giving birth. Despite the religious emphasis on pain’s salvific nature, doctors and midwives in this time period sought means of reducing birth pain.
From the 17th century on, Christianity supported the secularization of birth and consequently lost a crucial voice regarding the regulation of birth in the modern period. For instance, though many pregnant women still believed that relics and birthing bags (containing prayers, amulets and images of Saint Margaret or the Virgin Mary) hastened childbirth, the Catholic Church and Protestant sects attempted to eliminate such superstition after the Reformation. Though the Catholic Church in the early modern period licensed midwives to administer last rites to either mother or child if no priest was present, it gave up its supervisory role over time. In the 18th century, European hospitals started training programs for midwives, turning birth from a ritual embedded in religion and superstition into a scientific practice of anatomical manipulation. Though Exodus celebrates the Hebrew midwives who stood up to the Pharaoh, the church more often linked their work and the processes of birth with impurity (Lev 12). Starting in the 17th century, religious nursing orders refused to care for pregnant patients and the church frowned upon the few religious congregations that practiced midwifery. In 1901 the church banned outright the training of sisters in obstetrics, only lifting this injunction in 1936 for missionaries abroad.
The church had long supported the use of cesarean sections to remove a live child from a living or dead mother in order to administer last rites. Doctor Francois Mauriceau (d. 1709), however, found this practice inhumane, as it meant the death of the mother, and in the late 17th century started practicing baptisms “in utero” with a syringe. Despite his solution, the church continued to encourage cesarean sections, which were almost always deadly to the mother until the 1880s. In 1930 Pope Pius XI reiterated that doctors should never kill an innocent child to save a mother, increasing the use of cesarean sections in Catholic countries even more. (Encyclical Casti Connubii)
In the West, labor, or more generally the pain of pregnancy, was also understood to be the curse referred to in Gen 3:16. By the 19th century both doctors and feminists questioned the link of pain to sinfulness in women. Promoting the use of chloroform for pain relief in childbirth, Doctor James Simpson, of Scotland, published a pamphlet in 1847 on the subject of religious objections to pain relief. He argued that “sorrow” in the KJV (Gen 3:16: “I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children”) could be translated to mean “labor” rather than pain. Chloroform allowed the woman to labor while relieving her of the pain. He also argued that God wanted humans to improve their lot, and even implied that God had invented chloroform when God put Adam into a deep sleep to extract his rib. However, most doctors objected to the use of chloroform on the grounds that it was dangerous, rather than on theological grounds.
Nevertheless, theological debate did surface in the 1950s, when Pope Pius XII first promoted the importance of pain in childbirth. In his 1951 address to midwives, the pope used John 16:21 instead of the argument of the curse to argue that a woman’s suffering was necessary because it made her love and value her child all the more. After the introduction of the Lamaze method and Dick-Read’s Natural Childbirth method, Pius XII revised his stance in a 1956 address to gynecologists, arguing for the benefits of natural painless childbirth. In 1957, addressing doctors, he argued that childbirth pain could be alleviated since “man keeps, even after the fall, his right to dominate the forces of nature, to use them in his service.” At the same time, he also argued that suffering had value because it linked women to the suffering Christ.
In the early 21st century a minority of Christians still debates methods of childbirth, often focusing on the role of husband as sole head to the wife (1 Cor 11:3) rather than on issues of pain and sin. Yet the larger religious dialogue has mostly shifted away from issues of childbirth to those of birth control, abortion, and artificial means of conception.
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D New Christian Movements
In the HB and NT, “labor” has important biological/genealogical and theological/eschatological senses, which pass over the literal and metaphorical divide. The somewhat ambivalent nature of the biblical texts on this subject has led to a variety of competing theological and sociological teachings on childbirth, ranging from a woman’s right to choose to the right to life of the unborn, a virtual apotheosis of childbirth per se that has given impetus in some cases to austere proscriptions against any form of birth control and total condemnation of abortion. At the same time, some of the strongest opponents of birth control and abortion also prohibit members from using artificial methods of insemination even though pregnancy is said to be a divine calling and, in the example of the Mormon faith, a married couple’s very eternal salvation.
Onan, who attempted to avoid his brotherly duty by spilling his “seed” (Gen 38:8–10, KJV) on the ground instead of impregnating his dead brother’s wife as the Mosaic law required, is stricken down for his turpitude by a bolt of lightning from heaven, leading to the traditional Roman Catholic teaching known as the “Sin of Onan” and a twin proscription against masturbation and birth control. Onan’s crime is worthy of death because it runs contrary to the original command given to Adam and Eve: “Be fruitful and multiply; fill the earth and subdue it” (Gen 1:28).
Of the new Christian-derived faiths, the Latter-day Saints are largely Catholic in their childbirth beliefs and social patterns. Although not official church doctrine, birth control is discouraged, abortion equated with murder and thus a mortal (unforgivable) sin except in the case of pregnancies which threaten the life of the mother. Artificial methods of birth control and fertility are considered “unnatural” and contrary to the faith. Masturbation is not only a sin, but alleged to lead inexorably to homosexuality, the two having in common a love of pleasure, lustful in their basic nature, and displaying a predilection for the childless lifestyle. Importantly, modern Mormonism’s extreme pro-life and anti-LGBTQ positions go hand in hand with erstwhile racial theorizing and the religion’s esoteric and magical origins.
The furthest from the Mormon pro-life, neo-pagan fertility stance are Jehovah’s Witnesses who have consistently defended a pro-choice position, arguing that the Bible is mute on the issue of birth control. The tale of Onan is thought to preclude masturbation only, which is held to be an “unclean habit,” likely to lead to impure thought patterns. Life begins at conception and the life of the unborn precious to Jehovah (Exod 21:22, 23; Ps 127:3), hence abortion by artificial means is regarded as a serious sin, although abortion may be permitted if it saves the life of the mother.
The Family International (formerly the Children of God) combined elements of radical free love and a strident pro-life position. Originally, birth control was strictly prohibited. One problem from a purely biblical view is that the teaching known as “The Law of Love,” which encourages sexual relationships with multiple partners – at one time even permittting incestuous relations – apparently abrogated biblical teaching. Pregnancy is a blessing and children a crown of old men; God forms life in the womb and therefore abortion is murder. The commandment to be fruitful and multiply must not only be followed, but comes with many blessings, including ease in giving birth.
The Unification Church might be supposed to make the most elaborate pro-life and prenatal stance thus far. Their Divine Principle text includes a tri-partite division of “passion,” which culminates in conjugal love, creation, and childbirth as the highest and deepest expression of the love that two committed, heterosexual partners can experience. Unlike the Mormon understanding of childbirth, in the Unificationist doctrine conjugal love between a married man and wife is not exclusively for procreation. It is also a loving act in which God should be a participant, all children coming from him and by virtue of his passion. Consequently, sexual relations outside the boundary of marriage are unthinkable. Because children are supposed to be a natural and a supernatural byproduct of conjugal love at its most sublime, birth control is discouraged, but not prohibited. Natural rather than artificial birth control is the preference. Unificationists do not believe that the embryo and “spirit self” are coterminous, yet abortion is said to destroy the “spirit base,” which in turn severs the relationship the unborn has with God’s divine love (Wilson: 145–74). With such a strong heterosexual bias, not unlike Mormonism, same-sex relationships and thus lesbian, gay, bisexual, or transgender persons have no place in the Unification Church at present.
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E World Christianity
There are two concerns in World Christianity with respect to the biblical reception of labor and childbearing. The first concerns the significance of passages in the Bible, such as Rom 8:22 and Gal 4:19, in which labor is portrayed as a metonymic metaphor for the formation of nations, particularly Christian nations in this formative moment of Christian history (Calvert Koyzis 2009: 228, 221).
The second concern is the great incidence of maternal and infant death in childbirth. Successful labor is by no means a “given” as it is compared to the global north, where medicine and techniques are far more advanced. In addition, infant care in the global south is far less developed than it is in the north, as statistics near the end of this article will show. Christians in the global south read the relevant biblical texts on labor in ways very different than those in the more developed world. In some ways the global south context of today is a context much closer to the biblical worldview, especially in the importance of fertility as well as the difficulties and dangers permeating the labor experience.
There are a few biblical texts on labor and infancy that are particularly relevant to Christians of the global south. Of significance is the punishment of a painful labor in Gen 3:16 that is extended to all women (Stole: 137). Biblical narratives of difficult labor and death are also of importance, for example Rachel’s hard labor on her journey to Bethlehem and death in childbirth, and her burial on the route (Gen 35:16–19). The reception of this passage by Christians in the global south underlines the painful experience that is fraught with danger, that no medical treatment can alleviate. Likewise, an unfulfilled labor may occur as the result of pregnancy ending in miscarriage (Exod 21:22–25; Kugel: 268), where either the fetus has already died or will die in birth. The biblical phrase phrase “woman in travail” (John 16:21) would have been especially pertinent to the many who had lost wives, daughters, mothers, and/or children, grandchildren, and siblings in the anguish of childbirth (Calvert Koyzis: 228). In this regard, Stole mentions the following examples: Jer 4:31; Isa 13:8; Nah 2:10; Isa 26:17–18; and Mic 4:9–10.
Biblical labor, while fraught with pain and threatened by death, evinces a kind of knowledge as strength; so this theme is intepreted by Christians of the global south. Together with pregnancy, it signifies a woman’s toil which is comparable to Adam’s punishment of toil as a tiller and hunter-gatherer (Kugel: 55–56). Furthermore, fertility implies the productivity of land and is a metaphor for women’s bodies for pregnancy (Kugel: 55), so labor provides a sense of parity in the gendered distribution of work. Labor is a site of gendered solidarity: the midwives Shiphrah and Puah lie to the King of Egypt that they cannot carry out his order to kill infant Jewish boys because Hebrew women do not need midwives in labor (Exod 1:15–20) and therefore they are not present at the births of these boys. The anger and pain of labor permit an expression unconstrained by social convention, leaving no possibility of self-restraint, which enables an act of honesty and truthfulness. God is the one depicted in Isa 42:14 as experiencing labor pains: “Now I will cry out like a woman in labor/I will gasp and pant,” where labor signifies an unstoppable creative force (Calvert-Koyzis: 231).
Labor remains the most dangerous activity a woman can undertake aside from going to war; 830 pregnancies or deliveries were recorded fatal globally each day in 2015 (unicef). A staggering 99% of these maternal deaths occur in three chief regions in the global south. Sub-Saharan African countries are particularly dangerous places for women who are pregnant, in labor and recovering from birth, with 62% of these deaths occurring there, whilst India has 17% and Southern Asia 22%. Women in these regions are at increased risk because of the higher rate of teenage pregnancies in these regions – adolescents below 15 years of age are most at risk of developing complications in labor – and because they have more pregnancies than women in the first world. Women in these regions also have tenuous or no access to reproductive health support, and labor is the least attended medical procedure. Access to reproductive health is intrinsically linked to MMR because most complications which cause maternal mortality are medically treatable. This situation is akin to biblical times, when labor was handled by women in the domestic arena. Catholic missions in Africa have focused on this very issue. Nuns who acquired the right to work as doctors and medical staff in 1953 built and ran hospitals and health care initiatives focused on labor and maternal care in African countries (Mann Wall) and trained medical practitioners to continue this aid after they departed. Women's access to early terminations in safe and legal abortions likewise follows political point-scoring rather than addressing women's reproductive rights and needs; consequently illegal abortions account for approximately 8% of these deaths.
Towards the end of the 20th century, worldwide initiatives through the Millennium Development Goals programs were set in motion to safeguard womens lives in pregnancy and labor and have resulted in huge gains in ensuring women’s access to safer labors and better maternal health. Millennium Development Goals 5 reduced the MMR by 43% since 1990. The improvement was slow in the initial years between 1990 and 2000, and gained momentum between 2000 and 2013. Whilst strides have been made, for example the MMR for Latin America has more than halved, to 85 deaths to 100,000 live births, some argue that these improvements are not enough and not good enough. Indeed, the MMR may be dramatically higher, because 52% of the world’s countries need reliable civil registration of deaths, and the deaths of women in childbirth are frequently unrecorded or recorded incorrectly. People in rural and domestic conditions fail to diagnose complications which arise during pregnancy such as high blood pressure, called preeclampsia, complications during and immediately following labor, particularly loss of blood, and those that arise within 42 days of delivery, as related specifically to pregnancy or labor. Deaths from infections like the breast infection mastitis and others which may occur within the first year of the labor, called late maternity deaths, are seldom counted as part of the MMR. Statisticians are also uncertain of how to include malaria or cancer- and AIDS-related deaths during pregnancy (Trends 26) in the MMR, even though these pre-existing conditions are the chief cause of maternal mortality worldwide. These patients’ actual vulnerability to maternal health dangers is much more stark because pregnancy and labor have an impact on the advancement of these illnesses. The growing awareness around these issues has led to even more concerted efforts to reduce the global MMR to a third of its current level of 210 deaths per 100,000 live births, to around 70 per 100,000 live births, with no country having more than twice the global average. Given these statistics, the lively ongoing reception of biblical texts on an anguished experience of childbirth is relevant and important.
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Concerning labor in Islam the Qurʾān asserts God alone generates human life (S 2:228) in threefold darkness (S 39:6) and fashions that life within the womb (raḥim) as God wills (S 31:34; 3:6). Similar to Micah 4:9-10, the Qurʾān also depicts God as a midwife who delivers human creations “out from the bellies (buṭūn) of your mothers” (S 16:78). As a ruler of fate, God selects some of God’s creations to be blind and deaf (S 2:17–18), some to die young, and others to grow old (S 40:67).
Although God alone bears full responsibility for the generation of human life, the Qurʾān depicts pregnancy, labor, and breastfeeding as a privileged means through which women can submit to God. Their willingness to “grow heavy” (S 7:189), and carry a child “in weakness upon weakness” becomes a selfless act that invokes men to honor them and to thank God for their love and sacrifice (S 31:14). Contrary to Gen 3:16, the Qurʾān assumes no causal connection between Adam’s wife’s disobedience and the toil or sorrow (ʿeṣeb) women experience with childbirth. Neither does the Qurʾān associate birth pangs with curses, punishment, or sin, as put forth in early and medieval Jewish, Christian, and Muslim writings (BerR 20:6–7; bEr 100b; Tertullian, Cult. fem., 1:1; al-Ṭabarī, Tafsīr, 1:526, 529, 531; 12:356). The Qurʾān also avoids biblical analogies drawn between labor pains and the vicarious suffering of men or Israel (Isa 21:3; 26:1; Jer 13:21), or between childbirth and new world orders that burst forth from violent, apocalyptic moments (1 Thess 5:3; Mark 13:8; Gal 4:19). Rather, the Qurʾān lauds a woman’s willingness to embrace the agonizing experience of reproducing life as God commands, and demands men to respect her efforts.
The qurʾānic story of Mary’s (Maryam b. ʿImrān) giving birth to Jesus illustrates this essential link between the pain suffered during parturition and a woman’s embodied submission. While the Gospel narratives state briefly that Mary “bore a son” (Matt 1:25) and “gave birth to her firstborn son” (Luke 2:7), they give no voice to the thoughts or hardships she experienced in the process. In contrast, the Qurʾān recounts in minute detail Mary’s initial protests against God’s plan for her to conceive without a father (S 19:20–21) and the subsequent trials she faced as a result of her pregnancy (S 19:28). Several passages also recite fully the agonies Mary endured as she labored alone, without a partner or midwife, under a date-palm tree. In her pain she cried out, “Oh, would death have overcome me before this!” (S 19:23). These agonizing shouts of protest underscore the revelation’s rejection of Christian beliefs that she was no ordinary woman. Exempted from Eve’s initial sin because she bore the Son of God, and thus felt no pain and shed no blood, the Christian Mary was subject to worship or veneration, an idea the Qurʾān condemns (S 5:116). Contrarily, the Qurʾān encourages ordinary humans to cultivate Mary’s virtuous behavior in their own lives (S 66:11–12).
The Qurʾān states Mary’s despair under the palm-tree was alleviated when she heard a voice from below, instructing her to shake the trunk to drop its fruits for her to consume (S 19:25). By bestowing Mary with command over the tree as she strove to give birth, the qurʾānic story departs from similar, contemporary Christian works such as the Pseudo-Matthew, which likewise places Mary to rest under a palm-tree, but after she has given birth (20). In the Pseudo-Matthew, Joseph tries to pluck the fruit from the tree to satiate his wife’s hunger, but fails. The child Jesus, however, makes up for Joseph’s deficiencies by calling the tree to bend over for Mary, who then consumes its fruits (Ps.-Mt. 20). While the Pseudo-Matthew utilizes Mary’s hunger to demonstrate Jesus’s divine power over male authority, the Qurʾān highlights her very human efforts to embody God’s will.
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Biblical films frequently include birth stories, whether they depict multigenerational tales (e.g., the ancestors) or the story of a single hero (e.g., David, Jesus). Films depicting Gen 1–3 inevitably include the divine command to “be fruitful and multiply” (Gen 1:28) and the so-called “curse” of Eve (Gen 3:16). Director John Huston provides the solemn voice of God in The Bible: In the Beginning (1966, US/IT), which intones, “Eve, I will greatly multiply thy sorrow and thy conceptions. In sorrow shalt thou bring forth children, and thy desire shall be to thy husband and he shall rule over thee.” This traditional reading connects female subordination in marriage to women’s reproductive functioning. The film includes a childbirth scene during which the infertile wives attend a party for the adopting mother and their handmaids sit on the floor of the birthing chamber, breathing and panting through childbirth in concert with their laboring counterpart.
Huston’s film also includes a treatment of the Abraham story, and, like most films depicting this patriarch, it includes the momentous birth of Isaac to Sarah. (Ishmael’s birth to Hagar typically occurs off screen.) As men sit in a circle silently playing a game, women begin to bustle about in the background. An infant’s cry is heard a few moments later, and the camera tracks in to focus on the father. The men watch with smiles as he rises and enters the tent to meet his son. This clear divide between male and female space is repeated in most films depicting the birth of HB/OT heroes.
The Red Tent (dir. Roger Young, 2014, US) is unusual in that childbirth scenes are filmed from the women’s perspective. In this adaptation of Anita Diamant’s 1997 novel, Rachel is portrayed as a skilled midwife who is training Leah’s daughter Dinah as her assistant. In the eponymous red tent, the women support one another in giving birth as they pass down skills and stories through the generations from mother to daughter. Birth scenes show women massaging and encouraging women through the early stages of labor. Then Rachel and Dinah help the laboring woman stand on blocks during the delivery. Dinah heroically performs an episiotomy on herself during her own labor.
All Mary films and the majority of Jesus films include some version of Luke’s nativity story (2:1–7), in which Mary gives birth in a stable or grotto. The birth of Jesus has been the sole focus of at least two films: The Nativity (dir. Coky Giedroyc, 2010, UK) and The Nativity Story (dir. Catherine Hardwicke, 2006, US). Jesus’ birth story is of particular interest to Catholic commentators familiar with the theology of in partu virginity, symbolized in the Protoevangelium of James by Mary’s unbroken hymen (O’Brien: 456). Mary’s labor pains range from mild discomfort in most Jesus films to searing agony in The Nativity and Per amore, solo per amore (dir. Giovanni Veronesi, 1993, IT, For Love, Only for Love). A notable exception is Maria di Nazaret (dir. Giacomo Campiotti, 2012, DE/IT) in which Mary delivers on her own and is already holding the baby Jesus when Joseph returns with a midwife. Joseph assists with the delivery in The Nativity Story.
Biblical allusions sometimes characterize depictions of labor and childbirth in non-biblical films. The problem of infertility in Amos Gitai’s Kadosh (1999, IL/FR) and Moshé Mizrahi’s Nashim (1996, IL) echoes narratives of barrenness in the HB/OT. Eve’s heavily pregnant mother miscarries after planting a tree in Eve and the Fire Horse (dir. Julia Kwan, 2005, CA). A young mother dies in childbirth in Ordet (dir. Carl Theodor Dreyer, 1955, DK), only to be resurrected by her insane brother-in-law who believes he is Jesus. In other films nuns are discovered to be pregnant and have babies, playing on the biblical concept of a virgin birth: Agnes of God (dir. Norman Jewison, 1985, US) and Les innocentes (dir. Anne Fountaine, 2016, FR/PL, The Innocents). In both of these films, however, the pregnancies prove to have resulted from rape.
Jean-Luc Godard’s Je vous salue, Marie (1985, FR/CH/UK, Hail Mary) offers a modern retelling of the nativity story in which a stranger called Uncle Gabriel informs a young virgin that she is pregnant. He also persuades her skeptical boyfriend to support her. She bears a son, whom they raise together until he leaves home to pursue “his father’s business.” A different modernization of the nativity is offered by C.R.A.Z.Y. (dir. Jean-Marc Vallée, 2005, CA), which begins with Zac’s birth on Noël 1960. Legs still covered in the blood of childbirth, his mother watches anxiously as doctors perform C.P.R. on the infant. After revealing his homosexuality to his family, the adult Zac wanders the desert outside of Jerusalem until he collapses from thirst and exhaustion (cf. Mark 1:12–13 and par.).
Both Children of Men (dir. Alfonso Cuarón, 2006, US/UK/JP) and The Handmaid’s Tale (dir. Volker Schlöndorff, 1990, US/DE) depict a post-apocalyptic world in which most women are barren. In Cuarón’s film the protagonist helps a miraculously pregnant African refugee escape the U.K., which has become a police state, and rendezvous with the “Human Project” (a scientific group working to cure infertility on a ship named Tomorrow). The woman gives birth to a baby girl in a rundown warehouse during their journey. In The Handmaid’s Tale, which has been developed into a successful TV series (dir. Reid Morano et al., 2017, US), fertile women are assigned to infertile upper-class couples as their handmaids. The ceremony joining a handmaid to the couple for whom she will bear a child includes quotations from Gen 30. Infertile working-class women, called Marthas (cf. Luke 10:38–42), are domestic servants. This cautionary tale, adapted from Margaret Atwood’s 1985 novel, depicts a society governed by biblical law in which fertile women have no choice regarding their own bodies and reproductive function.
Finally, the birth of a demon child or antichrist is a central element of the horror genre: e.g., Rosemary’s Baby (dir. Roman Polanski, 1968, US), The Omen (dir. Richard Donner, 1976, US/UK), Legion (dir. Scott Stewart, 2010, US), and Devil’s Due (Matt Bettinelli-Olpin/Tyler Gillett, 2014, US). These films typically borrow images from apocalyptic literature. In a slightly different plot The Seventh Sign (dir. Carl Schulz, 1988, US) portrays a pregnant woman trying to forestall the apocalypse. While giving birth, she has a vision in which she realizes that she was present in a past life for the scourging of Jesus. Her child is stillborn because the “well of souls” in heaven is empty, but she willingly sacrifices her own soul, replenishing the well and allowing her baby to live.
Overall, cinema perpetuates many biblical associations with childbearing. Movies frequently present motherhood as the ultimate purpose of a woman’s life and infertility as a tragic curse. Cinema’s heroes typically get remarkable birth stories just as biblical heroes do. Supernatural births mark saviors and demonic forces. And film depicts the consequences, real (Les innocentes) and imagined (The Handmaid’s Tale), of women being deprived of their reproductive freedoms and forced to bear children.
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