Doctor of the Church or Abortion-Providing Saint? Hildegard After Dobbs
by Gennifer Dorgan
In the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health decision, Justice Samuel Alito argued that the right to abortion is at odds with “Anglo-American” legal traditions going back to the Middle Ages. Historical examples tell a different story. Writers like Olivia Campbell and Lynn Stuart Parramore look to the twelfth-century German abbess Hildegard of Bingen to demonstrate how wrong Alito’s version of history is, claiming that Hildegard is a Catholic saint who, in Campbell’s words, “prescribed medical abortions.” But what Hildegard actually wrote about the topic is more complicated. Her apparent reference to “abortion” could just as easily refer to “miscarriage” — a fact which should prompt us to reflect on our modern urge to distinguish the two, focusing on the cause of a medical emergency rather than the emergency itself.
Responsible for taking care of people in her community, Hildegard compiled information about the medicinal properties of plants in her encyclopedia Physica. She describes two in particular, deer truffle and European wild ginger, as abortifacients (substances that can induce an abortion). As Lydia M. Harris has argued, she probably includes them “as a warning to women to avoid should they wish to remain pregnant.” Deer truffle, for instance, is useful for treating gout. However, Hildegard warns of pregnancy loss as a side effect: “it also makes a pregnant woman abort [Latin: abortire] with great risk to her body if she has eaten it” (in Bruce Hozeski’s English translation). While it is certainly possible that 12th-century women could have learned about abortifacients from reading Physica (a scenario imagined in Margarethe von Trotta’s 2009 film Vision), there is no direct evidence that Hildegard prescribed these plants, both of which she describes as extremely dangerous, to anyone seeking to induce an abortion.
That being said, it is important to recognize that Hildegard’s use of the verb abortire doesn’t translate perfectly to the English terms “abort” or “abortion.” Unlike these, Latin abortire and abortus or abortivum do not necessarily convey an intention to end the pregnancy. The verb Hildegard uses can just as easily be translated as “miscarry.” Whether or not the termination is intentional — that is, whether it was what we would describe as an abortion or a miscarriage — is supplied by the context. For instance, Exodus 21:22 in the Vulgate Bible, the single most significant Latin text that circulated in the Middle Ages, describes an abortivum that was clearly a miscarriage:
If men quarrel, and one strike a woman with child, and she miscarry indeed [abortivum quidem fecerit], but live herself: he shall be answerable for so much damage as the woman’s husband shall require, and as arbiters shall award.
Intention did matter. To most medieval theologians, intentionally terminating a pregnancy after “quickening” (when the fetus was first felt to move, two to three months into pregnancy according to medieval intellectuals or in the fifth month according to modern science) was considered murder. Hildegard herself wrote in The Book of the Rewards of Life that women who aborted a fully formed fetus had to fast and scourge themselves to avoid the pains of hell. Significantly, however, she makes no mention of earlier terminations — the kind that would have been easier to induce with herbs.
Like other medieval intellectuals, including Augustine and Thomas Aquinas, Hildegard believed that the fetus only received its soul around 40 days after conception. Up to that point, there was less at stake, so intention didn’t matter as much — and in medieval Latin it was possible to discuss the termination of a pregnancy without passing judgment on intention at all. This stands in stark contrast to contemporary English, in which the word “abortion” seeks to establish a connection between the outcome of a termination and the choice that supposedly preceded it — a choice that, if determined by the state, can now lead to a charge of homicide.
Language does not need to comply with punishing people for pregnancy loss, as reading Physica after Dobbs reveals. When Hildegard writes that deer truffle can cause a woman to “abort,” she does so without indicating whether the woman intends to terminate her pregnancy or suffers a spontaneous miscarriage after taking the fungus to treat gout. Physica is a medical text, and in it Hildegard is primarily concerned with care and healing, not evaluating the morality of a patient’s actions. Moreover, even when Hildegard did comment on the moral implications of terminating a pregnancy, the question of intention only became relevant to her once the fetus was fully formed.
We won’t ever know much about Hildegard’s lived experiences with pregnant people, but human biology tells us that in the 12th century as in the 21st, early-term pregnancies must have ended all the time, for all sorts of reasons that are too complicated to shoehorn into an abortion-miscarriage binary. While the ambiguity (as we perceive it) of Latin abortire lets this complexity stand, English insists on lexically reducing the cause of a termination to the pregnant person’s intention or lack thereof.
How did we get to the point where we can’t discuss the end of a pregnancy without judging intention? According to the Oxford English Dictionary, the English terms “abort” and “abortion” entered the language with the development of learned medical discourse in the late Middle Ages, as described by Monica Green. For a time, they remained synonymous with the Latin terms from which they were derived. Starting at the end of the 19th century, the sense in which they are currently used began to predominate, with “abort” coming to mean “to terminate (a pregnancy) by undergoing or performing an abortion” and “abortion” itself no longer requiring contextualization as “spontaneous” or “induced.” As the term “spontaneous abortion” faded from usage, it was supplanted by “miscarriage,” which had originally meant misconduct or failure (as in “miscarriage of justice”).
These lexical shifts were shaped by medical, legal, and later political usage: that is, they were driven by the forces that have attempted to restrict women’s bodily autonomy since the Middle Ages, according to Monica Green’s painstaking research. The first attested usage of “abort” is in a translation of The byrth of Mankynde by Eucharius Rösslin, who purported to correct the ignorance of Frankfurt midwives after being installed as their supervisor in 1506. As Sylvia Federici has argued, the replacement of midwives by a new, male-dominated medical establishment constituted a usurpation of the power of women by the state; witch trials, in which midwives’ alleged crimes against the fetus were presented as evidence, were one of the state’s main tactics. On the pretext of rectifying women’s supposed inability to responsibly manage conception, pregnancy, and birth, the biopolitical state has reached deeper and deeper into these processes, plumbing their situational complexities in ways Hildegard could not have imagined.
Under these specifically modern circumstances, “abortion” and “miscarriage” have been made familiar to us as mutually exclusive categories. The separation of these categories allows US states such as Indiana to declare abortion murder from conception onward (a much more extreme position than that taken by medieval law codes, as critics of Alito’s argument have pointed out) while insisting that pregnant people who unintentionally miscarry will not be prosecuted. Of course, the aftermath of the Dobbs decision reveals that any legal fine line drawn between these poles is a fiction: it is impossible to criminalize induced “abortion” without criminalizing spontaneous “miscarriage” as well, because intent–to the extent it is unknowable–can be maliciously manufactured.
It is understandable that opponents of these developments would look to the past for an alternative history to Alito’s, one in which the state did not involve itself in pregnancy. Physica can help to provide this alternative. However, interpreting Hildegard’s abortire as “abort” in an attempt to make premodern women’s experiences with abortion more visible risks naturalizing the abortion-miscarriage binary, projecting it into a past in which it did not yet exist. Instead, we should try to understand Hildegard on her own terms.
In Physica, the problem with a woman “aborting” after taking deer truffle or wild ginger is that she could suffer, bleed, and possibly even die. Even though Hildegard did believe that intentionally terminating a pregnancy after quickening was murder, abortire, as she uses it, describes what is strictly a medical emergency. The best English translation would be “to lose the pregnancy,” which emphasizes the moment of loss rather than any decision leading to it. In the 21st century as in the 12th, the physiological aftermath of spontaneous “miscarriage” and induced “abortion” typically requires the same kind of care. From a medical standpoint, they cannot be separated; it is mainly from legal and cultural perspectives that they are distinct.
Even if Alito’s version of history were correct, the past is usually not the right place to turn for direction in the present. For instance, modern gynecology, in spite of its checkered history, has helped to make obstetrics safer than ever. As for Hildegard, she isn’t the abortion-providing saint that some contemporary feminists would like her to be. She can, however, prompt us to reflect on how we describe pregnancy loss — the same medical emergency she describes in Physica — as either an “abortion” or a “miscarriage.” These ideas can never be fully separated. By insisting on their separation regardless, contemporary English serves the interests of those who would make induced abortion a crime.
Gennifer Dorgan is a medievalist, Latin instructor, and daughter of a maternal-child health nurse. Her work on rhetoric and bilingualism in the literatures of medieval women’s religious communities has appeared in Early Middle English and the Harvard Library Bulletin; she has also written on comparative global manuscript studies, Latin pedagogy, and translation. She is currently completing her PhD in Comparative Literature at University of Massachusetts Amherst. You can find her on Twitter at @dorgan_g.
