Scholia Reviews ns 12 (2003) 30.

Konstantinos Kapparis, Abortion in the Ancient World. London: Duckworth, 2002. Pp. viii + 264, incl. two appendices. ISBN 0- 7156-3080-6. UKú40.00.

Betine van Zyl Smit
University of the Western Cape

Abortion remains a controversial topic in most societies, although the procedure was legalized in many countries in the course of the twentieth century. Abortion in the Ancient World presents the ancient debate on abortion and its ethics against the legal, economic, social and cultural background of the time, and links it to the modern debate in a scholarly and dispassionate way.

Kapparis describes and discusses the views of ancient physicians on abortion, as well as medical and philosophical theories about the human status of the unborn in the ancient world, the Hippocratic Oath and other important documents on Greek medical ethics. In addition, he probes the factors that drove women to seek abortions, male attitudes to abortion, and the social, cultural, religious, and demographic trends that influenced the legal status of abortion in antiquity.

In the modern world abortion is predominantly a woman's issue, in the sense that there is great emphasis on the woman's right to control her own body and on the agonizing decisions that women sometimes have to make to abort children that they are unable to support. The traumatic experience of the procedure and its aftermath has been described in great detail in fiction and non-fiction. In the ancient world women undoubtedly suffered similarly, but we have no woman's account of that. Because methods of contraception were not very effective there was a higher risk of unwanted pregnancies. Kapparis points out that almost every account we have of abortion in the ancient world has been by men. Thus our understanding of women's views and experiences is at best partial. This has to be borne in mind throughout. Secondly, the material from the ancient world comes from a long period of time, from different civilizations and religions, and from various nations and cultures. Each aspect has to be interpreted against its particular time and place.

Kapparis approaches his complex subject in a systematic and highly organized way. He devotes a chapter each to the six themes he must regard as the most important. Each chapter starts with a short description of the current status of opinion about the issue under discussion and then goes back to the ancient world to follow the argument in Greek and Roman medical, philosophical and literary works. The body of each chapter is divided into subsections with clear titles, so that it is easy to find one's way around the text. Each chapter ends with a conclusion that condenses its gist.

The titles of the subdivisions in Chapter 1, 'Methods of Abortion: Science and Superstition' (pp. 7-31), are self- explanatory: (i) orally administered drugs, (ii) pessaries, (iii) externally applied drugs, (iv) mechanical means, (v) surgical abortions, (vi) ancillary techniques, and (vii) magic and superstition. Apparently nearly all the techniques of procuring an abortion known to medicine until the 1950s were already known in antiquity. Of necessity their application was considerably cruder, as is amply illustrated by Celsus' description of a dilatation and curettage (commonly known as D&C) operation to remove a foetus nearly at term but already dead (pp. 24-26). Further references to, and quotations from, ancient authors on their methods should bring the reader to agree with Kapparis that such operations in the ancient world 'might resemble the suffering of Prometheus' (p. 31).

The second chapter, 'When Does Human Life Begin?' (pp. 33-52), examines the ethical and legal implications of this important question. There are plenty of references to modern works in the endnotes, but the information in the chapter itself will be valuable to anyone seeking an overview of the thoughts of the ancients. Kapparis has drawn his information not only from the philosophers and scientists, but also from poets. The first division he traces is between those who believed that life began at conception (many early Christian authors, but also the Pythagoreans), and those who considered that it began at birth. He does point out that those in the second category did not necessarily condone abortion. However, by far the most important faction was the 'gradualists' who concluded that human life started somewhere between conception and birth. This conviction again is in line with most modern approaches and was based upon meticulous observations of human development by Hippocratic medical practitioners.

Chapter 3, 'The Doctor's Dilemma' (pp. 53- 89), addresses an issue which is still relevant, even in countries where abortion is permitted by law, namely how an individual doctor will apply that law. In many modern jurisdictions where abortions are legal, abortion on demand is not. Instead one or more doctors have to agree that a termination is required because of physical or mental factors. Here a modern doctor may react according to the dictates of her own conscience and circumstances. In the ancient world where there was no legal impediment to abortion, the medical practitioner or midwife had to make their decisions on the basis of their own judgement and conscience. Kapparis shows how, because there was no uniform training for doctors in the ancient world, there were enormous differences in knowledge and skill. The absence of a professional body did not imply that there were no ethical standards. The Hippocratic Oath encapsulated the high ideals of the ancient Greek medical practitioner. The fact that it is still regarded with respect today proves its outstanding quality. However, in general, doctors in ancient Greece did not have to obey binding rules. They had to use their own judgement.

'The Woman's Point of View' is set out in Chapter 4, (pp. 91-132). Kapparis starts with an excerpt from a 20th century Greek novel, Life in the Tomb, by Stratis Myrivilis. The extract centres on the disastrous consequences of an abortion on Lesbos in 1913. The point that Kapparis makes is that the situation depicted in the novel is timeless. In the modern world, as in the ancient, women continue to seek abortions whatever deterrents society, law or religion may impose. He discusses the findings of recent surveys on the motives of women seeking abortions, as well as anthropological studies of abortion. He then extrapolates these findings to the ancient world and tries, by dividing the women into groups, to explore their personal circumstances against the economic and cultural circumstances of their society. In this way he attempts to explain why women were prepared to face considerable risks in order to have pregnancies terminated. His categories are: (i) The adulteress; (ii) The prostitute; (iii) Abortion for the sake of beauty; (iv) Abortion for social and economic reasons; (v) Abortion as a political statement.

After careful investigation of evidence from the ancient world Kapparis concludes that abortions for socio-economic reasons other than adultery or prostitution seem to have been performed on a very limited scale. This is understandable because while the procedure is safe and relatively painless in the modern world, it was too risky and painful to be seen as an easy way out in ancient times. Alternatives such as adoption, exposure or infanticide would be safer for the mother. This underscores the fact that abortion was a drastic step and would not have been chosen lightly.

Chapter 5, 'The Man's Point of View' (pp. 133-65), uses as a framework Cicero's example in Pro Cluentio 32 (quoted on p. 135) regarding the loss a husband, or any man, suffers when a woman aborts his child: 'She deprived her husband of the hope of becoming a father, the memory of his name, the successor to his generation, the heir to his family, and the city of a future citizen.' Kapparis discusses each of these aspects in detail and shows how children provided security for old age and would also perform the funeral rites for their parents. He stresses the importance of name succession and inheritance in the family and probes the importance to various states in the ancient world of a healthy birth rate amongst citizens. He cites the Persians of the Achaemenid dynasty as having the strictest anti-abortion laws known (pp. 151- 53). Procuring an abortion or assisting anyone in doing so carried the death penalty. Kapparis concludes that the male attitude to abortion in the ancient world was complex and depended on period, place and personal circumstances.

'Abortion and the Law' is the title of Chapter 6 (pp. 167-94). Kapparis first discusses the links between religion, abortion and the law. Homicide in ancient Athens was regarded as an offence against the gods and on a secondary level as against 'the ordinances of man'. Abortion was never linked to homicide in mainstream Graeco-Roman religious culture. All that was required after abortion was a purification ceremony similar to those dealing with a birth or death. This is testified by various inscriptions from different places and dating from the fourth, third, and second century BC to the second century AD. Abortion thus seems to have been treated as on a par with natural events such as birth, sexual intercourse or death. However, in Christian writings there is a great contrast; induced abortion was regarded as a crime against God comparable to homicide, and severe penalties were imposed on a guilty woman.

The available evidence as to whether abortion was legally prohibited in the ancient world suggests that this was not the case until the third century AD. Kapparis argues that it was probably regarded as an individual or family issue, not a public one. Only when the Romans started worrying about outside pressures and their ability to keep their identity and control their vast territories, did their attitude change towards a practice that could hold a threat to the population of Rome and her capacity to rule. Caracalla, the emperor who sought to increase the numbers of Roman citizens by enfranchising the whole population of the Empire, also introduced the prohibition of abortion.

The short (pp. 195-99) last chapter provides a historical perspective on attitudes to abortion and sums up the matters discussed in the previous chapters.

The first appendix is a translation, with introduction and commentary of the Pseudo- Galenic study Whether what is carried in the womb is a living being. The second, Abortion, the Hippocratic Oath, and the sacred ordinances of the Philadelphia inscription (LSA 20), (pp. 214-18), is a translation of the inscription, again with introduction and commentary.

Kapparis has provided a very useful select bibliography of works in several languages, dealing with different aspects of abortion in the ancient and modern world. His index of ancient authors cited demonstrates the impressive range of his scholarship. There is also a short index of topics.[[1]]

In sum, this is an important and wide- ranging work. It will be a valuable source of information not only for classicists but also for those seeking information on medical history and women's studies.

NOTES

[[1]] It seems petty to point out a few typographical errors in this valuable and scholarly work, but it may be useful for a future edition. On p.4 the sentence starting 'The speeches written for trials . . .' lacks a verb. On p. 9 'what it is preserved for us', 'it' should be omitted. On p. 95 'throughout history is not be hard to believe.', 'be' should be deleted. On p. 116 'trace of make-up' should be 'traces'.