Monthly Archives: November 2020

In his dissertation on the site, David R. Hoot says, “The Sanctuary of Asclepius at Epidaurus was the most famous healing sanctuary of the ancient world,” (Hoot 2014).  That is what drew me to the site. The history is rich, and the site can be considered one of the birthplaces of modern medicine. The archeological site of the sanctuary of Asclepius is located near the town of Epidaurus, a mountainous region of Greece in the prefecture of Argolis. It is believed that the nearby hill is the birth place of Asclepius (Hoot 2014).

The sanctuary and surrounding buildings have had a broad and varied history with a long occupation by both the Greeks and Romans. According to UNESCO, who has designated it as a world heritage site, “in the 2nd millennium BCE it was a site of ceremonial healing practices with curative associations that were later enriched through the cults of Apollo Maleatas in the 8th century BCE and then by Asklepios in the 6th century BCE” (Sanctuary). Chronology was used to identify the dates associated with different artefacts throughout the site. The site was occupied until it’s abandonment in the 5^th Century AD. (Hoot 2014)

The archeological inquiry at the site is ongoing, and efforts to conserve and protect the artefacts and structures continues currently. (Sanctuary) Much scholarship has been done on the site, even during its occupation, it was a destination for scholars. (Hoot 2014) Anthropologist Theodore Wiegand was the first to discover the site in the 1920’s and anthropologists have been working at the vast site almost continuously since that time.  

Asklepion Temples are associated with the worship houses of Apollo representing the duality of prophesy and healing (Ioannis et al. 2017). So, the sanctuary was much more than just a religious site, though this was the primary function. The site showcases excellent examples of classical and Hellenic architecture, which include a theater, a hospital, a banquet hall, baths and several temples honoring healing gods (Sanctuary). It appears that many modifications were made later by the Romans as well, including the addition of a Roman cistern (Hoot 2014). Found at the site there were also examples of ancient sculpture, medical tools and reliefs. All the artefacts were in exceptional condition for the time period and give us great insight into the purpose of the site as well as the activities that might have occurred there. 

Archeologists and classical historians were able to determine a lot about the people and the events that took place in this amazing site, due to the types of artefacts found there. It is clear that the individual temples were made for the purpose of warship to the gods, specifically Asklepius, Apollo, and Artemis (Sanctuary).  The people who occupied this site had a complex metropolitan culture. The buildings were engineered to align to specific astronomical positions and are mathematically advanced, “astronomical orientation of the temples is studied for their azimuth, angular altitude of the horizon and celestial declination,” (Ioannis et al. 2017). Researchers have used Google Earth and other GPS imaging software to determine more about how the site aligns with ancient astrological ideas. In addition to this, the artefacts found indicate the advances in medicine that the people made during different time periods. Surgical instruments, as well as other medical devices have been found and dated, giving us understanding into the development of different healing practices.  The theater would have been used for performances of dramatic plays (Sanctuary), and a gymnasium and baths for social interaction as well as general health and hygiene. 

The site of the sanctuary of Asclepius at Epidaurus is a unique window into the past for archeologists and historians alike. It helps us to connect the practices and lifestyles of the Greek, Romans and Hellenistic peoples. It has given us valuable information about healing practices of the ancient world, and how those practices evolved into what we know today as modern medicine. The people left us records in the form of stone tablets, medical reliefs and art made to honor their gods, showing us a complex and well-developed culture. Due to all of this combined, this fascinating site is considered one of the most important in the ancient world. 

References Cited

Feder, Kenneth L.  

2017.  The Past in Perspective: An Introduction to Human Prehistory, 7th Ed. Oxford University Press. 

Sanctuary of Asklepios at Epidaurus.

 https://whc.unesco.org/en/list/491/. Accessed 9/24/2019

Hoot, David R. 

2014.   The Sanctuary of Asclepius at Epidaurus in Roman Times, University of Florida, Ann Arbor, ProQuest, https://searchproquest.com.ezproxy2.library.colostate.edu/docview/1710396669?accountid=1022

Ioannis Liritzis, Evgenia Bousoulegka, Anne Nyquist, Belen Castro, Fahad Mutlaq Alotaibi, Androniki Drivaliari. 

2017.   New evidence from Archaeoastronomy on Apollo oracles and Apollo-Asclepius related cult. Journal of Cultural Heritage, 26:129-143

Epidaurus was among the first sites of the Asclepiad healing cults of Ancient Rome and Greece and was said to be built in a place sacred to the healing God. These sites were the forerunners of what we now call hospitals, but they involved much more than healing. The Gods worshiped were, of course, Asclepius and his father Apollo, though other gods and goddesses who had healing powers were also mentioned in connection with the site including Aphrodite, Hygeia and Artemis, as well as Epidaurus for whom the site is named.

The site would contain a temple, a school, a hospital, a theater and many other smaller structures. The architecture is among some of the best surviving examples of Ancient Greek buildings demonstrating a high level of skill, knowledge and precision. They are mostly built from stone, quarried from the nearby mountains.  Life was complex here. In the beginning students who wished to learn to heal must be descendants of other physicians, as it was believed that all the healers or high priests of the healing cult were descended from the gods that had given them the gift of healing. Later, other students were accepted as well. They would have attended the school and worked as assistants and apprentices to acting Asclepiades, Fully qualified high priest healers.  

Patients of all social classes took pilgrimages to the sanctuary to seek cures. Though many of the patients seeking cures at the sanctuary would have been women, I can find no evidence that any of the healers would have been. 

Rituals of healing would involve a variety of steps. Practices like bathing in sacred hot springs, hygiene practices, and restricted diets were often used. It is believed that substance induced sleep and dream work were used for both patient and physician in order to determine the best course of action in healing the patients. Contemplation and prayer were also prescribed along with healing herbs and other remedies. 

Because the sanctuary was not structured as a city-state in the typical ancient Greek way, the only permanent residents were the members of the healing cult, and so social structure was also very different than it might have been in a typical Greek city-state. It was considered independent.  The highest ranking would have likely been the high priest healers, who had worked to gain their rank through study and apprentice, but also carried rank through birth. 

As excavation of this amazing site has been ongoing for many centuries, we have found a great deal of material artefacts to give us insight to the activities that might have taken place here. 

The ancient Greek diet was extremely important in the role of healing, and would have been carefully modulated at the Asclepios. The Greek people had complex agricultural practices and ate a wide variety of cultivated plants and domesticated animals. The Greek healers championed the ideas of moderation, avoidance of harmful substances and regular exercise for the prevention of illness, called hygiene, named for Hygeia Asclepius’ daughter. 

References Cited

Feder, Kenneth L.  

2017.  The Past in Perspective: An Introduction to Human Prehistory, 7th Ed. Oxford University Press. 

Sanctuary of Asklepios at Epidaurus.

 https://whc.unesco.org/en/list/491/. Accessed 9/24/2019

Hoot, David R. 

2014.   The Sanctuary of Asclepius at Epidaurus in Roman Times, University of Florida, Ann Arbor, ProQuest, https://searchproquest.com.ezproxy2.library.colostate.edu/docview/1710396669?accountid=1022

Ioannis Liritzis, Evgenia Bousoulegka, Anne Nyquist, Belen Castro, Fahad Mutlaq Alotaibi, Androniki Drivaliari. 

2017.   New evidence from Archaeoastronomy on Apollo oracles and Apollo-Asclepius related cult. Journal of Cultural Heritage, 26:129-143

            In order to understand why women choose unassisted childbirth (UC) we must first define what the term unassisted childbirth means. In some situations, and reference materials UC is also called free birth, autonomous birth or unhindered birth. (Miller) For the purposes of this project, I am looking to understand only planned out of hospital births without the assistance of a medically trained birth attendant. In some cases, the women who choose UC are trained in attending births in some way, if they were the only trained medical professional in attendance, I still count this as an UC. Women are rarely actually alone for UC and may have family and friends present. (Freeze, 2008)

                    My aim is to understand what motivates women to choose this option, and what kinds of obstacles they may encounter in doing so. Women seem to have many options when it comes to the birth experience in America, yet relatively few choose non-normative, out of hospital births. We have very little data concerning women who choose to give birth without the assistance of a medical professional in the United States (Miller and Schriver, 2012) and I would like to gain a greater depth of understanding into who they are and why some mothers choose something so outside of what the current culture in our country dictates as normal.

                    I believe that women who choose UC do so for a number of reasons. Many of the primary reasons are due to previously negative experiences in hospitals or with medical care providers. Others are personal, spiritual or religious beliefs. Much of the data surrounding the choice in UA is unrecorded or inaccurate due to women feeling stigmatized or judged for their decisions, particularly with medical professional. I believe there will be trends among women who make this choice, not only in previous experience, but in other choices they make regarding their own and their child’s health beyond birth. I believe there is an upward trend in making the choice to birth without medical assistance, and I believe it is important for the medical community as well as the community as a whole to understand more thoroughly the reality of the risks associated with birthing at home and how to best understand the choices women make in a non-judgmental and compassionate way.

                    According to Plested less than 1% of women in the United States choose to give birth at home, and less than 1% of those that do choose to do so unassisted. This is interesting to me since birthing outside the home is such a recent trend from a historical perspective. Women most frequently choose homebirth after having one hospital birth (Rossi and Perfumo, 2018) which leads me to consider the possibility that their hospital experience was a factor in their decision. I’d like to explore the key motivating factors for making the choice to birth unassisted, and what they mean. I will delve deeper into several of the most frequently mentioned reasons for choosing UC.

                    Empowerment was a key term that frequently arose in the literature I examined and is a major self-reported marker of why women choose to birth unassisted. Women mentioned that they feel more in control and proud of the accomplishment when they birth without medical assistance. They feel powerful and independent and want others to understand how empowering the experience can be.

            The next major theme explored in choosing UC was a distrust of the medical establishment. Women cited negative previous experiences with both medical professionals and hospitals. Not only did they believe they were undervalued as patients, but they also felt like their requests were not considered when being treated in these situations. Respect is a recurring theme in choices of birthing situations. Miller and Lalonde said that, “improved outcomes, including fewer cesareans, enhanced bonding, improved breastfeeding, decreased reports of stress after birth, and reduced need for operative deliveries, when women had companions during labor and birth, were treated as equals in the birth process, and were allowed to hold and breastfeed their babies immediately after birth.” Women do not feel they are treated as equals when they are in hospitals or birthing with medically trained personal.

                    Religious motivations factored into some accounts of women’s choice to birth unassisted. Either these women felt that their beliefs wouldn’t be respected in a hospital environment or their beliefs dictated limited medical care.

                    One woman I personally spoke with had a confidence in her own knowledge over the knowledge of others. Many women feel they can prepare and educate themselves enough to take control of their own birth experience. This is particularly true of women who had had more than one previous birth. They did not give authoritative knowledge to medical professionals and instead felt that they or their social circles held more authoritative power.

            Some women expressed fear of unnecessary medical intervention and believed that birth with a trained medical professional would put them at higher risk for interventions. In 2016 Plested said “the encounter with maternity services is experienced as stepping into a risk obsessed system driven by fear” Statistics proved that this in fact was the case. Women who give birth in a hospital do have higher rates of unnecessary C-sections and other medically induced complications (citation).

                    Next, I would like to look at factors that may have gone into the decisions that women made on where and how to birth as it applies to UC.

                    It is common for women to feel that others perceive their choice as the wrong one. Women believe that there is a stigma surrounding UC and choose not to tell many people when they do make this decision. They also mention feeling shamed or judged by others as an irresponsible mother by those that don’t understand the reasons behind their choices. Women not specifically that they feel stigmatized by those in the medical community, and they cite this as a reason for choosing not to engage with medical professionals.

                    Lack of medical support factors into the decision-making process. There is some concern among women that if something does go wrong during labor, they could be denied proper medical care when they do choose to seek it or that it will not be available at all.  Because of this, women have hidden still born babies, and have even died from complications rather than seek professional treatment. Women who do consider the choice to birth unassisted but ultimately do not, frequently mention those as a reason for choosing otherwise.

                    It seems that women who are aware of this option in birthing but do not consider it, say that they lack personal knowledge or authoritative knowledge about birth. They also say that they fear complications and emergency situations arising. (Plested, 2016)

                    We do not have enough data on this type of birth due to many of the above-mentioned factors, and there is no way for women to self-report UC outcomes and experiences. Only by continuing an open dialogue can we understand the motivating factors for their choices. If the medical establishment has failed to provide what women want and need in their birthing experience, I believe they will continue to make choices that do not include doctors and hospitals. We also must allow women the freedom to choose what is best for themselves, without stigma or shame.

Citations:

Miller, Amy Chasteen, and Thomas E. Shriver. “Women’s Childbirth Preferences and Practices in the United States.” Social Science and Medicine 75, no. 4 (2012): 709–16. https://doi.org/10.1016/j.socscimed.2012.03.051.

Rossi, A. Cristina, and Federico Prefumo. “Planned Home versus Planned Hospital Births in Women at Low-Risk Pregnancy: A Systematic Review with Meta-Analysis.” European Journal of Obstetrics Gynecology and Reproductive Biology, 2018. https://doi.org/10.1016/j.ejogrb.2018.01.016.

Van Der Hulst, Leonie A.M., Edwin R. Van Teijlingen, Gouke J. Bonsel, Martine Eskes, and Otto P. Bleker. “Does a Pregnant Woman’s Intended Place of Birth Influence Her Attitudes toward and Occurrence of Obstetric Interventions?” Birth, 2004. https://doi.org/10.1111/j.0730-7659.2004.0271.x.

Dannaway, Jasan, and Hans Peter Dietz. “Unassisted Childbirth: Why Mothers Are Leaving the System.” Journal of Medical Ethics 40, no. 12 (December 2014): 817–20. https://doi.org/10.1136/medethics-2012-101150.

Chasteen, Amy, and Thomas E Shriver. “Social Science & Medicine Women’s Childbirth Preferences and Practices in the United States.” SSM 75, no. 4 (2012): 709–16. https://doi.org/10.1016/j.socscimed.2012.03.051.

Freeze, Rixa Ann Spencer. “Born Free: Unassisted Childbirth in North America.” ProQuest Dissertations and Theses. The University of Iowa, 2008. https://search.proquest.com/docview/287924589?accountid=10223.

Snowden, Jonathan M., Ellen L. Tilden, Janice Snyder, Brian Quigley, Aaron B. Caughey, and Yvonne W. Cheng. “Planned Out-of-Hospital Birth and Birth Outcomes.” New England Journal of Medicine 373, no. 27 (2015): 2642–53. https://doi.org/10.1056/NEJMsa1501738.

Plested, Mariamni, and Mavis Kirkham. “Risk and Fear in the Lived Experience of Birth without a Midwife.” Midwifery 38 (July 2016): 29–34. https://doi.org/10.1016/j.midw.2016.02.009.

Cummins, Molly Wiant. “Reproductive Surveillance: The Making of Pregnant Docile Bodies.” Kaleidoscope 13, no. 1 (2014): 33. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.686.9862&rep=rep1&type=pdfWax, Joseph R., F. Lee Lucas, Maryanne Lamont, Michael G. Pinette, Angelina Cartin, and Jacquelyn Blackstone. “Maternal and Newborn Outcomes in Planned Home Birth vs Planned Hospital Births: A Metaanalysis.” American Journal of Obstetrics and Gynecology, 2010. https://doi.org/10.1016/j.ajog.2010.05.028.

Miller, Suellen, and Andre Lalonde. “The Global Epidemic of Abuse and Disrespect during Childbirth: History, Evidence, Interventions, and FIGO’s Mother-Baby Friendly Birthing Facilities Initiative.” International Journal of Gynecology and Obstetrics 131 (2015). https://doi.org/10.1016/j.ijgo.2015.02.005.

Barker-Williams, Kerry. “A Systematic Review to Examine the Evidence Regarding Discussions by Midwives, with Women, around Their Options for Where to Give Birth.” Practising Midwife, 2017.

Feeley, Claire, and Gill Thomson. “Tensions and Conflicts in ‘Choice’: Womens’ Experiences of Freebirthing in the UK.” Midwifery 41 (October 2016): 16–21. https://doi.org/10.1016/j.midw.2016.07.014.

Feeley, Claire, and Gill Thomson. “Why Do Some Women Choose to Freebirth in the UK. An Interpretative Phenomenological Study.” BMC Pregnancy and Childbirth 16, no. 1 (December 21, 2016): 59. https://doi.org/10.1186/s12884-016-0847-6.

Jackson, Melanie Kathleen. “Birthing Outside the System : Wanting the Best and Safest Women to Choose a High-Risk Homebirth Or,” no. July (2014). https://search.proquest.com/docview/1948832128?pq-origsite=primo.

Gibson, Erica. “Women, Birth Practitioners, and Models of Pregnancy and Birth—Does Consensus Exist?” Health Care for Women International 35, no. 2 (February 2, 2014): 149–74. https://doi.org/10.1080/07399332.2013.810219.

Cameron, Heather Jean. “Expert on Her Own Body: Contested Framings of Risk and Expertise in Discourses on Unassisted Childbirth.” ProQuest Dissertations and Theses. Lakehead University (Canada), 2012. https://search.proquest.com/docview/1758020391?accountid=10223.