Book Review
When Abortion Was a Necessary Sin

When Abortion Was a Necessary Sin

Lara Freidenfelds

Anyone tempted to make facile arguments about abortion politics, on either side of the aisle, needs to read John Christopoulos’s new book, Abortion in Early Modern Italy.

The book is beautifully written and the stories in it are jaw-dropping, with nearly tabloid-worthy details about individuals’ sex lives and relationships, though handled with appropriate respect. As far as is possible with extant sources, Christopoulos shows was it was like for women to have abortions before the modern era. While the book is a close study of Italy in the sixteenth and seventeenth centuries, it captures in detail a sensibility about sex, pregnancy, and abortion that has largely characterized the western Christian world from at least the Middle Ages through much of the twentieth century.

I came to the book interested to learn about the history of abortion in a Catholic context. As I have noted before, much of the scholarship about the history of pregnancy has been developed in Protestant contexts, and I wondered if the field was failing to consider anything that fell outside of white, Anglo-Saxon Protestant culture. Works such as Barbara Duden’s The Woman Beneath the Skin, Laura Gowing’s Common Bodies: Women, Touch and Power in Seventeenth-Century England, and James Mohr’s Abortion in America presented abortion in early pregnancy as a more-or-less accepted practice through the mid-nineteenth century. Fertility control was seen as shameful if it covered up extramarital sex, but was acceptable for married women, especially if they faced health issues. In contrast, internalist histories typically claim that Catholics have always regarded abortion as murder. Was this discrepancy the result of historical cultural differences in the beliefs and practices of ordinary Protestants and Catholics, or an artefact of politically-motivated history writing?

Cover of Abortion in Early Modern Italy, features a sketch of two women in an embrace
Cover of Abortion in Early Modern Italy. (©Abortion in Early Modern Italy)

The history of abortion in Catholic Italy as described by Christopoulos was largely familiar from what I already knew about Protestant England, Germany, and the United States. These western contexts, which share a larger history of medical practice and Christian heritage, have much more in common than not. As Christopoulos briefly points out in his introduction, the contemporary Catholic church makes historical arguments based in modern politics and theology, not history. In contrast, his book is a rigorous, multilayered social history of abortion. Weaving individuals’ experiences of pregnancy and abortion throughout, the book’s chapters address abortion as medical practice, the theology and church governance of abortion, and legal treatment of abortion.

Christopoulos paints a world in which abortion was seen as sinful yet sometimes necessary and understandable. A woman could be theologically and legally excused for aborting if it were the lesser of two evils: to preserve her life and health, to avoid bringing the shame and scandal of nonmarital sex onto her family, or to preserve the moral and social order by removing the evidence of disorderly sexual conduct. These were not rare circumstances. Abortion was a regular practice and a practical necessity. But at the same time, it was stigmatized, and women, their partners, and their care providers faced spiritual jeopardy and— in extreme cases— criminal liability.

Christopoulos begins with a thorough consideration of the ambiguities of pregnancy diagnosis and the variety of expulsive treatments routinely offered by healers ranging from barbers to pharmacists to physicians. Healers were held liable for knowingly prescribing abortifacients, but expulsive drugs and bloodletting were common treatments for many illnesses, and it was easy for patients and healers to take advantage of this ambiguity. Christopoulos’s survey of sources allows him to describe in detail the variety of abortive methods used, from herbals to bloodletting to physical assault, and he asserts confidently that surgical abortion does not appear in the historical record in this time period. Here, as elsewhere in the book, Christopoulos brings together his primary research with the substantial existing secondary literature to provide a lucid and detailed synthesis that any scholar trying to understand pregnancy and abortion in the early modern period will find valuable.

Like many scholars of abortion history, Christopoulos punts on the question of how (and whether) various abortifacients worked. The multitude of women’s stories sprinkled through the book give a clear impression that abortifacients were not reliable or might take repeated efforts; that they sometimes worked (or appeared to work) some time after the initial treatment; and that women had justified concerns about their safety.

Christopoulos directly addresses the church’s attempts to limit abortions. Here the differences from the literature on Protestant countries are most apparent. What is most different, though, is not the theology but the structure of church discipline. The church taught that contraception, abortion, and even miscarriage (if the result of carelessness) were all mortal sins of homicide, and they appear undifferentiated in sources such as instructions for confessors. Because the Catholic church required regular confessional interaction between clergy and laypeople, Christopoulos can trace out the complex negotiations over the acceptability of the abortions that laypeople clearly believed were necessary and confessed with some regularity. While individual confessions were not recorded, Christopoulos makes creative and illuminating use of correspondence between local vicars and bishops and the Congregation of Bishops about individuals who had confessed to procuring abortions, as well as instructions for confessors that addressed abortion as a common and expected issue, and mentions of confessions in court cases about abortion.

The centuries examined in the book were a time of increasing church discipline over laypeople as well as local priests. In 1588, Pope Sixtus V issued a papal bull dramatically cracking down on abortion, calling for all contraception and abortion, even early in pregnancy, to be punished as homicide by ecclesiastical and secular authorities. This caused such distress and disruption that three years later Sixtus’s successor repealed it. Christopoulos examines this episode in illuminating detail, especially attentive to the pleas from confessors for commonsense modifications to absolute rules that threatened to cause grave social disruption. Confessors wanted to continue to secretly counsel women and their helpers in abortion cases. They preferred to quietly offer penance and absolution that would allow parishioners to avoid disruptive sexual scandals and repair their relationship to God and the church. The official position on abortion had never been tenable in practice, and confessors needed the wiggle room to handle the sin in a reparative way.

In the book’s final chapter, Christopoulos addresses the treatment of abortion in law and the court system. As in the confessional, courtroom judges preferred to exhibit flexibility and leniency. Women’s bodies were widely understood to be difficult to “read,” and it was almost impossible to determine whether a woman had really had an abortion. Extenuating circumstances too played a major role. Women successfully defended themselves by demonstrating that they were victims of men who raped them or who had promised marriage and reneged, pushing abortifacients on them to remove the evidence.

One of the most interesting points Christopoulos makes about the court cases is that they generally happened because of local social relations and micropolitics and not top-down enforcement. Cases came to the court’s attention because a community was punishing a troublemaker and tamping down a source of ongoing discord. Christopoulos describes three cases in detail, using them as a window into the social settings and conflicts that led to dramatic prosecutions for abortion. In one case, a family feud played out publicly on the body of a young woman who became pregnant by her brother-in-law. In a second, townfolk tried to get rid of a corrupt, despised town cleric who impregnated a young woman he took as a concubine, subsequently forcing her to seek an abortion. In a third, a town went after a powerful man who openly slept with his niece, impregnating her and then forcing her to abort. These stories are sordid and dramatic, involving sexual scandals and tortured interrogations. They are clearly not representative of all abortion experiences. But they do give a vivid view into a world where women were sexually vulnerable to the men who controlled their livelihoods and in which many abortions were not precisely matters of choice.

Examined through modern, secular eyes, this history— if clumsily handled— can become a story of wily women who thought abortion was just fine exerting the “weapons of the weak” to push back against misogynist patriarchs who unilaterally declared it a sin and crime. But this would be a mistake. Christopoulos acknowledges regretfully that the sources give little direct insight into women’s interior experiences with abortion and confession. But there are clues. Women and their assistants did confess to abortions, hoping for absolution. Perhaps not all abortions were confessed, but many women did seek forgiveness, although they and their confessors did not seem to believe that abortion called for excommunication. Today, many reproductive rights activists try to destigmatize abortion by declaring it to be morally and spiritually neutral. But as the reproductive justice movement calls us to better serve the full range of needs of women of color, who are more likely than white women to be religiously active, Christopoulos’s history offers an additional, alternative view of abortion: for some women it can be not so much a matter of “choice” as an unfortunate necessity that requires and deserves compassionate medical and spiritual care. Abortion in Early Modern Italy is a lucid, thorough, perceptive history, told with clarity and compassion. It should be on the reading list of everyone who cares about pregnant women and the politics and realities of abortion, past and present.

Featured image caption: Drawing from a 13th-century manuscript of Pseudo-Apuleius’s Herbarium, depicting a pregnant woman in repose, while another holds some pennyroyal in one hand and prepares a concoction using a mortar and pestle with the other. Pennyroyal was historically used as an herbal abortifacient. (Courtesy Wikimedia Commons)

Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at