Marked: Birthmarks and Historical Myths of Maternal Responsibility

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“You ate a lot of strawberries when you were pregnant with that baby, didn’t you?” When I was a child, my mother heard this exasperating refrain from complete strangers. Shortly after I was born, I developed a large vascular birthmark, an infantile hemangioma, on my face. Because bright red, raised hemangiomas resemble strawberries, people believed for centuries that infants bore these birthmarks because their mothers had eaten strawberries during their pregnancies or else badly craved them. They thought a pregnant woman’s craving impressed the image of the longed-for strawberries onto her fetus. The theory of maternal impression – that a pregnant woman’s desires, experiences, and thoughts could physically mark her fetus – was long discredited by the late-twentieth century. A few of the intrusive strangers who repeated the myth about strawberries to my mother seemed serious, while most appeared eager to inform her about “that old wives’ tale” – as if she hadn’t heard it many times before.

While myths about birthmarks and maternal impressions may seem like quaint folklore, they are a troubling example of the long history of blaming mothers’ behavior during pregnancy for their children’s differences and disabilities. As Latin was for centuries the language of science and medicine, the most common medical term for a birthmark was naevus maternus, or “mother’s mark.” In contemporary European languages, too, the very words for birthmarks blame them on mothers and their desires. In German, a birthmark is ein Muttermal, “a mother’s mark.” In Italian, it is una voglia, “a desire,” and a strawberry birthmark is una voglia di fragola – “a desire for strawberries.” Today, many researchers think that birthmarks originate with a cell mutation in the vascular system during fetal development. Yet in many respects, birthmarks remain mysterious. The theory of maternal impression proved long-lived in part because people sought a simple – if ultimately harmful – explanatory framework to make sense of medical conditions whose causes they did not understand. Where causation was unclear, ordinary people and medical experts alike defaulted to blaming mothers, their actions during pregnancy, and their runaway imaginations.

Ancient Mediterranean writers wrote about the powerful influence of pregnant women over their fetuses. In the first century CE, the Roman author Pliny the Elder wrote that pregnant women’s diet, “[their] gait in walking,” and their “recollections of sights and sounds and actual sense-impressions” all influenced the appearance and health of their children. Pliny’s assertions likely reflected popular beliefs in the ancient world. Medieval European writers later cited ancient authorities like Pliny when discussing birthmarks, for which they also blamed mothers.

The belief that birthmarks resulted from maternal cravings, especially thwarted desires to eat fruit, circulated widely in premodern culture. European Christians believed that just as Eve brought sin into the world through her unquenchable desire for forbidden fruit, a pregnant woman who uncontrollably desired fruit might impress its image onto her unborn child. One male writer in late-fifteenth-century France satirized women who declared that pregnant women should fulfill their cravings to avoid marking their fetuses with birthmarks that resembled strawberries, cherries, or red wine. The fictional Frenchwomen turned maternal impression into a boon for pregnant women, suggesting that there could be dire consequences if they were not brought the food they craved.^[1]

In the early modern era, philosophers now associated with the Enlightenment, such as Voltaire and Descartes, confidently wrote about how pregnant women’s imaginations shaped their fetuses.^[2] Increased literacy among women in Europe and its colonies meant that more women read and wrote about maternal impression, too. The author of The Midwives’ Book (1671), usually identified as English midwife Jane Sharp, wrote:

Sometimes the mother is frighted or conceives wonders, or longs strangely for things not to be had, and the child is markt accordingly by it… Since the child takes part of the mother’s life whilst he is in the womb, as the fruit doth of the tree, whatsoever moves the faculties of the mother’s soul may do the like in the child… so Strawberries or Mulberries or the like be fashioned upon them.^[3]

“Man-midwives,” who increasingly began delivering babies in the eighteenth century, also urged women to regulate their minds to avoid having negative influences on their offspring. Scottish man-midwife John Maubray blamed disabilities and facial differences on “the imagination of the mother while she either conceives such shapeless phantasies in her mind, or while she frequently and intently fixes her eyes upon such deform’d persons or disagreeable objects.” If a pregnant woman was startled by an animal or if “an apple, pear, plum, [or] cherry fall upon any part of her body,” he warned, “the mark of the thing” would be “instantly imprinted” on her fetus. If she touched her face in fright, she should “move her hand to some more remote, private, or convenient place of the body” so the birthmark would be “averted or at least stamped upon the other part touch’d.” Because facial birthmarks were more visible and stigmatizing, it was up to the pregnant woman to try to relocate her child’s birthmark elsewhere!^[4]

The eighteenth century saw a series of debates over maternal impression in Europe, with some skeptical physicians challenging the widespread belief that mothers marked their unborn children in the womb while other medical writers continued to accept the theory. In his 1714 treatise on skin diseases, English physician Daniel Turner inadvertently provided a prime example of how maternal impression placed blame on women. He described how he had admonished his pregnant “kinswoman” for wearing beauty mark patches, a popular fashion accessory, warning her she would mark her future child with a “great black spot” on its face. His words created an “apprehension” in the woman’s mind, he noted. In his book, Turner blamed her actions during pregnancy for the facial birthmark with which her daughter was eventually born.^[5] In a response to Turner’s 1714 treatise, physician James Augustus Blondel criticized maternal impression as “a vulgar error.” He called it “scandalous and provoking” to suppose that tender and loving mothers could “breed monsters by the wantonness of their imagination.” Turner and Blondel sparred for over a decade in a pamphlet war, which partly weakened the theory.^[6]

Yet belief in the destructive power of pregnant women’s imaginations persisted, particularly in the United States.^[7] In the 1890s, U.S. physicians heatedly debated the theory of maternal impression in medical journals. “When we see a child upon whose person there is a naevus bearing some resemblance to a fruit or a flower, which the mother tells us she had longed for during her pregnancy, we may doubt,” acknowledged one physician. Yet, he wrote, “I myself have seen what the mothers have told me were dried peaches, strawberries, raspberries, port-wine stains, and a variety of other objects.”^[8] Women clearly sought explanations for their children’s birthmarks through beliefs about maternal impression and shared them with doctors. Physicians, in turn, contributed to their fears. “I, for one, never fail to warn my pregnant patients to be careful what they look at,” one doctor wrote ominously.^[9]

During the Progressive Era, some Americans blended the theory of maternal impression with the dangerous science of eugenics, whose advocates sought to encourage the birth of “fitter” children and stem the reproduction of “unfit” people.^[10] “The mother is the architect of her child,” declared eugenicist Thomas W. Shannon in Heredity Explained (1913). He wrote that birthmarks and birth defects could be prevented if a pregnant woman kept her thoughts clear and untroubled.^[11] C.J. Bayer, author of Maternal Impressions (1897), surely terrified his readers by telling them that “the mind of a mother, by a mental operation” had “disarranged the atoms of flesh and bone” in many a child, causing “so-called birthmarks” and “human monstrosities.” For Bayer, “the blind, the deaf, and the malformed” and “the feebleminded” were all “ill-born” due to negligent mothers who failed to regulate their minds.^[12]

A myth, once lodged in our cultural imagination, is difficult to dislodge. Only gradually in the mid-twentieth century did maternal impression theory begin to fall into disrepute in the U.S.. Maternity guides refuted the idea that pregnant women’s imaginations could mark their fetuses, while lamenting that it remained widespread.^[13] Yet misinformation about birthmarks continues to circulate today. “Birthmark meaning” and “birthmark spiritual meaning” are among the most popular Google search terms related to birthmarks. People still seek to assign some greater meaning to birthmarks. Similarly, a recent medical textbook about treating infants with birthmarks advises physicians to make a special effort when talking with the child’s family “to dispel blame and the preconceived notion that the mother’s behavior or thoughts during pregnancy could have caused” the birthmark.^[14] Myths about birthmarks have proven particularly persistent because we still do not fully understand their causes.

Wherever medical uncertainty and complexity exist, people demonstrate a dangerous tendency to look for simplistic answers and scapegoat mothers. In September 2025, Robert F. Kennedy, Jr, and Donald Trump held a press conference to announce that fetal and early childhood exposure to acetaminophen, the active ingredient in Tylenol, causes autism. Yet there is no evidence of a direct causal link between acetaminophen and autism. Decades of research have instead linked autism to over a hundred different genes. Moreover, as medical professionals quickly clarified, Tylenol is one of very few pain relievers approved for pregnant women to use and it reduces fevers, which can be dangerous if left untreated. There is no magic bullet for preventing autism and no reason to increase the anxieties of pregnant women or parents.

Myths of maternal responsibility have historically caused people to blame mothers, and they have also led mothers to blame themselves. As we have seen, medical practitioners who wrote about birthmarks used their patients’ stories as evidence of the theory of maternal impression. Sadly, the women who provided these stories to doctors had likely searched their memories for the triggering incident, the persistent craving, or the intrusive thought that led them to “mark” their child. Searching for answers, they interpreted their children’s differences using the widespread but baseless theory of maternal impression. Their stories show all too clearly the harms caused by myths of maternal responsibility.

Notes

1. Theresa Vaughan, Women, Food, and Diet in the Middle Ages: Balancing the Humors (Amsterdam University Press, 2020), 81-6. ↑
2. Rebecca Wilkin, “Essaying the Mechanical Hypothesis: Descartes, La Forge, and Malebranche on the Formation of Birthmarks,” Early Science and Medicine 13, no. 6 (2008): 533-67. ↑
3. Jane Sharp, The Midwives’ Book (London, 1671), 111-122. ↑
4. John Maubray, The Female Physician (London, 1724), 62-9. ↑
5. Daniel Turner, De Morbis Cutaneis: A Treatise of Diseases Incident to the Skin (London, 1723), 155-186. ↑
6. Julia Epstein, “The Pregnant Imagination, Women’s Bodies, and Fetal Rights,” in Inventing Maternity: Politics, Science, and Literature, 1650-1865 (University Press of Kentucky, 1999), 111-137. ↑
7. For the longevity of maternal impression in the U.S., see Karen Weingarten, “From Maternal Impressions to Eugenics: Pregnancy and Inheritance in the Nineteenth-Century U.S.,” Journal of Medical Humanities 43 (2022): 303-317; Miriam Rich, “Conceiving Monsters: Women, Knowledge, and Anomalous Births in the Nineteenth-Century United States,” Bulletin of the History of Medicine 99, no. 2 (2025): 316-346. ↑
8. C.H. Maston, “Maternal Impressions,” Medical News, April 2, 1898. ↑
9. H.B. Lee, “Maternal Impressions,” Medical Record, October 24, 1891. ↑
10. Weingarten, “From Maternal Impression to Eugenics.” ↑
11. Thomas W. Shannon, Heredity Explained (Marietta, OH, 1913), 104-116. ↑
12. C.J. Bayer, Maternal Impressions (Winona, MN, 1897), 12-15, 140-7. ↑
13. See, for example, Arthur Dean, “Your Boy and Girl: Common Myths Blasted,” Pasadena Star-News, February 1, 1933. ↑
14. John Mulliken and Joyce Bischoff, “Pathogenesis of Infantile Hemangioma,” in Mulliken and Young’s Vascular Anomalies, 43-67. ↑

 

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Feature image caption: The midwives book. Or the whole art of midwifery discovered. by Jane Sharp. (Wellcome Collection).