Why Women in Ancient China Didn’t Give Birth on Beds
Image from The Story of Minglan
“Push, madam, push! I can see the baby’s head!” The mother-to-be lies on a bed while the midwife repeatedly lifts the thick quilt to check. Scenes like this often appear in Chinese historical dramas. But if we check medical texts, this scene is a bit of a bug: the most common childbirth posture in ancient times wasn’t lying flat on a bed, but rather half-squatting on the ground.
“As women of old time gave birth, they squatted on straw, as if preparing for death.” (古時婦人產，下地坐草，法如就死也。)
This record from a medical scholar of 5th-century China shows that childbirth was not only a matter of life and death, but also took place off the bed, in a squatting posture. Straw or animal skins spread on the ground served both to cushion the newborn and to prevent blood from soiling the house and offending the gods.
Yet childbirth is an exhausting marathon. While squatting makes it easier to push, it’s hard to maintain for hours. That’s why the delivery room needed several “waist supporters” (also called “birth watchers”). One woman would stand behind the birthing mother, supporting her under the armpits so she could lean back safely; another stood in front, ready to catch the newborn.
The term “linpen” (臨盆, literally “next to the birthing basin”) is rare in early texts; even “fenmian” (分娩, literally “fetus departing”) only became common after the 10th century. But 1,500 years ago, if someone said “baoyao” (抱腰, literally “supporting the waist”), it meant preparing to deliver the baby.
Given how painful childbirth is, why didn’t ancient women just give birth lying on soft beds?
Dr. Lee Jen-der suggested that being upright made it easier to push and helped the baby descend more quickly. Records before the 10th century also mentioned beds as high as several chi (尺, one chi ≈ 23 cm). There was even a 4th-century account of a woman attempting to induce an abortion by repeatedly throwing herself off her bed.
Considering this, it’s easy to see why giving birth on high beds wouldn’t be ideal for heavily pregnant women or their midwives. Material factors also mattered: in ancient times, life was less comfortable than today, and beds were valuable furniture — not something you’d want to ruin with blood.
Photo by Lee Jen-der
A Month-By-Month Guide to Ancient Pregnancy Foods
Childbirth wasn’t only a life-or-death matter for women; in a patriarchal society, it was also crucial for continuing the family line.
Starting from the 2nd century, medical texts began focusing explicitly on women’s reproductive health, offering guidance and taboos for pregnancy, childbirth and postpartum recovery.
Between the 5th and 7th centuries, medical knowledge about women became more organized. Based on gendered views of the body, more unified standards gradually emerged, and by the 13th century, women’s medicine had become a separate field.
For example, the famous Han physician Zhang Zhongjing (張仲景, ca. 150-219) recommended that pregnant women regularly take Danggui powder (當歸散) to enhance a smooth delivery. Doctors of the 5th century advocated taking Danshen paste (丹參膏) — made from Salvia root, ginseng, and angelica — in the seventh month of pregnancy for easy delivery.
But Northern Qi physician Xu Zhicai (徐之才, ca. 505-572) argued Danshen paste was too slippery and should only be taken at the last month of pregnancy. Tang physician Sun Simiao (孫思邈, ca. 581-682) followed Xu’s view.By the 12th century, the idea of taking such medicine in the seventh month had largely disappeared.
Xu Zhicai also offered detailed “monthly fetal nourishment formulas,” advising grains and meats to be taken during each of the pregnant months, paired with herbal remedies. In modern terms, it’s like a “monthly pregnancy meal plan” tailored to each stage of fetal development.
Alongside recommended foods, there were strict taboos. After the meridian theory was established in the 3rd century, medical books also advised acupuncture points to be avoided in different months of the pregnancy to prevent miscarriage.
Ancient Fetal Education: Avoiding Soy Sauce and Harsh Words
Many modern mothers feel pressured by advice like “eat this so your baby’s skin will be fair” or “avoid that so the pregnancy stays stable.” Ancient mothers were no different!
Medical texts recorded not just herbs and acupuncture but also what now seem like superstitions. In a pre-scientific worldview, “prescriptions” (fang 方) meant methods to ward off disease and protect life — herbal remedies, avoiding spirits and rituals alike. All aimed to safeguard mother and child.
Examples include: don’t eat soy sauce or the baby’s skin will darken; avoid ginger to prevent having a child with six fingers; want a boy? look at roosters, tigers, swords and martial displays; want a girl? wear earrings and beads.
To have a kind and upright child: don’t eat misshapen meat, don’t sit on crooked mats, avoid seeing, hearing or saying anything improper — because what the mother perceives shapes the fetus.
Surprisingly modern, isn’t it? What we call “fetal education” today had already been written into ancient medical texts over two thousand years ago.
Dr. Lee notes:
While these practices may seem “unscientific,” they reflect the Chinese concept of Qi (氣) as the foundation of the body.
People believed the universe was filled with Qi, which also animated the human body; external beauty or ugliness, goodness or evil could transmit qi into the mother’s body, affecting the child.
Patriarchal scholars even said, “If a child is born foolish or deformed, it must be traced back to the mother.” Thus, a child’s character became a judgment on the mother’s conduct. Mothers’ worries, it seems, are timeless!
Hoping for Boys- and Better Boys: Ancient Chinese Family Ideals
All these practices — protecting the fetus, nourishing it and fetal education — aimed not only at safe delivery but at having a good child: “seek pregnancy, seek a son, seek a good son” — all in one go!
This led to the most critical moment: childbirth.
Families would prepare a space in advance, either a designated corner in the house or a special birthing tent. The room’s position wasn’t random; it had to match the month’s auspicious direction. For example: “In the first lunar month, with the heavenly qi moving south, the mother faces south for great fortune.”
This system of timing and direction reflected the belief in resonance between heaven and humans, where time, space and people mutually influenced each other. Medical texts even included “birth charts” for each month, helping families plan every step.
Image from Annotations on the Mawangdui Medical Texts
Image from Wai Tai Mi Yao (外台秘要) by Wang Tao (王燾, ca. 670-755)
As labor began, midwives (waist supporters) stayed close by to comfort the mother, massage and help her relax. She could sit, lie or walk — whatever felt best. When to start pushing? Today, it’s based on cervical dilation; in ancient times, it depended on pain: only when the pain radiating to the lower back and spine was its time to squat and push.
Even a smooth labor could take over ten hours, with the mother squatting and midwives supporting her. If there weren’t enough helpers or labor was prolonged, tools were used — like cloth straps tied to beams or hanging wooden bars to help the mother pull and brace herself.
In Taiwan during the Japanese Colonial Period, dowries sometimes included a special birthing bucket; in old Hong Kong, a similar “descendants’ bucket” (a kind of chamber pot) also served as a birthing aid. Both were designed so that women could hold the brim while squatting inside during delivery.
Just Born? Quick, Hold the Baby Apart!
What happened next?
Historical dramas often show the exhausted mother saying, “Quick, let me see the baby!” But from an ancient Chinese medical view, this was wrong.
The midwife should first take the baby away and not reveal its sex immediately — so as not to disappoint the mother if it wasn’t what she hoped for. Even after delivery, the danger wasn’t over: postpartum hemorrhage, retained placenta, and other complications were deadly.
For the first three days, the mother’s life had to be closely monitored, with continued care up to seven days, and only after thirty days could she resume normal life — similar to today’s “sitting the month (坐月子),” a month-long period of rest and recovery observed after childbirth.
The “Aunties” Who Stood by the Mother’s Side
Childbirth always carries risk. In difficult births, beyond medicines, some medical texts recorded midwives performing life-saving maneuvers.
If the baby presented arm-first, which could be fatal, the midwife might push it back, massage to correct the position, and guide it out safely. Such records appear not only in Chinese texts but also in ancient Hebrew ones describing skilled midwives delivering breech twins.
Interestingly, some Chinese texts even advised writing the father’s name on the baby’s palm before repositioning — threatening the “rebellious” child into compliance!
“Male physicians tended to emphasize patriarchal symbolism, but from this record we can infer that midwives at the time may have possessed practical clinical skills to handle obstetric emergencies,” Dr. Lee explains.“Throughout the entire birthing process, there were usually no male doctors present — it was the birth attendants who actually played the most crucial role.”
Yet because medical texts were written and preserved by men, these midwives — a group of elder women and birth attendants — remained nameless in formal medical history, despite being the real practitioners who supported women through life-and-death moments.
Photo from iStock
Gentle Birth: Returning Agency to Women
Looking at ancient childbirth, the biggest difference from today is posture: why did women shift from standing or squatting to lying flat?
Dr. Lee explains:
Vertical positions were common worldwide until the rise of hospital births in the 19th century. Postpartum hemorrhage, retained placenta, and other complications were deadly.
As births moved from home to institutions, control shifted from the mother to the doctor. Women lying down made medical intervention easier. Modern medicine has saved many high-risk pregnancies, dramatically reducing maternal deaths.
But highly medicalized childbirth also distanced women from their own birthing experience, shifting it away from being centered on the mother.
Drawing on years of research into gender and medical history, Dr. Lee often reminds audiences: historically, women experienced diverse ways of being pregnant and giving birth, with midwives as partners — not just passively lying down while doctors decided everything.
But this isn’t about rejecting medicine or going back to the past; it’s about looking at history to see there are always multiple choices.
“History is like a vast database,” Dr. Lee reflects. “By exploring human experiences across different times and places, we can better reflect on our present circumstances and realize they are not the only possible way to live.”
She adds, “This concern is not just about studying the history of childbirth or women’s history — it also speaks to the deeper value and meaning of history as a field within the humanities.”
Photo from iStock
