Medieval family planning: meet the strong-willed women who redefined motherhood in the Middle Ages

In the Middle Ages, the bearing and raising of children defined women’s lives. But as Elinor Cleghorn explains, there were women who had other ideas and boldly challenged attitudes towards motherhood

A Renaissance-style painting showing a woman in red and blue clothing with a patterned gold head covering nursing a curly‑haired child against a geometric patterned background

Published: April 19, 2026 at 12:30 PM

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In the winter of 841, a Frankish noblewoman named Dhuoda decided to compose a book of life advice for William, her eldest child. Since 824, when she married, Dhuoda had been living in Uzès, a town in southern France. Her husband, Bernard of Septimania, was a duke and military guard with family ties to the ruling dynasty of the first Carolingian emperor, Charlemagne. Almost two and a half years after their marriage, they welcomed their “most dearly desired first-born son”. As Dhuoda began writing to William, she pictured how he would hold her book when it was finished, how he would touch and turn its pages.

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Fifteen years earlier, William had issued “forth out of [her body] into the world”. Now, as he was leaving childhood behind, the lessons issued from her hand to his, from her body to his, would guide him towards adulthood. Dhuoda named her book Liber Manualis, Latin for handbook – literally translated as ‘hand-held book’ – and she hoped William would keep it with him always.

As well as a collection of advice about how he should serve God, live virtuously, overcome hardships and be an honourable man, the Liber Manualis was a channel through which she hoped they would remain connected. For Dhuoda would not be there in person to care for William as he grew up.

The Carolingian empire, as Dhuoda noted, was “in the midst of much agitation and discord”. Charles the Bald, son of Emperor Louis the Pious, and his half-brothers had been embroiled in civil wars over lands and succession for years. In June 841, after Charles won a bloody battle, Bernard, who fought against him, appeased Charles by offering his son William as vassal. Back in the spring of 841, Dhuoda had given birth to their second child, a boy. Bernard was a contentious figure with many enemies so, for his newborn son’s protection, he had him removed from his family home and taken to Aquitaine.

A medieval illuminated manuscript shows a veiled religious woman with a halo seated and writing in a book. She wears blue and brown robes against a gold background, with decorative blue-and-white border patterns on the left.

A 13th-century depiction of Hildegard of Bingen. Though she never had children of her own, the German abbess took on the role of mother to her spiritual community (Image by Topfoto)

Dhuoda, under Bernard’s orders, remained at home in Uzès. She was lonely and fearful for her children, but there was nothing she could do. Bernard, as father and patriarch, determined the fates of his sons. Dhuoda, as a woman, a mother, had no such right. Composing her handbook, which she hoped William would show to his younger brother one day, was a way for Dhuoda to process her grief by mothering from afar. “I am somewhat ill at ease and eager to be useful to you,” she explained as her handbook began. Through the act of writing, she was sustaining her bond with the children she had birthed and nurtured. “Even though I am absent in body, this little book will be present,” she wrote.

Little is known about Dhuoda’s life other than the details she gives in her handbook. But like so many medieval women, her existence was defined by bearing and raising children. As a woman of noble birth who married into aristocracy, Dhuoda’s principal duty was to provide her husband with heirs. But, regardless of class or circumstance, womanhood in medieval Europe was synonymous with motherhood. Carrying, birthing and caring for children was viewed as a woman’s natural purpose. By virtue of the female body’s reproductive biology, mothering was assumed to be irrefutably inscribed into a woman’s being. Marrying a man and bearing his children was often the only way for women to ensure their safety and security. In addition, at least for those who were married, becoming a mother garnered respect, both from women’s families and wider society.

A perilous undertaking

But while motherhood did afford many women status and stability, it could leave them vulnerable. Children were assumed to be the legal property of their fathers, and mothers such as Dhuoda had few parental rights. To become a mother in the first place, women also had to navigate the dangers of pregnancy and birth. Pregnancy losses and stillbirths were sadly commonplace, and 15–30 per cent of babies died before their first birthdays. Childbirth was a leading cause of women’s deaths.

Much of what we know about the experiences of medieval mothers is gleaned from records of childbirth rituals, medical texts detailing midwifery practices, and even in accounts of life-saving miracles that reportedly happened during dangerous births after a would-be mother or her caregivers prayed to a saint for protection. Of course, medieval motherhood went beyond giving birth. But there are few sources available today that reveal what caring for and raising children, through infancy and beyond, felt like and meant to women themselves. Dhuoda’s Liber Manualis, intimately addressed in her first-person voice to her beloved son, is one of the only surviving texts from the early Middle Ages to describe the duties of mothering and the emotions of motherhood in a woman’s own words.

As well as their many domestic duties running households and tending to their families, mothers were recognised in medieval culture as being responsible for nurturing their children’s souls and spirits. For Dhuoda, the responsibility she held for guiding William’s faith was sacred, and she was determined to do her duty to him regardless of the distance between them. Dhuoda was educated and literate, and she wove her knowledge of scripture, Christian doctrine, natural science and ancient philosophy into her lessons.

Medieval women were expected to remain modest, and Dhuoda admonished her thoughts as those of an “unworthy woman”, a “frail vessel” and a “feeble... shadow”. But she was steadfast in her belief that, as a loving mother, no one was better qualified to teach her child how to become a good man. “My son, you will have learned doctors to teach you,” she wrote, at the end of the first chapter of Liber Manualis. “[But] they are not of equal status with me, nor do they have a heart more ardent than I, your mother, have for you.”

Dhuoda saw herself as “twice a mother to [William], both in soul and in body”. Mothers’ ability to serve as their children’s moral and religious guardians was certainly related to their intimate physical connection. Parallels were drawn between the bodily nourishment a mother provided during pregnancy and while breastfeeding, and the spiritual nourishment of her tutelage and guidance. But while women were respected for creating and sustaining new lives, their reproductive bodies were still believed to be steeped in shame.

The Bible decreed that Eve, the first woman, was responsible for unleashing sin into the world. To atone for her wrongdoings God commanded that all women suffer in childbearing and maternity. Women existed to ‘go forth and multiply’, but the agonies they endured while doing so were punishments for their inherent sinfulness. Through the model of Mary, motherhood become associated with salvation. Yet Mary was exceptional because, unlike all other mothers, she became pregnant and gave birth without any of the corruptions of sex, blood or pain.

Spiritual motherhood

The highest state of womanhood, according to medieval clerics, was achieved not by biological mothers, but by those who committed to lifelong ‘virginity’ and devoted themselves to God as nuns and abbesses. The religious culture of the Middle Ages denigrated the physical processes of childbearing and held biological mothers to strict moral standards. But, by elevating the significance of motherhood beyond the body, it also enabled women to be mothers in ways that were not confined to marriage or tethered to domesticity. By adopting the role of spiritual mothers, some medieval women gained rare opportunities to lead, think, create and write.

Three centuries after Dhuoda wrote her handbook, Hildegard, a German abbess of the Benedictine order, established a new women’s monastery, the Rupertsberg, on top of a hill near the town of Bingen in the Rhineland. Hildegard was born in 1098 as the youngest of 10 children. She was tithed to the church by her noble parents. Aged just 14, she became a nun and retreated into a cloistered cell in the Disibodenberg monastery in Germany’s Rhineland-Palatinate region, which later expanded into a convent. In 1136, she was appointed magistra, or mother superior, at Disibodenberg, and 14 years later she moved with the nuns over whom she presided to the Rupertsberg. Hildegard’s life was full of hardships and privations, but she was devoted to guiding and teaching her spiritual family. “I exercised the care of my daughters in all things necessary for their bodies and souls,” she wrote.

An old woodcut-style illustration showing a woman in labour seated in a small room, supported by one woman standing behind her while another kneels in front as a midwife. All three wear early modern European clothing.

A medieval woodcut shows a mother-to-be on an obstetrical chair. Hildegard of Bingen celebrated women’s role in childbearing and motherhood (Image by Wellcome Images)

In her work as the primary caregiver of her community, Hildegard showed how the strongest maternal bonds could be forged beyond biology. As she guided her daughters in prayer and taught them scripture, she also showed that the work of mothering was as much about the cultivation of minds as the nurturance of bodies.

Hildegard claimed to have experienced visions from God since childhood, but she kept them secret for fear of being branded a heretic. When she was 42 and suffering with illness, she was called by a “voice from heaven” to reveal what she had seen and heard.

Alongside running her monastery and tending to her daughters in spirit, Hildegard began to write about her visions. The year after she moved to the Rupertsberg she completed Scivias, the first of three illustrated volumes of her theological insights, and soon she became a prolific composer of hymns, poems and music. It was also at the Rupertsberg that Hildegard wrote two medical treatises. Causes and Cures dealt with the creation of the world and the human body’s place within it, while Physica described the healing properties of plants, herbs, animal substances and earthly elements.

In medieval Europe, monasteries often provided healthcare to people in need. At Disibodenberg, Hildegard tended to medicinal plants in the gardens and assisted in the infirmary. In the library, she immersed herself in Latin translations of Greek, Roman and Arabic medical and botanical discourse. Although she had never experienced biological motherhood, her role as a caregiver to women’s bodies and souls inspired her to think compassionately about their physical experiences as child-bearers and infant nurturers.

While she believed that women who didn’t devote themselves to God were created to be subject to men and to mother their children, she also countered some of the more misogynistic ideas promoted by Christian doctrine, and concerned with women’s reproductive, maternal and sexual bodies. She wrote of Eve as the “first mother” rather than a tempted deceiver. She described menstrual blood as the “vital force” through which women brought forth offspring as trees bear fruit. She honoured the work women’s bodies did to sustain the growth of a foetus, give birth and produce milk to nourish infants. She even celebrated women’s sexual pleasure and wrote one of the earliest descriptions of the female orgasm.

The monastic sphere was one of the few places where medieval women were afforded the time, space and resources to cultivate their own communal, creative and intellectual lives. But Hildegard’s extraordinary contributions to religious culture, medicine, science and art, which she achieved because of her role as a maternal caregiver, mark her out as a truly path-breaking medieval mother.

The privileged few

The breadth of education Hildegard received as a nun and abbess was only available to a privileged few. Most medieval women received no education beyond domestic skills, basic literacy, and religious instruction when they were young, and many were not granted opportunities to pursue lives of the mind as they grew up.

Once they married and became mothers, the burden of their household and care-giving duties rarely allowed them to read and study. Among the vast numbers of women who needed to provide for their children and families, it was rarer still for mothers to sustain their livings as writers and thinkers. But after being widowed in 1389 and becoming the sole provider for her children, Christine de Pizan, an Italian-French writer, found a way to do just that.

A medieval illustration showing a robed figure in a tall white headdress gesturing toward an armoured person holding a staff. Between them is a table with an open book, a closed red book, and a small writing box, set in a room with a lattice window and decorative arches.

The writer Christine de Pizan – shown (left) in a 15th-century manuscript illumination – was a source of inspiration for mothers across France (Image by Topfoto)

Born in Venice in 1364, Christine wanted to pursue learning from childhood. She was encouraged in this by her father, a physician and astrologer who served in the royal court of Charles V in France. When she was 15, she was married to Etienne du Castel, a secretary and notary to Charles V, and they went on to have three children. After Etienne died of plague, Christine faced financial strife because of complications with the sales of her late husband’s estate. Instead of opting to remarry to ensure her and her family’s security, she decided to support her children, along with her own mother and a niece for whom she was also responsible, on her own.

She began her career by writing lyric poems, and soon she was composing ballads and poetic narratives for wealthy patrons in the royal court. In the 10 years after her husband’s death, Christine became France’s first professional woman of letters. As a working mother, she studied independently and wrote prolifically. In 1405, she wrote the book that has assured her legacy as one of history’s most important proto-feminist thinkers. The Book of the City of Ladies celebrated notable historical women and countered centuries of ingrained misogynistic arguments claiming women were weak, incapable of thought, prone to vice and dependent on men.

That same year, Christine also wrote The Treasure of the City of Ladies, in which she advised women of all social classes and circumstances – from peasants to royalty – on how to become fulfilled, resilient and useful in their roles as wives and as mothers. Christine wished for the text to be read and shared widely by “valiant ladies and women of authority” the world over. She achieved this dream decades after her death when the advent of print meant her books were published and distributed widely.

During her lifetime Christine gained unprecedented recognition and her influence continued for centuries. For some mothers, her work also became a guiding light. Anne de Beaujeu, Princess of France and elder daughter of Louis XI, owned a copy of Christine’s Treasure, and it inspired her to write a book of lessons for her own daughter Suzanne, who was born in 1491. About 25 years earlier, The Book of the City of Ladies graced the birthing chamber of Elizabeth of York, Duchess of Suffolk, at the Oxfordshire home of her mother-in-law, Alice Chaucer. This was because Chaucer made sure the room where Elizabeth would give birth to her third child contained books that reflected her and Elizabeth’s maternal expertise as teachers and guides.

Women lost to history

Though the majority of medieval women were mothers, few had the ability or opportunity to reflect on their mothering lives in writing. The voices of the many who lacked the privilege of education and literacy are lost to history. But, through the writings that survive, we can see that motherhood was then as nuanced and multifaceted as it is today. Dhuoda, Hildegard of Bingen and Christine de Pizan represent the breadth of those meanings and experiences. Even in their socially and biologically ordained roles, women still found ways to take control of their lives. And they achieved this in a male-dominated world where women, as mothers, often had little freedom to determine their destinies.

Dhuoda continued to be a mother despite being separated from her children. In doing so, she left a moving, curious and revealing account of her relationship with her son – and with herself. Hildegard’s awesome achievements showed what was possible when the work of mothering transcended biology. Christine proved that motherhood was no impediment to women becoming providers and independent thinkers. All three of these women created their own concepts of motherhood. Despite social, financial and ideological barriers, they mothered on their own terms.

Elinor Cleghorn is a feminist cultural historian, writer and researcher. Her latest book is A Woman’s Work: Reclaiming the Radical History of Mothering (W&N, 2026)

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This article was first published in the April 2026 issue of HistoryExtra Magazine

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