‘The One Who Holds the Heart’: a history of midwifery in Cyprus

By Iole Damaskinos–Vernhes

For years the figures have told the same tale: Cyprus’ caesarean rates are far too high, the highest in Europe.

The average caesarean rate in the EU is 27 per cent. In Cyprus, it is 58.5 per cent in the private sector and slightly lower at 55.3 per cent in the public sector. In close to 40 per cent of those cases, the mother chose to have a c-section.

All of which, I hope, makes my research both more poignant and more necessary.

Over the summer I had the pleasure of working on a project with the wonderful Eleni Hadjigeorgiou, professor of midwifery at the Cyprus University of Technology, drafting the beginnings of a written history of midwifery in Cyprus.

Terracotta childbirth statuettes for the 6th century BC in Lapithos

My research took me on a wild ride from the Bronze Age all the way into recent times. From the luscious ‘Lady of Lemba’ to the amazing terracotta birthing depictions from ancient Lapithos (both housed in the Cyprus Museum), I met the ancient protectresses of childbirth: Hero, Artemis, Leto, Eleftheia.

I learned that Ottoman practices included placing a nazar (ammatopetra) on the newborn as we still do in Cyprus today. I read that Jewish, Muslim and Greek midwifery all included the idea of ‘posarantoma’, the 40-day period of post-partum confinement, rest and recuperation for mother and infant.

I found out that Turkish Cypriot mammouthes (midwives) used to put a pinch of salt into the baptismal font (a practice that seems to link back to post-partum rites from Hippocratic times).

I read in horrified fascination about Ignaz Semmelweis, the tragic Hungarian obstetrician, who in the mid-1800s already held the key to ridding Europe of childbed fever – for obstetricians to wash their hands – but no one in the entrenched medical establishment believed him.

The Lady of Lemba

I found stories of Cypriot midwives, trained by the British colonial administration in the 1950s and 60s (midwifery was the first formal female profession in the Cypriot civil service – even before nursing).

And lastly, I had the delightful experience of interviewing one such midwife, Antigoni ‘Pyrgou’, a sprightly 94-year-old from Pyrgos Tyllirias (as well as her husband, who couldn’t help putting in his 2 cents worth, beaming with pride about his wife’s accomplishments).

The more I researched and spoke with midwives the more I felt in awe of this ancient profession, at once simple and profound, which for centuries was such a commonplace aspect of our lives as women.

I was touched by the raw intimacy of the work itself; by its universality across cultures and time; by how crucial birthing support has been to society, and how inextricable it is from women’s rights and empowerment.

I was also struck by how recent the phenomenon of hospitalised birthing actually is. Until the upheaval of 1974 there were still community midwives travelling and working around Cyprus. Birthing, for so very long, has been a domestic, exclusively female affair.

My summer investigations barely scratched the surface and much remains to be discovered, understood and recorded. The work of piecing together, as much as possible, the Cypriot story of birthing, is important for all women living in Cyprus today. If we can search out, safeguard, and pass on this knowledge, we can recover a central part of our herstory before it gets lost.

To begin the process, I offer here a compilation of ‘snippets’ of traditional Cypriot midwifery practices. I encourage readers to approach them like looking through a pile of old photographs – bearing in mind that some of the details may have faded and context may be missing. These ‘snapshots’ are not in any particular order; they range from amusing to puzzling, delightful to profound.

Since ancient times in Cyprus, as elsewhere in the world, mammouthes used a birthing stool (sellin) to help women birth in an upright position. The birthing woman could bear down using the armrests and the midwife would be ready to catch the baby below her. The midwife would massage warm olive oil or honey wax onto the vaginal walls and perineum to ease the birth.

The midwife was often accompanied by a so-called karkiovastousa or ‘one who holds the heart’.  She was usually an apprentice whose job was to give courage to the birthing woman, holding or supporting her from behind. (This exact configuration can be seen in the ancient clay depictions from Lapithos).

According to records found at the dispensary of Machairas monastery, midwives associated with the monastery and prepared (or gave instruction for the preparation of) treatments for infertility among other things. Particular use was made of the placenta from a sow, which would be dried and ground into a powder. Women would be instructed to drink a broth made of this powder at the completion of their monthly menses to increase chances of conception.

Ignaz Semmelweiss

Folkloric tradition held that a pregnant woman should be promptly given whatever she wanted in terms of food or drink, to avoid miscarrying. It was said that if a pregnant woman were denied the food she craved, a birthmark, in the shape of that food, would appear on the newborn.

In the case of dystocia, or slow labour progression, the woman would be lifted up and made to walk with the help of other women. Folk wisdom maintained that such walking would help the baby to ‘walk out of the womb’.

In the event of a stalled labour, the woman would be held by her hands and feet and rocked back and forth to ‘dislodge’ the baby. Another approach was that the midwife would call in the husband (men were usually banished from the birthing event). The husband would be asked to stand astride his wife and repeat in front of her: ‘I put you in and I will get you out!’ ‘Egio s’evala tzie’gio enna se vkalo!’

At the start of birth, the custom was to request women in the family to unlock every door and cupboard in the house to invite an easy delivery.

Cypriot women traditionally would work in the fields, cook, or finish whatever task they were engaged in during the early stages of their labour. As labour progressed they would bathe, if possible, and only then call for the midwife and confine themselves for birthing.

After birth, midwives would often tie the woman’s waist with a special girdle so as ‘not to leave a belly’. Sometimes a red thread would be tied around the woman’s waist. The mother’s head would be dressed with a red headscarf (tsemberi). A small charm against the evil eye, along with a medallion depicting Saints Constantine and Helen, would be attached to the newborn.

On the fifth or seventh day post partum, the midwife would raise the woman up and ceremonially walk her around the house together with her infant in the shape of a cross, blessing the space with a sanctified candle.

Midwives were paid very little. Often their reward was in the form of food that the family farm produced, such as a chicken, cheese or sausages. In some regions the midwife would cut the umbilical cord by grinding it with a coin and this coin would be given to the midwife to keep.

New mothers were encouraged to drink wine for the first few days following delivery. It was believed that this would strengthen the woman, as well as promote lactation.

In some mountain villages, during post-partum visits, the midwife would place hot water in a big earthen pot (pythari) and encourage the new mother to sit over it covered by a sheet. Warming the woman with heated stones or tiles placed in the bed near her, was also a traditional practice for aiding recovery.

Mary the Liberator (Panayia I Eleftherotria) and Ayios Eleftherios were the patron saints of childbirth. Ancient Greek Cyprus is unique in counting Ariadne among the deities protecting women during labour.

It is clear that until relatively recent times birthing – and by extension midwifery – were recognised as acts requiring collaboration with the sacred forces of nature. Entering the birthing space a woman and her companions, both human and divine, were entering the space between this world and the other. This liminal space had to be acknowledged and respected. (In Hellenic times it was believed that newborns sleep so much because they are still travelling to fully arrive into our world of Being, from the world of non-Being).

Women were accompanied on their journey by other women who were familiar faces to the new mother. Birth was mediated through communal ritual in which the midwife officiated.

In this sense, the midwife was not merely a ‘technician’. Although part of her role was technical, (midwives performed massage, applied compresses, turned breech babies), her role extended beyond this to the woman’s primary psychological support system, at a time that was recognised as a female rite of passage – an encounter with mortality. The support offered by the midwife came from her organic position within the wider context of the woman’s life and community.

With the advent of technology and hospitalised birth one cannot help but wonder what has been lost. While foetal monitoring and the sterile protection of the hospital setting may seem to be improvements, the routine use of reclined birthing position, artificial induction and medicated pain relief, have taken the place of a deeper kind of care and reverence for the birthing process.

Our modern rituals consist of being fitted with an IV drip, having our privates shaved, being administered an enema and putting on a hospital gown. Instead of incantations for safe delivery and having our ‘hearts held’ we hear the hustle and bustle of busy hospital staff and electronic monitors. And what of our post-natal rituals of support and recovery?

In exploring the practices of the past it is, of course, important to acknowledge the context and the limited resources within which early Cypriot mammouthes worked. Yet, it is also important to suspend judgement – at least momentarily – to see if anything can be learned from the centuries’ old traditions, anything precious, in the deep, experiential knowledge of our foremothers. To sense if there is anything here that perhaps we ourselves have collectively longed for, as birthing women in hospitals and clinics across Cyprus.

Getting to know the past might help us to return to that ancient, bone-deep recognition: that entering the birthing space means crossing over a threshold. That it means crossing over into the unavoidable liminality which is female time and sacred time. And that this time demands to be honoured.


Iole Damaskinos-Vernhes is an independent writer-researcher and women’s wellness instructor. If you have any family background of midwifery in Cyprus and would like to contribute to the project of preserving this history please contact [email protected].