Medieval Europe was sparsely populated; life expectancy was low by modern standards, with rates of infant mortality suggested at around 25% during the first year of life and half as many again dying before the child’s fifth birthday. If a person successfully survived childhood they could reasonably expect to live until their mid-forties, if they managed to avoid war and the dangers of childbirth. Those were big ifs, and they made the production of large families a necessity both in terms of continuity of line, title or land for those with assets to pass on (where success meant succession), and in providing additional hands to boost the family economy for others. With procreation taking on such importance – and being surrounded by such mystery – in this world, it was no wonder that so many beliefs and practices existed to encourage pregnancy.

Ancient doctors had long recommended that men eat fennel to increase their fertility, while women were encouraged to try chestnuts, pine nuts, leeks, asparagus and almonds to help them conceive. Many young couples started their marriages drinking a special soup or spiced wine on their wedding night to encourage them to conceive a child quickly. Common practice was for women to remain prone with their legs crossed after sex or massaging their belly as a way of increasing the chance of becoming pregnant.

The disaster that was infertility was often, perhaps unsurprisingly, blamed on the woman. However, the 12th century medical compendium Trotula, for example, noted that conception could be impeded “as much by the fault of the man as by the fault of the woman”. Pilgrimages, prayers, taking holy waters and making votive offerings to various saints (such as St Anne, patron saint of the infertile) were often recommended as cures to lift the curse of childlessness. Trotula also suggested that women test the temperament of her womb to find if it was too hot or too cold, and then treat herself with herbs that encourage the opposite effect. If she is hot should use “marsh mallows, violets, and roses in water” to cool her body; those too cold should apply the warming herbs “clove, spikenard, calamite storax, and nutmeg” instead.

Other medieval remedies suggested women should drink the blood or urine of pregnant animals as an aid to conception or use mandrake root, a remedy that was long established due to its appearance in the Bible, where it helps Rachel to conceive Jacob. Following the doctrine of signatures – where plants that resembled a body part could be used to cure that part – the mandrake appeared very powerful owing to its human-like appearance. It could therefore, the theory went, bring control over the entire body, inducing love and bringing about conception. Such was the demand for this powerful herb, that it was not unknown for fraudsters to sell counterfeited mandrake to the unwary.

The Early Modern world also viewed the idea of birth control as a means of driving up rates of fertility rather than the more recent association with controlling it at relatively low levels. Most wives at this time bore a child within the first two years of marriage, and couples had available to them a vast traditional lore that promised to encourage conception and offered as much in the way of reassurance as it did in medical knowledge. It is difficult at this time to separate medicine and what we might think of as magic, some of which continued despite being forbidden by the Church. Herbs were supposed to be gathered at certain times or while uttering specific incantations or charms to ensure their potency, for example.

Infertility could sometimes be attributed to spells, witchcraft and malign enchantments at this time; such was the fear of this that Parliament passed three acts against witchcraft being used to blight fertility (in 1542, 1563 and 1604). William Drage, a physician and apothecary from Hertfordshire, wrote in 1665 that, “Witches use certain words, which they mumble, and tie a knot many wayes, and sometimes hinder copulation.” Witchcraft could therefore be offered as a way to explain infertility when no other physical reason could be identified. The Church offered prayer and fasting as the sanctioned response to such supernatural attacks; many physicians preferred charms and aphrodisiacs as cures. Theophile Bonet, a doctor in Geneva, noted, “I myself have restored some bewitched and tied up in this manner by Aphrodisiacks alone, particularly by the stimulating… Chocolad.”

The noted herbalist Nicholas Culpeper produced a Directory for Midwives in 1656 that promoted both approaches that we would recognise now for women who wanted to conceive (good diet and exercise), as well as those we wouldn’t, such as wearing amulets of lodestone, eating ‘fruitful’ creatures such as crabs, lobsters and prawns, and trying potions made from the dried wombs of hares and the brains of sparrows. Another 17th century author, Katherine Boyle, suggested women walk in the shadow of “a strong and lusty fruitful woman… so treading will attract the strength and fruitfulness of the other.” Louise Bourgeois, midwife to the Queen of France, advised women to use vaginal irrigations of chamomile, mallow, marjoram and catmint boiled in three pints of white wine to help them get pregnant.

A passage in Samuel Pepys’ diary from July 1664 records his conversation with a group of women over dinner as to how he and his wife Elizabeth might go about having a child after several years of marriage with no pregnancy. The women “freely and merrily” gave various pieces of advice to the couple, including eating no late suppers, drinking the juice of sage, Elizabeth not to tie her corset too tightly, not hugging “too hard or too much”, and to lie in bed with their feet raised above the head. Sadly, this advice didn’t work for the Pepys family and the couple remained without the child they badly wanted. The diary does show us that Samuel didn’t just consider the apparent infertility to be just his wife’s problem; he accepted that he may also be to blame, and in asking for advice in this way, tried to remedy the problem.

Many sources at this time also noted the importance of the woman’s pleasure to procreation, which is in stark contrast to the prudishness of later centuries. Other authors of the period were less sympathetic and went in more for body-shaming of women who struggled to conceive, be they too fat, too thin, had a weak womb or if they were a “foolish and uncomely shape” as physician Philip Barrough put it. In other words, women not of the curvy, busty form that was attractive to men.

By the 1800s, infertility was beginning to be seen as a mechanical rather than a moral issue, and the advice to women on how to promote conception likewise changed. In 1898, prominent Berlin physician Karl Gerson wrote a journal article stating that, “violent movements of the body can cause a shift in the position and a loosening of the uterus as well as prolapse and bleeding, with resulting sterility, thus defeating a woman’s true purpose in life, ie, the bringing forth of strong children”. The 19th century woman was therefore seen as a delicate creature who should avoid any vigorous physical activity – including singing – if she wanted to successfully become pregnant.

Popular traditions still held sway in some areas, despite the advancement of scientific knowledge, however. Women could variably be told to rub their stomachs, strike bells or avoid urinating outside during a full moon as ways of avoiding infertility. Hazels, long a symbol of fertility, were still promoted to young couples as an encouragement to having children and many customs of using hazel branches or nuts at weddings persisted. In Devon, for example, brides were traditionally given a gift of hazelnuts as late as the 19th century.

With an improvement in agricultural production and public health that started in the mid-eighteenth century, more children started to survive into adulthood, especially after 1850. Whereas women had previously had average fertility rates of at least five children each, levels started to drop – and continued to drop as children became less able to contribute financially to families, and women began to have more freedom and choice. The latest figures in the UK put the fertility level at just 1.83 children per women, although this doesn’t stop many new folk beliefs and superstitions about conception from appearing and circulating – such as drinking grapefruit juice, chanting fertility mantras or applying to adopt a child.