May 2024

Connections between birth and death in pre-colonial Mexico

The most reliable written source for our knowledge of Mexican culture, the Aztec Empire, and the Spanish conquest was written by Franciscan monk Fray Bernardino de Sahagún alongside a group of indigenous collaborators. Completed in the second half of the 16th century and known under the title General History of the Things of New Spain, the twelve bilingual volumes (Spanish-Náhuatl) not only represent a unique documentary heritage but also shape our current knowledge of birth in pre-Columbian Mexico.

Book VI sheds light on the ritual processes that accompanied a birth, the importance of a woman giving birth in Mesoamerican society in the late Postclassic period, the question in whose hands and on whose shoulders the responsibility for the success of a birth lay, and what words were addressed to mother and child. However, Book VI (Chapter XXX) also confronts its readers with the surprising notion that the time of birth was also called the «moment of death» (imiquizpan): «When it was time for labor—which is called “the hour of death [of the mother]” […]» / «oacico in imiquizpan, in iemixihuiznequi […]» (book 6, fol. 144r). While this metaphor for the noun mixihuiliztli (birth) appears to be a reference to the real danger of dying in childbirth, it associates birth and death on other levels of meaning. It is also an expression of cosmogony and corresponds to the idea that the Mexica had about the origin of new life. Through this, it is also associated with the temazcal, a type of steam bath that was used for ritual practices related to birth.

Temazcal, obstetrics and steam bath

«[…] [Y]ou now cry and call out to the mother of the gods, who is the goddess of medicine and healers, and is the mother of us all, the one called Yoalticitl, who has power and authority over the temazcales that are called xochicalli, which is the place where this goddess sees secret things, fixes whatever is unsettled inside people’s bodies, and strengthens whatever is tender and soft.» (book 6, fol. 131r).

The bath in the temazcal (metaphorically also known as the House of Flower, Xochicalli) was said to have beneficial properties before and after birth. During childbirth, a steam bath was intended to speed up the birthing process. After childbirth, the steam bath was used to promote the flow of breast milk and restore well-being and fertility. While steam baths have transcultural ritual significance, their use in obstetrics and gynecology has so far only been proven in the Mesoamerican cultural area.

The alignment of the baths with the fireplace in the east and the entrance in the south creates a symbolic link to the widespread warlike interpretation of pregnancy and birth of the Aztecs: male warriors accompany the sun from the east to the south after their death. At the zenith, the women who had died during their first pregnancy or birth take over and go to the same place in the afterlife as the male warriors. They accompany the sun on its course from the zenith to the western side (Cihuatlampa), where it plunges into the bowels of the earth, into the realm of the dead, for regeneration.

Yoalticitl, midwife of the night

Not shown in the above illustration of the Codex Florentinus is an image of the deity that was often depicted on the entrances to the temazcal. In her different aspects (each accompanied by different names) the progenitor Teteoinnan was associated in various ways with steam baths and fertility.

As Yoalticitl (midwife, healer of the night), she lingered in the steam bath and symbolized fertility and procreation. In her presence as Toci (grandmother), she refers to a fundamental Mesoamerican myth that offers a further explanation as to why the Aztecs established a conceptual link between the time of birth, the steam bath, and the time of the mother’s death: Various versions of this myth tell of the creation of the world. Teixel, the male sun, and Tetiej, the female moon, have children. Their eldest children kill their aged mother Iyom pak’lom (grandmother, midwife) in the steam bath. She enters the bath as an old woman with white hair and, with her death as the progenitor mother, lays the foundation for all further creation. The steam bath therefore has two meanings: as a tomb for the dead «grandmother» and as a kind of primordial uterus for humanity. Entering the bath meant entering «inside our mother, the one called Yoalticitl» (book 6, fol. 133r). By being confronted with a birth and entering the steam bath, an expectant mother not only begins a «mortal combat» (book 6, fol. 165v) but also simulates the death of the tribal mother, whose dying made human life possible in the first place.

According to Sahagún, after the birth has gone well, the mother is congratulated with, «Oh, lady, my granddaughter and daughter, most beloved and tender dove, and maiden! How are you? How are you feeling? You have endured a great hardship. You have performed an immense task. You have experienced great hardship. You have assisted, become the equal of, and imitated your mother, the lady Cihuacoatl Quilaztli.» (book 6, fol. 156v). Cihuacóatl Quilaztli is just another facet of Teteoinnan, the divine grandmother who met her death in the steam bath, where she now heals and helps people and is imitated by an expectant mother during childbirth by paying her «tribute of death» (book 6, fol. 152v).

The significance of the metaphor imiquizpan and the link it establishes between birth and death therefore goes beyond the mere risk of dying in childbirth. (Mortality rates for the same period in Europe speak of a maternal mortality rate of 1-2 %. There is little reason to believe that mortality in post-classical Mesoamerica was incomparably higher). The word imiquizpan becomes understandable through the martial interpretation of birth and the goddess complex Teteoinnan, to whom, according to Sahagún, a «tribute of death» was paid at birth. The ritual use of the temazcal refers to an aspect of this deity who died in the steam bath and became the tribal mother of all further life. In «her moment of death», at birth, the mother symbolically repeats the death of the tribal mother and creates new life.


Hannah Mühlparzer collaborates with the project Interpretation of Childbirth in Early Modern Spain (FWF Austrian Science Fund, P 3226-G30). She dedicated her master’s thesis to the analogy of birth and death in baroque and neo-baroque literature. The author and the project team have contributed to the Virtual Museum of Human Ecology with the temporary exhibition Cultures of birth in Early Modern Spain and Europe. The author would like to thank León García Garagarza, Stephanie Wood, Wolfram Aichinger, Sabrina Grohsebner, Fernando Sánz-Lázaro, and Laura Kisser for their feedback.


Further reading

Alcántara Rojas B. 2000. Miquizpan. El momento del parto, un momento de muerte. Prácticas alrededor del embarazo y parto entre nahuas y mayas del Posclásico. Estudios Mesoamericanos, 2, 37–48.

Digital Florentine Codex / Códice Florentino Digital, edited by Kim N. Richter and Alicia Maria Houtrouw, “Book 6: Rhetoric and Moral Philosophy”, Getty Research Institute, 2023. (The translations that are used in the text come from López Austin & García Quintana (2000) and García Garagarza (2023) and are also included in the Digital Florentine Codex alongside the transcription of the text in Spanish and Náhuatl.)

Groark KP. 1997. To Warm the Blood, to Warm the Flesh: The Role of the Steambath in Highland Maya (Tzeltal-Tzotzil) Ethnomedicine. Journal of Latin American Lore, 20 (1), 3–96.

Johansson KP. 2017. Gestación y nacimiento de Huitzilopochtli en el monte Coatépetl: Consideraciones mítico-obstétricas. Estudios de Cultura ‘Nahuatl’, 53, 7–53.

Schofield R. 1986. Did the mothers really die? Three centuries of maternal mortality in the world we have lost. In The World We Have Gained: Histories of Population and Social Structure (pp. 231–260). Basil Blackwell. 

Sullivan TD. 1966. Pregnancy, childbirth, and the deification of the women. Estudios de Cultura Náhuatl, 6, 63–95.

Wójtowicz-Wcisło M. 2023. Ritual Sweat Bath in a Cross-Cultural Perspective. Open Theology, 9(1).