Into the Abyss: Pregnancy, Gynecology, and Death in Late Ottoman Istanbul

For Goncagül, a single, Muslim Circassian woman living and working in late Ottoman Istanbul, pregnancy meant “the abyss into which I am collapsing.” Her last letter, written on March 6th, 1882, not only reveals her personal struggles but also speaks to the realities of state intervention in women’s bodies in nineteenth-century imperial Istanbul. Addressed to her gynecologist, an Ottoman Jewish physician named Jean Miclesco, this correspondence sheds light on interethnic relations at the time through a gendered lens.¹

Miclesco was born in 1861 to a Jewish family from Iaşi, Romania, was trained in Munich, and settled in Istanbul.¹ His memoir is a gem in Ottoman women’s history, and it is within this memoir that I came across a reproduction of Goncagül’s letter, in which she tells her story. For her first twenty-five years of life, she lived in childlike happiness with her father and sister in a seashore house in Anadolu Hisarı—until the day she met the eyes of the man who “awakened me to the suffering of living and [broke] everything: tradition, principle, serenity.”²

Once I realized that Goncagül’s letter describing her life also announced her impending death, I was left wondering: Why would a Muslim woman write her suicide letter to her Jewish gynecologist? What brought them so close to one another—like parent and child for Goncagül, and like therapist and patient for Miclesco? Could the gendered and religious differences between them have been the factors that brought them closer rather than further apart? And what does this story tell us about the boundaries of religious, gender, and class affiliation in the late Ottoman period? 

Looking back at the history of Ottoman reforms in the mid-to-late nineteenth century can point to some answers. Especially during a wave of medical reforms in the mid-1800s, the Ottoman state incentivized women to consult a new crop of specialized, often Western-trained doctors for their reproductive care, instead of traditional midwives, who were increasingly painted as ignorant, unhygienic, or superstitious.² However, most women resisted; they refused to go to newer institutions and physicians because, first and foremost, this new “professionalized” field of medicine was exclusively male-dominated. Although it was highly systematized, it deprived women of the cultural solidarity network—composed entirely of women, from midwives to neighbors—that had sustained them up to that point. Ottoman women were so averse to visiting new medical institutions that a newly opened maternity hospital was deemed a “bastard house,”³ because the only people who opted to give birth there were those who had nowhere else to go, such as sex workers and destitute women. 

Considering gynecology’s status at the time as a professional field reserved to men, and taking into account women’s reluctance to change their centuries-old healthcare preferences for being treated by other women, gynecologists and their patients existed in a sort of stalemate—but there was one loophole. In a sense, being non-Muslim was an advantage for Ottoman gynecologists in the nineteenth century. According to shari’a, or Muslim ritual law, a Muslim woman could not marry a non-Muslim man, implying, in a sense, that relations between the two groups would be inherently desexed due to their uneven hierarchy. Accordingly, a Muslim woman may have felt more secure visiting a non-Muslim specialist, at least de jure. 

These factors can explain why a Muslim woman might have preferred a Jewish gynecologist, but the question remains: Why would Goncagül address such a personal, deeply anguished farewell to her gynecologist? Considering Goncagül’s own admission of dread of pregnancy, her letter may have been a last call for help, a plea for medical assistance to put an end to her unwanted fate. She was asking Miclesco “to perform a miracle in her heart of hearts.”

When making her case to Dr. Miclesco, Goncagül drew upon themes of orphanhood and loneliness, and invoked God’s name: “I am an orphan and lonely, too; I want to live; I don’t want to die so young. Therefore, in the name of Allah, I conjure you to overcome the scruples of an honest man; heal me, and he will bless your beautiful soul and reward your good work.” These themes, common in the Ottoman tradition of petitioning the government, are combined in this plea for a physician’s help. 

Considering Goncagül’s own admission of dread of pregnancy, her letter may have been a last call for help, a plea for medical assistance to put an end to her unwanted fate. She was asking Miclesco “to perform a miracle in her heart of hearts.”

In his memoir, Dr. Miclesco includes his response to Goncagül’s letter. He describes the last time he saw her before her death, by the shrine of Abu Ayyub al-Ansari, an Islamic saint and a close companion (الصحابه, sahaba) of the Islamic prophet Muhammad: 

“ . . . a young veiled woman, bent and trembling, crying, sobbing and begging, she covered with her lips the sacred glass of the turbo of Eyoub. 

Faith, confidence, aspiration, dream . . . Poor, veiled shadow! Here, more than ever, I felt that this daughter of Allah, bathed in faith, has well-deserved human indulgence and commiseration. In this sacred land of Islam, I was seized with a deep emotion and a sincere tenderness wrapped in melancholy.

And here we are at the denouement, at the hour of the destiny which rang. This Circassian, beautiful as the rose whose name she bore, died in her blood on the night of the Kandil fête. 

The Almighty, merciful, grants his rahma to this disenchanted.”

Sacred Islamic spaces in Istanbul were familiar to Dr. Miclesco, and he understood the valence of holy occasions like the five nights of Kandil, which commemorate the conception of the Prophet Muhammad. Besides calling Goncagül “a daughter of Allah,” he directly refers to an Islamic concept—rahma—a dedicated name for the mercy of Allah.

Furthermore, he explains his reasons “for remaining deaf” to her plea by problematizing abortion within a religious framework again: “For every sin, there is mercy! Not generosity? No, not anymore;⁴ this virtue is a crime here . . . There are situations in professional life where the doctor, far from obeying his worries, doubts, and scruples, is forced to overcome the noblest human feelings.”

A mere two words in Miclesco’s response—not anymore—encapsulate the direct relationship between the criminalization of abortion and the secularization of Ottoman law after the mid-1800s. While it is not encouraged, terminating a pregnancy within the first four months has been considered a private matter under Islamic law. By the same token, in the Ottoman Empire, where Islamic law was one of the major pillars of legal culture, midwives had the freedom to assist women in ending unwanted pregnancies for many centuries. In the mid-nineteenth century, the Ottoman state’s efforts to encourage population growth shifted the focus from reproduction as a private act to a vested interest in women’s reproductive roles. One of the most forceful expressions of these pronatalist policies was the reframing of abortion as a crime that conflicted with established Islamic law, and it was this criminalization that forced Goncagül to terminate her pregnancy on her own and ended her life.

Although scholars suggest that the late Ottoman period was characterized by the rigidification of national and religious affiliations and the thickening of boundaries between different millets,⁵ when we observe this case from a gendered angle, we see a remarkable story of social transgression driven by desperation. Amid the embers of the Ottoman Empire, a Muslim woman on the edge of suicide decided to share her most intimate feelings and memories with a Jewish gynecologist—memories that, in her words, “she could only tell her mother.” Despite holding a line of professional refusal (because of the new regulations on abortion), Miclesco was emotionally and intellectually sympathetic toward Goncagül.

With its new interventionist policies, like criminalizing abortion and increasingly surveilling the female body, the modern Ottoman state created its own marginal identities. Within this new marginality, Goncagül and Miclesco found themselves side by side. Religious culture constituted a shared semantic space in which they could meet and be understood by each other. Yet, neither sympathy nor mutual understanding could convince the doctor to help her under these oppressive material and political conditions. At the end of her story, Goncagül was alone in experiencing the patriarchal reorganization of medicine as death.

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Büşra Demirkol is a PhD candidate in the Interdisciplinary Program in Near and Middle Eastern Studies at the University of Washington. Her research focuses on nineteenth-century Ottoman social history, with particular interests in the history of medicine, modern Jewish history, and issues of women, sex, and gender.

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