This chapter deals with procreative practices in medieval Europe. It argues that these were broadly understood as women’s responsibility and should be studied as part of the history of women and gender. The connection is particularly direct in the case of childbirth, which beginning in the thirteenth century was normatively managed by the midwife-birth attendant pair. In cases of obstructed birth, these women might be assisted by barbers or surgeons, who were almost always men. Attempts to enhance or limit fertility involved a greater range of advisors and practitioners, female and male, unofficial and official. The latter increasingly included male physicians, consulted by women who had difficulties bearing children and bringing them to term. By the end of the Middle Ages, some physicians were beginning to claim authority over the birthing process itself, a situation made possible by the slow fading of taboos concerning the visual inspection of women’s genitals by men other than their husbands. However, there is no evidence for physicians’ participation in uncomplicated births, which were managed by midwives. By the same token, there is no evidence that midwives were involved in the general healthcare of women or that they offered advice relating to contraception and abortion.