The Christian doctrine of the Fall owes much of its modern architectural rigour to Saint Augustine of Hippo (354–430). While one might avoid a full theological discourse here, it is undeniable that Augustine’s interpretation of the Garden of Eden narrative has profoundly shaped various—though not all—strands of Western Christian thought.
It is perhaps Augustine's specific attitude towards humanity that manifests most memorably in a somewhat unholy reference to human (and particularly female) anatomy. His assessment of human nature post-Lapsarian was fundamentally pessimistic, viewing humanity as a massa peccati (a mass of sin), naturally inclined toward evil due to an inherited corruption of the will. This dim view may have its roots in his early adherence to Manichaeism—a dualistic philosophy that regarded the material world and the flesh as inherently corrupt. Consequently, a phrase frequently ascribed to him describes mankind as being born "between urine and faeces"—or, in the Latin, inter faeces et urinam nascimur. By this, he makes a direct, if crude, reference to the perineum.
The term perineum entered the English lexicon in the early 15th century via Late Latin, having been borrowed from the Ancient Greek perinaion. Its roots are a combination of peri- (meaning "around" or "near") and inan or inein ("to empty" or "evacuate"). It describes that specific anatomical site between the anal and urethral openings where, in the female, the vaginal opening is situated.
However, a scholarly convenience is at play here: while Augustine is the perennial source for this quote, the phrase does not appear in any of his surviving works. Hence, one often finds the phrase "attributed to Saint Augustine" used. Its earliest known appearance in print dates to an 1875 edition of Arnobius of Sicca’s Arnobii Adversus Nationes Libri 7, edited by August Reifferscheid. A variant, inter stercus et urinam nascimur ("we are born between dung and urine"), appears in 17th-century texts, such as Joannes Christophorus Avemann's 1695 Disputatio medica inauguralis, where it was actually attributed to the Roman philosopher Seneca. To further muddy the hagiographic waters, the phrase has also been linked to Bernard of Clairvaux.
Despite the lack of primary evidence, the phrase persists in modern theological and literary circles to illustrate the "messy" physical reality of birth in contrast to spiritual ideals. This juxtaposition is especially striking when compared to traditional religious iconography. Where medieval depictions of the Nativity or the Birth of Mary are typically sanitised and ethereal, this "Augustinian" sentiment forces the reader to confront the visceral proximity of the sacramental and the excremental. Without the convenience of this attribution, writers seeking to highlight this tension would find themselves without their most potent rhetorical weapon.
Moving beyond the polemics of the saints, the pelvic floor remains a critical anatomical region. A vast array of clinical issues can arise from the natural process of childbirth alone, quite independent of patristic commentary. While the term pelvic floor dysfunction has faced academic criticism for its lack of medical specificity, the very breadth of the problems it encompasses—from urinary incontinence to pelvic organ prolapse—makes the term particularly telling. We indeed enter the world via a complex anatomical threshold, a reality that persists whatever theological interpretations are put on it.
