History of women's health
A cartoon appeared in the publication PMT the unrecognised illness in 1979 and highlights one of the key problems experienced by women with reproductive health issues, the idea that women should simply ‘put up’ with their condition and that it’s part and parcel of being a woman.
This lack of understanding of women’s health has a much longer history. It is really crucial to look at the history of women’s health in order to understand why things are the way they are and how dominant ideas have emerged.
Dr Laura Kelly, Senior Lecturer in the History of Health and Medicine at the University of Strathclyde, Glasgow, explains more.
Hysteria and Puerperal Insanity
⦁ From the 1800s, women’s bodies and minds began to be more closely scrutinised by medical practitioners and psychiatry began to emerge and develop as a field.
⦁ Legislation in England and Wales in the early nineteenth century also resulted in the establishment of asylums for the insane across the country.
⦁ Moreover, as Elaine Showalter has suggested, asylums increasingly began to be populated by female patients as Victorian notions continued to define “proper” feminine behaviour.
⦁ One such illness which was linked specifically to women and their cycles was hysteria. Hysteria was used as a blanket term to cover a range of ailments which could include fainting, nervousness, anxiety, insomnia, nymphomania, sexual desire, and melancholy. It was thought to be a disease that affected women primarily and was often linked to sexuality, so women who were thought to be too sexually forward were often classed as hysterical.
⦁ A considerable proportion of female admissions to asylums were for ‘puerperal’ disorders or other conditions related to the female life cycle, from the onset of menstruation to its cessation.
⦁ Symptoms of puerperal insanity: excitable, irritable behaviour, restlessness, violence, insomnia, rejection of food, obscene/erotic remarks. A large number of cases in British asylums in 19th century.
Treatments; Rest cure, Improvement of diets, and tonics.
Photo Credit Fay Summerfield Photography
Understandings of Women's health
⦁ Understandings of women’s health in the nineteenth century were limited and were heavily influenced by perceptions around a woman’s place in society and the idea that women’s purpose was to bear children. Menopausal women, for instance, often faced ridicule.
⦁ The surgeon Lawson Tait writing in 1879, for instance, stated that ‘Although gynaecology has engaged the attention of many very able writers, it must be admitted that there is within its scope a great deal upon which our information is still far from being either complete or accurate’.
⦁ We can perhaps link the lack of research into women’s health conditions compared to other conditions to the expected function of women, to reproduce and have children. While there has been lots of research into childbirth, pregnancy and infertility, less medical research has engaged with women with reproductive health issues that are not directly related to having children.
⦁ Indeed, even today, we see with conditions such as endometriosis that many women don’t even get a diagnosis until they start to try to have children and encounter fertility issues.
⦁ Another important issue also is perhaps the lower numbers of women in the medical profession in the twentieth century. Medicine was not always viewed as an appropriate career path for women and it’s not until recently that equal numbers of women are being admitted to medical schools. Women still are highly disproportioned in leadership positions and certain fields in medicine.
⦁ More generally, however, for much of the twentieth century, women experiencing conditions such as miscarriage, endometriosis, menopause and PMS, have had to put up with stigma, shame and silences around these conditions.
Photo Credit Fay Summerfield Photography
The Rise of Activism, Self-Help and Charities
⦁ From the 1970s, with the emergence of feminist groups, there started to be more discussion of women’s health issues.
⦁ Feminist groups both in Ireland and the UK were also very influenced by American feminist health activism, such as the work of the Boston Health Collective, which published Our Bodies Ourselves and encouraged women to learn about how their bodies worked and gain ownership over their health issues.
⦁ British feminist activists, given that contraception and abortion were legal there, concerned themselves with women’s health issues regularly discussed in their magazine Spare Rib.
⦁ Concurrent with the rise of feminist health activism was the rise of self-help books on women’s health issues. These began to be published in the 1950s and really gained popularity in the 1970s and 1980s. Women’s health books, such as Katharina Dalton’s Once a month, provided women with information on their condition, symptoms, and treatment and provided advice on how women could raise the issue with their medical practitioner. In this way, self-help guides played a crucial role in educating women about their health conditions, promoting awareness and helped to equip women with the tools to empower themselves to obtain a diagnosis and treatment. Moreover, women’s magazines were a vital source of information on issues relating to women’s health.
In the frequent absence of adequate medical care and treatment for women, charities and grassroots organisations have been crucial in providing women with information on their condition, empowering them and spreading awareness and campaigning for better health care for women.
"One of the biggest problems that we have in medicine today is a complete disconnect between the physician's knowledge base and the patient's experience and the patient's knowledge base.
With the advent of crowdsourced knowledge base, it now turns out that, for some medical conditions -and #endometriosis is a perfect example- most of the educated patients have a knowledge baes which is greater than the knowledge base of the average physician."
Andrea Vidali MD
Today?
⦁ 'Why are women still being treated as hysterical, overly emotional, anxious and unreliable witnesses to their own wellbeing? Why do doctors still treat their patients who are female, people of colour or gender-diverse differently from their white male patients?’ Gabrielle Jackson, Guardian, 2019
⦁ Persistence of stigma, shame and silence around women’s health but there is starting to be more awareness and these issues are beginning to be taken more seriously – eg. Recent APPG report on endometriosis in the UK and the Dail hearing on the topic in Ireland.
⦁ Charities and grassroots organisations continue to be a source of empowerment for women experiencing reproductive health conditions.
⦁ Race, class, sexuality, disability and gender: an intersectional approach of individuals’ experiences is needed.
⦁ How do we further erase stigma, shame and silences?