9.1: Women's Health and the History of Medicine

Chapter Author: Imanni Sheppard, PhD

As noted earlier in the text, the primary means of healthcare and healthcare-related services for women is a medical specialty called obstetrics and gynecology. These two terms, while often used in relationship to each other, are not quite the same. The word obstetric comes from the Latin word for midwife (obstetrix), used in the late 18^th century. It is a medical specialty that cares for the health of a pregnant person throughout the course of their pregnancy and for the first six weeks after the child is born (postpartum). Gynecology, on the other hand, is the study of diseases, sicknesses, and functions of a person’s vagina relative to their reproductive health (from the Greek words for woman, gyne, and the suffix for "study of," logy). As such, obstetrics and gynecology as a medical field focuses on an individual’s vaginal and reproductive health throughout maturation.

Likewise, many aspects of Western philosophical and ideological thought, science, and medicine are heavily based on the work of Greek philosophers and alchemists--hence the use of the original Hippocratic oath as the basis of the professional identity formation, obligations, and appropriate practices of physicians. Hippocrates, for example, is considered the “father of modern medicine.” He often articulated his beliefs about women’s bodies relative to a lens of Otherness and in direct opposition to ideas about logic and rationality that he perceived as being inherent in man.[1] It is important to note, however, that the concept of “man” in the fifth century was a homograph in that it simultaneously referred to the species of man (referring to one’s perceived humanness) and the concept of man as a gendered, socio-political, and medically situated Self. This linguistic interplay did not create the male/female or man/woman dichotomies that contemporarily exist in Western society. They did, however, facilitate their perpetuation.

Other theories, such as the notion that a woman’s body was a defunct version of a man’s, that a woman’s uterus was a living creature that wandered around her body and caused her to be hysterical in nature, and that the womb “…pushes through a woman’s trunk wreaking havoc on her physical and mental well-being, causing her to faint or become speechless,” were all foundational aspects of the scientific ideas, medical practices, and epistemologies of the time.[2],[3] Thus, the belief that women were inherently unwell because of the deficient nature of their physicalities prompted the need for social and sociomedical paternalism.

Sociomedical paternalism often informs discriminatory practices, inequity, and sex-linked injustices within every ideological state apparatus (ISA).[4],[5] Additionally, within ISAs is an emphasis on reproduction or reproductive health care—with vulnerable populations and minoritized women being overrepresented relative to inequitable access, experimentation, and exploitation. As such, sociomedical paternalism, social injustices, and structural violences that instigate negative health outcomes also tend to disproportionately affect minoritized women.

The forced sterilization of minoritized women throughout the 20^th century in the United States, laws that limit or control reproductive freedoms, the history of gynecological exploitation in dialogue with the maternal/infant mortality rates for African American people, and the perceived viability of one’s offspring based on race, gender, class or able-bodiedness also follow the basic premises of medical paternalism. They are also remnants of Western philosophical and ideological thought that allowed for the direct or indirect normalization of structural violence in the epistemologies and practices of medicine.

Please continue to the following case studies as examples of such circumstances.

9.1.1 Case Study 1 - Forced Sterilization Programs

9.1.2  Case Study 2 - Social Darwinism and the Medical Quesiton of "Defective" Children

References

[1] Helen King, Hippocrates’ Women: Reading the Female Body in Ancient Greece (New York, New York: Routledge, 1998).

[2] Aristotle, Generations of Animals. Book 2. Translated by A. L. Peck. Loeb Classical Library 366. (Cambridge, Massachusetts: Harvard University Press, 1942).

[3] Jane Rowlandson, Women and Society in Greek and Roman Egypt: A Sourcebook, (Cambridge, Massachusetts: Cambridge University Press, 1999). We see the contemporary implications of these ideas in the use of the terms hysterical, hysteria, and hysterectomy which are all derived from the Greek word hystera which means womb. So, when referring to someone as “hysterical” we are essentially saying that her uterus is causing her to behave outside of social and emotional normative behavior. Likewise, within these ideologies, a hysterectomy (ectomy is removal of) was the removal of the thing (hystera/womb) that was hindering a woman’s ability to be a productive or sensible member of society.

Note: Bailey P., “Hysteria: The History of a Disease,” Arch Gen Psychiatry.1966;14(3):332–333. doi:10.1001/archpsyc.1966.01730090108024

[4] Faith Elliot Robertson, “The Family: Private or Adjunct of the State,” Journal of Law and Society Vol. 16, no. 4 (1989): 443-363.

[5] Georgia Detention Watch, Georgia Latino Alliance for Human Rights, South Georgia Immigrant Support Network, “Re: Lack of Medical Care, Unsafe Work Practices, and Absence of Adequate Protection Against CoVID-19 for Detained Immigrants and Employees Alike at the Irwin County Detention Center,” Letter to the Department of Homeland Security, the U.S. Immigration and Customs Enforcement Atlanta Field Office, and the Warden of the Irwin Country Detention Center (September 2020). https://projectsouth.org/wp-content/uploads/2020/09/OIG-ICDC-Complaint-1.pdf