OAH Distinguished Lecturer Profile

Though Upjohn Company had begun manufacturing Depo Provera (medroxyprogesterone, a synthetic hormone) in 1958, it would not be approved by the Food and Drug Administration for birth control use in the United States until 1992. The heated debate over the regulation of Depo-Provera attests to the increasing complexity of contraceptive regulation in an age of biomedicine. Beginning in the 1970s, consumers demanded access to and involvement in regulatory decisions previously considered beyond their purview. Women’s health activists, newly armed with political, legal, and medical expertise, introduced new evidence to the process: patient testimonials. They thus guaranteed that women’s experiences, rather than just those of lab animals, became part of the scientific testimony presented before the Food and Drug Administration on numerous occasions. They also altered the process of risk-benefit analysis by challenging the notion of value-free, objective science. Weighing the risks and benefits of a drug, particularly one prescribed to millions of healthy patients, required not just statistics but stories, they argued. Ultimately, the ideas, experience, and actions emerging out of the women’s health movement have widened the parameters of debate surrounding the drug testing and regulation. By challenging assumptions about contraceptive drug testing on women, risk benefit analysis, and the evidence of so-called “experts,” women’s health activists have established a legacy of rights which remain with us today.

In a decade that witnessed Watergate, violence in Vietnam, and social unrest at home, childbirth—specifically how and where women gave birth—took on particular significance in the United States. The most dramatic manifestation of this was a broad-based move toward alternative forms of childbirth. A quiet revolution spread across cities and suburbs, towns and farms, as these individuals challenged legal, institutional and medical protocols by choosing unlicensed midwives to catch their babies at home. Because the United States had virtually eliminated midwifery by the mid-twentieth century, most of these newer rebels had little knowledge of or exposure to the historic practice, drawing primarily on obstetrical texts, trial and error, and sometimes instruction from aging home birth physicians to learn their craft. While their constituents were primarily drawn from the educated white middle class, their model of care (which ultimately drew on the wisdom and practice of a more diverse, global pool of midwives) had the potential to transform birth practices for all women, both in and out of the hospital.

This talk focuses on the readers—several hundred ordinary women who responded to editions of Our Bodies, Ourselves in the 1970s and 1980s—to illustrate how readers played a crucial role in the development and articulation of health feminism. By analyzing the exchange between writers and readers of the most popular and influential women’s health text of this era, it reveals the process by which feminists translated and interpreted medical information on women’s bodies. To understand the nature and impact of the women’s health movement, scholars need to look beyond the feminist literature and feminist organizations of the 1970s. Everyday women readers, whose voices inform this study, actively redefined women’s health from a feminist perspective.

In this talk, I argue that eugenics, a widespread popular movement during the first half of the twentieth century, appealed to Americans who believed that the best way to strengthen family and civilization was to regulate fertility. Robert Dickinson, Louis Terman, and Paul Popenoe were all involved in researching and promoting sterilization of the “unfit” in the 1910s and ‘20s. In the 1930s, they turn to marriage counseling as a way of encouraging the “fit” (the white middle class) to develop lasting marriages and have more children. Their campaign paved the way for the “baby boom” of the 1950s.

This talk examines the late 20th-century controversy regarding pelvic examination instruction in American medical schools. In the 1970s, medical educators expressed concern over how best to prepare medical students for routine gynecological care. In response, schools experimented with a variety of approaches, including the use of plastic models, anesthetized patients, volunteers, and “simulated” patients (including prostitutes, graduate students, and nurses). By the late 1970s, new outsiders entered the debate, as female medical students, consumer rights advocates, and health feminists criticized some of these tactics as demeaning and destructive to women. Approached by female students at Harvard Medical School disappointed by their gynecological training, the Women’s Community Health Center in Cambridge, Massachusetts initiated an innovative “pelvic teaching program.” Laywomen acted as instructors and patient models for Harvard Medical students during a required introductory clinical medicine course. But after two years, the partnership disintegrated, with feminists feeling like no more than “talking pelvises” and medical educators disturbed by feminist politics, personal crusades, and “inappropriate patient model choices.” Drawing on the unpublished papers of the Women’s Community Health Center, medical journals, memoirs, and oral histories, I argue that this initial attempt to overhaul the traditional power relations between doctor and female patient, although unsuccessful, marks a crucial development in the negotiations between feminist health clinics, medical students, and organized medicine. Ultimately, this controversy helped to transform routine gynecological care by challenging many of the assumptions about how to understand and examine the female body.