Women as Patients: Obstetrics & Midwifery

Medicine on Women  Obsession with women’s reproductive functions  Concerns about population  Masculine concerns about male reproductive power

Menstruation  Many ancient cultures viewed menstruation as unclean  Also possibly dangerous

 Hypothesis that men used menstrual lore to: –Draw distinctions –Police boundaries –Enforce separation of the sexes

 Plato –Speculative –Uterus seat of women’s sexual instinct –Wandering uterus

 Hippocrates –Regularity of menses –Position of uterus –Therapies aimed at regulating these

 Soranus –Methodist –Contemporary of Galen –Believed that women’s health, like men’s, was not centred around their reproductive function

Reproduction  Speculation about the relative contribution of males and females to reproduction –They called it generation  What determines sex of the child?

 Hippocratics –Both male and female contributed a seed –Egalitarian

 Aristotle –One seed model –Women inferior to men –Women defective in heat –Semen concocted from blood

–Women simply the material that the hotter male semen could work on –Female child resulted if not enough heat generated

 Galen –Two seed model –Women still biologically inferior –Women’s reproductive organs were defective version of the male’s

–Male seed produced in right testis & female seed produced in right testis and implanted on right side of uterus produced a male

 Used anatomical explanation  Right testis in male and female nourished by arterial blood  Left testes nourished by venous blood

Medical Treatment of Women in the 19 th Century  Impact of Darwinianism on ideas about human reproduction  Increased interest of medical profession on women’s normal lives

 Proliferation of medical advice on many aspects of women’s life  Celibacy/marriage/child bearing/child rearing  Exercise

 Dress  Active promotion of the idea that biology is destiny  Era of full emergence of the specialties of obstetrics and gynecology

Medicalization of Childbirth 1. Emergence of obstetrics  Seminar papers will be considered here

2. Relieving the pain of childbirth  Use of anaesthetics became possible in the mid-19 th century –Nitrous oxide known in 1799  Used as anaesthetic in 1844 –Ether used in 1842 –Chloroform introduced in 1847

 James Simpson recommended chloroform for childbirth  Presented physicians with moral dilemma –Concern for the infant –Religious beliefs

 Snow used chloroform during delivery of Queen Victoria in 1853 & 1858  Ended the debate  Concerns that women would lose inhibitions under anaesthesia

 Seemed more likely that men would lose theirs in the presence of an anaesthetized woman  Canadian case in 1858 (Montreal) –Dentist sexually violated a female patient under anaesthetic –Inspired medical community to create guidelines for administration of anaesthetics to women

3. Contraception  Often portrayed as a feminist issue  Actually much more complex & subtle

 Involved –Organized religion –Class –Eugenics –Professional power  As much a political as a medical story

 Medical technologies prior to oral contraceptives developed by women –Technological advances on these made in 19 th and 20 th century

 Rest of material presented will be an examination of contraception in Canada integrating considerations of: –Organized religion –Class –Eugenics –Professional power