If there is a prominent reason for a woman to be grateful she lives in the 21st century, it’s health care.
Over a dozen speakers – scholars from the humanities and health care professionals – gathered at Pennsylvania Hospital last week to help illustrate this fact at the 10th Annual History of Women’s Health Conference.
Each year the conference serves as a forum for an open discussion of women’s health through a variety of historical and modern perspectives. And each year the research presented causes a full gamut of reactions from the audience: shock, horror, disgust, amusement, compassion and hope.
It’s difficult for us today to look back on the thoughts, practices and prejudices of health care in the past and not judge as well. We can all too easily think, Oh how sexist! How racist! How misogynistic! The conference presentations, mostly all studies of the evolution of women’s health care, help us better understand medical and public health during a very different time from our own. Attendees are confronted with thought-provoking observations that demonstrate how past treatment decisions (or lack thereof) impacted women’s lives and how these realizations lead to more compassionate, humane, and unprejudiced care.
“The conference has been a great success, and I’m so thankful to everyone who has presented over the past 10 years,” said Stacey Peeples, curator and lead archivist at Pennsylvania Hospital. “Our first conference started as a small project – a way to incorporate a bit of women’s history – that I created as a part of Pennsylvania Hospital’s celebration of its co-founder Benjamin Franklin’s tercentenary, or what would have been his 300th birthday. I wasn’t sure it would go beyond that first year, but people enjoyed it. They really liked the idea of celebrating both women’s history and women’s health and how integrated the two topics really are when you think about them. ”
A dozen presentations supported this year’s conference theme, “Women’s Health: Individual Stories, Global Impact,” with topics of worldwide interest such as: teaching reproductive health and sex education to children under during the restrictive and repressive Victorian era; the identification and diagnoses of anorexia nervosa through history; the improvement of maternal health in the developing world; and Muslim American Mothers’ influence on their American daughters’ health practices.
Shown above from L to R are: Wanda Ronner, MD, professor of Clinical Obstetrics and Gynecology; Keynote Speaker Rene Almeling, PhD; Scott E. Edwards, MD, associate professor of Clinical Obstetrics and Gynecology; and Stacey C. Peeples, Curator- Lead Archivist at PAH.
The keynote address, Sex Cells: The Medical Market for Eggs and Sperm by Rene Almeling, PhD, an assistant professor of Sociology at Yale University, gave an intriguing overview of the marketing of egg and sperm donations. Sex indeed does sell, and apparently so does sticking to gender stereotypes. In the marketplace, egg and sperm donations are framed very differently from each other and surprisingly, very traditionally. Female egg donation is positioned as a “gift” verses the “job” of sperm donation. Even though egg donation involves a series of appointments, women are compensated in one lump sum for their “generous gift to help another,” whereas men are asked to adhere to a specific schedule and are lured in by ads which promote bi-weekly pay checks.
Scott E. Edwards, MD, as associate professor of Clinical Obstetrics and Gynecology at Penn, followed Almeling’s presentation by discussing the evolution of sperm and egg donations at Penn Fertility Care. With the emergence of HIV and what we know about the transmission of viruses, it’s hard to fathom doing “fresh” inseminations where donations went directly from the sperm donor to the woman in the clinic. Edwards’ talk also gave pause to the thought of continuing gender stereotypical marketing of egg and sperm donations. In the beginning, 30-plus years ago, it was mostly heterosexual couples having difficulty conceiving seeking fertility assistance at Penn and in the market in general. “Now, the majority of the market is same-sex couples and single women,” said Edwards.
Switching things up next was Ava Purkiss, a PhD candidate at the University of Texas at Austin, with
Sound Bodies: Black Women's Public Health and Physical Culture in the Early Twentieth Century. Purkiss explored the economic, political, and social barriers to exercise for African-American women in the early 20th century and examined how black women circumvented those barriers and sought health, beauty, and recreation through the physical culture movement, a wellness campaign that became popular at the turn of the 20th century.
Despite segregation, sexism, and exclusion from fitness institutions such as gyms, sporting leagues, and even playgrounds, Purkiss revealed that black women actively participated in exercise programs at a time when physical fitness held new socio-political meaning. Considering their investment of time and effort to exercise, she argues that black women engaged in the physical culture to literally and figuratively shape their bodies and create a new vision of fit black womanhood. Purkiss posited how purposeful exercise in the past directly contradicted the unfortunate widespread misrepresentations of black women as lazy, overweight, disease-ridden, unattractive, and unfit for citizenship.
Rachel Walker, a PhD candidate from the University of Maryland, College Park, kicked off the afternoon sessions with her presentation, The Science of Sexual Difference in the Nineteenth Century. Walker began with a prevailing “medical” view in the late 19th century – physiognomy, the assessment of someone’s facial features to discover their moral and mental character. Of course this is considered absurd today, but at the time, it was a serious attempt at better understanding human nature.
Shown above from L to R are: Jack Ludmir, MD, chair of Obstetrics and Gynecology; Stacey C. Peeples, Curator- Lead Archivist; Peter Gearhart, MD, clinical assistant professor of Obstetrics and Gynecology.
Physiognomy was “like Fifty Shades of Gray is to us today,” said Walker. “Some people love it. Some people do not. But everyone knows about it and even those who don’t believe in it are still reading about it and everyone’s talking about it.“ What came out of the work of those supporting physiognomy, such as Johann Caspar Lavater, is the stuff that really can get us fired up today. Things like the notion that beauty is somehow equated with intelligence and that woman are the intellectual inferiors of men. Then there’s John Milton Mabbott who supported that it was ill-advised for women to enter the public sphere because, according to Walker, it would “cause an epidemic of hysterical and insane females.”
Walker held the audience’s interest with readings of female patient records where physicians documented cases of “seduction” – reluctant to even acknowledge a woman was raped. The very word indicated that somehow the woman was to blame. This prejudicial treatment of women no doubt caused harm. If a woman wasn’t traumatized enough by a rape, being expected to act as if nothing wrong occurred afterwards and as if she may have been to blame for it must surely have been more than many could bear.
Another horrifying yet fascinating part of Walker’s presentation was on the 1873 blockbuster book by Edward H. Clarke, a Harvard physician, Sex in Education: or, A Fair Chance for Girls. In the book, Clarke pushed his recommendations that women should not attend school with men, limit their study hours because their minds and bodies would become too strained, and most certainly should not attend school while menstruating.
A highlight of the conference was the presentation of Gertrude B. Hutchinson, MSIS, MA, RN, an archivist/historian at the Bellevue Alumnae Center for Nursing History of the Foundation of NY State Nurses, on Margaret H. Sanger, RN: A Courageous Advocate of Birth Control and Women's Self-Determination of Health Care. Sanger was a beacon of light for women at a time when much was out of a woman’s control, including her own body. A nurse and sex educator, Sanger was a birth control activist who opened the first birth control clinic in the U.S. – but not before getting arrested and having to flee the country for disseminating birth control info.
Sanger had to fight against both religion and the law. The Roman Catholic Church was pushing for their members to have larger families when most families couldn’t afford the children they did have. The Catholic publication in the U.S. at the time, Western Watchman, stated that a woman must first find a husband and that “a healthy wife ought to have a child within her arms or one on her bosom at all times.” One immigrant woman who confided in Sanger told her that when she asked a physician if there was a way to prevent pregnancy, she was told, in all seriousness, to have her husband sleep on their roof. “It didn’t work,” said Hutchinson.
Sanger believed that birth control improved sexual hygiene and enjoyment and was sorely needed to improve women’s health and family life in early 20th century, when large immigrant populations were struggling to make a better live for themselves. In 1914, she started her publication, The Woman Rebel newsletter, at a time when the 1872 Comstock Law existed, which forbade the use of the U.S. Postal Service to disseminate “lewd or promiscuous information.” Naturally, anything about birth control fell under this law.
After years of persistence, Sanger founded the Birth Control League in 1921 in Brownsville, Brooklyn. Known as the Planned Parenthood Federation of America today, this first-of-its-kind clinic became the test case to open clinics nationwide. By 1923, she created the Birth Control League’s manifesto, outlining how and why “the function of motherhood should be elevated to a position of dignity” and how it is impossible to do so “as long as conception remains a matter or chance.”
Sanger was fortunate to have lived long enough to see the 1965 U.S. Supreme court ruling that made contraceptives legal for married couples which meant they could pursue information about contraception without fear of legal reprisal.
No small thing after 102 years of the Comstock Law.
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The History of Women’s Health Conference is co-sponsored by the Pennsylvania Hospital Historic Collections, the Department of Obstetrics and Gynecology, and Hospital Professional Staff.