The Boston Women's Health Book Collective and Our Bodies, Ourselves: A Brief History and Reflection
Early Accomplishments of the Women’s Health Movement
Here are just a few snapshots:
- In the early 1970s, lack of information about birth control polls and a growing awareness among women about problems associated with their use led to organized protests, including disruption of special hearings in Congress conducted by Senator Gaylord Nelson. Fortuitously, Barbara Seaman, author of The Doctor’s Case Against the Pill,13 and Alice Wolfson met at the Nelson hearings; several years later they co-founded the National Women’s Health Network with Dr. Mary Howell, Belita Cowan, and Phyllis Chesler, Ph.D.
One important result of women’s efforts to obtain more and better information about oral contraceptives (as well as other drugs) was the introduction of the Patient Package Insert (PPI) program at the FDA (Food and Drug Administration). A related struggle involved the provision of PPIs for so-called estrogen replacement therapy. Not long after PPIs appeared for estrogen products, the Pharmaceutical Manufacturers Association joined the American College of Obstetricians and Gynecologists to sue the FDA in an effort to block the distribution of PPIs for estrogen products. In response, four women’s and consumer organizations, led by the National Women’s Health Network, entered the case as co-defendants and filed an amicus brief cogently arguing for the right to such basic information. And we won. PPIs for estrogen products were retained through the late 1970s, although later suspended by the Reagan Administration. The Clinton Administration has reinstated them in a different form.14
- Sterilization abuse, a longstanding problem for poor women in the United States, became the focus of a government inquiry after activists, journalists, and community organizations documented and publicized the degree to which certain women, especially women of color and Native American women, were sterilized without informed consent.15 This happened in a variety of ways: some women agreed to be sterilized without fully understanding what it meant, especially when information was given in terminology they did not understand; others were told that their public welfare benefits would be denied unless they agreed to sterilization; some were told that the procedure was reversible, when, of course, that was not true. Special hearings resulted in regulations, written in part by both consumer and physician health activists, designed to curb the incidence of abuse among federally funded sterilizations. These regulation included a 30-day waiting period, the provision of information in a language clearly understood by the woman, and prohibition of hysterectomy solely for the purpose of sterilization. Though far from perfect, these regulation have been somewhat effective.
- As early as the mid-1970s, the women’s health movement addressed controversies surrounding breast cancer. For many years the standard practice of US doctors, in doing a breast biopsy and finding malignant tissue, was to proceed immediately with a mastectomy. Several years of hard work during the 1970s, especially on the part of activist and journalist Rose Kushner, who has since died from breast cancer, resulted in a landmark recommendation by the National Cancer Institute that breast biopsies be performed as part of a two-step procedure in most cases. The panel advised that a diagnostic biopsy specimen be studied with permanent histologic sections before offering various treatment options to a patient with breast cancer. This recommendation represented an important step forward in the treatment of breast cancer and also increased general awareness of the importance of nonsurgical treatments.
- During the 1970s dozens of women-controlled health centers emerged as alternatives to the conventional delivery of health and medical care. Many were organized nonhierarchically with physicians having little or no policy-making roles. Most offered self-help groups that taught cervical self-exam, abortion services that were often the only ones in the region, and support groups for dealing with such experiences as premenstrual problems; infertility, and menopause. They also pioneered a more thorough, client-centered approach to informed consent. Several women among the founders of the Feminist Women’s Health Centers pioneered the development of a menstrual extraction technique that has since been used by women in other countries. In large part because of these women-controlled health centers, abortion became firmly established as an outpatient service. In 1992 only 7% of abortions were performed in hospitals, while in 1973 more than half of all abortions had been performed in hospitals.16 This assured that first-trimester abortions in this country would be appropriately demedicalized.
The authors wish to thank interns Tricia Collins and Jennifer Stetzer.
1 Hartmann B. To vanquish the hydra. Political Environments. Spring 1994.
2 Berer M. The quinacrine controversy one year on. Reproductive Health Matters. November 1994:105
3 Swenson N. Women’s health movement. In: Mankiller W, et al, eds. Reader’s Companion to U.S. Women’s History. New York, NY: Houghton-Mifflin; 1998:648.
4 Norsigian J. Women and national health care reform: A progressive feminist agenda. J Women’s Health. 1993;2:91
5 Managed Care Consumer Protections and Women’s Health: The Balanced Budget Act. Washington DC: Women’s Legal Defense Fund; 1997:1.
6 Horton J. ed. The Women’s Health Data Book: A Profile of Women’s Health in the United States. Washington, DC: Jacobs Institute of Women’s Health; 1992:93.
7 The Blue Sheet. Washington, DC: F-D-C- Reports; 1996:5.
8 Scully D. Men Who Control Women’s Health: The Miseducation of Obstetrician/Gynecologists. New York, NY: Teacher’s College Press; 1994.
9 Health Care Reform: What Is at Stake for Women? New York, NY: The Commonwealth Fund Commission of Women’s Health; 1994:13.
10 Ruzek S. Access, cost and quality medical care: where are we heading? In: Ruzek S, Oleson V, Clarke A, eds. Women’s Health Complexities and Differences. Columbus, Ohio: Ohio State University Press; 1997:197.
11 Rothchild A. From both ends of the speculum: A feminist analysis of health care. Paper presented at the American Medical Women’s Association meeting, New York City, March 8, 1998.
12 Zola IK. Medicine as an institution of social control. In Zola IK. Socio-Medical Inquiries. Philadelphia, Pa: Temple University Press; 1983.
13 Seaman B. The Doctor’s Case Against the Pill. New York, NY: Doubleday; 1969.
14 The phoenix rises: Patient package inserts reborn (if you help!). Network News. November/December 1994:3.
15 Chase A. Sterilization: The legacy and the lack of watch dogs. Medical Tribune. September 7, 1977:1,22.
16 Henshaw SK, Van Vort J. Abortion services in the United States, 1991 and 1992. Fam Plann Perspect. 1994;26:104.
Special thanks to the American Medical Women's Association for generously giving us permission to reprint the following article. The article was originally published in the Winter 1999 edition of Journal of the American Medical Women's Association.