Women's health movement in the United States facts for kids

The women's health movement (WHM, also feminist women's health movement) in the United States refers to the aspect of the American feminist movement that works to improve all aspects of women's healthcare. It began during the second wave of feminism as a sub-movement of the women's liberation movement. WHM activism involves increasing women's knowledge and control of their own bodies on a variety of subjects, such as fertility control and home remedies, as well as challenging traditional doctor-patient relationships, the medicalization of childbirth, misogyny in the health care system, and ensuring drug safety.

Notable organizations associated with the women's health movement include the Jane Collective, the Boston Women's Health Book Collective, the National Women's Health Network, the Black Women's Health Imperative and the Native American Women's Health Education Resource Center. Other results of WHM activism are the creation of feminist health centers, the Dalkon Shield lawsuit, the DES daughters lawsuit, and the Nelson Pill Hearings. Notable books and media resulting from this movement include Women and Madness by Phyllis Chesler, Our Bodies, Ourselves by the Boston Women's Health Book Collective, and La Operación.

The health clinics, groups, and activists of the WHM also advocate "nonprofessional caregivers, self-help, emphasis on alternative (nonprescription) remedies when possible, demystification of health information and providers, and clinic administration and control by nonprofessional women."

Historical context

The women's health movement has origins in multiple movements within the United States: the popular health movement of the 1830s and 1840s, the struggle for women/midwives to practice medicine or enter medical schools in the late 1800s and early 1900s, black women's clubs that worked to improve access to healthcare, and various social movements in the 1960s.

Helen Marieskind argues that like the popular health movement of the 19th century, the WHM worked to redefine health care, empower women, and support "preventive health concepts, self-awareness... [a] knowledge of bodily processes, and... demystify[ing] medicine." Barbara Ehrenreich and Deirdre English, in their work Witches, Midwives, and Nurses (1972), also compare the two movements.

The WHM shares ideology with other New Left movements. The environmental and anti-nuclear movements, like the WHM, oppose militarism, critique corporations and government agencies, express the need to protect humans and the environment from hazards, and stress the importance of Nothing About Us Without Us. Women and gender studies scholar Jennifer Nelson says that neighborhood health centers created by civil rights and other New Left activists were the "intellectual, political, and practical experiential precedents," for feminist health centers, which were one major result of the women's health movement.

The women's health movement grew directly out of the women's liberation movement during the late 1960s.

Women's liberation movement

Just as the Women's Suffrage movement grew out of the Abolition Movement, the Women's Liberation Movement grew out of the struggle for civil rights. Though challenging patriarchy and the anti-patriarchal message of the Women's Liberation Movement was considered radical, it was not the only, nor the first, radical movement in the early period of second-wave feminism. Rather than simply desiring legal equality, members believed that the moral and social climate in the United States needed to change. Though most groups operated independently—there was no national umbrella organization—there were unifying philosophies of women participating in the movement. Challenging patriarchy and the hierarchical organization of society which defined women as subordinate, participants in the movement believed that women should be free to define their own individual identity as part of human society. One of the reasons that women who supported the movement chose not to create a single approach to addressing the problem of women being treated as second-class citizens was that they did not want to foster an idea that anyone was an expert or that any one group or idea could address all of the societal problems women faced. They also wanted women, whose voices had been silenced, to be able to express their own views on solutions. Among the issues were the objectification of women, reproductive rights, opportunities for women in the workplace, redefining familial roles. A dilemma faced by movement members was how they could challenge the definition of femininity without compromising the principals of feminism. They were not interested in reforming existing social structures, but instead were focused on changing the perceptions of women's place in society and the family and women's autonomy. Rejecting hierarchical structure, most groups which formed operated as collectives where all women could participate equally. Typically, groups associated with the Women's Liberation Movement held consciousness-raising (CR) meetings where women could voice their concerns and experiences, learning to politicize their issues. To members of the WLM, rejecting sexism was the most important objective in eliminating women's status as second-class citizens.

By attending CR groups, women around the United States participated in "a process in which the sharing of personal stories led to a "click"--a sudden recognition that sexism lay at the root of their struggles." This process included sharing their healthcare experiences with each other. They discussed topics such as negative experiences with doctors during childbirth and and other aspects of women's health. This led them to "campaign to change how doctors, the government, the media, and the medical field treat...women and their bodies.

Issues and ideology

WHM activism covers topics such as access to reproductive technology, advocating against unnecessary medical intervention during childbirth, increasing access to healthcare through the creation of feminist health centers and self-help clinics, teaching women about their bodies, discovering the history of women in medicine, critiquing the misogyny in the healthcare system, and creating health advocacy groups for women. Due to the political and collective nature of the WHM, Helen Marieskind calls the ideology of the movement Feminist-Socialism.

They view the relationship between women and their doctors (especially male gynecologists) as similar to women's second-class status in society. WHM activists argue that the institution of medicine is "embedded in, and an embodiment of," patriarchal society and is an institution of social control. Nearly all of the early literature from the WHM argued that medicine and doctors work to subordinate women, people of color, and the poor; doctors are too powerful; healthcare costs too much; and that conventional healthcare leaves patients with little to no dignity, right to health information, or ability to choose their treatment.

1969–1973

The women's liberation movement, and consequently the WHM, were grassroots, so there were many different groups of women organizing around women's health issues in the United States at the beginning of the second wave of feminism. Anthropologist Sandra Morgen argues that there are three founding events of the WHM: the workshop and research that lead to the writing of Our Bodies, Ourselves in Boston, Carol Downer and Lorraine Rothman's self-help gynecology in Los Angeles, and Barbara Seaman's (New York) and Belita Cowan's (Ann Arbor) work to expose the health risks of diethylstilbestrol.

Our Bodies, Ourselves

In 1969 at Emmanuel College in Boston, Massachusetts, at one of the first conference's for women's liberation, Nancy Miriam Hawley organized a workshop called "Women and Their Bodies." Twelve white, middle-class women between the ages of 23 to 39 attended the workshop, which allowed the women to discuss health. The discussion created a consciousness-raising environment; the strong discussion supplied the women with the necessary tools and ideas that led to the attendees organizing as "the doctors group" to research about women and healthcare. "We weren't encouraged to ask questions, but to depend on the so-called experts," Hawley told Women's eNews. "Not having a say in our own health care frustrated and angered us. We didn't have the information we needed, so we decided to find it on our own." As a result of this goal, they spent the summer researching topics they were interested in and began teaching a course titled after the workshop, based on what they had learned and written about. It contained sections on pregnancy, postpartum depression, anatomy and physiology, and critiques of patriarchy, capitalism, and the healthcare system. The book also contained information intended to guide women on "how to maneuver the American health care system, with subsections called 'The Power and Role of Male Doctors,' 'The Profit Motive in Health Care,'" 'Women as Health Care Workers,' and 'Hospitals.' They put their knowledge into an accessible format that served as a model for women who wanted to learn about themselves, communicate with doctors, and challenge the medical establishment to change and improve the health of women everywhere. They used rhetoric that avoided describing the female reproductive system as passive, unproductive, helpless, or powerless, unlike any doctor or book at the time.

Their writing was so sought after that they started selling their research as a 35-cent, 136-page booklet called Women and Their Bodies, published in 1970 by the New England Free Press. By 1973, 350,000 copies of the retitled Our Bodies, Ourselves had been sold without any formal advertising. As a result of their success, the women formed the non-profit Boston Women's Health Book Collective (which now goes by the name Our Bodies Ourselves) and published the first 276-page Our Bodies, Ourselves in 1973. The collective published it with the major publisher Simon & Schuster, only on the condition that they would have complete editorial control and that nonprofit health centers could purchase copies at a significant discount. It featured first-person stories from women, and tackled many topics then regarded as taboo.

1974–1980

Rose Kushner's critique of radical mastectomies

After being diagnosed with breast cancer, Rose Kushner objected to the treatment which was then standard, in which a tumor biopsy and radical mastectomy were performed in a single surgical operation while the patient was under anesthesia. She had difficulty finding a doctor who would perform a diagnostic biopsy and allow her to decide what action to take next. In order to have a less invasive procedure, she had found Dr. Thomas Dao, who was willing to do a modified radical mastectomy.As Kushner recovered from her surgery, she started writing about her experiences with breast cancer. She traveled to Europe to learn about breast cancer treatment there, finding that the radical mastectomy was not used as widely as in the United States. Upon her return home, she published Why Me?, in 1975 under the title Breast Cancer: A Personal History and Investigative Report, which contained extensive medical information and advice for patients, including strong criticism of radical mastectomies and the practice of performing a biopsy and a mastectomy as a one-step surgical procedure. The book was strongly endorsed by Dr. Dao, but it was widely criticized by other doctors and the American Cancer Society. Kusher became a relentless critic of the treatment of breast cancer by the medical profession. She attended numerous meetings of medical professionals, interrupting presentations, questioning conclusions, and speaking against the prevalent practices of one-step breast cancer surgery and radical mastectomy. In 1975 she was "booed off the stage" at a meeting of the Society of Surgical Oncology, whose members objected to her challenges to traditional treatments.

In 1975 Kushner and Dorothy Johnston, established a telephone hotline called the Breast Cancer Advisory Center, based in Kensington, Maryland, that operated until 1982, responding to calls and letters from thousands of women wanting information about breast cancer and its treatment. The center's establishment was motivated in part by Kushner's desire to promote patient self-help and mutual support, thus displacing the medical profession and the American Cancer Society from their roles as information "gatekeepers".

In spite of her unpopularity with the mainstream medical profession, Kushner's work was well received in the public and won increasing respect in official circles. In June 1977, she was the only lay member appointed to a ten-member National Institutes of Health (NIH) panel that evaluated treatment options for primary breast cancer. In 1979, the panel issued its findings, concluding that the Halsted radical mastectomy should no longer be the standard treatment for suspected cases of breast cancer, instead recommending total simple mastectomy as the primary surgical treatment. Additionally, Kushner convinced her fellow panel members to include a statement calling for an end to the one-step surgical procedure. At the time of her death, Dr. Bruce A. Chabner of the National Cancer Institute said she was "probably the single most important person" in ending the practice of one-step surgery for breast cancer, because of her persistence and because she brought medical information to a wide public audience that otherwise might have remained unaware of the options.

Challenging sexism in medicine

In medical schools

Two laws in the United States lifted restrictions for women in the medical field -- Title IX of the Higher Education Act Amendments of 1972 and the Public Health Service Act of 1975, banning discrimination on grounds of gender. In November 1970, the Assembly of the Association of American Medical Colleges rallied for equal rights in the medical field.

The 1970s marked a great increase of women entering and graduating from medical school in the United States. From 1930 to 1970, a period of 40 years, about 14,000 women graduated from medical school. From 1970 to 1980, a period of 10 years, over 20,000 women graduated from medical school. This increase of women in the medical field was due to both political and cultural changes.

One study surveyed physician mothers and their physician daughters in order to analyze the effect that discrimination and harassment have on the individual and their career. This study included 84% of physician mothers that graduated medical school prior to 1970, with the majority of these physicians graduating in the 1950s and 1960s. The authors of this study stated that discrimination in the medical field persisted after the title VII discrimination legislation was passed in 1965. According to this study, one third of physician daughters reported experiencing a form of gender discrimination in medical school, field training, and the work environment. This study also stated that both generations equally experienced gender discrimination within their work environments.

This article provided an overview on the history of gender discrimination, claiming that gender initiated the systematic exclusion of women from medical schools. This was the case until 1970, when the National Organization for Women (NOW) filed a class action lawsuit against all medical schools in the United States.  More specifically, this lawsuit was successful in forcing medical schools to comply to the civil rights legislation. This success was seen by 1975 when the number of women in medicine had nearly tripled, and continued to grow as the years progressed. By 2005, over 25% of physicians and around 50% of medical school students were women. The increase of women in medicine also came with an increase of women identifying as a racial/ethnic minority, yet this population is still largely underrepresented in comparison to the general population of the medical field. Within this specific study, 22% of physician mothers and 24% of physician daughters identified themselves as being an ethnic minority. These women reported experiencing instances of exclusion from career opportunities as a result of their race and gender.

Timeline

• 1968
• 1969
• 1970
  • January: Congress meets for the Nelson Pill Hearings.
• 1971
• 1972
• 1973
  • The Jane Collective disbands.
  • Our Bodies, Ourselves is published by mainstream publisher Simon & Schuster.
• 1974
  • The National Women's Health Network is created.
• 1975
  • Rose Kushner publishes Why Me?, raising awareness about the overuse of radical mastectomies in breast cancer treatments.
• 1976
• 1977
• 1978
  • The Pregnancy Discrimination Act is enacted.
• 1979
• 1980
• 1981
• 1982
• 1983
• 1984
• 1985
• 1986
• 1987
• 1988
• 1989
• 1990
  • Society for the Advancement of Women's Health Research (Now Society for Women's Health Research) is created by Dr. Florence Pat Haseltine in 1990.
• 1991
  • US Department of Health and Human Services' Office on Women's Health is created.
  • April 19th: Dr. Bernadine Healy, the first woman appointed as director of the National Institutes of Health, announces the Women's Health Initiative.
  • 1992
  • Journal of Women's Health is established.
• 1993
  • February 5th, Family and Medical Leave Act of 1993 is enacted.
  • September 13th, the Violence Against Women Act is enacted.
• 1994
  • The Mammography Quality Standards Act is enacted.

Media

List of associated media

Periodicals

• The Monthly Extract. (Lolly and Jeanne Hirsch)  1974-1978.
• Health Right. (Women's Health Forum)  1975.
• Women and Health. (SUNY at Old Westbury)  1976.
• The Newsalert. (National Women's Health Network)  1976.

Books

• Kushner, Rose (1985), Alternatives: New Developments in the War Against Breast Cancer, Warner Books. ISBN: 0446345873, ISBN: 978-0-446-34587-3, ISBN: 0-446-34587-3

Essays, articles, and pamphlets

• Kushner, Rose (1984), Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the '80s?, CA Cancer J Clin 1984; 34:345-351.

Notable people

Notable activists