Slide1: Gillian Bendelow Reproduction and childbirth


The Medicalisation of ‘Everyday Life’: The Medicalisation of ‘Everyday Life’ REPRODUCTION Menstruation Childbirth Abortion Contraception Reproductive Technology Menopause EMOTIONS WEIGHT/BEAUTY ‘BUSINESS’ AGEING DEATH


Medicalisation Thesis(e.g Friedson Zola Illich Strong Kohler-Reissman): Medicalisation Thesis (e.g Friedson Zola Illich Strong Kohler-Reissman) TWO PROCESSES MEDICAL IMPERIALISM medicine annexes itself to areas of ‘ordinary’ life which may have been previously under moral, religious or legal jurisdiction. Behaviours and conditions are given medical meanings ie defined in terms of health and illness IDEOLOGICAL medicine as an institution of social control, eliminates/controls problematic experiences defined as deviant in order to adhere to social norms destroys traditional resources, creates dependence and passivity in patients TWO LEVELS CONCEPTUAL ie medical vocabulary used to define problem INSTITUTIONAL problem is legitimated when diagnosis/treatment occurs


Top 20 non-diseases (voted on bmj.com by readers) in descending order.: Top 20 non-diseases (voted on bmj.com by readers) in descending order. 1. Ageing (includes menopausal symptoms) 12. Allergy to 21stC 2.Work 13. Jet lag 3. Boredom 14. Unhappiness 4. Bags under eyes 15. Cellulite 5. Ignorance 16 Hangover 6. Baldness 17. Anxiety about penis size 7.Freckles 18. Pregnancy 8.Big ears 19. Road rage 9.Grey or white hair 20. Loneliness 10.Ugliness 11. Childbirth R.Smith BMJ 324(7342):883


medicalisation of reproduction: medicalisation of reproduction Discourses of 1.medicine as agent of social control 2.social construction of gender 3.sexuality within medicine have historically constituted a site of sexual discrimination using medico-scientific justifications for differentiating between men and women on the basis of ‘biology’ and anatomy.


Woman as ‘other’: Woman as ‘other’ ‘[Women] are periodically wounded in their most sensitive spot..even in the healthiest woman, a worm, however harmless and unperceived gnaws periodically at the roots of life’ Havelock Ellis 1876 ‘One is not born, but becomes a woman’(de Beauvior 1959) ‘I know of no woman for whom her body is not a fundamental problem’ (Rich 1976) ‘In the life cycle, as in the Garden of Eden, the woman has been the deviant’ (Gilligan 1982)


Female physiology: Female physiology pudenda: Latin pudere meaning `to be ashamed of’ oestrogen Greek oistros meaning `insane desire‘ hysteria Greek hysterus meaning `wandering womb'


Pathological bodies: Pathological bodies The female anatomy is not made to have babies- she was designed to be a four-legged animal. Instead she stands on two feet, so the entire weight of pregnancy doesn’t hang free, but sits on large vessels, causing fluid to build up in extremities.. furthermore there isn’t a cervix owned by any woman that doesn’t tear. Dr Waldo Fielding The Boston Globe 1894


Social/ Medical Control of Childbirth: Social/ Medical Control of Childbirth up to 18C childbirth preserve of women/ midwives 19C doctors offering intervention ‘pain-free’ 20C move to hospital UK births 1927 15% 1985 99% increased technology : monitoring , forceps, artificial induction, anaesthesia, episiotomy and caesarian secations conflicts in lay/ medical goals eg health of baby vs experience of mother ‘normal’ birth= social construction not biological fact Despite societal definitions of women as ‘reproducers’ and bodies as machines, inherently defective in need of medical intervention


Medical vs social models of childbirth http://www.socresonline.org.uk/10/2/teijlingen.html: Medical vs social models of childbirth http://www.socresonline.org.uk/10/2/teijlingen.html


The medical gaze: ‘symptoms’ of PMS: The medical gaze: ‘symptoms’ of PMS Laws et al (1985) Seeing Red: the Politics of Menstruation pp37-38 lists over 100 attributed symptoms including: oliguria, weight increase, ulcerative stomatis, nausea, diarrhoea,vomiting, pruritis vulva, sciatica, migraine, headache, backache,,metatarsalgia, nose bleeds, chest pain, breast pain, herpes, urticaria, acne, styes, boils, fever, epilectic fits, hypoglycaemia, sinusitis, irritated eyes, tiredness, sleeplessness, muscle weakness, postural hypotension, clumsiness, lack of concentration, feelings of worthlessness, phobic panic attacks, suicide , depression, paranoia, violent tendencies 75% of women claim to have PMS symptoms = womens’ bodies inherently pathological??


A woman’s right to choose?: A woman’s right to choose? WHO chooses and WHY? Abortion Human problem-medical concern- crime? Contraception Low- tech/ high tech New Reproductive Technologies Fit parents?


Gender and pain: Gender and pain I suppose one naturally expects women within the course of a healthy life to be involved with pain but not men on the whole unless they get hit with hammers. (Male, aged 40) Women have more physical awareness - a more intimate and responsible instinct to their biology - all we do is shave (Male aged 23) Women are made to suffer pain because we have periods and childbirth. Whatever happens, women end up bringing up children, we just don't have the 'privilege' of giving in to pain and sickness. (Female aged 39)


Reproduction=meeting of biological and social meanings and histories: Reproduction=meeting of biological and social meanings and histories ‘Men began taking over obstetrics and they invented a tool that allowed them to look inside women. You could call this progress, but when women tried to look inside themselves, this was called practicsing medicine without a licence’ Mead 1974 ‘For women to separate their bodies from who they are in the larger context of their lives is like trying to separate two sides of a coin’ Todd 1989 Pathologisation/ diseasing of women’s bodies not sole creation of medical practices but clinical encounters refelect and reinforce prevailing views in society.


Women and medicalisation: debates: Women and medicalisation: debates Traditional feminist critiques of 70’s and 80’s saw medicine as ‘imperialist’ perpetrating iatrogenic interventions on passive women ‘victims’ Women not an homogenous group, some women ‘more equal than others’ Women may actively seek out intervention and technology (cosmetic surgery CS section) Women active but not equal participants in the medicalization of reproduction -they have both gained and lost in the process Participation in medicalisation informed by level and exchange of information in lay/expert interaction