Women as Patients:

1
Women as Patients

• Obstetrics Midwifery

2
Medicine on Women

• Obsession with womens reproductive functions
• Concerns about population
• Masculine concerns about male reproductive power

3
Menstruation

• Many ancient cultures viewed menstruation as
  unclean
• Also possibly dangerous

4

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

5

• Plato
• Speculative
• Uterus seat of womens sexual instinct
• Wandering uterus

6

• Hippocrates
• Regularity of menses
• Position of uterus
• Therapies aimed at regulating these

7

• Soranus
• Methodist
• Contemporary of Galen
• Believed that womens health, like mens, was not
  centred around their reproductive function

8
Reproduction

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

9

• Hippocratics
• Both male and female contributed a seed
• Egalitarian

10

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

11

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

12

• Galen
• Two seed model
• Women still biologically inferior
• Womens reproductive organs were defective
  version of the males

13

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

14

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

15
Medical Treatment of Women in the 19th Century

• Impact of Darwinianism on ideas about human
  reproduction
• Increased interest of medical profession on
  womens normal lives

16

• Proliferation of medical advice on many aspects
  of womens life
• Celibacy/marriage/child bearing/child rearing
• Exercise

17

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

18
Medicalization of Childbirth

• 1. Emergence of obstetrics
• Seminar papers will be considered here

19

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

20

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

21

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

22

• 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

23

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

24

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

25

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

26

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