Woman; Women's Health Care: A History
Why exploration. Good evening and welcome to woman.
Tonight we're going to be discussing the history of women's health care.
We have some old gynecological and obstetrical instruments to show you.
I think you'll be very interested. My guest this evening is Virginia Druckman.
Virginia is currently the recipient of three fellowships. She is she is a Smithsonian fellow a Woodrow Wilson fellow and a Fellow of the Institute on human values in medicine.
She is a doctoral candidate doing research on women physicians and Women's Health at the Smithsonian Institution in Washington.
Welcome to the show Jenny. Hi.
At one time there were only women taking care of women's health care needs weren't there.
When was that. I would say that they sickly ever since antiquity women have been responsible for the health care of their families.
What were the reasons that only women were doing that.
Generally it was because health care was considered an extension of within the home.
If you open up. Recipe books in the 18th and 19th century for example when you turn to the back of this book you'll find recipes for home remedies that women could prepare for their families when they were sick so they were delivering babies then too.
Oh yes and in fact women were essential in control of that part of medical care they were they had a monopoly over the area of middle three. Only women responsible for this in fact in colonial New England it was against the law for a man to deliver a baby. So would it be fair to say do you think since 1830 1850 or so and only it's been that women have been in the medical profession caring for women. Absolutely. Up until that time women as I said control this area. Now what basically happened was that around the turn of the century various medical schools began to teach obstetrics and gone a classical course as to its medical students. What this meant was that medical students had access to these courses on obstetrics women who didn't have access to these schools didn't have access to this information. So that the midwives were discredited in a sense because the doctors were being taught that you know it was a profession right. What happened was that men could go around claiming that they had the educational tools necessary to offer obstetrical and gynecological.
And they could easily then define the midwives as ignorant and uneducated.
Another important change was technological advancements. There were at the same time around the 1830s 1840s 1850s a large number of instruments which were developed and again these instruments by male physicians they were taught to the men in the medical schools and again the women didn't have access to the schools than have access to this information. So it was easy for them to say don't go to this you know primitive person. We have the instruments and what you see happening is that what had originally been an area that was controlled by women now became a so-called profession. And as it became a profession women were pushed out and men moved in and took it over. So then that also meant it was becoming more lucrative.
Right. Oh absolutely.
Basically there was a very different situation as far as the ratio of doctors to patients in the 19th century than there is now there are far more doctors to patients then and then many more doctors and their patients so it's much more competitive. As far as finding a patient clientele and doctors began to look around and it didn't take too long to figure out that women and women's diseases would be a very very lucrative area of practice you brought them instruments. Yeah and they look for anything. We should thank the Smithsonian for allowing you to bring me to the studio because I understand they're very valuable. Yes they are some of the stories as far back as 18 40. But this is a forceps this force that says that around 1850 you can see how crude it is this is a new handle that was put in here.
The handles are even curved so you can see that it was hard to hold.
There's no way of sterilizing this you know I can kind of narrow off to the touch to write smoother and.
What what is this.
This is now the way this works is that when a fetus died inside a mother there is no from her. So they would have to literally go inside and cross the fetus and then remove parts of it and I can't open this like it's a nuisance here and this and then you see how this goes. Go at it. Now this we don't know anymore because first of all we have as a means of. Delivering babies if we can't deliver them normally and operational much more advanced now so this kind of thing is no longer necessary. Now one of the things that when I first saw these forceps was that basically they are generally very similar to these as far as forceps is concerned. And basically that has not changed as an extension of a physician. How ever the author of childbirth and she did that. She believes that there should be a great deal of research kinds of developments on the fourth of that. In fact I was aware of it had been rejected by the research company in Cleveland wanted to do research on making the forceps smaller so that there's no need for changes in that time.
Well they don't have wooden handles anymore and you can sterilize them.
That's I think heavy this. Yeah I kind of slipped in the extremely painful to them. If this is just looks absolutely weird this is a speculum in this is it. Open it up and then you open it like this. Now later that if the physician would like to go into the speculum and join you. Hopefully the doctor with better at it. This is another type of speculum. It's a 3 sizes for 3 different sized kindness. And those are for examination. This is a picture of a gynecological table in 1890 and you can tell that it's really quite crude. And in addition to me the most interesting thing about this kind of classical table is that the speculum the stationery which means that essentially the woman has to conform her body to where the speculum is rather than the doctor moving the speculum to conform to the position of the woman's body as in the stirrups of course that was still held that so many women complain about this look at extremely right. And this is a more forceps. You can see the change in the handles. This is a later pair of forceps and this was this is basically a force of one's antiseptic.
The handle is now. We have this uterine dilator. This works is that the physical instrument in China like this and then. Open it so that you could dial it in the US increase the size of it and it has sort of separated handles which indicates that this is a later tool and this is an accurate that's a very scary looking thing is are actually still used today. What is that and can grab hold of a pall of growth with very sharp points here today and when I first started using this is we now have anesthesia which wasn't always. One of the scraping of the DNC right.
Elevator. Now they have ways of showing up your Assume whatever temporarily during operation. And then there is this lever here which I could lift and I could you know they could adjust that. Now when I talk about. These are devices based on a particular kind of medical therapy electricity electricity. That was done on men and women for any variety of medical problems they were generators in and inject electricity in any kind of reason for paying for for a headache or whatever but specifically. The instruments that were used for gynecological problems this instrument that was John and then touched the cervix here OK. And then the current went through here and this was for any kind of purpose perhaps excessive bleeding during menstruation. The same thing with this this is a bad electrode. Now the way this worked was that this went into the vagina electric current went through one of the openings and medicine went to the other and out of these holes and this again was any kind of gynecological complaint cramps excessive bleeding they would even use it for a so-called undeveloped vagina exam. Part of the current that they were injecting into the person's body. So depending on how much the maximum amount of current was. I assume there's a broad spectrum as far as the feeling that the woman had with this device anywhere from a tangle to absolute pain I'm sure and I want to emphasize that electricity as a therapy was on both men and women. However I have no indication that there are there were electricity used on male penises where it certainly was widespread on China's. OK let's see this I think. This set here. OK we thank you. This is a cutting 6 1844.
And then explain what cupping.
Right. Cut the other kind of medical. The idea that you create a blister anywhere on the body and this will draw the germ to that blister. Then once you've gotten the blister and the germ concentrate in the blister you Lance the blister the blood and with the blood flows the germs. Now with just as with a letter for me cutting was done both men and women. However there's an interesting device here this one here in particular you can see that it's curved this metal rod goes inside this and this can go to the curvature here. This particular device was used for creating blisters inside a woman's vagina. So that again we see the same kind of broad spread of both electricity and cupping as a medical therapy but there's no device here that was used as it was. Cupping on the male penis. What is that this is the device that was used for the lancing for creating the gash is where the blood would flow. That is incredibly sharp. Yes yes. And this one where you are creating blisters around the breasts. And then this this device here created the vacuum which caused the blister and the blood flowed into this here. So that's what it meant like cupping. Yes.
There they are a very.
This was around the corner of a baby or whatever you were having trouble moving the baby during childbirth. In addition if you had a dead husband pray for Sept..
At the same time it has a wooden handle so there was no sterilization. Involved in this.
There's one more. Glass. Are you down with the China into the uterus and clear away any kind of. Obstructions or whatever.
And. Kind of this has been.
Yeah I think I've seen a more modern type set. I guess you know it's obvious to say that all this seems so primitive.
Extremely primitive and basically all that medicine at that time was very crude and it was really not very scientific at all. There was no there were no antibiotics to cure any kinds of infections. There was a very great resistance to the use of antiseptic procedures. Even the doctors have been made aware that antisepsis was absolutely critical there was a great deal of resistance to it. What about other procedures that surgical procedures now I've heard about very odd to me for instance and it's a very odd and it's a removal of the ovaries. And clear objectives which is the removal of the clipless were a gynecological operation surgical operations which are performed very often on women in the 19th century. Now it can be argued that for example the clitoris the removal of the clitoris that in some cases because there was not a doctor could do with a clearance became very infected for example very irritated Perhaps the doctor could justify and say well the only thing I could do would be to remove it. However there are other reasons. Why women were subjected to this operation. Oftentimes it depends on the kind of behavior. That they manifest as if they were caught masturbating for example or if they were. Suspected of engaging in excessive masturbation or enjoying sex too much. Then they were brought to their position and having to move for their own reasons.
You know you've done a lot of research to me Do you see a stick thin thread running through here.
I think sadistic is. A. Part of it but not so much that just because I think it's almost a fear that.
This just physicians physicians have no control over reproductive processes in addition have no understanding of them. And this is one way in which they could control than simply removing them. Women were much more susceptible to death during surgery at this particular particular because they were subjected to one particular kind of operation which men are never so susceptible to and that is that they were always going through childbirth because there was very little reliable. Birth control. Women became pregnant far more often than we do now. And childbirth was a very very dangerous procedure specifically because of the. Lack of use of antiseptic procedures. A doctor would go from patient to patient without washing his or her hands and the result as far as this is consistent infections are. Easily developed. Woman suffers from fever which is an infection directly resulting from child from childbirth. And without antibiotics the woman simply dies. But we're women going to hospitals at that time to help. Basically if you could afford not to go to hospital you stayed out of the hospital. I mean if you could afford not to go if you could afford to have a physician come and deliver your baby at home. That's where you had your baby doing most of the lying and hospitals are populated by women working class women. These are the women who could not afford to have a physician come and deliver for themselves. And what you find is that these lying in hospitals become. Beds infection. You know. In. Just. A moment is. A dying from childhood fever because the doctors are not washing their hands and not washing the forceps between deliveries. But there were other reasons given at that time weren't there for for the meth infections that were going on because they wouldn't understand why these infections were spreading basically Blain. Corporate fever for example on the women in the hospitals themselves. When you have this working class population of women in the hospitals it is very easy for the doctor to justify the fever on the basis of the so-called low moral character of the women.
So if she was promiscuous or she was promiscuous because she got the fever right. Absolutely. Incredible. There were hospitals specifically for women's diseases right.
Yes there are hospitals or hospitals for women and children. And if she had any kind of gynecological problem where she would go to have her babies delivered. So the upper class women stayed away.
It's absolutely. It seems like so much of the treatment you know is not even vaguely scientific or really medically sound. Do you think that's a fair assumption.
I think yes and yes. I mean there was no understanding of antiseptic procedures no appreciation of it there were no antibiotics it was very little that a doctor could do.
Well how do the doctors really justify their inability to treat women during that period of time.
Basically what they did was that they defined women as inherently sick. And it was defined as inherently sick. This is a justification for inability to cure them.
Well I mean they just didn't say all right you know women are inherently sick I mean be more specific what are the arguments that they use to convince people of this.
They argue that basically because of her reproductive organs specifically her ovaries it was her gaze which made a woman. Innately. Diseased. And what this meant was that. All of the female processes female reproductive process is also defined as disease like menstruation for example pregnancy. Men of course each of these reproductive process is defined as themselves diseases.
Now you're saying that they preach invalidism.
Really. To find women as invalids. Essentially. And that the only way that they could prevent any kind of massive medical problems was to make sure to rest. Basically. Most of their lives. Was there any resistance to this and the resistance mostly came from women. There was a very wide spread kind of propaganda campaign by physicians that women should rest. And. It became a very kind of. Political in the sense that it was became very restrictive of women's lives. There's one position for example and Dr. Edward Clarke who had worked at Harvard and he wrote a book called Sex in education or a fair chance for the girls and he argues that he is not stating that women should not be educated. He's arguing that women should be educated but that they should be educated in a womanly way. Now what he meant by this was that he's arguing for what I'm talking about the emphasis on the rest. During any time in a woman's life when her female physiological processes are functioning. He says that. A woman's body is in debt with a certain amount of energy. And that. Her body can only do one thing well at a time. Therefore the woman is menstruating. For example. There's an excess amount of energy that is needed to be focused on the proper. Functioning of menstruation. Therefore she should not divert energy from that to her brain. And he argues if for that during menstruation a woman should by no means be educated should involve herself in excessive studying that during puberty for example when there is so much energy needed for the proper development of the girl's ovaries that women should not be educated at all. What about today. What about you know.
Are there parallels between what happened then and what's happening to women medically today. I mean we have somewhat of an uproar coming from the women's movement about some of the health care practices.
I think there's several parallels First of all there's a controversy now over hysterectomy which is a very power which is parallel to the controversy in the 19th century over rights over Ottomans.
Women are beginning to demand control again over their bodies beginning to demand to know more about the reproductive process is that they started self-help. No no nobody courses which are. Have their historical antecedents in 1981 when we began physiological lectures where women would get together and someone would lecture to them on their bodies. And I think we can make another powder just to the control of the medical profession still has as far as defining what is correct medical treatment or care. The makers of model for example now are finally telling us every day of the month belongs to you. Moments ago they were telling us very few of the days of the month long. So I think that there is still a basic kind of control by the medical profession and women are again beginning to demand control of themselves.
Do you think the institutions will be formed themselves. Our medical institutions.
I think we can let a physician from the 19th century answer that question best. Three men are good hearted but too many of them are wrong headed and conservative in never reform themselves. Men become formers and outside influence must be brought to bear upon them.
Jenny thank you. Thank you for watching and good night.
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The Ford Foundation and the Corporation for Public Broadcasting.
This transcript is machine-generated and has not been corrected. It is likely there will be errors.
- Women's Health Care: A History
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- WNED (Buffalo, New York)
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- This episode features a conversation with Virginia Drachman. She is a Smithsonian Fellow, a Woodrow Wilson Fellow, and a Fellow of the Institute of Human Values in Medicine. She has brought old gynecological instruments from the Smithsonian to show us.
- Woman is a talk show featuring in-depth conversations exploring issues affecting the lives of women.
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- Copyright 1975 by Western New York Educational Television Association, Inc.
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Director: George, Will
Guest: Drachman, Virginia
Host: Elkin, Sandra
Producer: Elkin, Sandra
Producing Organization: WNED
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Identifier: WNED 04368 (WNED-TV)
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- Chicago: “Woman; Women's Health Care: A History,” 1975-10-21, WNED, American Archive of Public Broadcasting (WGBH and the Library of Congress), Boston, MA and Washington, DC, accessed February 16, 2019, http://americanarchive.org/catalog/cpb-aacip_81-48sbchx0.
- MLA: “Woman; Women's Health Care: A History.” 1975-10-21. WNED, American Archive of Public Broadcasting (WGBH and the Library of Congress), Boston, MA and Washington, DC. Web. February 16, 2019. <http://americanarchive.org/catalog/cpb-aacip_81-48sbchx0>.
- APA: Woman; Women's Health Care: A History. Boston, MA: WNED, American Archive of Public Broadcasting (WGBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from http://americanarchive.org/catalog/cpb-aacip_81-48sbchx0