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- Author: Caroline Rusterholz x
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Women’s medicine explores the key role played by British female doctors in the production and circulation of contraceptive knowledge and the handling of sexual disorders between the 1920s and 1970s at the transnational level, taking France as a point of comparison. This study follows the path of a set of women doctors as they made their way through the predominantly male-dominated medical landscape in establishing birth control and family planning as legitimate fields of medicine. This journey encompasses their practical engagement with birth control and later family planning clinics in Britain, their participation in the development of the international movement of birth control and family planning and their influence on French doctors. Drawing on a wide range of archived and published medical materials, this study sheds light on the strategies British female doctors used, and the alliances they made, to put forward their medical agenda and position themselves as experts and leaders in birth control and family planning research and practice.
After reminding the reader that the medicalisation of women’s bodies has a specific history, the introduction lays out the key arguments of the book. It presents the methodological framework adopted – namely a social, cultural and intellectual history framework that focuses on the environment in which women doctors lived, emphasising the opportunities they encountered and the constraints they faced. The introduction then reviews the main scholarship on birth control and family planning and makes the case for the need to study the role of women doctors. It locates women doctors’ contribution to the medicalisation of birth control and family planning within three different research strands: reproductive politics, gendered medical practices and contraceptive culture and scientific knowledge. It examines the interconnections of these elements to explain women doctors’ paths towards birth control and family planning.
Chapter 1 is concerned with the relationship between British reproductive politics and gendered medical practices. It covers the history of female doctors’ practical engagement with birth control and contraception in Britain, from the opening of birth control clinics in the early 1920s to the Family Planning Act in 1967. The chapter argues that women doctors introduced birth control as a field of medical research and practice because birth control clinics provided them with job opportunities. It also shows women were disproportionally represented among doctors interested in birth control, and they dominated this field due to their active participation in birth control clinics, the development of training in contraception and the production of medical and scientific knowledge on birth control and contraception. Drawing on sex and medical manuals, scientific publications in the British Medical Journal and the Lancet, as well as the archives of the Medical Women’s Federation and the Family Planning Association, this chapter focuses on the medicalisation process and the initiatives and strategies women doctors used to position themselves as respectable experts in the new field.
Chapter 2 explores the expansion of birth control sessions in family planning centres into sexual advice, which became available primarily through the activities of women doctors in Britain during the interwar period and onwards. The chapter analyses the way in which women doctors set up advisory sessions on ‘sub-fertility’ – i.e. sexual disorders and infertility – and how they shaped this advice, as well as their scientific contributions to these issues. It examines women doctors’ contributions to sex and medical manuals, scientific publications and sexual counselling sessions with their patients from the 1930s to the 1970s. This chapter demonstrates that Joan Malleson, Helena Wright and Margaret Hadley Jackson played a pivotal role in the development of this field. Their most important contribution was to create and sustain a new holistic approach to family planning where birth control advice, sexual disorders and infertility were treated together. Here, I argue that women doctors developed this approach, mainly in response to the difficulties faced by their patients.
This chapter turns to women doctors’ contributions at the international level between 1920 and 1937 through an explicit comparison between British and French women doctors by drawing on proceedings of international conferences and archival material. In the interwar years, British women doctors, although not numerous, were nevertheless agents of the legitimacy of birth control. Indeed, they were vocal and indispensable in the transnational movement for birth control. Owing to their somewhat peripheral position in the national medical field, they took up the task of the practical aspects of birth control; they opened clinics and fitted individuals. This practical experience paradoxically gave them specific female expertise and power, relative to men, in international associations. While birth control tended to be framed in eugenic/neo-Malthusian terms by male doctors before 1930, it gradually became a medical subject in which scientific vocabulary and concern for individual welfare predominated. Women doctors played a major role in this shift. The international conferences on birth control and population issues positioned women as experts in this medical field, but, as I show, also revealed national differences between Britain and France.
Chapter 4 uses the testing of the Gräfenberg ring, the first intrauterine device (IUD), and the rivalry between the female doctor Helena Wright and the sexologist Norman Haire to exemplify the new expert position acquired by Wright in both the international and national spheres. This chapter explores in detail the first clinical trials of the Gräfenberg ring. It reveals broader issues surrounding power relationships and expertise within the medical body and points out the way that female doctors were increasingly perceived as experts and reliable voices in the production of scientific knowledge on new contraceptive methods both at international and national level. In addition, it shows how international conferences and journeys were determinant spaces for doctors working in birth control, not only for gaining knowledge on new contraceptive methods but also for asserting their expertise.
The last chapter of the book delves into the many ways in which British women doctors pressed for the development of an international movement for birth control and family planning. It analyses their first attempt, in 1928, to create the Birth Control International Information Centre. The crucial role of British women is not restricted to the interwar years. Indeed, they proved successful in rebuilding a transnational movement after the Second World War. Due to the connections they established before the war, they managed to gather experts on family planning in order to redefine a new ‘planned parenthood’ movement. In addition, this chapter pushes the transnational approach even further by showing how the circulation of actors and knowledge from Britain to France eased the creation of a French family planning movement and family planning centres.
The conclusion highlights the principle contributions of the book: women doctors actively contributed to the medicalisation of contraception and family planning. They did so with a view to empowering women to avoid pregnancies and adopt female-oriented methods of birth control. But they also aspired to take these issues away from the moralists; instead, birth control, contraception and family planning were to be regarded as medical fields of research and practice in which female doctors would be central actors. By engaging medically with this topic and entering the field in large numbers, women doctors were trying to secure territory for themselves. Despite a feminist sensitivity to and awareness of their patients’ needs, they were nevertheless wielding their authority over the female body. At the national level, women doctors tirelessly advocated for access to contraception and reliable methods of birth control. At the international level, British women doctors participated in debates about the medicalisation of birth control at conferences in the 1920s and 1930s. They contributed to positioning birth control as an international health issue. The conclusion then engages with more contemporary debates on feminist criticisms of medical power and briefly assesses the legacy of these women doctors.