Helping ourselves to health......

(The following was excerpted from an article by Helen I. Marieskind which appeared in the Sept./Oct. 1976 issue of Social Policy I

A Historical View

Women teaching women about their bodies and their reproductive organs is nothing new. In fact, the earliest records of healing from the Egyptian and Sumerian civilizations indicate that women healers shared with their patients their knowledge of herbal spermicides. pessaries worn in the vagina to prevent conception, and abortion-inducing skills

In Italy in the eleventh century. Trotula di Ruggiero became a prominent obstetrician-gynecologist. Her numerous writings included the first description of the physical signs of syphilis. Her greatest works contain treatments for uterine disorders. dysmenorrhea, sterility. hygiene during pregnancy, the parturient woman. difficult labor. and procedures for midwives in all emergencies

Angelique Marguerite le Boursier du Coudray (1712-1789) was licensed to practice midwifery in Paris in 1740. She developed a manikin of the female torso in order to teach women the art of delivery. In 1759. Louis XVI appointed her to go into all the provinces of France to give free instruction to women.

Women were part of the popular health movement of

the 1830's and 1840's here in the U.S. They formed Ladies Physiological Reform Societies in which women lectured on elementary anatomy, sex. and general hygiene. Such common-sense-and. for that time, radical-ideas as frequent bathing. preventive care. loose-fitting female clothing (whalebone corsets worn by fashionable women did not allow enough room for organs). temperance, healthy diets, including whole grain cereals, and even birth control were taught.

Lydia Folger Fowler (1822-1879), who became in 1851 the first woman to hold a professorship in a legally authorized medical school in the U.S., began her medical career by lecturing to groups of women on anatomy, physiology, hygiene, and phrenology, writing Familiar Lessons in Physiology for the public in 1848. Elizabeth Blackwell, too, began her medical practice by presenting a series of lectues on physical education for young women. Some of her audience welcomed her enlightened views and sought her care as patients.

These few examples of the many efforts made over the centuries to educate women about their anatomy serve to raise the question: Why was/is it necessary to educate women about their bodies and functions in the first place?

History provides the answer, revealing a consistent effort to exclude women from anatomical and medical knowledge. This was achieved by the enforcement of highly biased policies denying females access to education, imposing standards of licensure to practice medicine which women could not meet, hoarding new medical knowledge and techniques, open harassment and murder, and pitting one type of female provider against another.

About 300 B.C. women doctors were generally barred from medical practice in classical Greece. That ban was broken, perhaps apocryphally, by Agnodice, whose masquerading as a male and whose obstetric and gynecologic skills led to her arrest for practicing medicine under false pretenses. Acquitting her, the magistrates passed a new law "which gave gentlewomen leave to study and practice all parts of physick to their own sex, giving large stipends to those that did it well and carefully. And there were many noble women who studied that practice and taught it publicly in their schools as long as Athens flourished in learning,"

But the gains made were soon lost to the biases of Christianity, the bond of church and state to force licensure, and the evolution of the universities as male preserves. In 1322 in Paris, Jacoba Felicie de Almania was charged with practicing medicine without a license.. She argued her case unsuccessfully on the grounds that *"it is better and more honest that a wise and expert woman in this art visit sick women, and Inquire into the

secret nature of their infirmity, than a man to whom it is not permitted to see, inquire of, or touch the hands. breasts, stomach, etc. of a woman; nay rather ought a man shun the secrets of women and their company and flee as far as he can. And a woman before now would permit herself to die rather than reveal the secrets of her infirmity to any man, because of the honor of the female sex and the shame which she would fee. And this is the cause of many women and also men dying of their infir mities, not wishing to have doctors see their secret parts. And on this there has been public sentiment, and the Dean and Masters will not deny it."

Repression of medical knowledge for women continued. When the Byrthe of Mankynd, one of the first midwifery texts, was ultimately revised and published in English as The Woman's Book by Thomas Raynald in 1540 or 1545, it was done so despite physicians' protests of the midwives' ignorance and against the doctors concerted efforts to prevent them from learning. The complaint raised was that by putting the information in the common language, boys and men might read it. So might women, and that was exactly what Raynald had in mind.

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Gynecological Self-Help Today

Today, a gynecological self-help group essentially tries to do the same thing: to make easily understood information about women's bodies, bodily processes, and related health care available to all women. To achieve this, self-help clinics are held. A self-help clinic is not four walls and a door but rather a process of health education. A group of approximately six to ten women becomes a self-help clinic (or group, as it is less confusing to call them), meeting together for about 10 weeks to exchange health information and experiences, to learn. breast and vaginal self-examination, and to learn about common gynecological conditions. This is a shared educational experience and is the basis from which more advanced self-help clinics may grow.

The sharing of information which is the underlying principle of a self-help clinic is what makes this contemporary form of women educating women different from the historical examples given earlier. In theory all members of the group are equal, and although one member may be more vocal and have more knowledge to share, each member's experience must be regarded as valid for the self-help concept to work. From this is relevant to them and reflects their experience. sharing, the women build up a body of knowledge that

Critics of the concept frequently challenge that the participants will end up only misinforming each other and adding more "medical mystery" to already inade-

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quate knowledge. While without doubt some misinformation is given, the group setting tends to minimize this danger. The women tend to question among themselves when information seems incongruous or irrelevant to their experience and will endeavor to seek additional input from other sources to clarify their understanding.

Advanced self-help clinics may learn more medical techniques, with the most advanced performing menstrual extraction. This is by far the most controver sial aspect of self-help. The procedure is done in a group and is available only to women who have been carefully screened and who have participated through the varied levels of self-help. Other variations of gynecological self-help are now common in the women's health movement. Groups for mastectomy and hysterectomy patients, for pubescent adolescents. for prenatal care, and for menopausal women are all functioning on the same principles as outlined above. Goals of Self Help

The specifically defined goals of any self-help group may vary, but two goals are always central to the group's function. One is to provide health education for the women; the second is to aid a woman in her own self-fulfillment.

While there is very little documentation beyond ver bal assurances of the gain in knowledge achieved by women who have participated in a self-help clinic. documentation does exist to verify women's lack of knowledge of their anatomy and gynecological care. In 1973 Muriel J. Reynard tested women for their knowledge of basic anatomy and simple gynecological procedures. Out of a perfect score of 8, the sample of 100 women had a mean of only 3,34. In studies which I did in 1975, 200 women were tested for their knowledge of basic anatomy and simple gynecological procedures. In tests measuring the women's ability to accurately name the parts of their anatomy from a diagram, the mean score was 57.7%. The most distressing finding was the relatively low knowledge women have of when to obtain techniques vitally important to maintaining their good health. Scores measuring knowledge of contraceptive contraindica tions (mean 33.4%) indicate that although there,may be high contraceptive utilization in this country, there is low understanding of the risks of each method. Particularly with the increasing evidence of risks attached to birth controll pill and IUD usage, such ignorance on the part of women consumers may prevent them from recognizing and preventing potential health hazards.

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page 8/What She Wants/November, 1977