Through history, Western medicine has focused on the study of disease rather than on health or healing. Only in recent decades has the importance of the patient's own defense mechanisms (including the mind) been recognized; research in this area is only in its infancy, and findings have not yet been widely applied to the practice of medicine in this country.
Excessive medical and surgical interventions on women are a tradition in U.S. medicine. Only one hundred years ago it was thought that a physiological basis for female insanity existed in the reproductive organs and that the obvious solution was surgery. For example, women underwent hysterectomies for "calming" purposes; the word "hysteria" is derived from the Greek word for uterus.
Although U.S. doctors no longer believe that women's reproductive organs cause mental illness, women still are treated very differently than are men. Thousands of prophylactic mastectomies (removal of healthy breasts to prevent the development of breast cancer) are performed in this country annually. One-third of U.S. women have had a hysterectomy before menopause; after menopause the number rises to one-half. Women are prescribed drugs more frequently than are men: some of the more overused drugs include hormones, tranquilizers, diet drugs, lactation suppressants, and drugs for premenstrual symptoms.
Preventive medicine also has become more interventionist: current research emphasizes using potent drugs to decrease the risk of one disease although they may cause another; the field has moved from disease prevention to disease substitution.
Normal processes such as menopause and childbirth have been heavily medicalized. The chronic use of hormone replacement therapy (HRT), even in women who do not need the therapy to treat hot flashes or vaginal dryness, has been heavily promoted to prevent heart disease and osteoporosis, although evidence is skimpy for these claims, and hormone replacement therapy appears to increase the risk of breast cancer.
Great strides have been made in reducing interventions in childbirth (women are no longer shaved, denied food during labor, or put under general anesthesia). Obstetricians are trained to view childbirth as a process fraught with potential problems. Fetal monitoring, for instance, is widely used, although studies show no difference in the outcomes of normal labors that are electronically monitored (usually with a belt around the woman's body that restricts movement) and those that are intermittently monitored by stethoscope.
Midwifery, which treats childbirth as a normal event with rare complications, is an example of health care, as opposed to disease care. Unlike obstetricians, midwives are trained to see childbirth as a normal process.
The women's health movement sprouted in the early 1970s with the publication of Our Bodies, Ourselves and the creation of the National Women's Health Network. Both were key in helping women to take control of their own health, battle unnecessary and dangerous medical interventions, and fight for better health care.
Birth control and abortion rights always have been a key part of the women's health movement. When abortion was illegal, feminists in Chicago organized the Jane Collective, a sophisticated network that allowed women to get safe abortions. Feminists also created self-help groups, where women learned cervical self-exam and menstrual extraction, a low-tech technique of early pregnancy termination.
A Harvard study found that one of three U.S. consumers surveyed had used some kind of alternative therapy (excluding exercise and prayer) in 1990. Consumers spent $13.7 billion on alternative medicine, which is more than the annual out-of-pocket amount spent on hospitalizations. Relaxation techniques were the most commonly used therapies, followed by chiropractic and massage. A survey distributed through Prevention magazine found that the use of alternative therapies was quite high among menopausal women.
More women than men visit alternative practitioners (or use alternative therapies on their own); however, practitioners of alternative medicine who have achieved media prominence are predominately white men, who rarely give credit to the African, Asian, Native American, and other cultures that spawned these forms of treatment. The only alternative fields dominated by women are therapeutic touch and massage. Women have long practiced herbalism, and, interestingly, in chiropractics, three of the first "Fifteen Disciples" of D. D. Palmer's Chiropractic School and Cure were women. One of these women was Minora Paxson, who coauthored the first textbook in the profession. By the 1920s between one-third and one-half of chiropractors were women. A backlash against women followed World War II; female admissions dropped precipitously and never recovered. In 1986 only 10 percent of chiropractors were women.
True health is not only the absence of disease but the optimum functioning of body, mind, and spirit. The presence of love, work, and meaning in women's lives is vital to health. Many alternative practitioners emphasize preventive medicine and stress reduction, including changes in diet, life-style, and exercise patterns. Concepts such as balancing energy or using tonic herbs to strengthen organs and prevent illness still are ideas guaranteed to elicit blank stares from most traditional physicians. As unconventional medicine is increasingly accepted and practiced, we can look forward to research on health as well as disease, to true partnerships between consumers and health care practitioners, and to the use of the most benign (instead of the most drastic) therapies for any given condition.
Boston Women's Health Book Collective , , The New Our Bodies, Ourselves (New York: Simon and Schuster, 1992); Barbara Ehrenreich and Deirdre English, For Her Own Good: 150 Years of the Experts' Advice to Women (Garden City, New York: Doubleday, 1979); Barbara Katz Rothman, Giving Birth: Alternatives in Childbirth (New York: Penguin, 1982).
Adriane Fugh-Berman
See also
Women's Health Movement.
