Born unmistakably out of feminism's second wave in the late 1960s, the Women's Health Movement's (WHM) values derived from feminism's broad commitment to equality and nondiscrimination. It came alive out of the protest climate of the 1960s, inspired by "the movement" for social justice then sweeping the land.
Unique to the WHM of the second wave was its insistence on placing female sexuality, sexual self-determination, and sexual identity at the center of women's health concerns. This analysis exposed the blame-the-victim moral tyranny, prejudice and health neglect underlying so many of the reproductive laws and medical practices of the day.
The WHM started spontaneously in different parts of the country through different activities, with varied leadership, and raising multiple issues; there was never any single individual or group founder of the WHM. Contrary to popular assumptions, however, women of various ages, women of color, and working-class women did participate in the WHM from its beginnings, although not in great numbers. Latinas, Black women, and Native American women knew firsthand about clinic care, illegal abortions, infant mortality, sterilization abuse, and population control. For the WHM, these scandals rapidly became core knowledge for every advocate in the ongoing class, race, and gender analysis of the health system.
"Consciousness-raising" and "know-your-body" group experiences gradually changed thousands of women's outlooks on their private lives and on the meaning of personal bodily and medical experiences, allowing them to see these events for the first time in political terms.
In women's groups across the country, and eventually the world, activists introduced personal gynecological self-examination via plastic speculums, along with alternative remedies, fertility awareness, and basic body wisdom, called self-help groups. Menstrual Extraction (ME) or Menstrual Regulation (MR) (withdrawing the uterine lining in a simple, sterile, mechanical procedure) was unquestionably the most precedent-shattering achievement of "lay" women working in advanced self-help groups. Their development of the flexible cannula was and is revolutionary. This innovation established a higher worldwide standard for abortion care, acknowledged by the medical establishment itself. The full potential of this technology for returning abortion control to women, however, has yet to be realized.
The era of citizen and journalist health investigations was at its height. Harmful drugs were on the market; contraceptive experiments such as the birth-control pill involved deaths that were concealed; unnecessary hysterectomies, ovariectomies, and mastectomies were widespread and ignored; poor women were used as guinea pigs in government-approved experiments.
WHM writers and researchers began producing a prolific flow of books, pamphlets, films, and articles. These works provided an enraging history of women's health, a platform for protest, and, eventually, a solid base of accurate knowledge on which ordinary women and the oncoming movement were nourished and could begin to pursue their advocacy and action efforts.
Ordinary women, "lay" women, suddenly felt entitled to conduct their own research, to challenge publicly the presumed scientific authority of doctors' pronouncements about female sexuality, women's proper roles in society, and their health and diseases. These attitudes and behaviors were considered extremely deviant at the time. As with sexuality, women patients challenging medical and scientific expertise in public discourse was shocking. Women began to listen to and trust other women. The WHM thus was considered "revolutionary."
The movement came early to its international, "global" outlook. Outraged by experimental birth control for poor women—mostly women of color—activists quickly took up the issue of population-control practices. In the 1970s the United States Agency for International Development's (USAID) policies made aggressive, high-technology birth-control programs a precondition for loans and economic aid to Third World countries.
When U.S. WHM activists realized their efforts were effective in protecting U.S. women by keeping dangerous or questionable drugs and devices off the U.S. market (e.g., the "high-dose" pill; the Dalkon Shield IUD; Depo-Provera), they saw these products simply "dumped" or widely available as bargains for financially strapped Third World governments. Without benefit of warnings, millions of women could be harmed by these rejects. The WHM protested, demanding action on behalf of women overseas. A global view thus became essential.
Much of the WHM's early focus was concerned with women's need for sexual self-knowledge, self-determination, and reproductive rights, but the WHM's vision was broader, including addressing the impact of DES and its iatrogenic effects, unnecessary surgery, damaging childbirth practices, and violence against women. Long before HIV/AIDS was identified, women's health advocates took the lead in educating women about the risks of undiagnosed sexually transmitted diseases and pelvic inflammatory disease. Menstruation was demystified and PMS alternative remedies discovered. Others founded Feminist Women's Health Centers in several U.S. cities, providing women-controlled settings for self-help programs, and, once abortion became legal in 1973, early abortion care. Simultaneously, other women's communities across the country launched their own well-woman health and abortion centers as "alternatives" to conventional care.
By 1975 the National Women's Health Network (NWHN) was formed, the nation's first and only public-interest membership organization devoted exclusively to all women's health issues, especially those related to federal policy. The NWHN helped to strengthen the FDA's Patient Package Insert (PPI) program, improving the quality of warnings, especially to healthy women, about the risks and side effects of the Pill and powerful menopausal estrogens. It supported class-action suits against drug companies that manufactured DES. The WHM monitored the federal budget for amounts spent on barrier methods of contraception as opposed to more experimental hormonal or device methods. The WHM also helped initiate the study and approval of the cervical cap as an alternative. It launched Citizen Petitions to the FDA, established registries for women given drugs or devices not approved for the purpose, and developed model informed consent forms so women could become more aware of potential health risks. Working with women scientists, it challenged research protocols and raised ethical issues concerning the use of healthy women in studies. It organized letter-writing campaigns to force the FDA to establish uniform labeling of tampons to prevent Toxic Shock Syndrome and helped expose corporate negligence related to the Dalkon Shield IUD and silicone breast implants.
By the mid-1970s, U.S. women and the WHM saw both setbacks and gains. The rise of the New Right and antiabortion religious groups had begun. The Hyde Amendment passed in 1977, eliminating federal Medicaid funding for abortions, forcing all states to decide whether or how to fund this service. Beginning in the 1970s and continuing through the 1980s, resisting right-wing and antiabortion efforts to roll back gains consumed the efforts of most activists. Despite this struggle, the WHM was now established.
Growing out of an NWHN project, incorporating WHM values, the National Black Women's Health Project (NBWHP) was ignited by a highly successful 1983 conference. It has become one of the country's major women's health groups advocating for the needs of women of color. Other groups, the National Latina Health Organization, the Native American Community Board's Women's Health Education Project, Asian American Sisters in Action, and the National Asian Women's Health Organization, also were formed. New national coalitions of women of color organized around reproductive rights, population and environment issues, violence, and AIDS. Women of color transformed the WHM by leading organizations drawn from their own communities and by participating in the leadership of multicultural women's health organizations such as the National Women's Health Network. Focusing on health issues in the context of racism, coercion and violence, and economic discrimination, these diverse voices have strengthened the movement at all levels.
The public became increasingly aware of the dearth of woman-centered medical research or health-care provisions. Many women found it difficult to demystify health-related concerns or to challenge doctors; instead, they pinned their hopes for better care on finding a sympathetic woman doctor. The results have been mixed. Although studies show that most women are pleased, many women bring inappropriate expectations to women doctors, whose ability to be flexible or question traditional medical practice often is more constrained than that of most male physicians. Most women doctors collaborate with the drug industry, just as male doctors do, and tend to disparage alternative therapies. Nevertheless, women physicians are mobilizing to change teaching programs in medical schools to include more about women's health. The WHM has always worked with progressive women professionals and supported women's struggle to become a critical new force in medicine and health care.
The WHM continues debate on the potential of women professionals' leadership to improve medicine or health and medical care for women. Some argue for a women's health medical specialty, while others agree with experts who conclude that the system needs fewer, not more, specialists. Opponents believe obstetrics and gynecology, as a surgical specialty that excludes primary care, needs either to be abolished altogether or drastically revamped to meet women's needs rather than those of doctors and surgeons. Many WHM activists feel that there are too many physicians, as much public-health research suggests. Recognizing the justice in women having equal access to a medical career, reformers promote increased use of midlevel nurse practitioners and nurse-midwives. They see nurses as the best possible providers of more satisfying and equitable care at far less cost—even as these health care workers become increasingly tied to the insurance and drug industries and to the medical profession.
The WHM continues to include all reproductive rights as a central part of its agenda, believing that a woman's right to control and express her fertility is a basic precondition for exercising other rights. Many believe that without improvements in fundamental economic conditions for women, family planning alone cannot cure poverty. Most continue to feel that women's reproductive options are best exercised within the framework of all women's right to optimum economic survival, comprehensive health services, and sexual self-determination.
The WHM remains concerned with the broadest range of health and disease issues affecting women as well as with the safety and efficacy of touted technologies and therapies. But it is also concerned with women's paid and unpaid relationship to the service-delivery and caregiving systems, which profit handsomely at women's expense. In addition to women-of-color concerns, the movement has also broadened since its beginnings to include older women; differently abled women; and the issues of working women facing occupational health hazards, reproductive rights violations, and harassment problems.
The WHM's strongest focus remains on issues of accountability to citizens/users/consumers/patients/clients. This includes making government more accountable for the impact on women of its health policies and regulations, more forthcoming to all citizens with health and medical care information it collects through taxpayers' money, and more vigorous in policing researchers and corporations. The WHM challenges conventional medical ethics and medical education or training to include feminist values, working to keep alive issues of patients' rights, informed consent, experimental treatments, and Patient Package Inserts in pharmaceutical products. In effect, feminist health activists have become a new breed of ethicists.
Citizen-led women's health organizations continue to play the major role in defining the WHM and producing its leadership, although many outstanding individuals contribute. The public interest initiative in women's health—community women's control and input, accountability from the medical establishment, government and corporations—will remain with the WHM for the foreseeable future. In some ways, these "lay" spokeswomen have themselves become experts in health, developing perspectives that have scientific validity but are frequently at odds with the medical establishment's opinion or practice. One original dream of the WHM, that all women would eventually be able to evaluate critically the entire realm of health and medicine for women, has remained elusive.
However, women's groups across the United States are now coming to the realization that health reform is overwhelmingly a women's issue. In a few states, women's health activists are now forming state-level coalitions, planning for the long haul to become a force with which their state legislatures and state regulators will have to reckon. Many observers feel that the WHM remains one of the most vibrant, active, leading edges of the women's movement.
Barbara Ehrenreich and Deirdre English, For Her Own Good: One Hundred Fifty Years of Experts' Advice to Women (New York: Doubleday/Anchor Books, 1989); Betsy Hartmann, Reproductive Rights and Wrongs: The Global Politics of Population Control (Boston: South End Press, 1994); Nancy Worcester and Marianne H. Whatley, Women's Health: Readings on Social, Economic and Political Issues 2d ed. (Dubuque, Iowa: Kendall-Hunt, 1994).
Norma Swenson
See also
Abortion Self-Help Movement;
Alternative Healing;
Boston Women's Health Book Collective;
Diethylstilbestrol(DES);
Medical Research.
