Women, Health, and Nation

Women, Health, and Nation: Canada and the United States since 1945

GEORGINA FELDBERG
MOLLY LADD-TAYLOR
ALISON LI
KATHRYN McPHERSON
https://www.jstor.org/stable/j.ctt7zxvb
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  • Book Info
    Women, Health, and Nation
    Book Description:

    Authors provide a much-needed analysis of the dynamic decades after 1945, when both Canada and the United States began using federal funds to expand health-care access, and biomedical research and authority reached new heights. Focusing on a wide range of issues - including childbirth, abortion and sterilization, palliative care, pharmaceutical regulation, immigration, and Native health care - these essays illuminate the ironic promise of biomedicine, postwar transformations in reproduction, the varied work and belief-systems of female health-care providers, and national differences in women's health activism. Contributors include Aline Charles (Laval University), Barbara Clow (independent scholar), Laura E. Ettinger (Clarkson University), Georgina Feldberg (York University), Karen Flynn (York University), Vanessa Northington Gamble (Association of American Medical Colleges), Elena R. Gutiérrez (University of Illinois, Chicago), Molly Ladd-Taylor (York University), Alison Li (independent scholar), Maureen McCall (physician, Nepal), Michelle L. McClellan (University of Georgia), Kathryn McPherson (York University), Dawn Dorothy Nickel (University of Alberta), Heather Munro Prescott (Central Connecticut State University), Leslie J. Reagan (University of Illinois, Urbana-Champaign), Susan M. Reverby (Wellesley College), Susan L. Smith (University of Alberta), Ann Starr (visual artist and writer), and Judith Bender Zelmanovits (York University).

    eISBN: 978-0-7735-7078-8
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. Acknowledgments
    (pp. ix-2)
  4. Introduction
    (pp. 3-12)

    North Americans often tell stories and anecdotes about their healthcare experiences. Some emphasize the benefits of Canada’s “socialized” national health-insurance program, while others praise the American system for giving insured patients quick and easy access to costly high-tech treatments. Policy analysts frequently compare the two countries’ health-insurance systems; indeed, popular opinion and the press often link Canada’s health-care system to the very fabric of Canadian national identity. Feminist scholars investigate and critique the biomedical orientation that both countries share.

    Yet there have been few scholarly analyses of how national healthcare differences have shaped women’s lives, and studies that address the...

  5. PART ONE WHY BORDERS MATTER
    • 1 Comparative Perspectives on Canadian and American Women’s Health Care since 1945
      (pp. 15-42)
      Georgina Feldberg, Molly Ladd-Taylor, Alison Li and Kathryn McPherson

      In September 1993 U.S. president Bill Clinton presented his comprehensive Health Security Plan to Congress, unleashing an enormous backlash, not just against health-care reform, but against government in general. As Americans battled over the very idea of national health insurance, many Canadians watched with amusement. Only two years earlier, the prestigiousNew England Journal of Medicinehad praised the economic efficiency of Canada’s comprehensive, government-funded health-insurance system, popularly known as Medicare. By the end of the decade, however, Canadians were themselves engaged in a passionate debate over the merits of their health-care system. As it became clear that Canadians were...

  6. PART TWO THE IRONIC PROMISE OF BIOMEDICINE
    • [PART TWO Introduction]
      (pp. 43-44)

      The rise of biomedicine in the years after 1945 dramatically reshaped the way women experienced health, illness, and medical care in Canada and the United States. The tremendous achievements of biomedicine included the extension of the fundamental understanding of life (for example, in the discovery of the structure of DNA), the creation of powerful new technologies and therapies (such as antibiotics), and the application of systematic, experimental methods to clinical research. Perhaps as significant was the expansion of the scope of what physicians and patients deemed appropriate subjects for scientific scrutiny and medical intervention. The essays in this section probe...

    • 2 “An Illness of Nine Months’ Duration”: Pregnancy and Thalidomide Use in Canada and the United States
      (pp. 45-66)
      Barbara Clow

      In the summer of 1962, Sherri Chessen Finkbine was living in Scottsdale, Arizona, a suburb of Phoenix.¹ Mother of four, married to a high school teacher, she starred inRomper Room, a popular television program for children. She was also expecting her fifth baby. In the early weeks of her pregnancy, Finkbine took some sedatives to “quiet her nerves” as well as her stomach, both of which were apparently in a state of turmoil. Her husband, Robert, had purchased the pills in England the previous year while leading a group of high school students on a tour of Europe. When...

    • 3 “A Kind of Genetic Social Work”: Sheldon Reed and the Origins of Genetic Counselling
      (pp. 67-83)
      Molly Ladd-Taylor

      Over forty and surprised to find myself pregnant with my third child, I did not hesitate to have amniocentesis, a prenatal test where the amniotic fluid is extracted to check for chromosomal anomalies, including Down’s syndrome. This was not the first time I had had amniocentesis, but it was my first time in Canada, and the experience felt dramatically different from the one I had had in the United States just three years before. In Minneapolis the amnio was done at a small private clinic, and the few people I saw were much like myself – white, middle-class or affluent, and...

    • 4 Marty Mann’s Crusade and the Gendering of Alcohol Addiction
      (pp. 84-100)
      Michelle L. McClellan

      One of the most influential yet least studied figures of twentieth-century public health was Margaret “Marty” Mann (1904–80), the founder of the National Committee for Education on Alcoholism and the leading popularizer of the disease model of alcoholism. A central player in the “modern alcoholism movement,” a loosely affiliated group of scholars and advocates who formulated and disseminated a medicalized view of problem drinking, Mann crafted a unique position as a result of her gender and her status as a self-acknowledged alcoholic. The ways in which the media and Mann herself portrayed her alcoholism and recovery illustrate the complicated...

    • 5 Marketing Menopause: Science and the Public Relations of Premarin
      (pp. 101-120)
      Alison Li

      One of the top-selling prescription drugs in the United States and Canada at the close of the twentieth century was Premarin, the trade name of a blend of estrogens used to treat the symptoms of menopause. The Montreal drug company Ayerst, McKenna and Harrison first introduced Premarin to the market in 1942. Although the drug is more than sixty years old and its patent expired over thirty years ago, it is the flagship product of Wyeth-Ayerst, a subsidiary of American Home Products (Ayerst merged with Wyeth in 1986), and possesses some two-thirds of the market share in menopausal drugs in...

  7. PART THREE TRANSFORMING CHILDBIRTH
    • [PART THREE Introduction]
      (pp. 121-122)

      Since 1945, the vast majority of babies in both Canada and the United States have been born in hospital. Some observers hail the medicalization of birth for reducing serious complications and easing anxiety. Others sharply criticize medical interventions into what they see as a natural event. Feminist health activists have been especially critical of male-dominated hospital birth, painting a powerful picture of postwar obstetrical patients plied with drugs, isolated from their families, and alienated from their bodies and babies. By the 1970s, they had brought about a modest revival of midwifery and “natural childbirth.” Nevertheless, the number of high-tech interventions...

    • 6 On the Cutting Edge: Science and Obstetrical Practice in a Women’s Hospital, 1945–1960
      (pp. 123-143)
      Georgina Feldberg

      North American hospitals changed dramatically in the atmosphere of scientific enterprise that followed the Second World War, and they acquired diverse goals, staffing structures, and standards for care (cf. Ettinger, Chapter 7; Charles, Chapter 13; and Li, Chapter 5). Amidst these scientific and institutional changes, Toronto’s Women’s College Hospital (WCH), Canada’s foremost and first training ground for women physicians, sought new ways to build and consolidate its status as a hospital that provided services for women, by women. This strategy included formal certification of its teaching opportunities in obstetrics and gynaecology, so in 1950, the secretary of the medical advisory...

    • 7 Mission to Mothers: Nuns, Latino Families, and the Founding of Santa Fe’s Catholic Maternity Institute
      (pp. 144-160)
      Laura E. Ettinger

      In 1948 Rosita and José, a poor Latino couple living just outside of Santa Fe, New Mexico, began preparing for the birth of their first child.¹ During the early stages of her pregnancy, Rosita saw the nursemidwives at Catholic Maternity Institute’s clinic once a month. As she entered her seventh month, her visits increased. Recognizing that “motherhood is more than a physical experience,” Rosita sought to gain a “richer and fuller appreciation of what it means to be a mother” by attending the institute’s classes for prospective mothers. José also attended “special classes for fathers so that he [would have]...

    • 8 “Midwife Preferred”: Maternity Care in Outpost Nursing Stations in Northern Canada, 1945–1988
      (pp. 161-188)
      Judith Bender Zelmanovits

      When nurse Jean Goodwill was hired by the Department of National Health and Welfare [DNHW] to work in an Arctic nursing station in the 1950s, the Canadian government was in the process of expanding the services it provided to northern Aboriginal¹ communities. One of the reasons underlying the expansion was a concern in the postwar period about infant mortality rates, purportedly disproportionately higher in the North than in southern areas of the country.² The other main factor cited was high rates of tuberculosis.³

      Goodwill had no special training in midwifery or advanced obstetrics, but she was assured that a nurse...

    • 9 Pursuing Conception: A Physician’s Experience with In Vitro Fertilization
      (pp. 189-196)
      Maureen McCall

      My husband and I have lived with infertility for years now, and living with it is like living with an invisible disability.

      In the first years of waiting for what most couples expect will be the natural and relatively easy consequences of a loving marriage, the constant questions from others about our reproductive intentions were embarrassing and difficult to answer. We’ve now heard them for nine years.

      Judgmental warnings not to put career before family and about growing old without children, and comments about the selfishness of childless couples hurt terribly and were almost impossible to answer.As a female physician...

  8. PART FOUR PATIENTS AND PROVIDERS
    • [PART FOUR Introduction]
      (pp. 197-198)

      When the women’s health movement emerged in the 1960s and 1970s, one of the first issues raised was the inordinate power of the male-dominated medical profession. Indeed, throughout the post–Second World War decades, doctors enjoyed unprecedented cultural authority. Biomedical science bolstered the social legitimacy of physicians and surgeons, while the extension of insurance programs offered doctors a financial stability they had never before enjoyed.

      Yet, as the essays in this section show, not every practitioner experienced medicine’s new cultural authority in the same way. Many physicians struggled to make scientific knowledge useful and relevant to new generations of patients,...

    • 10 “Guides to Womanhood”: Gynaecology and Adolescent Sexuality in the Post–Second World War Era
      (pp. 199-222)
      Heather Munro Prescott

      Today, the pelvic exam appears to be a straightforward, routine medical procedure, one that most contemporary textbooks recommend be performed on all age groups, not just on adult women. Until the midtwentieth century, however, it was extremely unusual for adolescent girls to receive a pelvic exam from a physician. This essay charts the changes in medicine and society that transformed gynaecology for adolescents in the post–Second World War era.

      Prior to the war, most gynaecology textbooks recommended that vaginal examinations of girls should be avoided, and many even advised against pelvic examinations for any unmarried woman. These views were...

    • 11 Nursing and Colonization: The Work of Indian Health Service Nurses in Manitoba, 1945–1970
      (pp. 223-246)
      Kathryn McPherson

      In the final years of the twentieth century, two unrelated events drew public attention to the otherwise unobserved lives of nurses working for Canada’s Aboriginal health services. The first event unfolded in April 1999, when Aboriginal leaders in Sioux Lookout, Ontario, mounted a hunger strike, protesting the shortage of staff at the local hospital and demanding improvements to nursing and medical services for the sixteen thousand residents of the remote region’s twentyeight communities. A year later, northern nurses were once again in the news, this time because a nurse in the northeastern Manitoba community of Berens River had been violently...

    • 12 Race, the State, and Caribbean Immigrant Nurses, 1950–1962
      (pp. 247-263)
      Karen Flynn

      The “state” – by which I mean governments and the diverse agencies that carry out public policy – has frequently been the focus of analysis for historical researchers on women’s health.¹ Attention is paid to the way state agencies provided (or did not provide) health services; how state agencies shaped women’s access to health professions; and how female occupations like nursing used the state to gain public and legal authority. However, women’s experiences within the health-care system have also been shaped by other forms of state power, such as immigration regulations and policies.

      In this chapter, I offer an anti-racist feminist analysis...

    • 13 Women’s Work in Eclipse: Nuns in Quebec Hospitals, 1940–1980
      (pp. 264-291)
      Aline Charles

      The history ofhospitalières(hospital nuns) in Quebec is a crossroads where women’s history, the history of health care, and the history of the Catholic Church in Quebec intersect. These women were still indispensable fixtures of Quebec hospitals in the 1940s, but they had almost disappeared by the 1980s. The aim here is not so much to paint a portrait of the nuns themselves, to measure their sphere of influence, or even to trace the reasons for their disappearance; rather it is to understand the nature and the evolution of the work they performed for so long before vanishing, body...

    • 14 Scenes from the Psychiatric Hospital
      (pp. 292-304)
      Ann Starr

      During the early and mid-1990s I was not infrequently a patient at an acute-care psychiatric hospital in Boston, Massachusetts. My stays were sometimes voluntary and sometimes not. They lasted between two and five days. There were times I would have felt much safer staying rather than being released, but I was never “authorized” to act in accordance with that personal assessment. It was always thought that longer internments would be “regressive” for me. What the institution considered infantilizing I usually considered barely at the threshold of my capabilities.

      My diagnosis was bipolar disorder and clinical depression, borderline personality disorder, and...

    • 15 Subcutaneous Scars: A Black Physician Shares What It Feels Like to Be on the Receiving End of Racial Prejudice, despite a Successful Career
      (pp. 305-310)
      Vanessa Northington Gamble

      I was frightened as I drove slowly through the winter storm. Although I had lived in New England and the Midwest for almost fifteen years, I still did not feel comfortable driving in snow. On this day my journey was particularly treacherous – the roads had not yet been plowed, visibility was severely compromised, night was falling, and I was upset from events that had occurred earlier in the day.

      I was a faculty member at a midwestern university school of medicine, and the dean had invited me to give a presentation about the status of minority faculty, residents, and students...

  9. PART FIVE WOMEN, ACTIVISM, AND THE STATE
    • [PART FIVE Introduction]
      (pp. 311-312)

      A large and growing body of scholarship demonstrates women’s role in shaping health care and public health services in the early twentieth century. The essays in this section explore women’s health activism in the years after 1945. On both sides of the border, women physicians, nurses, and activists battled for wider access to care, asked tough questions about the kind of health system women needed and wanted, and challenged the medicalization of life processes such as birth, menopause, and death.

      Women used many different strategies in their struggle to transform medicine. Writing was a particularly important and versatile tool, as...

    • 16 Writing as Activism: Three Women’s Health Documents
      (pp. 313-313)

      Popular education, or consciousness-raising, has been a central tool of women’s health activism since the 1970s. The three documents reprinted here – from a Canadian women’s magazine, an American women’s studies reader, and a Washington, D.C., magazine – provide a sampling of popular writing on women’s health. Note that while all three authors address a mostly white middle-class audience, they exhibit different approaches to and concerns about women’s health....

    • Show Me a Gynecologist and I’ll Show You a Male Chauvinist (Even If She’s a Woman) (1973)
      (pp. 314-321)
      Michele Landsberg

      Hop up on the gynecologist’s examining table, leave your shoes on when you plunk your feet in the stirrups, call him George if he calls you Mary, and remember to ask for the culture test for gonorrhea, because it’s more accurate than the Gram stain. Oh, and if he offers you a white sheet to hide your blushing femininity, immediately throw it on the floor. (You’re not ashamed of your body, are you?)

      That’s some of the women’s lib advice to gynecological patients these days. It’s a little tongue-in-cheek, of course – few of us can throw off the cultural shackles...

    • (Not Just) Another Day at the Gynecologist (1983)
      (pp. 322-323)
      Suzanne Hyers

      My doctor is a man, fiftyish, with a heavy accent; Austrian, I think. I’ve been seeing him for about four years. He doesn’t really appear to be at ease with my body, seeming almost shy. During the breast exam, for example, he always raises his head and shuts his eyes a bit while rolling my breast in his two hands, reminding me of a fortune teller with her crystal ball. I’m usually charmed by his awkwardness. He also gives me gynecological exams, referring always to my sex partner(s) as “he.” I’ve never corrected him. Until now.

      Last week we went...

    • Mom’s Secret: She Was One of the Lucky Ones – A Survivor. But No One Was Ever to Know (1998)
      (pp. 324-329)
      Chuck Conconi

      There was a festive air at last year’s Race for the Cure even though the June morning was cold and overcast. I was shivering as I watched more than 35,000 runners, rollerbladers, walkers, and some people in wheelchairs head up Constitution Avenue from Washington Monument. There were even dogs – Labradors, goldens, and a pit bull wearing a yellow race T-shirt.

      There were the breast-cancer survivors, proud and happy in pink T-shirts, and delegations from the military. But I was caught by the runners wearing makeshift signs in memory of “Aunt Wanda,” “My daughter Jill,” “Mom.”

      My mom had died six...

    • 17 Nursing the Dying in Post–Second World War Canada and the United States
      (pp. 330-354)
      Susan L. Smith and Dawn Dorothy Nickel

      In the mid-1960s, a student nurse in California sought to understand her emotional reaction to a female patient with terminal cancer. The nurse recalled that when the patient said, “I want to die,” she had kept thinking, “Well,Idon’t want to die – youcouldn’twant to die.” The nurse continued: “I was always thinking that shecan’tmean that, and tighten up … In some ways, I guess it was a drain on me because I got to like her so much, maybe more than I should have, and I just felt too much Iwishthere were some...

    • 18 Crossing the Border for Abortions: California Activists, Mexican Clinics, and the Creation of a Feminist Health Agency in the 1960s
      (pp. 355-378)
      Leslie J. Reagan

      After five years of organizing for abortion rights, Patricia Maginnis decided to break the law. In June 1966, she passed out a leaflet in San Francisco that named physicians in Mexico and Japan who performed abortions. With this daring act, Maginnis inaugurated the first open (and illegal) abortion referral service in the United States.¹ What began in protest of a new anti-abortion campaign instigated by California authorities resulted in the development of an underground feminist health agency for women’s rights and women’s health. The list of abortion providers took on a life of its own. As demand for the “List”...

    • 19 Policing “Pregnant Pilgrims”: Situating the Sterilization Abuse of Mexican-Origin Women in Los Angeles County
      (pp. 379-403)
      Elena R. Gutiérrez

      Spanning the late nineteenth and twentieth centuries, the formidable history of sterilization abuse in the United States is well documented.¹ Early campaigns labelled various groups genetically, mentally, or otherwise “inferior” and advocated their sterilization, but it was during the late 1960s and early 1970s that the most massive sterilization campaign the country has seen targeted poor women of colour. Although Native American, Mexican-origin, and Puerto Rican women were also affected by this egregious medical practice, the extant social history about this particular period of sterilization abuse predominantly documents the forced sterilization of poor African-American women.²

      While it has provided persuasive...

    • 20 Thinking through the Body and the Body Politic: Feminism, History, and Health-Care Policy in the United States
      (pp. 404-420)
      Susan M. Reverby

      Feminism and health care have had a long, if complicated, relationship.I would even dare to claim that every contemporary feminist movement has had something to say, in rhetorical language and political struggles, about women’s health care, sexuality, and the body. The critical roles played by science, medicine, and nursing in defining the “normal,” in deciding what was even “humanness,” have forced feminists who fight for any form of equality to confront science and the health-care system.

      In doing so, feminists have sought a language with which to speak to health-care providers; they have also sought to identify the issues they...

  10. Contributors
    (pp. 421-424)
  11. Index
    (pp. 425-438)