CHAPTER 1:
Historical Roots of Women’s
Healthcare
Introduction
• What it means to be female in American
society has changed over time.
• The relationship among women, their bodies,
and what is considered “healthy” is grounded
in assumptions and sociocultural contexts.
Child and Adolescent Health
• Principles of “scientific motherhood” were
promoted in the early 20th century.
• Sheppard-Towner Maternity and Infancy Act
(1921)
– Appropriated federal funds for maternal and child
healthcare for low-income families.
• Lewis Terman and healthcare in public schools
(1910s–1920s).
Adolescent Growth and Development
• 1930s: “Wonder drugs” were administered to
girls during puberty to keep their adult height
within socially acceptable norms.
– These treatments often caused severe medical
problems later in life.
• Average age at which children develop
secondary sex characteristics has been
declining for the past 50 years.
Sexuality and Sex Education
• Separate curricula were developed for each
gender.
• Contrary to pre-1920s beliefs, sexual curiosity
and sexual experimentation came to be
considered a normal part of healthy female
development.
• Routine pelvic exams for women were
recommended before marriage.
Sexuality and Sex Education
• Sex education programs were gradually
incorporated in colleges and universities and
then into public high schools.
• 20th century:
– Abstinence-only programs taught in schools
– Objections to mandatory HPV vaccines
The Birth Control Movement
• Margaret Sanger:
– Activist for contraception
• Birth control was controversial and not often
discussed.
• Common hormonal methods:
– Birth control pill (approved in 1960)
– Depo-Provera (approved in 1992)
The Women’s Health Movement
• 1960s and 1970s: Women’s individual
struggles as women seen as forms of societal
oppression
– Encompasses psychological, economic, sexual
struggles
• Direct roots in women’s liberation
• Advocacy, education, and alternative
healthcare organizations sought to increase
women’s control over their own bodies.
Pregnancy and Childbirth
• Medicalization of pregnancy and childbirth
– Debates over “natural childbirth” vs. “medicated
childbirth”
• 21st century: childbirth remains primarily a
medical event.
– >99% of American births are taking place in
hospitals.
– Rate of Cesarean deliveries is rising.
Abortion, Sterilization Abuse, and
Reproductive Rights
• Roe v. Wade and abortion reform in 1960s
– More than a medical or public health issue, but a
“collective problem for all women”
• Racism affects reproductive rights.
– Minority women are more likely than White
women to be sterilized.
Sexual Assault and the Anti-Rape Movement
• Before mid-1960s, physicians ignored problem
of sexual abuse.
• 1970s: Rape was argued as a “political crime
against women.”
• Early 1990s: Rape became a “bridge issue”
that brought together women from a variety
of political and racial backgrounds.
Gender Equality and Medical Research
• Gender disparities in medical research
• Public Health Service Task Force on Women’s
Health Issues (1983)
– Studied disease risks unique to women
– Assessed women’s health across lifetime
• Push for more women’s health research at NIH
• Creation of Office on Women’s Health (1991)
Gender Equality and Medical Research
• The mission of the Office on Women’s Health
is:
– To improve the health of American women by
advancing and coordinating a comprehensive
women’s health agenda throughout HHS to
address health care prevention and service
delivery, research, public and health care
professional education, and career advancement
for women in the health professions and in
scientific careers (2001)