Contending With Feminism: Women’s
Health Issues in Margaret Atwood’s
Early Fiction
Kirsten Braun BA. (Hons)
A dissertation submitted in fulfillment of the requirements of the degree of Doctor
of Philosophy
School of Arts, Media and Culture
Faculty of Arts
Griffth University, Queensland, Australia
August 2004
ii
This work has not previously been submitted for a degree or diploma in any university.
To the best of my knowledge and belief, the thesis contains no material previously
published or written by another person except where due reference is made in the thesis
itself.
Kirsten Braun
August 2004
_____________
iii
Acknowledgements
I wish to thank my supervisor, Professor Kay Ferres for her patience and professional
advice over the years. Her belief that one day my bits and pieces of writing would come
to something was both reassuring and motivating. Thanks also goes to my associate
supervisor Dr. Francie Oppel for her comments and encouragement on early drafts. The
Margaret Atwood Society has also proved invaluable, particularly in the compilation of an
annual bibliographic checklist.
I would like to thank my partner for his love, support and continued efforts to explain to
members of his family that I was not studying to be a ‘real doctor’. Thanks also goes to
the family cat, Rivoli, for her company during the many hours spent at the desk.
Lastly, I must thank Margaret Atwood. Without her wonderfully written fiction and
amusing responses to interviews, writing this dissertation would not have been nearly as
enjoyable.
iv
Abstract
Margaret Atwood’s early fiction provides a valuable insight into issues surrounding the
establishment of the women’s health movement. From The Edible Woman in 1969 to
The Handmaid’s Tale in 1985, Atwood’s work takes up key issues of the movement
during this time. Her fiction explores a number of women’s health topics including
contraception, abortion, birthing, assisted reproductive technologies, eating disorders
and breast cancer.
Atwood’s interest in the appearance of victims in Canadian literature, however,
leads to a rejection of the notion that women are fated victims of patriarchal institutions
like medicine. This thesis argues that while she does not deny women can be victims,
she refuses to accept that this role is inevitable. Foucault’s later constructions of power
and resistance are explored with the female protagonists refusing to believe their
situations are inescapable.
Atwood’s recognition of her role as a popular fiction writer and her refusal to wear
the ‘feminist’ label allow her the space to critique the women’s health movement. Her
early fiction exposes the absolutism of the movement and demonstrates its limitations in
accounting for women’s diversity.
v
Contents
….
1
….
17
Preface
….
57
Contraception, Abortion and Natural Birthing in Surfacing and “Giving
Birth”
….
60
‘A Small Defiance of Rule’: Assisted Reproductive Technologies and
Resistance in The Handmaid’s Tale
….
91
Preface
….
127
‘SCREW My Femininity’: Disordered Eating in The Edible Woman
….
130
Fat is the Self: Obesity and Multiplicity in Lady Oracle
….
167
Preface
….
197
Bodily Harm: An Alternative Breast Cancer Pathography
….
199
Conclusion
….
223
Works Cited
….
228
Introduction: Margaret Atwood and the F-Word
Part One:
The Women’s Health Movement
Part Two:
Part Three:
Part Four:
1
INTRODUCTION: Margaret Atwood and the F-word
“I’d never turn down the chance to write a novel for the chance to finish my [PhD] thesis.
I’ll do it sometime in a moment of emptiness or despair” (Hammond 101).
“works of literature are recreated by each generation of readers, who make them new by
finding fresh meanings in them” (Atwood, Negotiating With the Dead 50).
Margaret Atwood is one of the most read and written about contemporary authors.
Her writing has broad appeal, making her a favourite with academic and popular
readers. As Ray Robertson comments, Atwood’s work “can be found in both airport
newspaper shops and on graduate school syllabi all over the world” (20). The inclusion
of her fiction in countless secondary school and university curricula 1 indicates her ability
to convey messages and comment on current issues within ‘a good read’.
Fictional narratives provide unique opportunities for expression that are not always
possible in non-fictional narratives. Fiction is able to raise issues and questions without
necessarily having to resolve them. Catherine Belsey writes: “Fiction, which may have
no design on its audience but to entertain, can afford to mingle the propositions currently
in circulation, without any obligation to rationalize them” (17). Similarly, Mary Poovey
suggests: “Because literary texts mobilize fantasies without legislating action, they
provide the site at which shared anxieties and tensions can surface as well as be
symbolically addressed” (124). When the provision of answers is not an expectation,
more complex or controversial questions can be put forward. This characteristic of fiction
allows Atwood’s work to anticipate both feminist thought and critiques of feminist
1 The editors of Approaches to Teaching Atwood’s The Handmaid’s Tale and Other Works list “world literature,
comparative literature, humanities, women’s studies, Canadian studies, emerging English literatures (formerly
Commonwealth literatures), American literature, English literature, science-fiction and communication courses…” as fields
in which Atwood’s works are taught (Wilson, Friedman, and Hengen 1).
2
thought, leading to descriptions of her fiction as prophetic (Elliott 821). As a fictional
writer, Atwood can introduce matters of concern or interest earlier as she is not obliged
to provide answers or solutions.
Fiction also encourages people to see their worlds differently, to question what they
know and believe. Delese Wear and Lois LaCivita Nixon comment: “Stories can
momentarily lift or suspend us above or outside our thinking to examine the limits and
boundaries imposed by the structures and institutions that inform us” (8). To achieve
this, however, fiction also needs to fulfil an entertaining function. Atwood explains that if
fiction is only about conveying a message, “then we feel we’re being preached to and we
resent it” (Hancock 204). If the reader finds the text is enjoyable, s/he is more likely to be
receptive to any messages it contains. Atwood’s fiction invites a popular readership
through its use of popular genres such as science fiction, romance and crime fiction and
through its often satirical humour. It is this popular readership that allows Atwood to pose
questions about current beliefs or events.
A consequence of Atwood’s popular readership is that her work has been adopted
in support of a range of different causes or movements. Vegetarians, ecofeminists,
natural birthing advocates, size acceptance lobbyists and those opposing assisted
reproductive technologies, have all used Atwood’s fiction to exemplify their arguments. A
tendency for these readers to confuse the fictional protagonist with the author means
that Atwood herself has been positioned as a spokesperson for particular causes 2 . Over
2 At times Atwood appears to encourage such readings by giving a character a life with similarities to her own. For
example, in Cat’s Eye, the protagonist’s father is an entomologist (the occupation of Atwood’s own father). These
similarities prompt Robert Towers to comment that Cat’s Eye “reads like barely mediated autobiography” (50). For a
further discussion on how Atwood plays with the notion of the autobiographical in Cat’s Eye see Ingersoll “Margaret
Atwood’s Cat’s Eye”; Cooke “Reading Reflections”; and Hite “Optics and Autobiography”.
3
the years people have assumed Atwood was anorexic, an orphan, obese, a bullied child,
a breast cancer sufferer and vegetarian, to name just a few ‘identities’ 3 .
The movement Atwood is most often associated with is feminism. Her adoption by
feminism is, in part, due to the publication of her first novel, The Edible Woman,
coinciding with the rise of the women’s movement in North America. Atwood, however, is
careful to point out that the novel was actually written some time before, in the spring
and summer of 1965; the delay due to the publisher losing the manuscript for two
years 4 . Atwood argues that The Edible Woman is, therefore, “protofeminist” (The Edible
Woman 8). In an interview with Margaret Kaminski, Atwood strongly resists the feminist
label. When Kaminski insists The Edible Woman has “feminist themes”, Atwood replies,
‘“I don’t consider it feminism; I just consider it social realism’” (27).
Atwood’s reluctance at being labelled a feminist is based on a number of factors.
Firstly, she is unwilling to give the women’s movement credit for her success as a writer
when it was not established when she wrote her first two novels. Atwood is irritated by
writers who allow themselves to be adopted by the women’s movement when it has not
in fact been the source of inspiration for their work: “it would be fairly galling for these
writers, if they have any respect for historical accuracy, which most do not, to be hailed
as products, spokeswomen, or advocates of the Women’s Movement” (Second Words
191). She claims that if writers were honest they would not wish to be “wrongly identified
as the children of a movement that did not give birth to them. Being adopted is not the
same as being born” (Second Words 192).
3 One of the few novels for which she does not receive autobiographical comparisons is The Handmaid’s Tale. Atwood
discusses how writers of escape literature are exempt from such comparisons: “nobody would suggest that because
Agatha Christie wrote eighty thousand murder mysteries she must have murdered at least one person, to find out how”
(Sandler 47).
4 Atwood makes the point a number of times, including in the introduction to the 1979 publication of the novel and in
several interviews. See Kaminski 27; Levenson 24; Oates 75; and Mendez-Egle 162. Her frequent retelling of this story
can be seen as an attempt to distance her work from the rise of the feminist movement.
4
Secondly, Atwood is wary of how membership might affect her as a writer. She
discusses the practice of writers becoming directly involved with political movements and
concludes, “their involvement may be good for the movement, but it has yet to be
demonstrated that it’s good for the writer” (Second Words 190). Atwood appears
concerned that adoption by the women’s movement may restrict what she is ‘allowed’ to
write about, or in the very least, restrict the way people read her work. In Negotiating
With the Dead she comically asks:
If you’re a woman and a writer, does the combination of gender and vocation
automatically make you a feminist, and what does that mean, exactly? That you
shouldn’t put a good man into your books, even though you may in real life
have managed to dig up a specimen or two? And if you do courageously admit
to being one of those F-word females, how should this self-categorization
influence your wardrobe choices? (106-7)
The dangers of being an F-word female are evident in critical responses to her novel,
Cat’s Eye. In Cat’s Eye, the female protagonist, Elaine, is tormented as a child by three
other girls. Atwood’s exploration of women persecuting other women sat uncomfortably
with the sometimes idealised views of ‘sisterhood’ perpetuated by feminism. Gayle
Greene felt the novel had “so much fear and loathing of the female ‘blowing around’, a
misogyny so pronounced and so unprocessed, that it is impossible to say whether it is
Elaine’s, society’s or Atwood’s” (Rev. of Cat’s Eye 448) 5 .
Cat’s Eye’s Elaine is of interest as it is through this character that Atwood explores
the issues faced by an artist whose success comes from being embraced by feminism. A
telling sequence involves Elaine being interviewed by a journalist from the ‘Living’
5 Interestingly, there are several critics who, determined to read Cat’s Eye as a feminist text, dismiss the cruelty of women
toward each other as the effects of “patriarchal culture” (L. Brown 285). Ahern states: “Elaine realizes that Mrs. Smeath
was as much a victim of patriarchal ideology as she herself was” (16).
5
section of the local newspaper (which previously was called the ‘Women’s Pages’) (88).
Elaine’s responses to questions about her discrimination as a woman are not in keeping
with the feminist angle the journalist is wishing for. When the journalist asks Elaine,
‘“what about, you know, feminism?’”, she replies, “‘What indeed […] I hate party lines, I
hate ghettoes’” (90) 6 . Elaine objects to being positioned as not just a feminist but, in
particular, what Molly Hite refers to as a “mass media-defined” feminist (“Optics and
Autobiography 5). Feminists who appear in the ‘Living’ pages are expected to dress a
certain way 7 , retain body hair and share stories of outrage and pain of their treatment at
the hands of men. Elaine resents having her work and herself categorised in this way: “I
am not Woman, and I’m damned if I’ll be shoved into it” (Cat’s Eye 379).
Despite her best efforts, Atwood and her fiction are frequently labelled ‘feminist’. As
time passes this label threatens to become more permanent. In the same way that the
period of second wave feminism is being summarised for younger generations, Atwood’s
early novels and short stories are being categorised as fiction supporting the themes of
second wave feminism. This is particularly the case with Surfacing and The Handmaid’s
Tale.
While Atwood’s early fiction does explore many of the issues raised by second wave
feminism it is not simply an endorsement of its doctrines. It also explores the
contradictions and paradoxes which exist in the feminist movement. Coral Ann Howells
comments on how Atwood’s fiction is: “a combination of engagement, analysis and
critique of the changing fashions within feminism […] With every novel Atwood lights out
into new and dangerous territory, exposing the limits and blind spots of feminist
ideologies when faced with the slipperiness and variety of individual women” (Margaret
6 Elaine’s exasperating interview responses are reminiscent of some of Atwood’s own. When asked by Jo Brans what
pregnancy means in her writing Atwood replies, “Well, girls can have babies and boys can’t.. The fact has been noticed by
more people than me” (Brans 141).
7 Dressing in women’s colours of purple, green and white is an obvious choice. Atwood dresses two of her feminist
characters, Moira in The Handmaid’s Tale and Charna in Cat’s Eye in purple jumpsuits/overalls (47; 87).
6
Atwood 17-18). Atwood’s early fiction dares to pose questions about the movement’s
ideologies; questions which reveal the often contradictory nature of its arguments. For
example, Atwood’s early fiction examines the inconsistencies in the feminist movement’s
representation of women’s maternal role.
This element of Atwood’s fiction, however, is at risk of being overlooked in favour of
more traditional readings of her work as an F-word female author. A return to Atwood’s
earlier work, therefore, seems appropriate in order to re-discover this combination of
both engagement and critique of the women’s movement. The way in which Atwood’s
work is sympathetic to feminist thought has already been well-documented. The focus
here, therefore, will be to explore Atwood’s critique of the movement. Atwood’s early
fiction works to draw attention to the contradictions, essentialism and radicalism within
the movement.
Of particular interest is the way the women’s health movement and women’s health
issues are dealt with in Atwood’s fiction. I have worked in a feminist organisation in the
women’s health sector for the past seven years and so this aspect is especially relevant
to me. While the women’s health movement has been one of the most successful
offshoots of feminism it does also have a number of limitations. While a discussion of
these limitations may not necessarily be popular or welcome in the sector, it can serve a
useful purpose. Recognising and understanding the shortcomings of the women’s health
movement can help ensure it continues to remain viable in the future.
Women’s health issues were a major focus of the women’s movement of the late
1960s and early 1970s. Women’s right to safe and reliable contraception and access to
abortion services were key concerns. As the women’s movement gained momentum it
recognised that health issues for women were broader than just contraception and
abortion. It was argued that medicine used the male body as the standard for ‘normal’
and ‘healthy’ and, as a result, women’s bodies were being pathologised.
7
Atwood’s fiction is rich in its coverage of women’s health issues. Contraception,
pregnancy, childbirth, abortion, infertility, eating disorders, obesity and breast cancer all
feature. An examination of women’s health and the women’s health movement in
Atwood’s early fiction is of value as many of the issues raised are still relevant today.
Atwood’s engagement with women’s health issues is one of the reasons her fiction
remains current. Reproductive health issues like contraception, pregnancy and birth
remain so central to women’s lives that they continue to elicit responses. The epidemic
of obesity in western countries has seen weight, weight loss and eating disorders back
on the agenda. Lastly, breast cancer rates in the United States have been steadily
increasing, from a 1 in 14 chance in the 1960s to a 1 in 8 chance today (Jemal et al).
An investigation of women’s health issues is also fitting at a time when some of the
original gains of the women’s health movement are being threatened. Under the Bush
administration, for example, women’s access to abortion is being challenged. It is
important during this period of increased vulnerability that the women’s health movement
is brave enough to acknowledge both its weaknesses and its strengths. The recognition
of flaws allows the movement the opportunity to evolve and remain relevant to women’s
needs today.
Atwood’s critique of the women’s health movement and the broader women’s
movement is principally concerned with more radical proponents. Carol Downer, the
creator of self-help gynaecology and Gena Corea and Andrea Dworkin and their
‘reproductive brothel’ concept are the people and ideas that Atwood targets. In an
interview with Elizabeth Meese Atwood explains how she is critical of fanaticism of any
kind 8 :
8 Atwood’s work draws attention to extremism in other movements as well. In both Lady Oracle and Oryx and Crake she
continues the satirical attack on animal liberationists, started in The Edible Woman. In Lady Oracle, the SPCA protest
outside an artist’s exhibition of frozen road kill (240) and in Oryx and Crake, Jimmy’s roommate kidnaps his leather
sandals (which are in fact synthetic) and incinerates them (189). The explanation in Oryx and Crake that some of the
8
if practical, hardline, anti-male feminists took over and became the government,
I would resist them. Why? Because they could start castrating men, throwing
them in the ocean, doing things I don’t approve of. But any extreme group is
likely to behave that way. Why? Because they think they have the true faith […]
I think that fanaticism – as apart from belief – is dangerous. (183)
For Atwood, it is the extremism of some proponents of the women’s movement that
prompt a response.
While Atwood is aware that the radical voices are not representative of the entire
women’s health movement she recognises that they form the basis of many popular
portrayals. Atwood understands and appreciates the powerful role that popular culture
plays in public debate. In addition, she views readers of popular culture as active
participants rather than passive consumers. Atwood appeals to this readership through
her engagement with popular rather than academic discourses of the women’s health
movement. Susie Orbach’s Fat is a Feminist Issue and Louise Hay’s Heal Your Body are
the type of texts that Atwood addresses. Critiquing texts familiar to her popular
readership also allows Atwood the space to reveal further contradictions and
inconsistencies.
One of Atwood’s main issues with radical proponents of the women’s movement
and more specifically the women’s health movement, are their often black and white
portrayal of women’s treatment by medicine and society. Efforts to demonstrate how
much women have suffered often results in the depiction of modern medicine as a
monolithic force that cannot be escaped. Similarly, women are positioned as passive
victims with little opportunity or hope of achieving change.
environmental problems were caused by animal liberationist deliberating freeing gene-spliced, experimental animals is a
more serious example of the possible dangers of extremism.
9
The work of Michel Foucault, in particular his theories on power, is useful to
examine the women’s health movement’s representation of modern medicine. Foucault’s
work on power undergoes a number of modifications over time and this has resulted in
feminists responding to his work differently as well. In his earlier work, Foucault
dismisses a concept of power that involves “a general system of domination exerted by
one group over another” (The History of Sexuality 92). This could be seen to conflict with
the women’s health movement’s claims about modern medicine as it does not include a
traditional oppressor/oppressed model. Foucault instead claims that power is
“everywhere; not because it embraces everything, but because it comes from
everywhere” (The History of Sexuality 93). Rather than a top-down model he favours
one that can capture the far reaching nature of power. Key in his concept of power is
that of self-surveillance, in which a person is subject to: “An inspecting gaze, a gaze
which each individual under its weight will end by interiorising to the point that he is his
own overseer, each individual thus exercising this surveillance over, and against,
himself” (Power/Knowledge 155). This form of power is so complete that a person will
enforce it upon themselves.
Foucault’s early theories of power suggest more insidious forms of power relations
and this appealed to feminists seeking to explain how the discipline of medicine
constructs and controls women’s bodies. In his later work, however, Foucault progresses
his concept of power to include a more complex view of how people experience power.
In particular he acknowledges the importance of resistance. He writes: “Where there is
power, there is resistance […] These points of resistance are present everywhere in the
power network” (History of Sexuality 95). His description of resistance is worth quoting in
full:
there is a plurality of resistances, each of them a special case: resistances that
are possible, necessary, improbable; others that are spontaneous, savage,
10
solitary, concerted, rampant, or violent; still others that are quick to
compromise, interested, or sacrificial; by definition, they can only exist in the
strategic field of power relations. But this does not mean that they are only a
reaction or rebound, forming with respect to the basic domination an underside
that is in the end always passive, doomed to perpetual defeat […] they too are
distributed in irregular fashion: the points, knots, or focuses of resistance are
spread over time and space at varying densities, at times mobilizing groups or
individuals in a definitive way, inflaming certain points of the body, certain
moments in life, certain types of behaviour. (96)
Despite his assurances that resistances are not “always passive, doomed to perpetual
defeat”, Foucault’s work provides very little in the way of demonstrating how resistance
can be achieved. Lois McNay comments: “on the whole, this idea [resistance] remains
theoretically undeveloped and, in practice, Foucault’s historical studies give the
impression that the body presents no material resistance to the operations of power”
(40).
This lack of development has contributed to the neglect of the concept of resistance
in much feminist work on the discipline of medicine. Instead the writings tend to be
preoccupied with the ‘power is everywhere’ concept. The emphasis on women’s
victimisation results in the overall impression that the discipline of medicine is too
powerful to oppose. Deborah Lupton argues that Foucault’s theories on power “suggest
the individuals are enmeshed in a sticky web of medical power from which they will
never be able to emerge, their struggles only further imprisoning them” (“Foucault and
the Medicalisation Critique” 101). If feminist writers do discuss resistance it is often only
to draw attention to its futility. Barbara Ehrenreich and Deidre English’s discussion of
how women were able to use fits of hysteria as an emotional release provides an
example of this. They point out that, ultimately, hysteria “played into the hands of the
11
doctors by confirming their notion of women as irrational, unpredictable, and diseased”
(Complaints and Disorders 45). This has the effect of undermining any attempts to
challenge modern medicine’s ‘treatment’ of women.
Atwood’s interest in the women’s health movement’s depiction of women as passive
victims stems from her study of victimhood in Canadian literature, Survival. Survival
investigates the “superabundance of victims in Canadian literature” (39) and categorises
victimhood into four basic victim positions (36-39). Position One is to “deny the fact that
you are a victim” and involves spending “much time explaining away the obvious,
suppressing anger, and pretending that certain visible facts do not exist” (Survival 36).
Atwood explains how the position is: “usually taken by those in a Victim group who are a
little better off than others in that group. They are afraid to recognize they are victims for
fear of losing the privileges they possess, and they are forced to account somehow for
the disadvantages suffered by the rest of the people in the group by disparaging them”
(Survival 36).
Position Two is to “acknowledge the fact that you are a victim, but to explain this as
an act of Fate, the Will of God, the dictates of Biology (in the case of women, for
instance), the necessity decreed by History, or Economics, or the Unconscious, or any
other large general powerful idea” (Survival 37). In this position the person blames their
situation on something that is so large that they cannot be expected to do anything about
it. As Atwood explains, when you take on Position Two “you are permanently excused
from changing it, and also from deciding how much of your situation (e.g. the climate) is
unchangeable, how much can be changed and how much is caused by habit or tradition
or your own need to be a victim” (Survival 37).
Position Three is to “acknowledge the fact that you are a victim but to refuse to
accept the assumption that the role is inevitable” (Survival 37). This position differs from
Position Two in that the person does not believe they are a fated victim and, therefore,
12
can identify the real cause of oppression and determine how much of the objective
experience can be changed. Atwood explains that in Position Three you can “make real
decisions about how much of your position can be changed and how much can’t (you
can’t make it stop snowing; you can stop blaming the snow for everything that’s wrong)”
(Survival 38).
Position Four is to “be a creative non-victim” (Survival 38). Atwood explains how
strictly speaking this position is “a position not for victims but for those who have never
been victims at all, or for ex-victims: those who have been able to move into it from
Position Three because the external and/or the internal causes of victimization have
been removed” (Survival 38). She also clarifies that a person living in an oppressed
society can never really become an ex-victim until the entire society’s position has
changed (Survival 38).
As Atwood suggests, her victim positions can be applied to contexts outside of
Canadian literature. In Second Words, she translates the victim positions into “Womens’
Lib terms, just for fun” (145). She explains how in a sexist society a woman can:
1. Ignore her victimization, and sing songs like “I Enjoy Being a Girl.”
2. Think it’s the fault of Biology, or something, or you can’t do anything about it;
write literature on How Awful It Is, which may be a very useful activity up to a
point.
3. Recognize the source of oppression; express anger; suggest ways for
change. (145)
Atwood does not include the fourth ‘creative non-victim’ position as she suggests a
woman in a sexist society cannot write as a fully liberated individual until the society has
changed (Second Words 145).
The women’s health movement risks being trapped in Position Two through its
representation of the institution of medicine as “vast, nebulous and unchangeable”
13
(Atwood, Survival 37). By focusing on the details of medicine’s treatment of women
(How Awful It Is), the movement suggests there are limited opportunities for challenges.
As Atwood explains, there are two possible roles to play in victim Position Two, “be
resigned and long-suffering” or “kick against the pricks and make a fuss” (Survival 37).
She argues that when you take the second option, “your rebellion will be deemed foolish
or evil even by you, and you will expect to lose and be punished, for who can fight Fate
(or the Will of God, or Biology)?” (Survival 37).
Atwood also explains that in Position Two: “Anger, when present – or scorn […] is
directed against both fellow-victims and oneself” (Survival 37). This concept features in
the writings of the women’s health movement. Ehrenreich and English, for example,
partially blame the rise of male experts on women:
the [male] experts could not have triumphed had not so many women
welcomed them, sought them out, and even (in the early twentieth century)
organized to promote their influence. It was not only gullible women, or
conservative women, who embraced the experts, but independent-minded and
progressive women, even feminists. (For Her Own Good 28)
Atwood’s early fiction recognises the difficulties women face in the medical system
but avoids positioning all women as simply fated victims of that system. This is not to say
that all the women in Atwood’s early fiction are in Position Three. Some, like Surfacing’s
Anna remain in Position Two throughout, while others only move into Position Three
towards the end of the narrative. Still some “have a foot, as it were, in more than one
Position at once” (Atwood Survival 39).
Atwood depicts women making decisions around what changes they can make in
their lives. These changes are always in the context of the society in which they live. For
Atwood, freedom is “the power to use what you’re given in the best way you can. It
doesn’t mean that you’re given everything. You aren’t” (Brans 151). The changes the
14
women make, therefore, are often only modest. Atwood, however, resists dismissing
these changes as futile or misguided as such a response risks positioning women as
passive victims once more.
Emily Martin discusses how there are “a great many ways women express
consciousness of their position and opposition to oppression” (183) and how, therefore,
we need “extremely sensitive ways of looking for evidence of women’s consciousness of
their situation and for a wide variety of forms of objection or resistance” (22). There is a
need to think of resistance as encompassing more than just physical force. Interestingly,
even Martin uses such an image to describe her research involving interviewing
pregnant women: “I focus on specific incidents women described in interviews in which
they took strong issue with some medical practice or view, stories about women
grabbing the knife out of the obstetrician’s hand, so to speak” (xiii). Martin’s use of such
a metaphor demonstrates how closely physical assertion is connected with resistance
and, consequently, how non-physical behaviours can sometimes be overlooked as acts
of resistance.
In her second novel, Surfacing, Atwood explores issues of reproduction, including
women’s access to safe and reliable contraception, the right to terminate a pregnancy
and birthing options. Women’s experiences of contraceptives like the Pill, condoms and
diaphragm are explored. A clever sequence in which a narrative first presented as a birth
story is later revealed as an abortion, allows Atwood to both critique increases in labour
interventions while also highlighting a significant contradiction of the women’s health
movement. That is, how a movement calling for safe abortions can also portray modern
medicine as being entirely detrimental to women’s health. Surfacing also demonstrates
that a medically managed birth need not be inevitable, with natural birthing providing
women with a possible alternative. Typically, though Atwood later challenges some of
the philosophies of natural birthing in her short story, “Giving Birth”. Here, the
15
protagonist’s readings from her pregnancy and birth guidebook and experiences in antenatal classes, draw attention to the idealistic representations and essentialist views the
natural birthing movement relies on.
In The Handmaid’s Tale, Atwood addresses the issue of infertility and assisted
reproductive technologies (ARTs). Atwood creates her own version of radical feminists
Gena Corea and Andrea Dworkin’s reproductive brothel. Corea and Dworkin’s
reproductive brothel sees poor women acting as breeders for wealthier women in
another form of prostitution. Atwood’s reproductive brothel, however, does not result
from ARTs spinning out of control, as Dworkin and Corea fear, but by the new regime’s
endorsement of radical feminist arguments about the sacredness of women’s maternal
role. The Handmaid’s Tale also questions proponents of radical feminism that idealise
lesbianism and call for the censorship of pornography. She refutes the notion that
women are passive dupes of ARTs through depicting both collective and individual forms
of resistance.
The Edible Woman’s portrayal of disordered eating challenges the view that eating
disorders are caused by women being both deficient dieters and readers. The
protagonist, whose behaviour at times closely resembles that of an anorexic, uses her
relationship with food to try and take some form of control of her life, including control of
her body. Although the protagonist appears to be conforming to her fiancé’s definition of
an ideal woman, she is actually using disordered eating as a form of protest against the
limited roles available to her. Her appearance at her fiancé’s party dressed in a short,
red, sequined dress is in fact a parody of the feminine.
Psychoanalytic approaches become a source of comedy in Lady Oracle, with the
protagonist, Joan, suffering from an exaggerated array of traumatic events in her
childhood. Atwood rejects Susie Orbach’s (Fat is a Feminist Issue) suggestion that
inside every fat woman is a thin woman trying to get out, by having Joan long for her lost
16
fat body and even experience it as a type of phantom limb. Although Lady Oracle
provides an insight into society’s lack of acceptance of fat women and their sexuality it
refuses to position Joan as a victim. Through the incorporation of Bakhtin’s
carnivalesque, Atwood is able to demonstrate the transgressive potential of fat.
Finally, Bodily Harm focuses on arguably the most significant heath issue for
women, that of breast cancer. Atwood explores the devastating impact that breast
cancer can have on a woman’s life. The protagonist Rennie’s breast cancer experience
challenges popular breast cancer pathographies and their reliance on the notions of
concealment and healthy-mindedness.
The exploration of the women’s health movement through the fictional lives of
Atwood’s characters also serves as a reminder that many different elements impact on a
person, not just their health. In focusing on women’s ‘treatment’ by modern medicine, the
women’s health movement tends to suggest that these encounters are the most
influential experiences in a woman’s life. Fictional lives, however, provide the opportunity
to view a wide range of factors and circumstances which have an impact. Even for
Rennie, a breast cancer survivor, her breast cancer and breast cancer treatment are not
the only events of significance in her life. Viewing other aspects of character’s lives
avoids the suggestion that modern medicine is a monolithic force that overshadows
everything else. As Margaret Lock and Patricia Kaufert comment: “women’s lives are not
preoccupied with medicine” (19).
17
PART ONE: The Women’s Health Movement
The women’s health movement emerged in the United States in the late 1960s and
early 1970s. Its origins were predominantly in the women’s liberation movement but it
was also influenced by the civil rights movement, anti-war movement and a general
disillusionment with the health care system. Women’s right to control their reproductive
life was seen as a key feminist issue. It was thought that for women to make gains in
equality they needed firstly to be able to choose if, and when, to have children. Access
to safe and reliable contraception and abortion services, therefore, were early focuses.
Like any movement, the women’s health movement was not unified or homogenous
but “marked with division” (Morgen 27). Issues concerning class, race and sexuality
created constant tensions and conflict. There were also differences in the overall aims of
the movement. Some proponents wished to advocate for change to the traditional
medical model or the addition of women-specific services to exist alongside it. Others
proposed that women must take back control of health care altogether 9 .
Three separate events, Barbara Seaman’s exposé on the Pill (The Doctor’s Case
Against the Pill), and the medical mishaps of the drug diethylstilbestrol (DES) and the
Dalkon Shield intrauterine device provided the women’s health movement with
considerable momentum. The movement used the circumstances around these events
to demonstrate that modern medicine, in particular the specialities of obstetrics and
gynaecology, was making women sick.
The oral contraceptive pill, or the Pill as it became known, was heralded as a form of
contraception that was both reliable and user friendly. Most importantly it allowed women
to be in charge of their fertility and to separate birth control from the sex act. For women
9 Frances Hornstein, for example, explained the purpose of the Los Angeles Feminist Women’s Health Center was “not to
provide an alternative health delivery system […] We do not want to coexist with the medical establishment, we want to
take it over” (75-76).
18
who already had children the Pill provided them with the means to space further children
or to limit the size of their families. For those without children the Pill could be used to
delay childbearing to accommodate further education or a career. Although Pill
prescriptions were generally restricted to married women, many single women managed
to obtain it through sisters or friends, or by pretending to be married.
The Pill proved to be extremely popular in the United States and Canada. Within five
years of its launch over 5 million women were taking the Pill every year in North America
(Marks 183). The take up of the Pill demonstrates how women welcomed a
contraceptive with an improved efficacy rate. At a time when abortion was still illegal, a
reliable form of contraception was highly valued by women. Many women, however,
experienced side effects like nausea, weight gain, headaches and loss of libido due to
the high doses of the hormones used. The Pill formulations prescribed at this time
typically contained 100-150 micrograms of oestrogen, far higher than the 20 micrograms
used in some of the popular oral contraceptives today (Guillebaud 189). The Pill also
began to be associated with more serious side effects such as blood clots and resulting
deaths. By 1962, the Food and Drug Administration (FDA) had received reports of blood
clots in twenty-six Pill users, six of whom had subsequently died (Marks 138).
In 1969, Barbara Seaman published The Doctor’s Case Against the Pill, which
contained research evidence connecting the Pill to serious medical complaints such as
strokes, blood clots, cancer and sterility 10 . Seaman also highlighted the extent of the
clinical trials of the Pill, bringing into question whether the FDA’s approval process for
new drugs was adequate. In the following year, Senator Gaylord Nelson convened
Senate hearings to ascertain whether women were being provided with sufficient
10 In the same year Morton Mintz published The Pill: An Alarming Report which also questioned the safety of the Pill.
However, it was Seaman’s book which generated women’s concerns about the Pill.
19
information on the side effects of taking the Pill (Djeraasi 20) 11 . The FDA recommended
that an insert be included in Pill packets warning women of the risks. This move was
significantly different from Britain’s response to Pill related deaths, where doctors were
restricted to prescribing formulations containing less than 50 micrograms of oestrogen
(Marks 140). The American Medical Association vehemently opposed the Pill packet
inserts and instead it was agreed a label would appear on the packaging and that
doctors would provide women with a pamphlet, What You Should Know About the Pill 12 .
Unfortunately, the decision to allow doctors to provide the pamphlets directly meant that
not all women received the information 13 .
The publicity around the association between the Pill and blood clots had an
immediate impact on Pill use. Between January and March of 1970, the period of the
Nelson hearings, 18% of the American women discontinued their use of the Pill due to
the publicity (Marks 151). Further women stopped using the Pill due to intolerable side
effects. Seaman reports the findings of one study which reveals that of 2 000 women
who started the Pill in 1962, only 34 percent were still using it after six years (Free and
Female 218).
In the early 1970s, the side effects of another oestrogen based drug,
diethylstilbestrol (DES) became known, adding to women’s concerns about taking the
Pill. The medical community reported a link between DES, a drug administered to
prevent miscarriage, and cancer (Herbst, Ulfelder and Poskanzer). A rare form of vaginal
cancer, clear cell adenocarcinoma, was found in daughters of mothers who took the
11 Oral contraceptives had already been the subject of two separate reports by FDA advisory committees, in 1966 and
1969. For more information on these reports see Djeraasi 20-30.
12 Seaman’s reproduction of the FDA’s original insert version and the revised pamphlet version reveal a softening of the
description of the Pill’s possible side effects. For example, the original version’s “There is a definite association between
blood-clotting disorders and the use of contraceptives” does not appear in the pamphlet version (Free and Female 232238)
13 Seaman notes how a year and half following the FDA’s decision, “I have failed to locate one pill user whose doctor has
actually given her the pamphlet” (Free and Female 232). Lark, however, notes that between 1970 and 1975, 4 million
copies of the pamphlet were distributed to the 10 million women taking the pill each year (151).
20
drug during their pregnancy 14 . DES had been administered to women from the 1940s,
but its carcinogenic properties were only confirmed decades later 15 . Women became
concerned that a link between cancer and the Pill might be discovered in time as well.
It was in this climate that another contraceptive, the intra-uterine device (IUD) was
marketed to women as an alternative to the Pill. In some cases, those involved in
developing IUDs became significant opponents to the Pill, albeit as away of promoting
IUDs as a preferred contraceptive. Dr. Hugh Davis, inventor of the Dalkon Shield IUD,
had these comments to make about the Pill: “No one, as the FDA was careful to point
out, has the slightest idea what long range effects may result from such chronic use of
the pill for 15, 20, or even 30 years […] In many clinics the pill has been served up as if it
were no more hazardous than chewing gum” (qtd in United States. Cong. 5227-28).
Feminist writers also described the IUD positively as an alternative contraceptive.
Seaman explains it “does not interfere with sex, and unlike the pill, it does not change
the hormones or the rest of the body (Free and Female 238) 16 ”.
The popularity of the IUD led to a vast array of devices becoming available on the
market, with over 70 models available by 1971 (Djeraasi 44). One of the devices that
became most widely used was the Dalkon Shield. Its popularity was due in part to an
aggressive marketing strategy which saw the device promoted as having a failure rate
similar to the Pill (1.1%) but without the side effects (Djeraasi 43). The Dalkon Shield
14 DES has subsequently been linked to structural changes in the reproductive systems of daughters born to women who
took DES during pregnancy. These changes are associated with an increased the risk of infertility, ectopic pregnancy,
miscarriage and premature labour and delivery. Sons born to women who took DES during pregnancy are at risk of noncancerous cysts on the testes. Women who took the drug during pregnancy have a modestly increased risk of breast
cancer (United States Department of Health and Human Services, Centers for Disease Control and Prevention). Studies
on third-generation effects of the drug have been contradictory (Kaufman and Adam; Klip).
15 For more information on DES see Apfel and Fisher; Chetley; Meyers; Mintzes; and Orenberg.
16 Seaman includes several quotes from Dr. Davis, initially referring to him as “of the John Hopkins University School of
Medicine in Baltimore” and “author of the recent medical book Intrauterine Devices for Contraception” (239). Although she
later acknowledges him as the inventor of the Dalkon Shield (241) there appears to be no consideration given to whether
his information on IUDs could be considered reliable due to his interests. Djeraasi describes Davis’ medical book as a
publication which “read like a promotional tract for the Dalkon Shield” (44).
21
was also marketed for use in women who had not previously had children. IUDs were
generally not recommended for women who had not given birth vaginally as they were
difficult and painful to insert through the cervix. These strategies ensured the Dalkon
Shield a market with the types of women that the Pill had become so popular with. More
than 2 million women in the United States used the Dalkon Shield between 1970 and
1974 (Hicks 1).
By 1972, however, problems with the Dalkon Shield started surfacing in the medical
community. Speaking at a Planned Parenthood Physicians meeting in Detroit, Dr. Mary
Gabrielson reported that in a study of two clinics in California, the pregnancy rate was
four to five times that published by the Dalkon Shield manufacturers (Djeraasi 49) 17 .
Negative findings associated with the Dalkon Shield continued with several publications
appearing in medical journals the following year. The authors reported a range of
problems including perforation of the uterus, ectopic pregnancy, higher than expected
failure rates and septicaemia (Sprague and Jenkins; Draper and White; Marshall, Hepler
and Jinguji).
In June 1974, A.H. Robins Corporation, the manufacturer of the Dalkon Shield,
temporarily halted the sale of the device after acknowledging seven users had died and
between 100 and 110 had suffered a septic abortion (Djeraasi 60). By August 1974,
these figures had climbed to eleven deaths and 209 septic abortion cases (Djeraasi 60).
Several articles reported that the device’s construction contributed to an increased rate
of infection (Tatum et al; Guidoin et al) 18 . By 1976, there were over six hundred pending
17 Davis’ low failure rate could be attributed to the fact that in initial tests of the device women were instructed to also use
a contraceptive foam. A follow-up of participants two months after the original testing finished showed a pregnancy rate of
6%. However, the figure of 1.1% continued to be quoted in the promotional material for the device (Djeraasi 51, 43).
18 It should be noted that co-author of one of the studies, Dr. Howard J. Tatum was also the co-inventor of a rival IUD, the
Copper T IUD.
22
lawsuits against A.H. Robins involving the Dalkon Shield (“Dalkon Shield Suits Against
Robins Rise” 28) 19 .
Women’s health advocates were shocked to discover that as the majority of IUDs
did not contain active ingredients, they were not classified as drugs and, therefore, did
not have to undergo premarket testing to determine their efficacy and safety 20 . IUDs
were covered by the same legislation as hearing aids, orthopaedic shoes, dental plates
or exercise equipment. Given that IUDs were inserted inside the bodies of women, this
level of regulatory control appeared grossly inadequate.
The circumstances of the Dalkon Shield and the side effects of DES and the Pill
provided an emerging women’s health movement with evidence that modern medicine’s
‘treatment’ of women was seriously lacking. The details of how these drugs and devices
affected thousands of women fuelled, in particular, more radical responses. The
commonalities between the Dalkon Shield, DES and the Pill allowed more radical
proponents of the movement to not only argue that the medical profession was
incompetent but to make the more serious claim that it deliberately and knowingly used
women as guinea pigs for medical advances.
While one cannot really identify the time when the women’s health movement
became a distinct movement in itself, the Boston Women’s Health Collective is often
acknowledged as a significant development. Sandra Morgen identifies the formation of
the collective as one of the “foundational stories” of the women’s health movement and
the most widely known (16). In the spring of 1969, a Boston women’s liberation
conference ran a ‘women and their bodies’ workshop in which women shared their
experiences at the hands of the medical system. The women in the group spoke of how
19For more information on the Dalkon Shield see M. Hawkins; Mintz, At Any Cost; Perry and Dawson; Hicks.
20Sheryl Burt Ruzek reports that in 1968 two Supreme Court decisions gave the FDA authority to classify IUDs as “new
drugs” but they were ignored. It was not until 1976 that legislation was passed mandating the FDA to regulate medical
devices, including IUDs (44).
23
they found their doctors to be “condescending, paternalistic, judgemental, and noninformative” (Boston Women’s Health Book Collective, Our Bodies, Ourselves 1973 1). A
group of eight delegates from the workshop agreed to meet following the conference in
order to establish a list of suitable obstetrician-gynaecologists in the Boston area (Kline
87).
After acknowledging their own lack of knowledge about their bodies and women’s
health issues the eight women decided to each research a topic and bring the
information back to the larger group (Kline 87). The topics included anatomy and
physiology, sexuality, sexually transmitted infections, contraception, abortion, pregnancy
and childbirth, medical institutions and the health care system (Ruzek 32). The compiled
research topics formed the basis for a course on women and their bodies.
The papers were eventually published by the New England Free Press under the
name Women and Their Bodies with the group now being known as the Boston
Women’s Health Book Collective (Kline 87). The title of the publication was later
changed to Our Bodies, Our Selves and a total of 350 000 copies were printed (Morgen
7). By 1976, the Simon and Schuster published version (it had grown to large for the
New England Free Press) had sold over 1 million copies (Ruzek 33).
Our Bodies, Ourselves is widely recognised as one of the key texts in the women’s
health movement. Of particular interest was that the research consisted of information
from textbooks and medical professionals as well as women’s stories and experiences.
The Collective explains: “we learned what we learned equally from professional sources
– textbooks, medical journals, doctors, nurses – and from our own experiences” (Boston
Women’s Health Book Collective, Our Bodies, Ourselves 1976 12). Women’s voices
24
have continued to play a major role, with women’s letters and phone conversations
influencing the content of subsequent editions 21 .
Our Bodies, Ourselves also supported health prevention strategies, not just the
treatment of disease and illness. It was suggested that in a typical doctor-patient
relationship women were frequently not provided with sufficient information on their
health and, consequently, were excluded from the decision-making process. Our Bodies,
Ourselves, therefore, aimed to educate women about their bodies to enable them to
make better decisions about their health care. The Collective directed women to “insist
on enough information to negotiate the system instead of allowing the system to
negotiate you” (Boston Women’s Health Book Collective, Our Bodies, Ourselves 1973
268). In addition, women were encouraged to take a more active role in their health care
through exploring various self-help techniques. Susan Cayleff argues that Our Bodies,
Ourselves emphasis on self-help strategies was “a clear incursion into the professional
domain of medicine” (“Self-Help and the Patent Medicine Business” 332).
A second foundational story of the women’s health movement identified by Morgen
was the concept of self-help gynaecology (22). Addressing the 1972 American
Psychologist Association meeting, women’s health activist Carol Downer asked: ‘“How
can we rescue ourselves from this dilemma that male supremacy has landed us in? The
solution is simple. We women must take women’s medicine back into our own capable
hands”’ (Downer) 22 . On the 7th April 1971, at the Everywoman’s Bookstore in Los
Angeles, a place where women regularly met to discuss health issues, Downer inserted
a speculum into her vagina and invited others to view her cervix.
21 Wendy Kline’s article examines this process in more detail.
22 In her address Downer also states: ‘“Abortions are so simple, they are downright dull; vaginal infections are diagnosed
with a microscope; pap smears are easier to do than setting our hair; fitting a diaphragm is less complicated than stuffing
a turkey. We [women] can do these things”’.
25
Looking at one’s vagina and cervix, with the help of a speculum and hand heldmirror, became a symbol of the radical women’s health movement. As Morgen explains
when Downer performed cervical self-examination she broke two taboos, “she touched
her own genitals and she appropriated the tools of the medical profession” (22). The
significance of self-help gynaecology is demonstrated in Ellen Frankfort’s Vaginal
Politics which opens with a description of such an event at the Los Angeles Self-Help
Clinic: “An old church basement, a long table, a woman, a speculum – and pow! In about
five minutes you’ve just destroyed the mystique of the doctor” (vii).
Carol Downer and Lorraine Rothman embarked on a tour across the country to
demonstrate self-help gynaecology. Women were told how self-help gynaecology could
help them identify vaginal infections or sexually transmitted infections, check the
placement of IUDs and even notice early signs of cancer. Downer and Rothman took
self-help gynaecology a step further, promoting the practice of ‘period extraction’. Period
extraction involved the insertion of a cannular through the cervix and, using a suction
device, the removal of the uterine contents. While period extraction was promoted as a
means of reducing the length of a menstrual period, it was also apparent that it could be
used to terminate an early pregnancy 23 .
Downer and Rothman’s visits proved to be inspirational for many burgeoning
women’s health groups. The Roe vs. Wade decision on January 22 1973, legalising
abortion, saw the opening of women’s health clinics providing a range of services to
women 24 . These clinics became an extremely important aspect of the women’s health
23 The women’s health movement was divided on the concept of period extraction. Frankfort was concerned about the
long term effects of carrying out the procedure, the possibility of introducing germs into the uterus and the dangers of an
incomplete abortion. She comments: “Women can’t rail against drug companies using them as guinea pigs and allow selfhelp clinics to do the same thing” (xii). Elizabeth Fischel examined the broader significance of self-help gynaecology,
questioning whether it would result in changes in health policy and delivery.
24 A number of women’s health clinics were open prior to the Roe vs. Wade decision. They included the Vermont
Women’s Health Center, the Berkeley Women’s Health Collective, the Haight Asbury Women’s Clinic, the San Francisco
Women’s Health Center, the Santa Cruz Women’s Health Center, Aradia Clinic (Seattle), and the Women’s Clinic
26
movement. Morgen comments: “While all women’s health movement groups selfconsciously aimed to create organizations that practiced what they preached about
women’s empowerment, the clinic sector of the movement was most intentional about
actually embodying in organizational practices the political values that were at the core
of the movement” (71) 25 .
Women’s health clinics provided many different services, including pregnancy
testing and terminations, sexually transmitted infection screening, contraceptives and
ante-natal care. Some clinics also provided counselling, lesbian health information,
health sessions for rape and incest survivors and alternative therapies. Preventive health
was also a major focus and was seen as a departure from the medical profession who
were accused of being involved only in the treatment of disease. Screening for breast
and cervical cancer, breast-self examination and education on nutrition and safe sex
were all practised.
Women’s health clinics typically provided services for free, low-cost (often a
donation) or on a sliding scale basis 26 . In order to keep operating costs low many clinics
depended heavily on volunteers for administrative tasks 27 . The wages for paid staff were
often very low and in some clinics all positions received the same small remuneration.
This posed a dilemma for many clinics who believed in adequately compensating
women for the hours they worked but could not afford to do so if they were to keep clinic
fees affordable. The clinics also ideally wanted to use women as health care providers
but they struggled to recruit female physicians. Instead they often employed the services
(Eugene, Oregon). These clinics either operated in states where abortion laws were liberalised or they did not provide
abortion services (Morgen 70-71).
25 Morgen’s work details the conflict that often occurred between different clinics, in particular affiliates of the Federation
of Feminist Women’s Health Centres (FFWHC) and non-affiliates (99-100). Clinics were also dogged by internal conflicts
concerning race, class, sexuality and employment status (unpaid/paid).
26 Clinics belonging to the FFWHC were an exception and often came under fire from other clinics for having too high
fees (Morgen 102).
27 Some centres such as the Women’s Community Health Centre, Cambridge, Massachusetts did not use volunteers as
they felt that volunteerism as a tradition demeaned and devalued women’s labor (Morgen 97).
27
of nurses and nurse practitioners and non-professional health care providers, roles
where the majority of workers were women (Morgen 72). This fitted in with a general
philosophy of the women’s health movement that healing had traditionally always been
the role of women and, therefore, women should aim to take it back out of the hands of
male medical professionals.
One of the key values of women’s health clinics was to demystify medical practices
by providing women with relevant information about their diagnosis and treatment
options. As a result, women undergoing a gynaecological exam were not generally
draped so that they could more easily see what was occurring. The health professionals
explained the procedure step by step and encouraged the asking of questions. In more
radical feminist health clinic settings women received gynaecology services in a group
setting. The aim was to break down hierarchical relationships between providers and
patients through sharing information.
The women’s health movement’s distrust of the medical profession also saw it
embrace alternative systems of healing. Women’s interest in such systems is not a new
phenomenon, having its beginnings in the early 1800s with the Popular Health
Movement. The Popular Health Movement encompassed a range of systems including
Thomsonianism, Grahamism and hydropathy. The Popular Health Movement
incorporated many of the ideals that came to represent the women’s health movement.
At its core was an anti-medical philosophy that discouraged the domination of
professionals in the practice of healing. The Popular Health Movement aimed to provide
systems of health which individuals could learn about and participate in, therefore,
eliminating the need for the medical experts. The treatments were a direct response to
28
what was perceived as the harmful practices of regular medicine 28 such as blood letting
and purging.
The most significant movement was Thomsonianism 29 , developed by a New
Hampshire farmer, Samuel Thomson. Thomsonianism was a healing system based on
herbal remedies and steam baths. An herbal emetic (substance to induce vomiting)
based on the lobelia plant 30 , a cayenne pepper drink and tonics to improve digestion
were all features (Rothstein 42-3). In 1811, Thomson set up the first ‘Friendly Society’,
and published a guide, The New Guide to Health (Rothstein 43) 31 . Thomson sold
‘Family Rights’ to his treatments which included enrolment to the Friendly Society and an
instruction booklet (Numbers 50). The philosophy that everyone was their own healer
made Thomsonianism popular with the working class, particularly in the Midwest and
South. The success of Thomsonianism, however, led to it becoming professionalised
with the establishment of a medical school (Rothstein 46). These developments were not
all supported by Thomson who still wished for such knowledge and skills to belong to the
lay person.
In the 1830s, Thomsonianism was joined by Grahamism, established by Sylvester
Graham. Grahamism emphasised a diet based on wholegrain breads and cereals,
vegetables and fruit and the elimination of alcohol, tea, coffee and eating of flesh
(Whorton 62) 32 . In addition to the diet, followers were encouraged to get regular exercise
28At this time conventional medicine was referred to as ‘regular’ and other health systems like Thomsonianism were
referred to as ‘irregular’.
29 The movement is also referred to as Thomsonism by some authors (Rothstein 42).
30 While Thomsonianism favoured the use of the herb lobelia, rather than regular medicine’s calomel (mercury salt) for
purging, it could be argued that when administered in large dosages it was just as demanding on the body.
31 Thomson’s book did not just contain therapeutic information but also two hundred pages of autobiographical
information and criticisms of regular medical practitioners (Rothstein 43).
32 A key feature of his diet was an unleavened bread made from whole-wheat and molasses. At the time such a bread,
which later became known as the ‘graham cracker’, was radically different from the bread products eaten by most.
29
and fresh air (Whorton 62). Graham’s publication, Science of Human Health in 1839,
also saw the opening of boarding houses and health food stores and the beginning of
several periodicals dedicated to the topic. Followers of Grahamism founded the
American Physiological Society in 1837 (Blake 220). As some topics were considered
too delicate for a mixed group, a Ladies Physiological Society was established (Blake
220).
The Ladies Physiological Society lectures, presented by Mrs. Mary Gove 33 , were
aimed at providing women with education on anatomy and physiology of the body. In this
way they shared similar aims to the self-help gynaecology classes of the women’s health
movement, 130 years later. The topics for discussion included problems associated with
tight lacing 34 , menstrual difficulties and ‘self-abuse’ (Morantz, “The Lady and Her
Physician” 47). As Regina Markwell Morantz explains, the “full flowering of Victorian
delicacy” of the time made discussing such issues, “decidedly radical” (“The Lady and
Her Physician” 47). The lectures proved extremely popular, with one on tight lacing
being attended by around two thousand people (Blake 220). In 1842, the lectures were
published as Lectures to Ladies on Anatomy and Physiology (Blake 220).
Hydropathy, or the water cure as it was known, also provided people with an
alternative system to modern medicine. Like Grahamism, it emphasised clean air,
nutritious food and regular exercises but also incorporated the healing power of water.
Water was used in many ways including baths, wet sheet wraps and even vaginal or
rectal injections (Blake 224). Jane Donegan explains that hydropathy became popular
with women as although it viewed events like pregnancy as natural processes, it
suggested that women could exercise some control over these processes (xiv).
Hydropathy promised women relief from long labours, fewer complications and a shorter
33 For a detailed account of Mrs. Mary Gove’s role in health education see Blake.
34 Dress reform was also a key aspect of hydropathy. See Donegan 136-61.
30
recovery time (Donegan xiv). Hydropathy also actively solicited female practitioners,
allowing women to have female complaints treated by a woman (Cayleff, “Gender,
Ideology, and the Water-Cure Movement” 91). Hydropathic retreats, often located in the
countryside, became fashionable with the middle and upper classes. Taking a cure, as it
was known, became a legitimate way for women to temporarily escape their domestic
lives and duties. It also gave women the opportunity to meet other like-minded women
(Cayleff, “Gender, Ideology, and the Water-Cure Movement” 93).
The Popular Health Movement saw health reform as the way in which society itself
could be improved. As carers of children and the centre of family life, women were seen
as playing a crucial role in this reform. Morantz explains that health reformers
acknowledged that if women were to purify society they “would indeed have to enter it”
(“Nineteenth Century Health Reform and Women” 90). The Popular Health Movement,
therefore, provided some women with influence and opportunities outside their usual
role. Cayleff details how, for example, hydropathy “fostered an extension of women’s
sphere of influence from the domestic into the informally political realm” (Wash and Be
Healed 18).
A reluctance to allow the dominance of one system of healing and a search for
kinder healing methods are still reasons why the women’s health movement maintains
an interest in alternative health systems. These systems are today more accurately
described as complementary and alternative medicine (CAM). CAM is defined as “a
group of diverse medical and health care systems, practices, and products that are not
presently considered to be part of conventional medicine” (National Centre for
Complementary and Alternative Medicine). CAM includes acupuncture, aromatherapy,
ayurveda, chiropractic, dietary supplements, electromagnetic field, homeopathic,
massage, naturopathic, osteopathic, qi gong, reiki, therapeutic touch and Traditional
Chinese Medicine (National Centre for Complementary and Alternative Medicine).
31
From its beginnings, the women’s health movement incorporated aspects of CAM in
the health advice given to women. For example, yoghurt was favoured for the treatment
of thrush or candidiasis, rather than anti-fungal creams 35 (Ruzek 54). Amy Sue Bix
details how the Dalkon Shield scandal and FDA hearings into the safety of the Pill
contributed to a particular openness to alternatives in the area of contraception (158).
Our Bodies, Ourselves for example, listed “astrological birth control” as a method that
women might be interested in pursuing (Boston Women’s Health Book Collective 1976
209) 36 . Fertility awareness, achieved through tracking the position of the cervix and
cervical mucus changes was also promoted to women as a natural contraceptive
method, free from the harms of hormones or devices.
The women’s health movement also drew attention to what it considered
unnecessary surgery, in particular the radical mastectomy 37 . In the early 1970s,
women’s health advocates questioned the necessity of such extensive surgery which
involved the removal of the breast, pectoral muscle and lymph nodes under the arm. A
number of studies showed no significant difference of survival in women who had a
radical mastectomy compared to those who had had a simple mastectomy 38 (Williams,
Murley and Curwen; Stehlin et al; Peters). American researchers began a number of
randomised controlled trials to compare radical mastectomy, simple mastectomy and
lumpectomy (removal of breast lump only while leaving the rest of the breast), with or
35 In the raid on the Feminist Women’s Health Center in Los Angeles in 1972, yoghurt was among the items taken as
evidence of charges concerning the practicing of medicine without a license (Ruzek 57). There is actually little evidence
that yoghurt inserted into the vagina is an effective cure for thrush (Stewart and Spencer 200-202). Women may have
simply found its coolness temporarily soothed the itching and burning.
36 Bix explains that by the 1992 version of Our Bodies, Ourselves, astrological birth control was dismissed as not working
(159). The Holistic Health Handbook offers other forms of birth control including psychic contraception (using meditation,
breath regulation and yoga) or lunaconception (simulating natural rhythms by mimicking the moon’s cycle through
different lighting) (Kernis 307-15).
37 The women’s health movement was also concerned with high rates of hysterectomy (removal of the uterus). See
Seaman Free and Female 165-174; Laurence and Weinhouse 171-176. Numerous books were dedicated to the subject
with some of the most influential being Hufnagel and Golant; Stokes.
38 For a detailed analysis of the persistence of the radical mastectomy procedure in medical practice see Lerner.
32
without radiation 39 . The pressure for changes to breast cancer surgery continued during
the wait for the results of the American trials. The women’s health movement’s campaign
against radical mastectomy was bolstered by the support of two surgeons, Dr. Oliver
Cope and Dr. George Crile Jr. who publicised other alternatives to lay women (Batt 65).
When results from the trials were published in 1985 (Fisher, “Ten year results”; Fisher,
“Five year results”), confirming that radical mastectomy did not improve breast cancer
survival rate, the number of radical mastectomies being performed in the United States
had already declined dramatically. In 1970, an estimated 46 000 radical mastectomies
had been performed while in 1983 this figure was only 5 000 (Batt 65).
In addition to campaigning against radical mastectomy as standard surgical
treatment, women also brought about changes to the diagnostic process. Traditionally
women with suspected breast cancer had one-stage breast surgery in which a biopsy
was performed and analysed in the operating theatre. If cancer was found to be present
a mastectomy followed. Aside from the very real possibility of women losing a breast due
to a biopsy error, one-stage breast surgery meant that women went into surgery not
knowing if they would wake up with a breast or not. After successfully negotiating to
have a two-stage surgery, Rose Kushner led the charge to have it become standard
practice in breast cancer surgery 40 . In 1979 at a conference to establish national
guidelines for breast cancer treatment, the two-stage surgery was incorporated (Batt 69).
The women’s health movement’s activism in the area of breast cancer is a
demonstration of the new strengths gained by the movement. As Ellen Leopold explains,
breast cancer differed in a number of ways from the health issues the women’s health
39 The trials included B-04, multicentre trial launched in 1971 involving 1 765 women comparing radical mastectomy with
simple mastectomy, with or without radiation. This trial was followed by B-06 in 1976, a trial of 2 500 women comparing
simple mastectomy with lumpectomy, with or without radiation (Batt 64).
40 In her campaigning, however, Kushner was careful to distance herself from radical feminists’ claims about radical
mastectomy. She commented: “As for the accusation that mastectomies are male-chauvinist inventions created to butcher
women, militant Women's Libbers should drop the charge.”
33
movement had engaged with previously. Not only were the male physicians oncologists
rather than obstetricians and gynaecologists, but they were dealing with a disease that
typically had life and death consequences. She states: “Where male authority and
expertise were believed to be tied up with life-saving skills, the habitual female response
of total surrender was much harder to dislodge” (249). The enormity of the women’s
health movement’s questioning of a long-practised surgical approach to breast cancer
should not be underestimated.
In addition to breast cancer, the women’s health movement moved to investigate
other women’s health issues outside of reproductive and gynaecological health. Eating
disorders such as anorexia nervosa and bulimia nervosa were an obvious choice as
sufferers were predominantly women. It was claimed that eating disorders had reached
epidemic proportions, affecting as many as 5% of women and girls in the Western world
(Brumberg 4). The incidence on college campuses was said to be even higher with
Naomi Wolf explaining that if the higher estimates were used: “of ten young American
women in college, two will be anorexic and six will be bulimic; only two will be well”
(Beauty Myth 149).
Authors such as Kim Chernin argued that society’s obsession with thinness played a
significant factor in women developing eating disorders. Chernin states: “The image of
women that appears in the advertisement of a daily newspaper has the power to
damage a woman’s health […] If the pages of Vogue presented us with pictures of large
women […] the word bulmarexia might never have had to be created” (87-8). Examples
of previous historical periods where larger sized women were considered beautiful were
frequently used to demonstrate how thinness had come to equal attractiveness in the
current society. The women featured in the paintings of Renoir and the voluptuousness
of Marilyn Monroe were often cited (Chernin 84-85; Reismann 12).
34
The medical profession is also implicated through its focus on excess weight as a
causal factor of ill health. Opponents to the ‘thin is healthy’ message claim there is little
evidence to suggest that excess weight is actually associated with disease (Mann). The
medical profession is accused of being influenced by cultural norms and, as a result,
medicalising excess weight. Chernin claims that the medical profession “shares with its
patients an irrational revulsion for a large body” (41).
Feminists claimed it was no coincidence that a preoccupation with thinness
occurred at a time in history where women were increasingly entering the public domain.
The popularity of the flapper with her almost pre-pubescent shape followed women
receiving the vote in the United States and Twiggy graced the cover of Vogue the same
year the Pill became available (Wolf, Beauty Myth 150) 41 . The latest trend towards
thinness coincided with the rise of the women’s movement. Kim Chernin details how the
establishment of conscious-raising groups occurred simultaneously with weight loss
groups (99). Wolf explains that the obsession with slimness and dieting initiated with the
rise of the women’s movement was to: “make women’s bodies into the prisons that their
homes no longer were […] Dieting is the most potent political sedative in women’s
history” (Beauty Myth 150).
In response, the women’s health movement focused on teaching women to love
their bodies, whatever their size and shape 42 . By helping women to achieve a positive
body image it was hoped women could say no to body modification such as dieting or
cosmetic surgery. Women were also provided with information on the dangers of dieting
41 Wolf explains that in the 1950s women’s voluptuousness was permitted as women were once again entrenched in the
domestic sphere (150).
42 Elspeth Probyn cites the Body Shop’s campaign as an example which crystallises this idea. The slogan for the
campaign reads, ‘There are 3 billion women who don’t look like supermodels and only 8 who do’ (“The Anorexic Body”
126).
35
such as a tendency to gain more weight back than originally lost and the risks of dieting
drugs.
In 1990, the women’s health movement was boosted by findings of a General
Accounting Office (GAO) audit that the National Institute of Health (NIH) had failed to
implement its 1986 policy encouraging the inclusion of women as subjects in clinical
research (Eckman 130) 43 . The policy had followed the 1985 Report of the Public Health
Service Task Force on Women’s Health Issues (Public Health Service). An organisation
called the Society for the Advancement of Women’s Health Research had lobbied the
Congressional Caucus for Women’s Issues about the NIH’s apparent disregard of its
own policy. Subsequently, Congresswomen Patricia Schroeder, Olympia Snow Health
and Congressman Henry Waxman, chairman of the House Subcommittee on Health and
the Environment, called for the GAO to audit the 1986 policy (Laurence and Weinhouse
64).
One particular example of women being left out of clinical trials, detailed in the
report, captured the attention of the women’s health movement and the popular press. It
was a clinical trial investigating the protective qualities of aspirin on cardiovascular
disease and included 22 000 subjects, all male (Steering Committee of the Physicians
Health Study Research Group). As Eckman explains, the aspirin study and the lack of
biomedical research about women “functioned to produce a new narrative about the
source of women’s inequality” (138).
The GAO report resulted in a number of changes including the establishment of the
Office of Research on Women’s Health (ORWH) and appointment of the first female
director of NIH, Bernadine Healey (Hoffman and Massion 5). In 1991, the Women’s
Health Initiative (WHI) was established by the NIH and the National Heart, Lung and
43 Anne Eckman details the significance of June 18 1990 for women’s health.
36
Blood Institute (NHLBI) (National Heart, Lung and Blood Institute). The WHI was a “longterm national health study that focused on strategies for preventing heart disease, breast
and colorectal cancer and osteoporosis in postmenopausal women” (National Heart,
Lung and Blood Institute). The project involved three arms including a randomised
controlled clinical trial investigating the effect of hormone replacement therapy (HRT),
diet, calcium and Vitamin D supplementation in the primary prevention of cardiovascular
disease, breast cancer and osteoporosis in women. The second and third arms were an
observational study to identify predictors of disease and a study of community
approaches to developing healthful behaviours (National, Heart, Lung and Blood
Institute).
Results from the WHI to date have provided invaluable information for the health of
postmenopausal women. Most notably, results from the component investigating both
combined HRT and oestrogen-alone therapy. In 2002, the combined HRT arm was
prematurely stopped due to the statistics for invasive breast cancer exceeding a pre-set
level and because overall risks exceeded benefits (Food and Drug Administration). It
was revealed that combined HRT increased a women’s risk of heart attack, blood clots,
stroke and breast cancer compared to placebo (Writing Group for the Women’s Health
Initiative Investigators). Later, results from the oestrogen-alone arm also demonstrated
an increase in a woman’s risk of blood clots and stroke, although not heart attack or
breast cancer (Women’s Health Initiative Steering Committee) 44 . The WHI provided
evidence which contradicted the general medical opinion at the time, that oestrogen
replacement protected postmenopausal women from heart disease.
44 Further results have shown that combined HRT and estrogen alone therapy increase a woman’s risk of dementia
(Shumaker et al, “Estrogen and progestin and the incidence of dementia”; Shumaker et al, “Conjugated equine estrogens
and incidence of probable dementia”) and urinary incontinence (Hendrix).
37
The women’s health movement’s opposition to the practices of the medical
profession was bolstered by the work of a number of feminist historians. These
historians traced the rise of the profession and how it relied upon the destruction of
women’s traditional roles in healing and pregnancy and birth. The most prominent work
of this kind is Ehrenreich and English’s For Her Own Good: 150 Years of Experts’ Advice
to Women. Ehrenreich and English offered a university course on women and medicine
and had previously produced two pamphlets for their teaching, Witches, Midwives and
Nurses: A History of Women Healers and Complaints and Disorders: The Sexual Politics
of Sickness. These texts formed the basis of For Her Own Good. The publication details
the history of women’s oppression at the hands of “physicians, psychologists, domestic
scientists, child-raising experts” (For Her Own Good 4). Ehrenreich and English argue
that male experts use scientific ‘truth’ to maintain their dominance and keep women in
the domestic sphere.
Much of the feminist historians’ work on the discipline of medicine involves
documenting medical practices that, with today’s knowledge, appear barbaric or illinformed. In particular women’s experience of heroic medicine is described in detail.
Heroic medicine became popular in the late eighteenth century and consisted of treating
illness with aggressive methods such as bloodletting, blistering and purging. As many
female ailments were thought to stem from the reproductive organs they often became
the focus of treatments. The application of leeches to the vulva or cervix and the
cauterization of the cervix with a hot steel are two practices commonly cited (Ehrenreich
and English, For Her Own Good 123; Wood 224; Laurence and Weinhouse 15).
Individual male physicians and their specific medical practices are used by feminist
historians to emphasise the medical profession’s (mis)treatment of women. One of the
physicians discussed in detail is Dr. S. Weir Mitchell, a specialist in treating female nerve
disorders. His treatment, the rest-cure, involved the patient taking to bed where she was
38
strengthened by regular feedings, massages and electrical stimulation. Visitors were
forbidden as was any intellectual pursuits such as reading. Ehrenreich and English
depict Mitchell as a physician who cured by “the force of his masculinity alone” (For Her
Own Good 133). Similarly, Ann Douglas Wood accuses Mitchell as playing “the role of
possessor, even impregnator” and describes his female patients as “[d]ominated,
overfed often to the point of obesity, caressed and (quite literally) vibrating” (228) 45 . A
patient of Mitchell, Charlotte Perkins Gilman, rejected his rest cure and after divorcing
her husband became a writer. Gilman’s experience is regularly cited by female historians
as one woman’s ‘escape’ from the male experts’ treatment.
Feminist historians also accuse male physicians of breaking down women’s
traditional networks, leaving women isolated and dependent. Only then could the
medical profession achieve the prestige and financial rewards it desired. Particular
attention is paid to the male experts’ advancement into the arena of midwifery, a
specialisation seen as belonging to women. Ehrenreich and English claim the motivation
for this encroachment was to provide access to live patients for training hospital staff
(For Her Own Good 94). Alternatively, Laurence and Weinhouse argue that male
physicians “simply did not want to share the relatively easy and potentially lucrative
business of delivery babies” (19).
The work of feminist historians on women and health has also been a key feature in
the critique of the women’s health movement and the broader women’s movement. In
particular it is suggested that versions of medical history circulated by the women’s
health movement as evidence of women’s ongoing mistreatment are inaccurate. Martha
Verbrugge’s review of Ehrenreich and English’s pamphlet, Complaints and Disorders, for
example, states that the: “authors’ historical survey is superficial and oversimplifies an
45 This refers to a much quoted anecdote involving Mitchell in which he threatens to get into bed with one of his patients
after she refuses to get up following the completion of the six week cure. Douglas admits the anecdote “may well be
39
intricate network of people, ideas and conditions […] It tends to distort the historical
processes and the political context which have shaped the positions of women and
medicine in society” (324) 46 . Similarly, Morantz’s article, “The Perils of Feminist History”,
critiques the work of Ann Douglas Wood. Morantz accuses Wood of being “too willing to
distort historical evidence and lay blame, while missing a larger opportunity to explore
the immense complexities which lie at the root of Victorian attitudes towards women”
(“The Perils of Feminist History” 649).
Morantz focuses, in particular on Wood’s depiction of Mitchell. Morantz points out
that as a neurologist rather than a woman’s doctor, Mitchell treated both men and
women with his rest cure (“The Perils of Feminist History” 652). His first experience of
the success of the cure was in the treatment of Civil War soldiers. Feminist historians’
accounts, however, rarely acknowledge this fact, instead preferring to depict the rest
cure as a treatment Mitchell invented solely for the psychological torture of women.
Portraying women as the only subjects of treatments that today appear barbaric is a
common fault in historical accounts of nineteenth century medicine. We are left with the
impression that women were singled out, with men being offered treatments of a
different nature. Gosling and Ray’s work on nineteenth century nervous patients,
however, demonstrates that “[v]ictorian gynecology was not particularly harsh in
comparison with other therapeutics of the period” (260). They explain that men and their
reproductive organs were also the focus of treatments 47 . Men underwent surgical
procedures such as prostatectomy, vasectomy and the passing of metal sounds into the
urethra to stretch the opening (Gosling and Ray 260-1). Similarly, Joan Busfield argues
apocryphal” but claims “its spirit is not” (228).
46 Ozonoff and Ozonoff’s review of Ehrenreich and English’s pamphlets is also critical of the accuracy of their historical
accounts. They dispute Ehrenreich and English’s claim that the majority of women tried as witches were lay healers. They
also suggest that Ehrenreich and English’s portrayal of medical education changes is too simplistic.
47 Gosling and Ray argue that physicians’ gender attitudes “were more complex than has been suggested, intermingling
with both professional concerns and class stereotypes widely held in the medical community” (252).
40
that not all mental disorders were seen as distinctively female, with “the criminal lunatic,
the maniac and the hypochondriac […] typically represented as male rather than female”
(29) 48 . Morantz details how cauterisation was popular for the treatment of venereal
disease in men (“The Lady and Her Physician” 47).
The women’s health movement relies on sharply contrasting portrayals of female
healers and male medical professionals. Ehrenreich and English, for example, position
the female healer as providing personal care based on centuries of acquired knowledge.
Conversely, the male expert is depicted as lacking in knowledge and skill and motivated
by status and financial reward: “it was in the interests of doctors to cultivate the illnesses
of their patients with frequent home visits and drawn-out “treatments.” A few dozen wellheeled lady customers were all that a doctor needed for a successful urban practice”
(Ehrenreich and English, Complaints and Disorders 28). The female healers’ cures are
seen as legitimate and based on proven remedies, even though it is acknowledged
sometimes they are “purely magical” (Ehrenreich and English, For Her Own Good 36).
Ehrenreich and English’s explanation that although a female healer could not
always heal, “neither could she do much harm” (For Her Own Good 44), suggests the
safety of her remedies was perhaps due to their mildness. While this appears to be
regarded as a positive characteristic when related to female healers, the view changes
when the remedies in question are ‘owned’ by men. Male experts of the time are
criticised for practicing by “guesswork and myth” (Ehrenreich and English, For Her Own
Good 37). Homeopathy, a therapy founded by German physician Dr Samuel
Hahnemann, is dismissed by Ehrenreich and English as a clever invention by male
experts to “make a commodity out of doing nothing at all” (For Her Own Good 59).
Homeopathy uses heavily diluted substances to stimulate the body’s own healing
48 Busfield’s work also demonstrates that mental disorders were not only defined by gender but also by “age, marital
status, social class and ethnicity” (30).
41
process. It was thought that dilution not only reduced unwanted side effects but actually
made the substance more potent. Ehrenreich and English comment that the
homeopathic was someone who could be seen to “expend a great deal of effort and time
without doing a bit of harm” (For Her Own Good 60). While Ehrenreich and English
regard female healers’ harmless remedies as ‘soothing’, the equally harmless
homeopathic remedies of male experts are seen as fraudulent.
Radical proponents of the women’s health movement also claim that male medical
professionals are motivated by misogynistic tendencies. Seaman, for example,
questions why doctors choose to specialise as gynaecologists: “isn’t it hard to believe
that voyeurism or some special love-hate relationship with women doesn’t play a part?”
(Free and Female 144). Similarly, Barker-Benfield claims that gynaecologists were
involved in “snipping off addicting clitorises and removing the ovaries of women deemed
unfit to breed, or too rebellious in themselves to be tolerated” (122).
Claims that all male medical professionals were motivated by financial reward,
status or even misogynistic tendencies are extremely simplistic. This view denies the
male medical professional any interest in the betterment of women’s health and ignores
scientific developments which contributed to improvements in women’s health. Dr. J.
Marion Sims’ work on the surgical repair of vesicovaginal fistula, a tear between the wall
of the vagina and the bladder, provides a good example of this bias. Sims, regarded as
the founder of gynaecology, perfected the surgery in a series of operations he performed
on a number of female slaves in Alabama between 1845 and 1849 (Ojanuga 29).
The women’s health movement depicts Sims as a man who experimented on slave
women with little regard for their pain and suffering. Laurence and Weinhouse refer to
Sims work on the repair of vesicovaginal fistula as: “[o]ne of the most egregious
42
examples of experimental abuse of women” (22) 49 . Barker-Benfield even claims that
Sims had a “hostile (even aggressive) feeling towards woman’s pelvic organs” and that
cutting into them was his way of “dealing with the horror they aroused” (95-96). The
women’s health movement takes issues with the fact that the slave women were unable
to consent to the surgery because as slaves permission was given by their slave
masters (Ojanuga 29).
Although the women’s permission was not required and, therefore, not sought, this
does not necessarily mean the operations were performed against the woman’s will. The
terrible nature of a vesicovaginal fistula needs to be taken into consideration. Women
with the condition suffer from a constant seeping of urine which can in turn cause
irritation to the tissue in the genital area. A fistula would not only have meant a female
slave woman was worthless to her master but she would most likely also have been
shunned by her own community. In this position a slave may have consented to the
experimental operations as it was the only possible way of regaining any sort of life.
A second objection to Sims experimental surgery was that it was performed without
anaesthesia. Laurence and Weinhouse comment that “although anaesthesia had been
developed, Sims was not aware of it” (22). This remark implies that Sims was not up to
date with scientific developments and this led to the unnecessary suffering of the
women. As Caroline de Costa explains, however, it is not surprising that Sims was not
using anaesthesia as although the anaesthetic properties of some substances were
known, the routine use of anaesthetics in surgery took many years to be widely accepted
(662). At the time of Sims’ vesicovaginal fistula repair all surgery, whether it was
performed on slave women or free white men, was performed without anaesthetic (de
Costa 662).
49 Also see Axelson.
43
Sims is also accused of experimenting on slave women and poor women to perfect
his technique before going on to treat wealthy women. While Sims did go on to treat
women of the upper classes and even royalty 50 , it cannot be concluded that his interest
in treating slave women was part of an overall plan. As de Costa explains: “as a young
man living in the deep South […] Sims could not have anticipated the later course of his
life or expected that fistula repair would make him competent in the practice of
gynaecology, a speciality that did not exist in the 1840s” (662) 51 . Rather than seeing
slave women as “guinea pigs” as Laurence and Weinhouse claim (23), Sims recognised
the dire consequences of the women’s fistulas and sought to correct it.
The debate around Sims’ failure to use anaesthetic is an example of a further
limitation of the historical representations of medicine relied on by the women’s health
movement. They tend to judge historical treatment practices by today’s knowledge and
standards. As Morantz suggests, “treatment of disease in nineteenth-century America
cannot be viewed properly apart from the broad context of scientific ignorance which
was displayed at mid-century” (“The Perils of Feminist History” 653). Ehrenriech and
English frequently use examples of medical treatment which today appear ill-informed.
They cite, for example, the physician to Edward II writing on the jaws of a patient, ‘In the
Name of the father, the Son and the Holy Ghost, Amen’ to relieve a toothache (For Her
Own Good 37-38). They use examples such as these to continue their portrayal of male
medical professionals as both foolish and incompetent 52 . It is easy to view treatments
used historically as ludicrous and ineffectual in light of findings achieved by sophisticated
technology such magnetic resonance imaging (MRI) and gene testing. However, the
50 On a visit to Europe Sims treated Empress Eugenie, wife of Napolean III of France (Costa 661).
51 For other articles which defend Sims’ work see Kaiser; O’Leary.
52 As Verbrugge explains the ridicule of historical medical practices, “ironically encourage[s] the worship of present-day
medicine” (332).
44
level of scientific knowledge about the body and disease present at the time must be
taken into account.
Feminist exposes on the Pill provide a more recent example. The general argument
is that the clinical trials of the Pill were inadequate and women who took the Pill were
used as guinea pigs. Flora Davis discusses how the Pill was trialled initially on only 132
women and that a number of deaths associated with the drug were not properly
investigated (236). Ruzek also takes issue with the clinical trials stating: “Oral
contraceptives had passed through the FDA without being subjected to recognized
standards of scientific experimentation for safety” (37). Here it seems that Ruzek is
referring to current standards rather than those that were in place during the time of the
Pill clinical trials.
In her historical overview of the Pill, Lara Marks discusses how its testing took place
before 1962, the year the drug thalidomide was linked to birth defects, prompting
stronger laws governing the regulation of the new drugs (5). So while the Pill clinical
trials would not meet today’s standards they were in keeping with how drugs were tested
prior to 1962. Marks also explains that a lack of knowledge around the epidemiology of
chronic disease in the late 1950s meant researchers had little reason to suspect the Pill
was responsible for the deaths of trial participants (107).
The women’s health movement’s response to the Pill represents a further issue, that
the movement rarely recognises how medicine has improved women’s health. Rather
than focus on the way the Pill allowed women control of their reproductive lives, for
example, the emphasis has been on the Pill’s side effects. Robyn Rowland comments:
“The pill, supposed liberator of women, had led to thrombosis and cancer for many
women” (544). Here Rowland dismisses the positives of the Pill completely, even
suggesting that its role as a liberator of women has been falsely granted. Her inclusion
of ‘cancer’ in the general sense also implies that the Pill is linked to many cancers. While
45
it is associated with a small increase in breast cancer 53 , the Pill is also protective against
uterine and ovarian cancer (Guillebaud 148) 54 . Lupton identifies similar issues in what
she refers to as the “orthodox medicalisation critique” (“Foucault and the Medicalisation
Critique” 97). She writes: “One major difficulty with the orthodox medicalisation critique is
its rather black-and-white portrayal of Western medicine as largely detracting from rather
than improving people’s health status” (“Foucault and the Medicalisation Critique” 97).
Such a limitation is also evident in the women’s health movement’s discourse on
pregnancy and birth. The approach predominantly focuses on the dangers or downsides
associated with prenatal and labour interventions. Ultrasound and prenatal tests like
amniocentesis, for example, are often depicted as technologies which medicalise a
natural process, pregnancy. Ann Oakley argues that ultrasound became a routine part of
care, despite its safety during pregnancy not being adequately established (8).
Screening tests are said to undermine women’s confidence in their ability to produce a
healthy child (Hubbard, “Prenatal Diagnosis” 568). While there are undoubtedly issues
surrounding prenatal screening 55 it has alerted many women to foetal abnormalities,
allowing them the opportunity to decide whether or not to continue with their pregnancy.
These tests have particularly benefited families who carry genetic diseases which
significantly impact on a person’s quality of life and life expectancy, such as Huntington’s
disease.
Medicine’s advances in the area of pregnancy and birth are often interpreted by the
women’s health movement as an attempt to take control of the realm of production.
53 The increased breast cancer risk diminishes after women cease taking the Pill, with no increased risk present after ten
years (Guillebaud 155).
54 The protection the Pill offers against ovarian cancer is significant as the cancer displays few symptoms and is often
diagnosed when it is well advanced and the chances of recovery are low.
55 Some of the concerns raised are prenatal testing and sex selection (Hoskins and Holmes; Raymond “Sex
Preselection”), eugenics (Hubbard, “Prenatal Diagnosis”) and the impact on people currently living with disabilities
(Saxton; Finger).
46
Rowland, for example, draws a connection between keeping extremely premature
babies alive and the future development of an artificial womb (542). Radical responses
such as this show little appreciation for the progress medicine has made in
understanding the complexities of pregnancy and how this has benefited women.
Increased survival rates for babies born prematurely and treatments to reduce recurrent
miscarriage have meant fewer women have had to endure the loss of a baby 56 .
The women’s health movement’s close association with alternative and
complementary medicine (CAM) is also problematic. The evidence supporting the use of
CAM is limited and rarely consists of randomised controlled trials. Anecdotal evidence
from patients is relied on heavily as proof that CAM is effective. The use of anecdotal
evidence is consistent with the women’s health movement’s philosophy that women’s
voices and experiences are valued. However, this places the women’s health movement
in a difficult position. By accepting anecdotal evidence of efficacy and safety of CAM, the
movement risks creating situations where women are guinea pigs for treatments that are
not tried and tested.
The broad approach of CAM also has implications. Focusing on both the mind and
the body means that many aspects of a person’s life are examined in these systems.
Lupton comments on how CAMs “often level a much more intense and individualistic
gaze at the relationship of people’s everyday activities and their private lives with their
health status than does medicine” (“Foucault and the Medicalisation Critique” 107).
CAMs could be said to ‘medicalise’ a person more than modern medicine. Traditional
Chinese Medicine (TCM) provides a clear example of what Lupton refers to. An initial
TCM consultation will typically involve the person answering questions about their
56 One of the most significant developments is the treatment of infant respiratory distress syndrome (RDS) in premature
babies. The death rate from RDS in the United States dropped from 25 000 in the 1960s to 1 019 in 2001 (American Lung
Association).
47
eating, sleeping and bowel habits. They may be asked to describe the colour, smell and
texture of their faeces and even to have their breath smelt. The TCM practitioner will
make recommendations that impact on the whole spectrum of a person’s life, including
their diet, exercise schedule, relationships and work environment (Olsen 22). While there
are benefits to such a holistic approach, it cannot be promoted as a system which is less
medicalised.
The women’s health movement’s focus on preventative health rather than simply
treating disease can also lead to an increase in medicalisation. Breast self-examination
(BSE) provides an excellent example. BSE involves women regularly performing one of
several standard self-examination techniques in an attempt to find breast changes early.
It was promoted by the women’s health movement as something that women
themselves could do to reduce their risk of breast cancer. The Feminist Women’s Health
Centre’s BSE information, for example, states: “You are the best authority on your own
breasts. Doing self breast exam every month helps you become that authority”
(Punukollu).
It could be argued, however, that BSE medicalises a woman’s body by suggesting
that a woman’s breasts are a potential source of disease and so must be carefully
monitored. In reality, approximately 80% of lumps discovered are benign (noncancerous) and this rate is likely to be higher in younger women (Imaginis). Many
women are not empowered by performing BSE but in fact find it causes feelings of
anxiety and worry, particularly those with a family history of breast cancer (K. Brain et al;
Lindberg and Wellisch; Persson, Ek and Svensson; van Dooren et al). A review of
scientific evidence found BSE did not impact on reducing deaths from breast cancer and
increased a woman’s risk of undergoing a breast biopsy (Kosters and Gotzsche). As a
result some organisations now encourage women to develop ‘breast self-awareness’,
with BSE being seen as optional.
48
There are also limitations to the concept of informed choice, a key component of the
women’s health movement. The movement contends that women are not always
provided with adequate information to make decisions about their health care options.
Ruzek explains that when women seek medical care “physicians often fail or openly
refuse to give women enough information to discuss procedures or make decisions in a
reasoned, competent manner” (33). A much cited example of this is Dr. Elizabeth
Connell’s explanation of what oral contraceptive risks she discusses with patients: “Oh,
usually the thrombophelebitis and not too much else. They don’t understand anything
else” (Seaman, The Doctors Case Against the Pill 11).
The types of information that the women’s health movement suggests women need
to make informed choices include treatment success rates, costs, side effects and long
term risks and benefits. The movement’s emphasis on the provision of health care
information is based on the belief that health care providers are either not forthcoming
with the necessary information or that the information given to women is biased.
Publications like The Boston Women’s Health Book Collective’s, Our Bodies, Ourselves
aims to give women the information they need to make an informed choice.
While there are many benefits to people having a better understanding of health
issues, informed choice relies on a person being able to make sense of the various
options they are presented with in order to make the ‘right’ choice. Susan Sherwin
suggests: “The paradigm offered for informed consent is built on a model of articulate,
intelligent patients who are accustomed to making decisions about the course of their
lives and who possess the resources necessary to allow them a range of options to
choose among” (24).
In the case of Our Bodies, Ourselves, a woman would need to have a reasonable
level of literacy to understand the information it provides. Similarly, the World Wide Web
provides a wealth of health information but a woman requires skills in searching to be
49
able to find information that is both good quality and accessible 57 . Even if a person is
able to locate the information, they may lack a broader understanding of medical
terminology and systems to make proper sense of it 58 . The women’s health movement
does not appear to differentiate between the usefulness of informed choice in different
types of health issues, implying that it is valid in all circumstances. While informed
choice may be feasible for some women if the health issue is minor or straightforward, it
is much more challenging for complex health issues. A woman might find adequate
information to make a decision on a preferred method of contraception but struggle
when faced with a life and death issue like cancer.
As Sherwin indicates the idea of informed choice also assumes that a person can
freely choose between options. This is unlikely to be true for women of low socioeconomic status whose access will be restricted to what’s affordable. There is little
benefit in becoming informed of all the options if the majority are not financially available.
This may in fact leave women disempowered as they have become aware that the
options available to them as someone who is socio-economically disadvantaged may not
be optimal.
Informed choice also assumes women wish to take on the responsibility of making
health care decisions. This, however, may not be a priority for all women. Having to take
the responsibility for a health care decision can actually be displeasing for some. If a
woman has few opportunities to make decisions in other areas of her life she may not
wish to make them about her health. Being offered a range of health care options can be
57 The World Wide Web has become an increasing popular source of health information. However, many sites are
actually provided by commercial organisations and/or people with no health care qualifications. The Health on the Net
Foundation has established HONcode to assist people in locating quality websites. Websites featuring the HONcode
symbol must abide by a list of criteria (Health on the Net Foundation).
58An example of this occurring is the case of a woman with a recurrent thrush infection who read her laboratory reports
before presenting them to the doctor. The report revealed her vaginal swab contained Candida glabrata and Candida
krusei. A search on the internet revealed that both are rare strains. What the woman did not find out was that both strains
are naturally occurring and the more common strain of Candida had been eliminated due to the use of an anti-fungal
50
confusing and daunting for some women. Any decisions made may be accompanied by
a great deal of anxiety and worry over whether it was ‘right’ choice. Lupton argues that
advocating for people to become more informed about medical matters could be
regarded as “paradoxically advocating a greater ‘medicalisation’ of people’s lives by
encouraging them to acquire medical knowledge for themselves more actively”
(“Foucault and the Medicalisation Critique” 107).
Allowing a health professional to decide the course of treatment on one’s behalf
should also be considered as making an ‘informed choice’. Deferring the decisionmaking to a health professional need not be thought of as taking a passive role. Lupton
suggests that people who ‘go along’ with medical advice need not necessarily be seen
as passively accepting the doctor’s orders, “but rather could be seen as engaging in
practices of the self that they consider are vital to their own well-being and freedom from
discomfort and pain” (“Foucault and the Medicalisation Critique” 105).
The women’s health movement’s outrage over the lack of medical research
involving women is a further indication of the inherent contradictions in the movement.
After protesting over the effects of DES on unborn children and accusing the medical
profession of using women as guinea pigs in the development of contraceptives,
women’s health advocates called for more women to be included in research. The 1977
ban on women of reproductive potential from early phase clinical trials was not
interpreted as protecting women and their unborn babies but seen as a typically
paternalistic response. Researchers were accused of omitting women from clinical trials
as a way of simplifying trials and cutting costs. Laurence and Weinhouse claim that the
“scientific community did not so much have a blind spot as a willful disregard for
women’s health” (69).
treatment. Without the interpretive skills of a qualified medical professional the woman’s attempts to become informed
caused a great deal of unnecessary concern and anxiety (personal communication).
51
While there are areas where more research data involving women is desirable and
necessary, the notion of a gender-bias in research needs to be examined more carefully.
The women’s health movement’s claim that women were deliberately excluded from
clinical trials is too simplistic and does not take into account the complexities involved in
research. There is also evidence to suggest that women’s exclusion from research is not
as significant as first portrayed. Sally Satel’s discussion of clinical trials which did not
include women demonstrates that in many cases there were legitimate reasons. For
example, the Multiple Risk Factor Intervention Trial and Research Clinics in the 1970s
did not include women as the focus was on preventing heart attacks in middle age.
Previous studies which included women had shown that women’s risk of heart attacks
tended to be at a later stage in life (Satel 118).
Similarly, the aspirin study which received a great deal of attention after the GAO
report, recruited only men because the study population consisted of physicians and
there were very few females in the required age bracket (Satel 120). As recruiting large
numbers of participants is difficult, institutions such as the army were often called upon
to supply participants. These institutions were typically male-dominated. To be able to
obtain statistically significant results involving gender differences from clinical trials there
needs to be adequate numbers in each group (female intervention group, female control
group, male intervention group and male control group). The increase in recruitment time
and overall research costs may result in fewer studies being carried out.
In an article reviewing men and women’s participation in clinical trials the authors
Meinert and Gilpin found that while there was a slight excess in male-only trials in the
decade 1966-1975, there were sizeable excesses in female-only trials in the decades of
1976-1985 and 1986-1995. The authors conclude: “The results do not support the
perception that women have been understudied relative to males in clinical trials”
(Meinert and Gilpin 1164). Claims of a lack of research involving women also commonly
52
overlook large female-only studies. For example, the Nurses’ Health Study was
established in 1976 and initially involved 122 000 nurses 59 (Nurses’ Health Study).
Insisting on women’s participation in clinical trials has in some cases led to the overrepresentation of women. An example of where this occurs is in HIV/AIDS research.
Women were traditionally underrepresented in HIV/AIDS research and so improvements
in this area were beneficial. However, by 1998 women represented 36% of subjects in
NIH-funded AIDS trials, despite only making up 15% of AIDS cases (Satel 118). Satel
warns, of the “unerring tendency of so many women’s health advocates to view events
through a lens of aggrievement and to ignore the numerous adverse consequences of
elevating politics over science in setting research policy” (128).
Eckman identifies a further issue with women’s health advocates campaign for
changes to biomedical research; that it identifies biological sex as “the difference that
most determines women’s health” (141). Other factors such as race, class, ethnicity and
sexuality, therefore, are relegated to being of less importance. In addition, the emphasis
on heart disease as the example of gender-bias in research has seen this topic
addressed at the expense of other issues like reproductive health (Eckman 147).
Characteristic of many aspects of the women’s health movement is a tendency to
position women as passive victims of the monolithic force of modern medicine. In her
exploration of women and psychiatry, Janet Walker explains that such a situation occurs
because of feminist attempts to adequately communicate the pain and depth of
patriarchal oppression (xvii). She argues that these efforts can “lead to characterizations
of patriarchy and its constituent institutions, including psychiatry, as monolithic and
inescapable” (xvii).
59 In 1985, the Nurses’ Health Study II was established to examine a younger population of women, aged 25-49. The
study recruited 116 686 nurses (Nurses’ Health Study).
53
As a result feminist writings on women’s health often become a compilation of
quotes from patronising, misogynist health professionals alongside anecdotes from their
female ‘victims’. Seaman’s work, Free and Female exemplifies this approach with
chapter five detailing a long list of wrong doings by gynaecologists/obstetricians. They
include: dissuading women from breastfeeding; favouring lithomy positions in delivery for
convenience sake; donating sperm for financial gain; too slow in performing a
Caesarean section; intervening in labour due to impatience or to suit schedules;
interfering with the mother-infant bond due to a drug affected labour; bullying women
about weight gain during pregnancy; killing a woman’s baby during a forceps delivery;
causing brain damage to a newly born infant; failing to treat a gangrenous penis
following circumcision; sexually assaulting female patients during pelvic exams;
prescribing a diaphragm two sizes too small; failing to inform patients of IUD side effects;
prescribing oral contraceptive like candy; failing to gain informed consent; performing
unnecessary hysterectomies and; causing fertility problems in a women by prescribing
her the Pill.
Writings such as these are designed to provoke women into taking action and,
therefore, they rely heavily on dramatic and emotional stories of women as victims. In
Seaman’s chapter on gynaecologists/obstetricians, for example, the women she features
are almost entirely passive recipients of the questionable health care. A woman in labour
describes herself as “drugged, fat and helpless” (149) and a Pill user, “cowed by the
doctor’s brusqueness”, does not report the side effects she is experiencing (160). There
are few women who do not follow the doctor’s orders 60 .
A similar approach can be found in historical accounts of medicine’s treatment of
women. Although Ehrenreich and English do provide instances of women not heeding
60 The exceptions are Seaman who reports she continued breastfeeding despite her doctor’s opposition (142) and a
young woman who seeks a second opinion on her diaphragm (159).
54
male experts’ advice, their focus in these examples is the incompetence of the male
expert rather than the woman’s opposition. The story of Charlotte Perkins Gilman who
rejected the ‘rest’ cure prescribed by Dr. S. Weir Mitchell is depicted as exceptional:
“Gilman was fortunate enough to have had a “moment of clear vision” in which she
understood what was happening to her. Thousands of other women, like Gilman, were
finding themselves in a new position of dependency on the male medical profession”
(For Her Own Good 102).
Positioning women as victims of medicine is a gross simplification of how people
interact with the medical system. Modern medicine is not ‘all bad’ and women do
positively gain from their participation in it. This is not to say women’s bodies are never
medicalised, but that this is not the entirety of women’s experience. Rima Apple
explains: “Women were not, are not, passive recipients of medical advice and
therapeutics; we were not, are not, defined by male-constructed medical theories. We
are active participants who at times resist, at times embrace, and at times create the
conditions in which we find ourselves” (xv).
Apple’s claim that women are active participants is well demonstrated in the
circumstances in which women came to give birth with the assistance of male medical
professionals. The women’s health and natural birthing movements claim that doctors
sought to wrest control of pregnancy and birth away from women for either financial gain
or their envy of the reproductive role. In this scenario women are positioned as having
no role in such developments. Women are only seen as the recipients of the detrimental
changes in practice. This view, however, fails to acknowledge the complex processes
involved and, in particular, the important part that women played in bringing male
medical professionals into the delivery room.
Judith Walzer Leavitt’s work details the environment in which women gave birth in
the nineteenth and early twentieth century. She illustrates how as a result of various
55
conditions, women actively pursued changes, including the assistance of male medical
professionals for childbirth. Leavitt explains: “The process of changing childbirth
experiences throughout American history incorporated the wishes and demands of the
birthing women themselves; change occurred in large part when and how birthing
women wanted it to happen” (Brought to Bed 4).
One of the most significant contributing factors to women’s wish for change was the
fear they would die or suffer chronic health problems from childbirth. The women’s
health and natural birthing movements often highlight how traditionally women were
united through sharing the joys of their reproductive role. While this no doubt did occur,
women also bonded over shared feelings of dread and fear. High fertility rates at this
time meant that women spent a significant proportion of their adult life pregnant, nursing
or recovering from birth (Leavitt, Brought to Bed 14). On average, white American
women gave birth to seven live children but as miscarriage and stillbirth were also
common, actual pregnancy numbers would have been higher (Leavitt, Brought to Bed
14).
It was in this environment that women who could afford it, sought out the help of
male medical professionals to assist in childbirth. Whereas previously women
approached childbirth with “fatalism and passivity” (Smith-Rosenberg and Rosenberg
18), women began to see it as an event they could have some influence over 61 . Women
had experienced traditional childbirth and had found it wanting. They were, therefore,
willing to try new developments in obstetrics to see if they could improve the experience.
As many women at this time would have perceived it, they had a lot to gain through
believing in the possibilities of modern medicine and, perhaps, not a great deal to lose.
While the actual benefits of the introduction of interventions like forceps and anaesthesia
61 Catherine Scholten argues that, similarly, developments in the field of obstetrics “signified a partial rejection of the
assumption that women had to suffer in childbirth and implied a new social appreciation of women” (147).
56
for women are questionable, it is still important to acknowledge women’s role in bringing
these clinical developments into the arena of childbirth. The circumstances surrounding
birth such as the fear of death and/or disability, led women to seek out ways of achieving
safer and less painful births.
The women’s health movement has been, in many ways, extremely successful. It
has permitted women to take on a more active role in their own health care and the
health care of their loved ones. The provision of information on health topics has
resulted in women having a better understanding of their own bodies and the conditions
that can affect them. The examination of women’s treatment at the hands of the medical
profession has led to changes that have benefited all patients. Doctor-patient
relationships are, overall, less paternalistic with people being provided with information
about the health care they are receiving and having the opportunity to decide what that
health care will involve. Women’s dissatisfaction with their medical treatment has led to
time-honoured practices being reviewed and modifications being implemented.
With the successes, however, have also come some problems. The women’s health
movement has been, on the whole, a middle-class, white women’s movement whose
basic principles do not always translate to women of colour or socio-economically
disadvantaged women. In addition, the positioning of women’s reproductive role has
been the source of much contradiction. Most significantly, the women’s health
movement’s efforts to convey the full extent of women’s mistreatment at the hands of the
medical profession has led to the depiction of women as passive victims of a monolithic
institution. Continued depictions of this sort threaten to undermine the movement’s
premise of women taking health care back into their own hands.
57
PART TWO: Preface
Reproductive freedom, the right to choose if, when, and how to have children was a
central focus of the women’s health movement’s early campaigns. The movement was
quick to recognise the importance of reproduction in combating women’s oppression. If a
woman did not have control over this aspect of her life she could not be expected to
make gains in other arenas. This is not to suggest, however, that the movement’s beliefs
on different aspects of reproduction were compatible with one another. Rather, the
movement was characterised by a number of contradictions. The two most apparent
being the celebration of the maternal role and advocating for women’s right to forgo it
and demanding access to safe contraceptives and abortion while criticising modern
medicine for its interference in the arena of pregnancy and birth.
Although the Pill had been available since the 60s, its prescription was generally
limited to married women and even then often required a husband’s permission. Many
women also experienced significant side effects from taking the Pill, given that the
hormone levels were many times stronger than those used today. Alternative forms of
contraception were unappealing or had failure rates many found unacceptable.
Consequently, access to safe and reliable contraception and the right to terminate a
pregnancy were important issues in the early days of the women’s health movement.
While the discipline of medicine was criticised for its inability to develop safe and
reliable contraception it simultaneously came under attack for its apparent interference in
the areas of pregnancy and childbirth. Scientific advances in these areas were not
welcomed, with the women’s health movement contesting that ‘natural’ processes were
becoming increasingly medicalised through procedures such as prenatal screening and
58
labor interventions. Women were encouraged to reject the medical model of birth in
favour of more ‘natural birthing’. While the original principles were sound enough, what
constituted a successful, ‘natural’ birth became increasingly narrow, excluding some
women. In addition, the natural birth discourses generally assumed the woman was
white and had a loving and supportive partner.
Paradoxically, the women’s health movement’s protection of women’s maternal role
was accompanied by calls for women’s right to forgo that role by aborting an unwanted
pregnancy. The movement also demanded that those requiring an abortion should have
access to a sterile environment and the services of an adequately trained medical
professional rather than risk their lives in illegal back-yard establishments. The same
medical environment that made abortions safer, however, was being portrayed as
unsuitable for birthing.
The 1980s saw the development of assisted reproductive technologies (ARTs) for
couples with fertility problems. Technologies like in-vitro fertilisation (IVF) and the use of
surrogate mothers, however, were rejected by many in the women’s health movement
as another example of men trying to take control of women’s reproductive role. Infertile
women (or women with infertile partners) who wished to share in the proclaimed joy of
motherhood found it was reserved for naturally fertile women or women willing to adopt.
The women’s motivations for wanting to fulfill their maternal role were questioned. Their
desire to have a child was not a celebration of the maternal role but apparently due to
patriarchy convincing them it was their only option.
Margaret Atwood’s Surfacing, “Giving Birth” and The Handmaid’s Tale explore many
of the issues raised by the women’s health movement regarding reproduction. The
limitation of contraceptive options, the effects of abortion being illegal, the impact of
labour interventions and the infertile woman’s experience of her body are all examined.
Atwood’s fiction, however, also works to reveal the many contradictions inherent in the
59
women’s movement engagement with women’s maternal role. Atwood dares to pose the
question, if we celebrate women’s difference from men, in particular woman’s ability to
reproduce, how can we simultaneously advocate opting out of this role (through
contraception or abortion) and criticise developments in medicine that enable women to
achieve this role? Equally, how can we propose that the maternal role is the same for
women of different classes, races and relationship statuses?
Atwood also rejects the women’s health movement’s positioning of women as
passive dupes of medical treatment. The women in her fiction are not too naïve, too
coerced or too desperate to oppose practices and circumstances they find unacceptable.
They are involved in a variety of resistances, collective and individual, active and subtle,
but all significant. They seek out alternatives to medicalised birth and oppose a regime
where love and desire are redundant and where women are separated according to their
fertility.
60
PART TWO: Contraception, Abortion and Natural Birthing in
Surfacing and “Giving Birth”
Margaret Atwood’s Surfacing was published in 1972 during the rise of the women’s
health movement. The women who were to become the Boston Women’s Health
Collective had been meeting since the late 1960s and would go on to publish the first
edition of Our Bodies, Ourselves. Ehrenreich and English published their first booklet,
Witches, Midwives and Nurses in 1972 and the topic of women’s health was being
added to university women’s studies programs (Morgen 38). Atwood’s short story,
“Giving Birth” was published several years later in 1977.
The five year span between the publication of Surfacing and “Giving Birth” sees a
shift in Atwood’s perspective. While Surfacing addresses contraceptive choices and
abortion, holding up the natural birthing movement as a valid alternative to medicalised
birth, “Giving Birth” critiques the essentialism of the natural birthing movement and its
prescriptive tendencies. In “Giving Birth” Atwood also highlights the way the women’s
health movement and the women’s movement in general largely represent white,
middle-class women, neglecting women of colour and low socio-economic status.
Significantly, “Giving Birth” was published in the same year as Medicaid funding for
abortion was withdrawn, a decision largely affecting poor women and women of colour
(Morgen 181).
The protagonist of Surfacing is an unnamed woman who works as a commercial
artist. Her ambition to be a ‘real artist’ is quashed by her art teacher who declares the
idea “cute but misguided” (46). He instructs her to study something she can use,
because “there have never been any important woman artists” (46). The first person
narrative follows the protagonist’s return to her childhood home in a rustic cabin in
Northern Canada after being informed of her father’s disappearance. She has been
61
estranged from her parents for a number of years, not even returning after her mother
dies of a brain tumour. Not owning her own car she relies on friends, David and Anna, a
married couple, to drive her to the remote location. She is also accompanied by her
current boyfriend Joe, a potter who mutilates his pots with holes, slashes and bends. Her
relationship with him appears to have developed out of convenience rather than love.
She compares making the decision to live with him to “buying a goldfish or a potted
cactus plant, not because you want one in advance but because you happen to be in the
store” (36).
In a significant passage the protagonist and Anna discuss the inadequacies of
currently available contraceptive options. Their conversation echoes the women’s health
movement’s criticisms concerning the safety, efficacy and practicality of contraception.
Both women have had to discontinue use of the Pill due to side effects. Anna developed
a potentially lethal blood clot in her leg and the protagonist had blurred vision. Anna’s
comment: ‘“Bastards,’ […] ‘they’re so smart, you think they’d be able to come up with
something that’d work without killing you’” (74) restates the feminist critique that science
has not been able to give women a safe and effective form of contraception.
The protagonist also comments on the packaging used by the drug companies
manufacturing the Pill: “handy green plastic packages, moon-shaped so that the woman
can pretend she’s still natural, cyclical, instead of a chemical slot machine” (74). The
moon-shaped packets reproduce the notion of a natural cycle even though the
chemicals they contain stop ovulation. Attempts to make Pill users still feel natural is
also achieved by packaging it in a 28 day packet, complete with a pill free interval of
seven days. The pill free interval induces a ‘withdrawal bleed’ similar to a menstrual
period, making women feel as though they still have a menstrual cycle. There is actually
62
no scientific or medical reason why women have to experience a withdrawal bleed while
taking the Pill, its main purpose being to convince women they are still ‘natural’ 62 .
The protagonist also refers to the effectiveness of the Pill: “as in magicians’ tricks or
burglaries half-success is failure” (74). As the protagonist suggests, when it comes to
contraception, no failure is acceptable. Even when it is taken as directed, the Pill still has
a 1% failure rate. Vomiting, diarrhoea, antibiotic use and the use of some other drugs
and supplements can all impact on the Pill’s absorption and reduce its effectiveness
further.
Due to the side effects she experienced while on the Pill, the protagonist has had to
return to previous forms of contraception: “Sex used to smell like rubber gloves and now
it does again” (74). The protagonist is most likely referring to condoms (sometimes
referred to as a ‘glove’) or perhaps the diaphragm. In both cases she has had to go back
to using less reliable and less convenient forms of contraception. The comparison of sex
to rubber gloves, often used when washing dishes also demonstrates the effect these
forms of contraception have on the spontaneity of sex.
The conversation between the two women is also of interest for its commentary on
the women’s health movement’s emphasis on sharing experiences of medical
mistreatment. The protagonist is initially “startled” by the personal nature of Anna’s
question, ‘“You on the Pill’”? and thinks to herself “why did she want to know” (73). The
protagonist’s reaction demonstrates that although the movement enabled such topics to
be more openly discussed, not all women felt the need to participate in this information
sharing. The protagonist is clearly uncomfortable discussing her contraceptive choices
62 It has only been very recently that drug companies have revisited the original 28 day packaging, with the introduction
of a new oral contraceptive in the United States which only incorporates a pill free interval every three months instead of
monthly. Interestingly, the use of the natural is still being relied on for marketing purposes with the product being called,
Seasonale®
63
with Anna 63 and initially only provides her with a simple answer, ‘“Not any more’” (73). It
is only following Anna’s story concerning her blood clot that the protagonist feels
compelled to reveal more details of why she stopped taking the Pill. She does not,
however, tell her everything: “It was like having vaseline on my eyes but I didn’t say that”
(73).
The protagonist’s thoughts on contraceptive options are followed by what appears to
be a description of a birthing experience. The sequencing of the description suggests the
protagonist’s first pregnancy may have been due to contraceptive failure. We have
already learned that she was married and had a child but has since got divorced and has
left the child with her former husband. The divorce and abandonment of her child appear
to be partly why she ceased contact with her parents 64 . The description takes up many
of the women’s health movement’s concerns regarding the current medical management
of pregnancy and birth. The protagonist’s statement: “they shut you into a hospital, they
shave the hair off you and tie your hands down and they don’t let you see, they don’t
want you to understand, they want you to believe it’s their power, not yours” (74), reflects
the view that modern medicine wishes to control the natural events of pregnancy and
childbirth. Shaving the genital area was routinely performed as a way of reducing
infection. The medical necessity of shaving, however, is questionable. Women’s health
movement advocates suggest the practice had the effect of infantising a woman in a
63 Atwood draws attention to the discomfort felt by some women in sharing their experiences in a group setting in several
of her novels. In The Robber Bride, Roz attends a conscious-raising group but finds the other women do not equally
value her stories of pain as she is financially better-off (350). Similarly, when Elaine in Cat’s Eye is asked to participate in
group showings with fellow painters she knows her stories do not fit the criteria: “I am insufficient in scars. I have lived a
privileged life, I’ve never been beaten up, raped, gone hungry” (378). Elaine’s experience demonstrates an obvious
limitation of the concept of conscious-raising, that unless women are from similar circumstances it may only serve to
highlight women’s differences rather than their commonality.
64 This loss of contact with parents is not unique to the protagonist. Anna, David and Joe have all “disowned their parents
long ago” (11). The protagonist believes her return to look for her missing father actually embarrasses her friends,
“they don’t understand it” (11). See Klovan for a discussion of family relationships in Surfacing.
64
further effort to make her feel powerless. At the very least, shaving often caused women
added discomfort during their recovery from the birth.
The protagonist’s comment about not being able to see could be seen as a
reference to the lithotomy position of birthing in which the woman lies on her back with
her feet in stirrups. From such a position the woman’s view of the birth is almost entirely
obscured, leaving her reliant on the doctor’s version of events. This lack of knowledge
about what is happening places the woman in a less powerful position. If, for example,
she is not given adequate information about procedures being performed, she is in no
position to question their necessity. The lithotomy position is also said to make birth
more prolonged and painful.
The protagonist also portrays modern medicine’s treatment of the pregnant body as
a passive vessel from which the baby is extracted: “They stick needles into you so you
won’t hear anything, you might as well be a dead pig, your legs are up in a metal frame
[…] they take the baby out with a fork like a pickle out of a pickle jar” (74). This refers to
the routine use of drugs during labour, in particular drugs that have an anaesthetising
effect on women, such as an epidural. Women’s health advocates condemn epidurals
because they leave the woman unaware both physically and mentally of the birthing
process. The ‘pickle fork’ is a bitterly comical reference to the use of forceps. A woman
who is administered an epidural during childbirth is much more likely to have further
interventions such as a forceps-assisted delivery.
In her drugged and immobilised state the protagonist sees herself as a ‘dead pig’.
Comparing women giving birth in hospitals to animals, often livestock, is a common
feature of the women’s health movement’s writings on the medicalisation of pregnancy
and birth. Sheila Kitzinger’s introduction to Michel Odent’s Birth Reborn, for example,
provides a typical example of how women/livestock comparisons are used to highlight
65
women’s loss of power. She describes women having a medically managed birth as
“tethered cows in an electronic, space-age milking parlor” (xii).
The protagonist labels medical professionals as “technicians, mechanics, butchers,
students clumsy or sniggering practising on your body” (74). These views are shared by
her mother who avoided going to the hospital until late into her illness from a brain
tumour because, “she must have been afraid they would experiment on her” (15). The
use of the terms ‘technicians’ and ‘mechanics’ recalls a common criticism of modern
medicine, that it treats the body as a machine made up of replaceable parts. Martin’s
comparison of the production analogies used in factories and reproduction reveals how
the metaphor of body as machine explains our willingness to apply technology to birth.
She comments: “The woman’s body is the machine and the doctor is the mechanic or
technician who “fixes” it” (54).
The details about the protagonist’s former life as a wife and mother are expanded
upon at several points in the novel. In a conversation with Anna about her marriage, the
protagonist thinks of the bitterness she holds towards her former husband and the child
she had to leave. Similarly, the protagonist’s refusal of Joe’s proposal is accompanied by
a description of her previous marriage ceremony, conducted in a post office by a J.P.
The protagonist’s version of events remains intact until she goes diving in order to locate
the rock paintings her father was documenting before his disappearance (the paintings
are now submerged due to a rise in the lake’s original water level). While diving she
discovers: “a dark oval trailing limbs. It was blurred but it had eyes, they were open, it
was something I knew about, a dead thing, it was dead” (136). The protagonist has in
fact found the body of her father. A fractured skull suggests he fell from somewhere
above, his body drifting in the lake for sometime, weighed down by a camera hanging
around his neck.
66
The protagonist’s discovery causes a number of memories to ‘resurface’. The image
of her father’s body recalls her brother’s near drowning before she was born, the
creatures her brother kept imprisoned in glass jars and, lastly, a child she previously
aborted. With her parents now both deceased the protagonist no longer feels she has to
keep up the charade: “They never knew, about that or why I left. Their own innocence,
the reason I couldn’t tell them” (138). It is revealed that the details of the protagonist’s
married life, child and divorce have been invented by her as a way of escaping a more
painful ‘truth’. The ‘truth’ is she had an affair with her married art teacher and, after
falling pregnant to him, he arranged for her to have an abortion in an illegal
establishment 65 .
The previous descriptions of the birth and the marriage ceremony are in fact the
events surrounding her abortion and her married lover coming to pick her up afterwards.
In both of the descriptions significant hints are provided as to the real nature of the
events. In the ‘birthing’ description the protagonist comments: “it was too much to go
through for nothing” (74). Similarly, the protagonist includes blood type among the
details she fills out on the forms at the ‘wedding’ and recalls the smell of antiseptic
coming from another doorway in the ‘post-office’. Such references are, however,
generally overlooked by the reader in favour of the birth/wedding descriptions as these
are compatible with the other information the protagonist has provided 66 .
65 Bonnie St. Andrews argues that Atwood’s self-deceiving narrator “becomes reliable” (106). How truthful this new set of
memories are, however, is also in doubt. The reliability of the narrator’s memory is questioned throughout the novel. For
example, after recalling specific details of her brother’s drowning she states, “It was before I was born but I can remember
it as clearly as I saw it, and perhaps I did see it” (26). Similarly, the narrator comments, “I have to be more careful about
my memories, I have to be sure they’re my own and not the memories of other people telling me what I felt, how I acted,
what I said” (67). There is no certainty that the narrative about the affair with the married man and the abortion is any
more truthful than the previous one.
66 Some critics find the details of the protagonist’s marriage, child and divorce so convincing they fail to realise they are
invented. Joan Larkin states the protagonist “has survived an affair with a married teacher, an abortion, a loveless
marriage, and the birth of a baby” (49). Roberta Rubenstein describes how the protagonist “entered into an empty
marriage. Following an emotion-numbing abortion and divorce” (388) and Rosemary Sweetapple says the protagonist has
“been through a love affair, an abortion, and a broken marriage in which she gave up her child” (50).
67
Apart from the obvious difficulties in admitting to an illegal abortion, the protagonist
invents the new circumstances as a way of rewriting herself. Rather than accepting she
was a gullible, young woman who believed the married man she was having an affair
with wished for a future with her, she depicts herself as the one who leaves, “I was
what’s known as the offending party, the one who left” (41). Deserting her husband and
child is, for the protagonist, a preferable version of events as it casts her in an active
role.
The re-framing of the ‘birthing’ description to an abortion allows Atwood the
opportunity to expose the contradictions within the women’s health movement regarding
the intervention of medicine into the realm of pregnancy and birth. The women’s health
movement insists that women have a right to a ‘safe’ abortion, a reference to back-yard
abortions that often resulted in serious complications, even death. Presumably the word
‘safe’ means in a sterile, clean environment (clinic or hospital), carried out by an
appropriately qualified person. Atwood’s reframing explores how an environment
considered acceptable in the termination of a pregnancy can be viewed as invasive in a
continuing pregnancy. The contribution modern medicine has made to ‘safe’ abortions is
often neglected by the women’s health movement. In order to maintain the argument
that modern medicine negatively impacts on women’s bodies these more positive
advances are ignored.
The reframing also reveals inherent contradictions in the women’s health
movement’s representation of women’s maternal role. Atwood poses the question: How
can the women’s health movement celebrate women’s maternal role as the source of
her power but also support her right to an abortion? The dangers of such a contradiction
are evident in the pro-life 67 movement’s appropriation of the feminist concept of
67 Christina Lee discusses how the term ‘pro-life’ is a misnomer as those involved “are not generally in favour of
movements which aim to protect life” (79). ‘Pro-social control’ or ‘anti-choice’ are offered as more accurate terms.
68
women’s reproductive power. If a woman’s ability to produce a child is said to be the
source of her power, pro-life groups argue that terminating a pregnancy will have a
devastating impact on the woman. Pro-life groups have embraced post-traumatic stress
syndrome (PTSD) as proof of how women’s lives are destroyed by guilt and despair
following an abortion.
Surfacing has in fact been read by some as an antiabortion novel 68 . Such a reading
is encouraged by the protagonist’s statements about the after effects of her abortion: “I’d
carried that death around inside me, layering it over, a cyst, a tumour, black pearl” (139).
In a letter written to Dan Noel in late 1974, however, Atwood states she would be: “most
upset if my book were to be construed as an antiabortion tract” (Christ, “Margaret
Atwood” 328). Atwood explains: “The abortion was coerced – it was forced. That’s not an
“antiabortion” stand. It’s an anticoercion stand. I don’t think even women who are in
favour of freedom of choice would say abortion is a good thing that should be forced on
everyone” (Brans 141). The novel is not a condemnation of abortion but is instead a
critique of the protagonist’s lack of involvement in the decision: “He said I should do it,
he made me do it; he talked about it as though it was legal, simple, like getting a wart
removed” (138). However, the fact that Surfacing has been interpreted as an
antiabortion tract reinforces the notion that a celebration of the maternal role can result
in women being reduced to that role.
The actual re-framing of the birthing description goes largely unexplored in much of
the literary criticism of Surfacing. Predominantly, the passage is referred to as an
abortion anecdote. The knowledge that the protagonist has invented her marriage and
child sees the initial suggested meaning of childbirth overlooked or ignored 69 . Sushila
68 American Life League’s online Pro-life Activist’s Encyclopedia uses a quote from Surfacing to introduce a section of
chapter 45, “Post-Abortion Syndrome: Abortion’s Lasting Hold on Women”.
69 While Gerstenberger does not specifically examine the links between childbirth and abortion in the Surfacing passage
she does discuss the similarities between abortion in Surfacing and the birth scene in Sylvia Plath’s The Bell Jar (147-8).
69
Singh, for example, suggests: “The trauma of abortion has never been dealt with such
extraordinary understanding before in fiction” (90). Interestingly, the reverse is true for
feminist writers who cite the passage as an example of the horrors of the medically
managed birth. They rarely acknowledge that the description is really about a woman’s
abortion experience. Paula Treichler, for example introduces the passage as “Atwood’s
vision of medicalized (American) childbirth” (119).
Following her abortion the protagonist attempts to distance herself from her body
and its emotions: “I didn’t feel much of anything, I hadn’t for a long time […] At some
point my neck must have closed over, pond freezing or a wound, shutting me into my
head” (99). The mind/body split is first alluded to through Anna’s reading of her palm:
“‘You had a good childhood but then there’s this funny break’” (2). Later the protagonist
compares the split to that in a magician’s show: “I’d allowed myself to be cut in two.
Woman sawn apart in a wooden crate […] The other half, the one locked away, was the
only one that could live; I was the wrong half, detached, terminal. I was nothing but a
head, or no, something minor like a severed thumb; numb”(102).
Although the protagonist’s emotionless state has been a way of escaping the pain of
her failed relationship and abortion, she expresses regret at the detachment and wishes
to feel again: “if my body could be made to sense, respond, move strongly enough,
some of the red lightbulb synapses, blue neurons, incandescent molecules might seep
into my head through the closed throat, neck membrane” (105).
The mind/body dichotomy intersects with other dichotomies in the novel, namely
men/women, city/wilderness and American/Canadian. Atwood’s use of dichotomies,
however, attempts to avoid positioning either side as privileged over the other. As the
protagonist explains, “if the head is detached from the body both of them will die” (70).
Graham Huggan comments that Atwood’s “presentation of a series of opposites […] is
predominantly sceptical and ironic” (6). The dichotomies become blurred or are shown
70
as arbitrary. In a revealing passage the protagonist compares the city to the wilderness
of the island: “I always felt safe here, even at night. That’s a lie, my own voice says out
loud […] sometimes I was terrified” (67). The simplicity of a dichotomy that positions the
wilderness as safe and the city as dangerous and corrupt is, therefore, challenged 70 .
Similarly, it is revealed the protagonist’s brother’s classification of leeches into ‘good’ or
‘bad’ is invented and the American fishermen believed responsible for killing a heron turn
out to be Canadians. The American/Canadian dichotomy is again shattered when the
‘Americans’ admit they thought the protagonist and her party were Americans: ‘“Say,
what part of the States are you all from? It’s hard to tell, from your accent. Fred and me
guessed Ohio’” (122).
The most significant assault on dichotomous thinking, however, occurs when the
protagonist recognises that playing the innocent victim does not excuse her from being
the victimiser. The first sign of this recognition occurs when the protagonist passes by
the dead heron for the second time: “I felt a sickening complicity, sticky as glue, blood on
my hands, as though I had been there and watched without saying No or doing anything
to stop it” (124). Her perceived lack of action recalls her complicity in not freeing the
animals her brother once kept in jars: “I was afraid to let them out again. Because of my
fear they were killed” (125). Later, when she finds her father’s body she is finally able to
take responsibility for the part she played in the abortion: “I let them catch it. I could have
said no but I didn’t; that made me one of them too, a killer” (139). Up until this point she
has failed to not only acknowledge her involvement in terminating the pregnancy, “it was
his idea, his fault” (74) but even for her part in the conception: “I never identified it as
mine” (28). André Brink comments: “From the instant the narrator assumes responsibility
70 Northey claims that in Surfacing, nature and civilisation are “two equally dangerous alternatives” (67).
71
for her abortion instead of regarding herself merely as a victim […] all easy distinctions
are suspended” (268).
When the protagonist no longer hides behind her victimhood, the split between her
mind and body begins to diminish: “feeling was beginning to seep back into me, I tingled
like a foot that’s been asleep” (140). The protagonist returns to her childhood
scrapbooks choosing one in particular because it was “heavier and warmer” (152). Out
of it falls a loose page with a childhood crayon drawing of “a woman with a round moon
stomach: the baby sitting up inside her gazing out” (152). Guided by the drawing of the
woman and baby, the protagonist decides to conceive a child to replace the one she has
aborted. With this decision her behaviour shifts from one of passivity to being in control.
When Joe comes to bed that night she instructs him to go outside with her and
leads him through the darkness to a spot near the shore of the lake. Making sure the
moon is on her left the protagonist has sex with him:
his beard and hair fall over me like ferns, mouth as soft as water. Heavy on me,
warm stone, almost alive […] pleasure is redundant, the animals don’t have
pleasure. I guide him into me, it’s the right season. I hurry.
He trembles and then I can feel my lost child surfacing within me, forgiving
me, rising from the lake where it has been imprisoned for so long […] the two
halves clasp, interlocking like fingers, it buds, it sends out fronds. (155-6)
Believing she has conceived the protagonist now decides that this pregnancy and
birth will be different: “Nobody must find out or they will do that to me again, strap me to
the death machine, emptiness machine, legs in the metal framework, secret knives. This
time I won’t let them” (156). The protagonist’s distrust of the machines leads to her
decision to have a natural birth. Her decision serves to highlight a flaw in some of the
women’s health movement’s writings on the medicalisation of pregnancy and birth, that
women passively accept these conditions and practices. The women’s health movement
72
has encouraged women to voice their concerns over current birthing practices and to
seek out more suitable options. Some women’s health advocates, however, ignore the
progress made in this area by still portraying women as passive victims.
The continued popularity of the natural birthing movement is an example of how
those dissatisfied with the birthing experience being offered by modern medicine can
and do seek out other options. Kitzinger, a natural birthing advocate, explains: “Instead
of suffering birth passively and leaving decisions to the professionals who help them,
women are assuming much more of an active, decision-making role for themselves […]
they are finding out the alternatives available and making change happen” (The
Experience of Childbirth 13). Kitzinger’s explanation exemplifies Atwood’s discussion of
how one moves from Position Two to Position Three, by deciding “how much of the
objective experience could be changed if you made the effort” (Survival 38). Rather than
focusing on the injustices of the medical system and its take-over of the arenas of
pregnancy and birth (Position Two) women are making changes to achieve an
experience they find more acceptable (Position Three).
The natural birthing movement supports women’s right to give birth vaginally, in a
comfortable environment, free of drugs and interventions (such as forceps and Cesarean
section). This type of birthing is said to be more rewarding and satisfying for the mother
and improves the bonding between mother and child. The natural birthing movement
also strongly favours the use of a midwife over an obstetrician and home or birth centre
births over hospital births. A midwife-assisted home/birth centre birth is said to have a
lower risk of interventions.
A key figure in the natural birthing movement is Ina May Gaskin, co-founder of the
Farm, a small spiritual community in Tennessee, and author of Spiritual Midwifery.
Spiritual Midwifery includes different women’s stories about their pregnancies, births and
even miscarriages. In many of the stories the experience of childbirth is related as a
73
sexual experience: “All of a sudden I got this big rush of energy. My whole thing started
to open up; it almost felt like I was coming on to an orgasm” (134). Some of the women
also speak of returning to a more animalistic state during birth: “I became more like an
animal, like the cat having kittens […] I began to make all kinds of sounds when I was
pushing out the baby […] They were like pre-human sounds that I ordinarily couldn’t
make” (200). Other sounds include “mooing like an old cow” (135) and “amazing lion
roars” (214). These comparisons of pregnant women as animal-like differ greatly from
those often used by the women’s health movement in their critique of the medicalisation
of pregnancy and birth. Whereas their comparisons portray women as docile livestock,
those in Spiritual Midwifery serve to highlight childbirth as a natural event.
In Surfacing, the protagonist’s idea of how she would like to give birth, shares
similarities with the women featured in Spiritual Midwifery: “This time I will do it myself,
squatting, on old newspapers in a corner alone; or on leaves, dry leaves, a heap of
them, that’s cleaner. The baby will slip out easily as an egg, a kitten and I’ll lick it off and
bite the cord, the blood returning to the ground where it belongs; the moon will be full,
pulling” (156). The protagonist’s reference to returning to an animal-like state and to the
baby as a kitten is reminiscent of the woman at the Farm. Her description incorporates
several principles of the natural birthing movement including the use of natural birthing
positions such as standing and squatting rather than the lithotomy position and returning
the cord back to the earth. Many women who have natural births perform a ritualistic
burial of the placenta 71 .
While the protagonist wishes for a birthing experience without the interference of
modern medicine she later recognises that it is unrealistic to stay on the island and have
her baby alone: “withdrawing is no longer possible and the alternative is death” (185).
71 Some more radical natural birthing advocates recommend consuming the placenta and as a result there are numerous
recipes.
74
The limited supplies on the island and its sheer isolation mean that she will have to
return to the city. As Atwood explains in Survival, a move from Position Two to Position
Three involves deciding “how much of your position can be changed and how much
can’t” (38). Deciding what real changes can be made is reflected in the story of Pamela
in Spiritual Midwifery. She explains: “I read a novel about how the peasants in China just
squatted in the field to give birth and then went on with their work […] I didn’t want to
give birth in the field, but I was sure if the peasants could do it that way, that I could do it
at home in my own bed “ (28). Pamela, like the protagonist, decides what changes she is
able to realistically make to improve her birthing experience.
Even though the protagonist decides to return to the city to have her child there is a
sense that this pregnancy will be different to the last. Her move to Position Three means
she will endeavour to take on a more active role in making decisions about her life and
her pregnancy: “This above all, to refuse to be a victim. Unless I can do that I can do
nothing. I have to recant, give up the old belief that I am powerless and because of it
nothing I can do will ever hurt anyone” (185). She recognises she can no longer hide
behind being a victim but must take responsibility for her choices, whatever they may be.
The ending of Surfacing is viewed by critics in two distinctly different ways. As Philip
Kokotailo explains the more popular reading is of the novel as “a rite de passage from
which the narrator emerges a newly integrated and realized self” (155). John Moss, for
example believes the narrator “has achieved the integration of head and body, resolving
the amorphous parts of herself into a single coherent identity” (130). The critics who
examine various quest motifs in Surfacing, also see the protagonist achieving some form
of unity 72 . Barbara Hill Rigney argues that the protagonist discovers “that woman can
descend, and return – sane, whole, victorious” (115).
72 See Christ, Diving Deep; S. Thomas; Baer; Pratt; and Davidson and Davidson.
75
In contrast to the novel being interpreted as the “closed narrative” (Robinson 113), a
number of other critics suggest little has been resolved at the conclusion. Bruce King
argues “the note of hope at the end is cautious. There has been no great success, no
great tragedy. The road to salvation remains fogged and uncertain” (29). Donald Bartlett
agrees, claiming that the ending is “tentative, indeterminate” (27) 73 . Although the
protagonist appears to have made the decision to return to the city it is not certain when
this will be and whether it will be with Joe. When Joe returns to look for her she is still
hiding behind the trees deciding on whether to reveal herself or not. Doubt also
surrounds her pregnancy: “I can’t know yet, it’s too early” (185).
Like many of Atwood’s novels the ending of Surfacing is deliberately ambiguous 74 .
As Annis Pratt suggests in her discussion of women’s rebirth novels (of which she
includes Surfacing), the conclusions are “at best, open ended, the hero’s precise place
in society being left to guesswork on the part of the reader” (145). The ambiguity allows
Atwood to avoid endorsing particular life choices for women. By leaving the protagonist
contemplating her future from the trees she is not suggesting that marriage to Joe and
motherhood is the solution. Huggan comments: “the ending is left in suspense, as if to
comment on the narrator’s avoidance of the tyranny of definition […] seeking instead to
mediate between possible alternatives” (11-12).
Atwood challenges the interpretation of the conclusion of Surfacing as a ‘happy
ending’, suggesting: “It’s nice that she doesn’t want to be a victim, but if you examine her
situation and her society in the cold light of reason, how is she going to avoid it?”
(Sandler 43). Valérie Augier poses a similar question: “What she has really found is a
new equilibrium but will she maintain it in the society that she is returning to?” (17). A
73 Lecker argues that Surfacing in fact provides a “parody of all the conventions associated with ‘search for identity
literature”’ (192). Also see Mandel (169); Sullivan (39) and Rogers (85).
74 In an interview Atwood suggests she does not know what becomes of the protagonist: “People say to me, “What is she
going to do? Will she marry Joe?” I don’t know what she’s going to do. I fill in what I know, and after that anybody’s guess
is as good as mine” (Sandler 43).
76
return to Survival finds the protagonist’s circumstances perfectly described: “What
happens to an individual who has reached Position Three in a society which is still in
Positions One or Two? (Not very nice things, usually)” (39). The protagonist’s return to a
society where women are valued as sexual objects and have limited roles available to
them 75 will certainly limit the changes she is able to make. Her rejection of the victim
role, however, means she will at least now consider what changes are possible.
Atwood’s short story, “Giving Birth” also explores pregnancy and childbirth. Its
publication several years later, however, reflects a shift in Atwood’s position on the
natural birthing movement. While Surfacing portrayed natural birthing as a viable
alternative to a medically managed birth, “Giving Birth” questions some of the natural
birthing movement’s philosophies. The short story opens with an unnamed narrator who
has a partner and a small child. She is a writer currently working on a story about giving
birth. The narrator is careful to separate the subject of the story, Jeanie from herself:
“This story about giving birth is not about me. In order to convince you of that I should
tell you what I did this morning before I sat down at this desk” (226) 76 . However, as
Kathleen Wall suggests, the narrator’s details of her morning do not really provide any
convincing evidence that the subject of the story is not herself (80). The one difference
between them: “My own hair is not light brown, but Jeanie’s was” (228) is brought into
question by Jeanie’s hair being referred to in the past tense, suggesting it is now
different (and, therefore, possibly the same as the narrator’s).
75 Anna clearly demonstrates the limited roles available to women. She does not wear jeans because she “looks fat in
them” (5) and her husband, David has never seen her without makeup. While we are told of David and Joe’s occupation,
Anna appears to have no paid employment.
76 The denial that the story is autobiographical could also be seen as a reference to Atwood’s own struggle to
differentiate her life from that of her characters. Despite her efforts, some critics have interpreted “Giving Birth” as
autobiographical. Russell Brown comments that Atwood uses “both narrator and Jeannie (sic) to talk about her own recent
experiences of actually having given birth” (227).
77
The narrator later interjects: “By this time you may be thinking that I’ve invented
Jeanie in order to distance myself from these experiences. Nothing could be further from
the truth. I am, in fact, trying to bring myself closer to something that time has already
made distant. As for Jeanie, my intention is simple: I am bringing her back to life” (229).
Here, the narrator refutes an interpretation typical of popular psychology, a person
projecting their experiences onto another in order to distance themselves from them.
The statement suggests the narrator has some knowledge of such discourses. The
revelation that Jeanie is a “devotee of handbooks” (228), books which often encourage
people to psychologise their lives, is a further suggestion that the narrator and Jeanie
are one and the same. It appears that having a baby has changed the narrator’s life so
much that the only way she can reconstruct that time is through giving the person she
was then another name.
There is a further double in the narrative, that of a woman in a checked coat who
shadows Jeanie during her pregnancy and time at the hospital. Jeanie sights the woman
at a clothing store, a supermarket and on several street corners. It is only when she
climbs into Jeanie and her partner’s car at a set of lights on their way to the hospital that
Jeanie is fully aware that the woman is “not real in the usual sense” (232). Jeanie’s
partner, referred to as A. “for convenience” (229), does not react to the additional
passenger and so Jeanie knows “the woman is not really there” (232). If Jeanie opens
her eyes wide enough she can even make the shape of the woman disappear, but “the
feeling” (232) of her presence remains. Wall compares the woman in the checked coat
to the convex mirror in the painting The Arnolfini Marriage: “The mirror thus presents a
different version of what is represented within the frame” (76). The woman in the
checked coat (she is nameless throughout the story) serves as a contrast to Jeanie’s
birth experience as a white, middle-class, English speaking woman in a stable
relationship.
78
“Giving Birth” examines the popularity of guidebooks and self-help books, their
advantages and also their limitations. The rise of women’s health guidebooks began with
the publication of Our Bodies, Ourselves, designed to help women “become active
participants” in their own health and medical care (Boston Women’s Health Book
Collective 1971 269). Since the publication of Our Bodies, Ourselves there has been an
enormous growth in women’s health guidebooks. Many of these publications are aimed
at demystifying the discipline of medicine so that people are able to more actively
participate in making decisions about their health.
In “Giving Birth”, Jeanie’s guidebook readings provide her with information that
enables her to negotiate a birth experience she is more comfortable with. When admitted
to hospital she informs the nurse of an allergy to the painkiller Demerol: “Jeanie doesn’t
know whether this is true or not but she doesn’t want Demerol, she has read the books”
(233). Jeanie’s guidebooks have warned her about Demerol and its adverse side effects.
Jeanie’s allergy lie shows how women are able to manipulate the medical profession’s
own systems in order to achieve desired outcomes. Jeanie realises if she were to tell a
nurse she didn’t want Demerol because her guidebook had warned against it, her
wishes may not have been respected. Instead she invents a recognised health problem,
a drug allergy, to avoid being given Demerol. Her knowledge of the health system and
the drugs used in childbirth allow her to create a ‘legitimate’ reason for not being
administered the painkiller. A further example of how guidebooks assist Jeanie during
pregnancy and birthing occurs when Jeanie begins to experience back labour. She and
A. are able to look up ‘back labour’ in the guidebook, “[I]t’s useful that everything has a
name”, in order to find out what to do (233). Her guidebook has also taught her how to
breath slowly during her labour by visualising numbers as she counts.
While women’s health guidebooks can play a useful role, Atwood also points out
their limitations. “Giving Birth” parodies the notion that a book can provide all the
79
answers to something as complex as pregnancy and childbirth 77 . This is reflected in the
description of Jeanie’s collection of guidebooks: “at least two shelves of books that cover
everything from building kitchen cabinets to auto repairs to smoking your own hams”
(228-229). Positioning pregnancy and birth alongside smoking your own ham
demonstrates the vast difference in DIY smallgoods and giving birth and how a
guidebook cannot possibly provide adequate preparation. The collection of items Jeanie
has brought with her to the hospital, following the guidebook recommendations, is a
further example. The guidebook has recommended, “a washcloth, a package of lemon
Life Savers, a pair of glasses, a hot water bottle, some talcum powder and a paper bag
[for hyperventilation]” (229). While the items may help in small ways to make the birthing
woman more comfortable, their ordinariness appears incompatible with the magnitude of
giving birth.
Guidebooks also tend to present only a narrow range of pregnancy and birthing
narratives. The vast majority of women depicted are white, middle-class and
heterosexual with long-term partners who are loving and supportive 78 . Pregnancies are
of course always wanted and although side effects and complications might be
mentioned, they are generally downplayed.
“Giving Birth” also questions the way some guidebooks portray modern medicine
and medical professionals negatively. While many women’s health guidebooks simply
provide factual information in a format that is easy to comprehend, some display an
underlying distrust of the ‘expert’. They appear to suggest the reason people need to
inform themselves on health matters is because the ‘experts’ cannot be relied upon.
77 Atwood’s questioning of the helpfulness of self-help books is continued in her futuristic novel Oryx and Crake. The
protagonist writes a college essay, “Self-Help Books of the Twentieth Century: Exploiting Hope and Fear”, and quotes
parts of the books in a stand-up routine in student pubs (195).
78 Some exceptions include McLaughlin’s 1976 guide, Black Parents’ Handbook and more recently, Hutcherson’s Having
Your Baby: A Guide for African American Women and Allers’ The Mocha Manual to a Fabulous Pregnancy.
80
These guidebooks tend to position medical professionals as self-serving or under the
control of pharmaceutical companies or other health product companies. The popularity
of the series, What Your Doctor May Not Tell You is a prime example of guidebooks
encouraging and capitalising on people’s declining confidence in the ‘expert’ 79 . Jeanie’s
guidebook readings appear to contribute to her distrust of the ‘experts’, in this case the
hospital staff. For example, she declares on arrival at the hospital that she intends to
“put up a struggle over her pubic hair” (233). Her comment positions the staff at the
hospital as being confrontational and directly opposed to the wishes of the patients. In
fact, contrary to what Jeanie has read in her guidebook, the nurse “doesn’t have very
strong feelings about it” (233), and she does not have to be shaved.
In addition to questioning the role played by health guidebooks, “Giving Birth” also
examines the advice provided by the natural birthing movement in general. The short
story highlights how some of the philosophies of the movement are just as restrictive as
a medically managed birth. The natural birthing movement has created its own rules that
women need to follow in order to achieve a more satisfying birth. Women who do not
follow the rules can be made to feel guilty or inadequate. In Misconceptions, Wolf
speaks about how women are often reluctant to consider natural birthing because “it,
too, has been presented as so rigid an option with such extreme requirements of
courage and faith” (157). Similarly, Helen Marshall comments that “ante-natal classes
often leave me feeling almost as bossed-about as did encounters with a (pleasant,
relatively nonautocratic) obstetrician” (260).
One of the questionable philosophies of the natural birthing movements is the
tendency to present childbirth as not only a natural event but also a painless one. This is
79 Titles in the series include: J. Lee, What Your Doctor May Not Tell You About Menopause; Goodwin, Drum and
Broder, What Your Doctor May Not Tell You About Fibroids; and Cave and Mitchell, What Your Doctor May Not Tell You
About Children’s Vaccinations.
81
reflected in one of Jeanie’s ante-natal classes in which a woman voices her preference
for pain relievers because in her last birth she “went through hell” (231). The other
women in the class respond with “mild disapproval. They are not clamouring for shots,
they do not intend to go through hell. Hell comes from the wrong attitude, they feel. The
books talk about discomfort” (231). This is a reference to guidebooks such as Spiritual
Midwifery in which the pain associated with labour is rarely mentioned. In Spiritual
Midwifery the belief is that if a woman approaches the birth positively and is provided
with enough love and support she will have higher levels of endorphins and this will
block any pain. A woman experiencing pain, therefore, is doing so because she is not
committed enough to the natural birthing experience. She has the ‘wrong attitude’ or is
not concentrating enough on achieving a drug free birth.
The actual term ‘pain’ is also denied, often replaced with more positive words. One
woman in Spiritual Midwifery comments: “sometimes I had to override brief temptations
to interpret that powerful earthy push as pain instead of as life force” (185). Gaskin
advises another woman who starts to think about the pain: ‘“Don’t think of it as pain.
Think of it as an interesting sensation that requires all your attention’” (43). Wolf lists
‘babyhugs’, ‘angeltaps’, ‘cuddlebunnies’, ‘pillowfluffs’, ‘sunflights’ and ‘bellybounce as
alternative words used by the natural birthing movement for painful contractions, all of
which she feels are inadequate terms to describe what can be “agonizing contractions”
(158). She writes: “Such vocabulary can be just as condescending and unhelpful to
women facing the rigours of birth as that used by traditional doctors” (158).
Historical accounts also reveal how women campaigned to have access to pain
relieving drugs in childbirth. Edward Shorter comments: “In the hundred years after the
discovery of ether and chloroform, it was mothers who desperately snatched these
anesthetics from the hands of unwilling doctors and midwives” (Shorter 146). A number
of substances had been used in an effort to relieve the pain of childbirth including
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laudanum, an opium based tincture (Brought to Bed 45). In 1847, James Y. Simpson
started experimenting with the substance chloroform. Hearing of the developments,
Fanny Longfellow and her husband approached doctors in Boston to use the drug in her
labour. Eventually she engaged the services of a dentist to administer the drug and a
doctor to deliver the baby. After successfully delivering her baby under the influence of
the drug she praised it as “the greatest blessing of this age” and “a gift of God”
(Wagenknecht 130).
Women’s desire for pain relief during childbirth grew and doctors found that if they
did not provide it their services may not be needed. Chloroform, however, was not an
ideal drug as it could interfere with a women’s muscle function and had been linked to a
number of deaths. A new form of anaesthesia, scopolamine, became the preferred
option and women campaigned passionately for its availability. Scopolamine was both a
narcotic and amnesiac and when administered with morphine, produced a state referred
to as “twilight sleep”. Twilight sleep first became known to American women through an
article published by McClure’s Magazine. Written by two women, Marguerite Tracy and
Constance Leupp, the article described the practice of twilight sleep in the Freiburg
women’s clinic in Germany. The two authors claimed that having experienced it once
women would “walk all the way from California” to give birth using this method (Tracy
and Leupp).
Women’s desire to bring the method to America, culminated in the formation of the
National Twilight Sleep Association (Leavitt, “Birthing and Anesthesia” 153). The
Association spread the word about the benefits of twilight sleep in rallies which featured
women who had travelled to the Freiburg clinic to give birth (Leavitt, “Birthing and
Anesthesia” 154). Doctors visited the Freiburg clinic to learn the technique and by 1915
it was being practised around the country. Questions over the safety of twilight sleep,
83
however, led to the technique later being abandoned by some hospital and doctors
(Leavitt, “Birthing and Anesthesia” 163).
Jeanie’s ante-natal classes reveal other expectations of women committing to a
more natural birthing experience. When the nurse asks the class who intends to
breastfeed all the women except one put their hands up: “the one lone bottlefeeder, who
might have (who knows?) something wrong with her breasts, is ashamed of herself. The
others look politely away from her” (231). The woman’s decision to bottle-feed is
condemned by the other women who have no doubt read in their guidebooks the many
benefits of breastfeeding for both mother and child. The woman is made to feel ashamed
by her choice and is seen by her fellow class members as not only a ‘bad mother’ but
also as possibly defective. Reasons for bottle-feeding such as convenience or the ability
to share feeding duties with one’s partner are rejected in favour of the woman being
somehow incomplete or inadequate.
Breastfeeding advocates have long used feelings of guilt and inadequacy to
encourage women to breastfeed their babies. They report a long list of benefits of
breastfeeding including improved cognitive function in the baby and a reduction in
infections and allergies. Women who do not breastfeed are, therefore, perceived as
depriving their baby the best start in life and of exposing them to unnecessary risks of
infection and illness. Breastfeeding advocates use similar tactics to those regarded by
the women’s health movement as controlling and manipulative in modern medicine.
They ask, “Do you want a healthy baby?”, the same question the women’s health
movement claims is used to coerce women into having labour inducing drugs and
Cesarean sections.
“Giving Birth” also questions the natural birthing movement’s notion that birthing in
pre-industrial countries is easier and safer. The movement often uses the example of
women in pre-industrial countries to demonstrate women’s ability to give birth without the
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interventions of modern medicine. The implication is that with the right attitude and
environment women in developed countries can also give birth effortlessly like their
‘sisters’. Wolf accuses the movement of portraying an “idealized Edenic state of perfect,
unmedicated, earth-centred easy birth among women in tribal or pre-industrial cultures”
(Misconceptions 159). Such images come to Jeanie’s mind when she is asked to go to
the delivery room in a wheelchair. She tells herself “about peasant women having babies
in the fields, Indian women having them on portages with hardly a second thought”
(233). Such images, however, do not truly reflect the reality of childbirth in these
countries or in times past.
Women living in the nineteenth century and in pre-industrial countries experienced
the often debilitating effects of repeated pregnancies and births. Prolonged and difficult
labours led to vaginal and perineal tears causing women great discomfort, sexual
difficulties and problems in future deliveries. More seriously, women suffered genital
prolapse and fistulas. In prolapse the uterus or other organs descend into the vagina or
vaginal wall. Fistulas, tears between either the vagina and the rectum or the vagina and
the bladder, result in chronic incontinence (Leavitt, Brought to Bed 28). As Wolf explains
women in pre-industrial countries “still suffer rupture and hemorrhage, though supported
by the earth and surrounded by their ‘sisters’” (159).
The fear of death also placed a large emotional burden on women. Death during
childbirth was not uncommon and women generally knew of someone who had suffered
such a fate 80 . It was, therefore, a constant thought for many women during their
pregnancy. Leavitt’s work incorporates diary entries and letter excerpts from pregnant
women expressing their anxieties about childbirth. Peris Sibley Andrews, for example,
writes, ‘“As the time draws near I fear & tremble’” (Leavitt, “Birthing and Anesthesia”
80 Leavitt estimates the deaths from maternity-related causes at the turn of the twentieth century were approximately 65
times greater than they were in the 1980s (Brought to Bed 23).
85
159). Similarly, Agnes Reid writes during her second pregnancy, ‘“I confess I dreaded it
with a dread that every mother must feel in repeating the experience of childbearing’”
(Leavitt, “Birthing and Anesthesia” 159). Women also entered pregnancy with the
uncertainty that they would be able to carry the baby to term or with the fear that their
child would die at a young age. As women typically fell pregnant within a relatively short
time frame after losing a baby, women often did not have a great deal of time to grieve
losses. A new pregnancy was, therefore, often clouded by feelings of dread at the
prospect of losing another child.
The natural birthing movement’s image of a woman giving birth in a field also fails to
acknowledge that for these women there is no other option. If they had a choice they
may also choose a hospital birth. The events surrounding the move from the home to the
hospital in the United States in the early twentieth century suggest this may be the case.
Leavitt identifies a number of factors which led to an increase in hospital birth including
the diminishing of traditional networks and the popularity of the automobile 81 . Most
significantly though was women’s perception that hospitals represented progress in
science and medicine and, therefore, they offered the best chance of a successful birth.
As Leavitt explains, “the possibilities of scientific obstetrics captured birthing women,
who, like the rest of the population, were determined to join the march of medical
progress” (Brought to Bed 175).
In addition to drawing attention to some of the restrictions associated with natural
birthing, “Giving Birth” also exposes the women’s health movement’s neglect of coloured
women and poor women’s health issues. The movement was predominated by white,
middle-class women and their health issues. Many of these issues did not apply to
women of colour or poor women in the same way. A prime example is the women’s
81 Kobrin also argues that a declining fertility rate meant, “pregnancy and anticipated delivery seemed sufficiently rare to
be generally equated with major operations and worth of greater expense” (324).
86
health movement’s calls for women to have the right to choose sterilisation. Women
were often refused sterilisation unless they were of a certain age or had already had
children. Similarly, women sometimes required the permission of their husbands before
the procedure could be performed (Davis 249). However, sterilisation was a very
different experience for coloured women who were often subjected to sterilisation
abuses. Coloured women were sterilised without their consent 82 or were incorrectly
informed that the procedure was easily reversible (Davis 250). Morgen discusses how
the women’s health movement’s critique of the professional dominance of health care
was another element not shared by women of colour (54). They were still experiencing
difficulty in gaining access to professional services in their communities. Black women’s
health activists also cite the inadequate action from the women’s health movement on
the withdrawal of Medicaid funding for abortions in 1977 as a further example that the
movement ignored the plight of women of colour and poor women (Morgen 48). The lack
of Medicaid funding for abortions disproportionately affected these women.
Atwood addresses some of these differences in “Giving Birth” through the character
of the woman in the checked coat. The women in the checked coat speaks a foreign
language, possibly Portuguese. Her non-English speaking background means she is
significantly disadvantaged in her attempts to successfully deliver a healthy baby. Aside
from the difficulties in communicating her needs she is also more likely to experience
labour interventions. Wolf believes the disproportionate number of coloured women
having their labour induced “suggests that white medical practitioners are simply not as
inclined to hang around and support women of a different race or class background
while they go through labour” (155).
82 This issue was brought to prominence in 1973 when two black girls aged 12 and 14 were sterilised in a family planning
program without their informed consent (or that of their mother). A lawsuit was filed on their behalf (Morgen 47).
87
The woman in the checked coat is also from a low socio-economic background,
arriving at the hospital with her belongings in a paper bag. This is in stark contrast to
Jeanie who has her things carefully packed in a small flight bag. The woman’s low socioeconomic status means that, if employed, she has more than likely had to work late into
her pregnancy and may need to return to work not long after having her baby. She is
also more likely to have been employed in a field where conditions were less than ideal
for a pregnant woman (perhaps standing for much of the day with limited opportunities
for breaks) and where she may have been exposed to environmental pollutants. Her
socio-economic status may also be the reason why Jeanie did not remember seeing her
at ante-natal classes. A study of women who attend childbirth classes found that women
who did not attend classes tended to be younger, poorer and less likely to be married (S.
Brown 88). All of these factors make the woman in the checked coat’s pregnancy and
birth experience a very different one from Jeanie’s.
Another notable difference between Jeanie and the woman in the checked coat is
her apparent aloneness. She arrives at the hospital unaccompanied by either the
prospective father or other family members. It is uncertain if the woman is a single
mother or if her partner is simply absent. Whatever the circumstances it is unlikely that
she has had someone help her practice breathing exercises or accompany her on a tour
of the hospital. Her lack of a supportive partner is perhaps another reason she has not
attended Jeanie’s ante-natal classes. Such classes are generally structured for couples
and if even they did encourage the attendance of single women it is unlikely such
women would feel comfortable in the environment.
When the woman in the checked coat climbs into Jeanie’s car, Jeanie comments
that she knows little about her except “she is a woman who did not wish to become
pregnant, who did not choose to divide herself like this” (230). Jeanie is unsure of why
the woman is unhappy about her pregnancy, wondering: “Has she been raped, does she
88
have ten other children, is she starving?” (236). A reason that Jeanie does not consider
is that the woman may have had little choice in continuing her pregnancy. With the
abolition of Medicaid funding for abortions she may not have been able to afford to have
a pregnancy termination.
While Jeanie has avoided pregnancy related symptoms such as “morning sickness,
varicose veins, stretch marks, toxemia and depression" (231) the woman in the checked
coat has not had such an easy pregnancy. Her description as having a “haggard face”,
“bloated torso” and “too-sparse hair” (231), suggests she may have suffered from
symptoms like fatigue, water retention and hair loss. She is perhaps also afflicted with
some of the other conditions Jeanie has happily avoided.
After Jeanie and A. reach the hospital in the car, the woman in the checked coat
disappears through the doors. The next time Jeanie encounters her is when she hears
her screams through a dividing screen while she waits for her room: “the woman
screaming is the other woman and she is screaming from pain” (232). The woman’s
screams of pain are directly contrasted with Jeanie’s relaxed preparation. As her
contractions are not far along she is allowed to have lunch, “tomato soup and a veal
cutlet” and then decides “to take a nap while A. goes out for supplies” (233). Even when
her contractions become stronger she is able to read a detective novel in between them.
The whole process is described as taking place in a very orderly fashion with everything
going as planned.
Jeanie sees the woman in the checked coat again on her way to the labour room: “a
woman is wheeled past on a table, covered by a sheet. Her eyes are closed and there’s
a bottle feeding into her arm through a tube. Something is wrong” (234). Unlike Jeanie
the woman in the checked coat’s labour is not going to plan. The bottle feeding into her
arm suggests she is being administered a drug or substance intravenously. The woman
may have been given fluids due to dehydration as there was no mention of her having
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lunch as Jeanie did. The bottle could also mean she is being given drugs to speed up
her labour. Labour inducing drugs frequently cause more painful and prolonged
contractions than which occur in a natural labour. This could explain why Jeanie’s next
hears the woman screaming through the labour room walls: “it’s the other woman, in the
room next door or the room next door to that. She’s screaming and crying, screaming
and crying. While she cries she is saying, over and over, ‘It hurts. It hurts’” (236).
Despite Jeanie’s labour suddenly progressing more quickly than expected her baby
is born without incident after three ‘pushes’. Later after she returns to her room she
thinks of the other woman: “Something has happened to her, Jeanie knows. Is she
dead? Is the baby dead” (239). The fates of the woman in the checked coat and her
baby are never revealed but what is certain is that for her the outcome has been
different from Jeanie’s. Earlier, Jeanie had thought about what can go wrong in
childbirth: “Internal bleeding, shock, heart failure, a mistake on the part of someone, a
nurse, a doctor” (235). These are perhaps hints as to the fate of the woman in the
checked coat.
The conclusion of the short story comes with Jeanie being presented with her new
baby. It is explained that in the days that followed giving birth: “Jeanie herself becomes
drifted over with new words, her hair slowly darkens, she ceases to be what she was
and is replaced, gradually, by someone else” (240). The comment on her hair darkening
is a reference to the narrator’s earlier suggestion that her hair is not light brown the way
Jeanie’s was. It is now clear the narrator is in fact Jeanie, changed forever by the arrival
of her new baby.
Atwood’s exploration of women’s reproductive role in Surfacing and “Giving Birth”
highlights some of very real limitations of modern medicine including the inadequacies of
contraception and the increase in labour interventions. This exploration, however, avoids
portraying women as passive dupes of the patriarchal institution of medicine. Although
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Atwood explores some of the issues women face, she acknowledges women’s efforts at
resisting practices they find unacceptable. The fiction also draws attention to significant
contradictions within the women’s movement. In particular, the discrepancy between
celebrating women’s maternal role while also advocating for women’s choice to forgo it
and guidelines for a natural birth becoming as restrictive and daunting as those for a
medically managed birth. It is in through these fictional works that Atwood is also able to
reveal the essentialism of the movement; how its principles at first appear to encompass
all women but, in many cases, are only of relevance to middle-class, white women.
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PART TWO: ‘A Small Defiance of Rule’: Assisted Reproductive
Technologies and Resistance in The Handmaid’s Tale
The Handmaid’s Tale was published in 1985 at the height of feminist debate surrounding
assisted reproductive technologies 83 (ARTs) (Corea, The Mother Machine; Arditti, Klein,
and Minden). ARTs had been in the spotlight since the 1970s when Shulamith Firestone
proposed they could play a vital role in freeing women “from the tyranny of their
reproductive biology” (233). Firestone believed women’s oppression was in part linked to
their childbearing role and, therefore, saw ARTs as a way women could escape the
“barbaric” state of pregnancy (233) 84 . Her rather idealistic vision of ARTs was not shared
by many feminists, particularly certain proponents of radical feminism such as Corea and
Dworkin. They both feared that the development of ARTs would lead to some women
becoming breeders for other women and the institution of a ‘reproductive brothel’
(Corea, The Mother Machine 275; Dworkin, Right-Wing Women 182).
In The Handmaid’s Tale, Atwood enters the debate by creating her own version of a
reproductive brothel, in the Republic of Gilead, a totalitarian state located somewhere in
the former United States of America. Through the narrative of Offred, a “two–legged
womb” (146), we discover how the acceptance of radical feminist claims that ARTs
interfere with women’s unique role of reproduction can result in the programmatic
reduction of women to a maternal function. Atwood’s reproductive brothel has arisen not
from ARTs spinning out of control, but from the new regime’s adoption of radical feminist
arguments declaring the sacredness of women’s maternal role. Similarly, radical feminist
83 The term ‘reproductive technologies’ was initially used to refer to prenatal screening techniques such as ultrasound
and amniocentesis but was later expanded to include technologies like in vitro fertilisation (IVF) (Stanworth 10). As IVF
and the associated techniques of gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT) opened up
entirely different possibilities they were often called the ‘new reproductive technologies’ as a way of distinguishing them
from prenatal screening techniques. As IVF can now no longer be considered ‘new’ an alternative term, assisted
reproductive technologies (ART) is often used. This is the term that will be used throughout.
84 Firestone also had little regard for natural childbirth, likening it to “shitting a pumpkin” (227).
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censure of pornography has informed widespread censorship and the virtual elimination
of sex for pleasure. The dystopic genre of the novel allows Atwood to also critique
radical feminism’s portrayal of women as passive victims of ARTs by detailing both
collective and individual acts of resistance.
ARTs like in vitro-fertilisation (IVF) were first developed as a way of achieving
fertilisation in cases where a woman’s fallopian tubes were blocked, damaged or absent.
The children born as a result were genetically the couple’s (Farquhar 50). Variations to
this basic format soon developed with the use of donor sperm and the ability to store
extra embryos for future implantations. Such developments also re-ignited the debate
around the issue of surrogacy. While there was nothing ‘new’ about the idea of
surrogacy (it is mentioned in the Bible), technologies like IVF created significant changes
to how it could be practiced. Whereas previously the surrogate mother was also always
the biological mother, IVF enabled the biological mother to be someone different from
the gestational mother, either the commissioning mother or a third party, in an egg
donor. The redefinition of the term ‘motherhood’ and the entry of science into the
‘natural’ world of reproduction generated much discussion on ARTs. A number of high
profile legal cases involving surrogacy also highlighted the legal, ethical and moral
dilemmas associated with ARTs 85 .
Dion Farquhar proposes that responses to ARTs can be divided into two main
discourses, fundamentalist and liberal 86 . Fundamentalist discourses on ARTs derive
from the New Right as well as certain proponents of radical feminism. Radical feminism
views ARTs as another feature of the patriarchal institution of medicine and its attempts
to control the arena of pregnancy and birth. Rita Arditti, Renate Duelli Klein and Shelly
85 The most notable of these cases was that of Baby M. See Pollitt 59-80; and Chesler. For the story of the surrogate
mother of Baby M see Whitehead.
86 For further discussions of the different views on reproductive technology within feminism see Charlesworth; Rushing
and Onarato.
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Minden comment on how women are: “At the mercy of technologies developed by men
[…] Technologies that were not made by us. We doubt that they are in women’s
interests” (2). ARTs are seen as being developed, controlled and delivered by men, with
little acknowledgement of the role of female doctors and nurses in programs treating
infertility.
Radical feminist discourses on ARTs also promote a fear of science and technology
by detailing dystopic scenarios that could result if they are not controlled. The term ‘testtube baby’, a somewhat inaccurate and sensationalist concept first employed by the
popular media, has been widely adopted as a way of highlighting the ‘horrors’ of ARTs 87 .
By suggesting that ARTs involve growing babies in a laboratory, radical feminism
attempts to demonstrate women’s loss of control over the process of reproduction 88 . The
term invokes connections to Aldous Huxley’s Brave New World and the possibility of
ectogenesis, which radical feminism sees as men’s ultimate goal. Examples of
premature babies being kept alive from as early as twenty-one weeks and of pregnant
women being kept alive following their death until their baby is ‘viable’ are provided as
evidence that man is on the way to creating an artificial womb. Rowland asks: “What
would it be like to be an adult who had never been carried in a woman’s womb or who
had never experienced birth?” (542).
One of radical feminism’s most contentious arguments concerning ARTs is the claim
that women who participate in them are coerced or conned. Women’s intense desire to
have a child, their desperation, is said to affect their ability to make a ‘correct’ decision.
Rowland voices such concerns: “Those women who will have access to the new RTs by
choice will be few; those who will have access by coercion will be many” (544). To
87 Arditti, Klein and Minden take the term further, entitling their collection of essays on ARTs, Test Tube Women: What
Future for Motherhood?
88 In reality only initial fertilisation takes place in a test-tube.
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highlight the perceived passivity of women participating in ARTs, radical feminist
discourse often employs analogies between these women and animals. Corea’s The
Mother Machine opens with a narrative of the artificial insemination of a woman followed
by a description of a cow being artificially inseminated. The cow/woman analogy is
continued in chapters five and six, respectively titled “The Cow Industry: Embryo
Transfer in Animals” and “The Woman Industry: Embryo Transfer in Humans” (69, 80).
Corea attempts to establish a connection between cows and women by describing the
cows in human terms and the men’s treatment of the cows in terms of human
relationships 89 . Significantly, the majority of women Corea refers to as participants of
ARTs are described as being anaesthetised: “Woman, once deified as the life-creating
Goddess, is now lying on a table with her mouth taped shut, having the eggs sucked out
of her body” (The Mother Machine 176).
In addition, radical feminists view a woman’s decision to use ARTs as directly
impacting on other, less fortunate women. They provide details of Third World women,
ethnic women and poor women's experiences of health care (or lack of it) in order to
trivialise the infertile woman’s attempt to have a child. Ruth Hubbard comments: “where
many children are dying from the effects of malnutrition and poor people have been
forcibly sterilized, expensive technologies are being pioneered to enable a relatively
small number of well-to-do people to have their own babies” (“Test-Tube Babies” 369).
Radical feminism, therefore, calls for women to reject ARTs for the ‘good of all women’.
Women participating in ARTs are also criticised for not considering other alternatives like
remaining childless and the adoption of handicapped children. Less controversial are
claims that ARTs are a high cost (and low success) form of treating infertility and instead
the emphasis should be on prevention through educating people about sexually
89 In a somewhat bizarre sequence Corea reports how the men involved in the artificial insemination spoke sarcastically
and swore at the cows and then refused to look at them after the insemination has taken place (Mother Machine 13).
95
transmitted infections and the decline in female fertility with age. Similarly, radical
feminists believe that more research is required in treating male infertility so that women
do not have to undergo procedures due to their partner’s fertility problems.
Echoing some of radical feminism’s objections to ARTs is the New Right (now more
commonly referred to as the Extreme Right). In The United States the New Right gained
momentum in the Reagan era by preaching a return to traditional family values. It placed
the blame for modern society’s woes on such factors as women working outside the
home, the availability of contraception and abortion, and homosexuality. The New Right
strongly opposes ARTs because of the impact they can have on the traditional family
unit. Of particular concern to the New Right is the use of ARTs by people who do not fit
their idea of the traditional family: lesbians, gays and single women.
Liberal feminist discourses on ARTs condemn radical feminism’s depiction of
science-fiction scenarios of test-tube babies and artificial wombs as real, arguing that
they involve an exaggeration of the capabilities of science and medicine (Stanworth 17).
They challenge radical feminism’s view that women who use ARTs are “neither
authentically wanting nor freely choosing medical/technological assistance to reproduce”
(Sandelowski 40). They argue that such representations refuse to acknowledge or take
seriously the desires of women and their ability to make conscious decisions.
Sandelowski warns that a feminist discourse “that allows women no free will beyond the
will inculcated by patriarchal culture, itself permits women no volition, no agency at all”
(40). Similarly, liberal feminist discourse dismisses the ‘shared sisterhood’ notion of
radical feminism as highly essentialist, neglecting the differences between women and
assuming common interests. They also reject the suggestion that infertile women should
adopt, questioning why having a healthy child of the same genetic background should be
reserved for only some women (those that are lucky enough to fall pregnant naturally).
They ask why it is acceptable for some women to decide they do not have the
96
resources/ability to bring up a handicapped child (those women putting up their children
for adoption) but not for others to make a similar decision (infertile women) 90 . Liberal
feminists emphasise how ARTs could help a range of people who are currently childless,
not just infertile women but also lesbians and single women to have children of their
own.
Liberal discourses on ARTs also include medical discourses and those of the
popular media. In medicine, ARTs are generally portrayed as scientific miracles that
provide women with their only opportunity to have a child. Medical experts involved in
ARTs are pictured as brave pioneers dedicated to bringing happiness to infertile
couples. Such portrayals are also the centre of the popular media’s coverage of ARTs,
with the focus being on success stories. Pictures of couples with their new ‘miracle baby’
are common, with multiple births being of particular interest. While reports may include
details of the number of attempts a couple made before their success, this is often
downplayed or dismissed as being all worthwhile now that the birth of a healthy child has
been achieved. Couples who were not successful in taking home a baby after
participating in ARTs are rarely featured, unless they have subsequently conceived a
baby naturally. Such images are criticised for underestimating the emotional and
financial stress experienced be people undergoing ARTs and for disguising the relatively
low success rates of such procedures 91 .
Atwood’s The Handmaid’s Tale engages with the different discourses on ART, in
particular the fundamentalist discourses of radical feminism and the New Right. Her
90 For a further discussion of the ‘infertile women should adopt’ concept see Purdy 205-208.
91 Lesley Brown, the first woman to have a baby by IVF, “assumed hundreds of test-tube babies had already been born”
(Corea, The Mother Machine 167).
97
dystopia 92 is centred on The Republic of Gilead. As Amin Malak explains, the emphasis
in a dystopia is “not on horror for its own sake, but on forewarning 93 […] the aim is
neither to distort reality beyond recognition, nor to provide an escapist world for the
reader, but “to allow certain tendencies in modern society to spin forward without the
brake of sentiment and humaneness”” 94 (10). Similarly, Chinmoy Banerjee describes a
dystopia as “creating a fictional world that is marked as an extension of the existing
one” 95 (75). Atwood’s choice of the dystopian genre also provides her with the
opportunity to explore the notion of resistance. As Susan Jacob suggests, “resistance is
embedded as a central code in the dystopian genre and the hold that this genre has on
the popular imagination lies in its ability to articulate various forms of resistance” (31).
In the Republic of Gilead fertility rates have declined dramatically due to a
combination of contraception, environmental pollutants and sexually transmitted
infections. The environmental pollution has a range of sources including: nuclear power
plant accidents (due to earthquakes along the San Andreas fault); the overuse of
chemical insecticides, herbicides and other sprays; leakages from chemical and
biological-warfare stockpiles and toxic waste disposal sites; dumping toxic substances
into the sewerage system; and women taking medicines (a reference to hormones from
the Pill ending up in the environment). Many of the elite in men in the Republic are sterile
from coming into contact with a virus that was developed by gene-splicing experiments
with mumps. The explanation: “The air got too full, once, of chemicals, rays, radiation,
92 The depiction of a futuristic world in The Handmaid’s Tale has often seen it classed as ‘science fiction’. However,
Suvin’s definition of science-fiction’s main formal device, “an imaginative framework alternative to the author’s empirical
environment” (7-8), suggests that the term dystopia may be a more accurate description for Atwood’s novel.
93 Several critics comment on The Handmaid’s Tale as serving as a warning. Foley proposes the Historical Notes
epilogue has several functions, “the most thematically central of which is to sound a warning” (44). Raschke comments
that: “Margaret Atwood’s The Handmaid’s Tale is, in part, a warning” (257).
94 Here Malak is quoting Sage’s article (307).
95 Atwood refers to The Handmaid’s Tale as “speculative fiction” (C. Davidson 26).
98
the water swarmed with toxic molecules, all of that takes years to clean up” (122),
suggests that while measures have been taken to correct these problems much of the
damage has already been done 96 .
The regime takes power after killing the President and Congress and suspending
the Constitution. Newspapers are censored or closed down, “for security reasons” (183)
and everyone is issued with Indentipasses. Most significantly, women are barred from
accessing their finances and from having paid employment. After early protests, the
marches stop when it becomes known that protestors will be fired upon. In an effort to
boost declining birth rates all second marriages and de facto relationships are deemed
adulterous, with the ‘offending’ women arrested and any children from the relationship
removed. These children are placed with elite families, providing an immediate solution
to their childlessness. While ARTs such as IVF are banned, the practice of surrogacy is
retained due to its biblical connection in the Old Testament narrative of Rachel, Jacob
and Bilhah 97 . Any of the ‘offending’ women who are still fertile are given the choice of
becoming Handmaids, surrogate mothers for elite families. If they refuse they are sent to
the Colonies, areas on the fringes of the Republic, to clean up toxic waste.
In the Republic of Gilead women are divided on the basis of their fertility and their
class. All women are reassigned to one of six categories: Wives, Handmaids, Marthas,
Econowives, Aunts and Unwomen. Each is easily identified by the colour of their
clothing. The Wives, who wear blue gowns, are the spouses of Gilead’s elite men, the
Commanders. The Wives’ duties consist mainly of attending various functions including
96 Atwood’s novel Oryx and Crake sees her return to the genre of speculative fiction. Like The Handmaid’s Tale, Oryx
and Crake is “supported by snippets of real life” (Prior 14). Environmental degradation has led to the widespread
extinction of animal species, the melting of the northern permafrost, and the loss of seasonal variations in weather.
Significantly, Harvard university again features, this time being ‘drowned’ by rising sea levels.
97 In Genesis, 30:1-3, Rachel who is unable to have children proposes that Jacob use her maid, Bilhah, as a surrogate.
She says: “Behold my maid Bilhah, go in unto her; and she shall bear upon my knees, that I may also have children by
her”. This biblical narrative is included as Atwood’s first epigraph in the novel and is also read out by the Commander
before the official monthly ceremony (99). For a detailed analysis of biblical references in The Handmaid’s Tale see
Filipczak.
99
births, Prayvaganzas (praying extravaganzas) and Salvagings (where dissidents are
killed). Due to their husband’s status, the Wives are assigned domestic servants called
Marthas, who wear dull green dresses. The Marthas look after duties such as cooking,
cleaning and caring for any children.
Handmaids wear red, habit-like gowns and white winged hats that restrict their
vision and the ability of others to see their faces. They are indoctrinated at the Rachel
and Leah Re-Education Centre (referred to as the Red Centre), a former college. As
there are not enough Handmaids to go around they are posted to different households
for a certain period of time. If they don’t succeed in becoming pregnant after the
allocated time they are sent to a new posting. Similarly, if they do successfully have a
child, after finishing breastfeeding, they will be sent to a new posting to try again. The
Handmaids are no longer known by their previous names, but by the prefix ‘Of’ and their
Commander’s name - Offred, Ofwarren, Ofwayne and Ofglen. Apart from their
reproductive duties they are also responsible for the daily shopping for the household
and attending various ceremonies.
The women responsible for indoctrinating the Handmaids are Aunts. They wear
brown gowns and carry cattle prods. Their names are derived from commercial products,
Aunt Elizabeth (Elizabeth Arden), Aunt Sara (Sara Lee), Aunt Lydia (Lydia Pinkhammedicinal remedies for gynaecolological problems) 98 . Lower ranked men in the Republic
do not receive the same entitlements as the Commanders. Their wives, aptly named
Econowives, have to perform reproductive, domestic and wifely duties. The status of the
Econowives is reflected in the quality of their clothing, described as “cheap and skimpy”
(34). They wear dresses of blue, red and green stripes to indicate their multi-purpose
98 For a further discussion of the Aunts names see Kaler 48.
100
function. If the Econowives or their husbands are infertile they will remain childless
unless their husbands are able to gain a promotion into the position of Commander.
Unwomen is the term given to women who work in the Colonies, cleaning up toxic
waste dumps or radiation spills. If they are lucky they may receive an agricultural posting
which involves less hazardous activities such as fruit harvesting. Unwomen wear grey
dresses and are comprised of women who resisted their reassigned roles; Handmaids
who fail to conceive after three assignments and women who have been deemed not
useful for anything else, such as the elderly. About a quarter of the people in the
Colonies are actually men (who are also made to wear the grey dresses).
In addition to the six official categories of women are the women that work at
Jezebels, a brothel established for the Commanders, senior officials and trade
delegates. The women at the brothel are either prostitutes from the pre-Gilead era or
women who have chosen it as an alternative to going to the Colonies. They are clothed
in tatty costumes from the pre-Gilead era, including cheerleader outfits, Playboy bunny
suits, swimwear and stage costumes. The men in the Republic of Gilead are also divided
according to their class, but not their fertility.
In depicting a world where women are divided according to their class and fertility,
Atwood creates a version of radical feminist Andrea Dworkin’s reproductive brothel 99 .
Dworkin claims there are two models through which women are socially controlled and
used sexually, the brothel model and the farming model (Right-Wing Women 174). In the
brothel model women’s purpose is to be used by men for sex only, an explicitly nonreproductive role. In the farming model women’s main purpose is to bear children
through becoming the land in which the man’s seed is ‘planted’. For Dworkin, ARTs, in
99 Gena Corea also discusses how ARTs will allow women who are considered genetically unworthy to serve as breeders
for the embryos of ‘superior’ women. She suggests that the genetically unworthy women will no doubt be women of colour
with the superior women being white women. Those serving as breeders will be sterilised to ensure they cannot have their
own genetically related children but only carry the children of others (The Mother Machine 276).
101
particular surrogate motherhood, combine these two models, resulting in a reproductive
brothel. In the reproductive brothel women “can sell reproductive capacities the same
way old-time prostitutes sold sexual ones” (Right-Wing Women 182). The scientists
involved in the development and application of ARTs or those running surrogate services
become the pimps and the scientific research institutes and medical hospitals become
the brothels 100 . Dworkin predicts that with the help of ARTs men will be able to create
and control the kind of women they want: “there will be fewer but better women” (RightWing Women 188). The use of ARTs along with the forced sterilisation of certain races
will create three categories of women, “domestics, sex prostitutes, and reproductive
prostitutes” (Right-Wing Women 188). In addition, Dworkin explains that politically
dissident women will “no longer be tolerated on any scale […] The criteria for politically
dissident women – troublemakers – will be extended to include any women not
domestics, sex prostitutes or reproductive prostitutes” (Right-Wing Women 93-4).
As in Dworkin’s reproductive brothel, sexual, reproductive and domestic functions in
the Republic of Gilead are kept completely separate. The Handmaids are supposed to
perform a solely reproductive function: “We are for breeding purposes: we aren’t
concubines, geisha girls, courtesans” (146). They are forbidden any contact with men
outside the monthly impregnation ceremony with their Commander. The Marthas,
Unwomen and prostitutes who work at Jezebels are all sterile to ensure these
boundaries are maintained: ‘“Nobody in here [Jezebels] with viable ovaries either, you
can see what kind of problems it would cause’” (261). Political dissidents have been
banished to the Colonies, along with anyone who cannot fit into one of the three
prescribed roles. This includes older women: ‘“I bet you’ve been wondering why you
100 Raymond draws an even closer association with ARTs, namely surrogacy, and prostitution. She claims the expansion
of surrogacy internationally will “depend tremendously upon organized prostitution networks and the traffic in women that
is already established in various parts of the world” (“The International Traffic in Women” 52).
102
haven’t seen too many of those around any more”’ (260). Those who are chronically ill or
disabled and, therefore, cannot be put to work, are presumably killed. This is intimated
when one of the Handmaids at the Red Centre shows signs of a mental breakdown:
“They won’t mess around with trying to cure you. They won’t even bother to ship you to
the Colonies […] they just take you up to the Chemistry Lab and shoot you” (228).
The Republic of Gilead, like Dworkin’s reproductive brothel, also restricts access to
ARTs, in this case the services of a Handmaid, to those of the elite. In Gilead,
‘genetically unworthy’ women such as women of colour are not used as surrogates, as
suggested by Corea, but are segregated or eliminated from the regime. We are told how
Blacks are resettled in National Homelands and Jews are forced to either convert or
emigrate to Israel. Radical feminism’s anxieties that the treatment of infertility unfairly
focuses on women’s bodies are realised in the Republic of Gilead’s belief that only
women are infertile: “There is no such thing as a sterile man any more, not officially.
There are only women who are fruitful and women who are barren, that’s the law” (70-1),
and “It’s only women who can’t, who remain stubbornly closed, damaged, defective”
(215). Atwood also uses Corea’s popular analogy between women participating in ARTs
and animals in her depiction of life as a handmaid. The Aunts carry cattle prods as
weapons, suggesting the Handmaids are livestock and Offred refers to herself as being
like a laboratory rat, or a pig being fattened in a pen: “I wait, washed, brushed, fed, like a
prize pig” (79).
Although Atwood’s The Handmaid’s Tale initially appears to be a representation of
Dworkin’s reproductive brothel it also provides a critique of Dworkin and other radical
feminist’s complete rejection of ARTs, including any benefits they could provide. In the
Republic of Gilead, technologies such as ultrasound and amniocentesis are banned,
despite many of the babies having terrible deformities: “a pinhead or a snout like a dog’s,
or two bodies, or a hole in its heart or no arms, or webbed hands and feet” (122). The
103
doctors and scientists involved in ARTs or pregnancy terminations in the pre-Gilead era
are now treated as war criminals, executed at special ceremonies and hung on the Wall
for all to see. To symbolise their crimes placards with a drawing of a human foetus are
placed around their necks. They have been tracked down through hospital records
(although these have now been mostly destroyed) or by informants such as ex-nurses or
other doctors. The banning of prenatal screening and abortion in Gilead results in three
out of four women carrying a baby to full term only to discover it is severely disabled. It is
unclear what happens to these babies, except they are “put somewhere, quickly, away”
(123). Their nicknames of ‘Unbabies’ or ‘shredders’, however, suggests they are killed.
The treatment of the Unbabies demonstrates the hypocrisy of a regime that bans the
technology to detect birth defects, but fails to accept those born with disabilities.
The reproductive brothel of Gilead has, therefore, not arisen from a growth in ARTs,
as radical feminists feared, but by the new regime’s adoption of both radical feminist
arguments concerning the sacredness of women’s maternal role and the Extreme
Right’s views on protecting the unborn. Atwood’s Gilead provides an example of how
radical feminist arguments can be manipulated to support right-wing values. When the
Handmaids are shown documentary films of feminist marches from the pre-Gilead era,
(in order to demonstrate that these women have now been sent to the Colonies), the
Aunts admit “some of their ideas were sound enough […] We would have to condone
some of their ideas, even today” (128).
Radical feminism’s celebration of women’s maternal role has always been in danger
of being used by others to reduce women to a reproductive role and to threaten women’s
‘right to choose’. In its opposition to ARTs, radical feminism finds itself with such strange
bedfelllows as antiabortion lobbyists and religious fundamentalists. Farquhar notes how
Corea, like antiabortion lobbyists, elides the difference between embryos and woman
(116). In Corea’s discussion of how the unborn might be used in the reproductive brothel
104
she comments: “A female embryo could be developed just to the point where an ovary
emerges, and then the ovary could be cultured so that the engineers could get eggs
from it. The full woman would never be allowed to develop. Just her ovary” (The Mother
Machine 278).
In the Republic of Gilead, women have been completely consumed by the
importance of women’s maternal role. They have become, “two-legged wombs […]
sacred vessels, ambulatory chalices” (146). As the Handmaids’ fertility is so precious, all
precautions are taken to preserve it. They are given healthy, but bland food which they
must eat (any uneaten food would be reported by the Marthas) and are forbidden things
that are thought to interfere with fertility such as coffee, tea, alcohol and cigarettes. They
are also subjected to compulsory monthly visits to the doctor for tests: “urine, hormones,
cancer smear, blood test” (69). The description of Offred’s monthly examination reveals
how the regime positions the Handmaids as nothing more than receptacles: “When I’m
naked I lie down on the examining table […] At neck level there’s another sheet,
suspended from the ceiling. It intersects me so that the doctor will never see my face.
He deals with a torso only” (70). The sheet’s placement decapitates Offred so that the
doctor sees her as nothing but a body.
Offred’s reduction to nothing but a maternal function is evident in the different way
she now thinks of her body: “I used to think of my body as an instrument, of pleasure, or
a means of transportation, or an implement for the accomplishment of my will […] Now
the flesh arranges itself differently. I’m a cloud, congealed around a central object, the
shape of a pear, which is hard and more real than I am and glows red within its
translucent wrapping” (83-4). Here, Offred has become nothing more than her pear
shaped womb. When Offred has her bath prior to the monthly impregnation ceremony
she avoids looking at her body: “not so much because it’s shameful or immodest but
105
because I don’t want to see it. I don’t want to look at something that determines me so
completely” (72-3).
A further element of the Republic of Gilead which has been ‘inspired’ by radical
feminism is the practice of natural birthing. In order to convince the Handmaids that their
experience of giving birth will be superior to that which took place from the time before,
they are shown a film of a woman having a Cesarean section. The description is straight
out of radical feminist literature:
a pregnant woman, wired up to a machine, electrodes coming out of her every
which way so that she looked like a broken robot, an intravenous drip feeding
into her arm. Some man with a searchlight looking up between her legs, where
she’d been shaved, a mere beardless girl, a trayful of bright sterilized knives,
everyone with masks on. A co-operative patient. Once they drugged women,
induced labour, cut them open, sewed them up. (124)
Dworkin supplies a similar description of a Cesarean section being performed in which
the woman is “drugged and sliced into, surgically fucked […] [the doctors] fuck the uterus
directly, with a knife” (Pornography 223).
In the Republic of Gilead, birthing has been returned to the realm of women, a move
commonly advocated by radical feminists. The pregnant Handmaid, other Handmaids
and the Commander’s wives all take part in a Birthing Ceremony. Doctors are not
permitted at the Ceremony but instead wait outside in the Emerge van, only allowed
inside “if it can’t be helped” (124). As in natural birthing manuals, the labouring woman is
compared to an animal giving birth: “another smell, more animal, that’s coming, it must
be, from Janine [Handmaid]: a smell of dens, of inhabited caves, the smell of the plaid
blanket on the bed when the cat gave birth on it” (133). The practices used to assist
Janine, baby oil rubs, ice chips and breathing exercises, are also those recommended
by natural birthing advocates. In a show of female solidarity the Handmaids perform the
106
breathing exercises along with Janine: “The soft chanting envelopes us like a membrane
[…] We’re with her, we’re the same as her” (133,135). When the labouring Handmaid is
ready to give birth she is placed on a birthing stool similar to the ones used by midwives
in medieval times.
Atwood’s portrayal of the Birthing Ceremony is not, however, a celebration of
women’s maternal role but a critique of the radical feminist notion that women’s
reproductive role binds them together. For some of the Handmaids the Birthing
Ceremony only serves as a reminder of their inability to conceive. Many return home to
their Commander’s homes feeling exhausted and empty: “We ache. Each of us holds in
her lap a phantom, a ghost baby. What confronts us, now the excitement’s over, is our
own failure” (137). The Birthing Ceremony scene questions radical feminism’s portrayal
of natural birthing as Eden-like. Offred thinks of her mother, a radical feminist in the preGilead era: “Mother, I think. Wherever you may be. Can you hear me? You wanted a
women’s culture. Well, now there is one. It isn’t what you meant, but it exists. Be thankful
for small mercies” (137). As Alice E. Adams explains, Atwood’s purpose here is to
“demonstrate the futility of basing hopes for revolution on the creation of a specifically
maternal subjectivity” (110).
Other traces of radical feminist ideologies in the Republic of Gilead are the regime’s
attitudes towards sex and the treatment of pornography. In the 1970s some radical
feminist proponents began to equate heterosexual sex with women’s oppression and
subordination. Dworkin comments that: “In practice, fucking is an act of possession –
simultaneously an act of ownership, taking, force; it is conquering” (Pornography 23).
Dworkin sees nothing pleasurable for women in being ‘fucked’ by men and claims that
women prefer to avoid it: “For centuries, female reluctance to “have sex”, female dislike
of “sex,” female frigidity, female avoidance of “sex,” have been legendary. This has been
the silent rebellion of women against the force of the penis” (Pornography 56). Lynne
107
Segal documents how feminist attempts to understand and eliminate rape and violence
against women resulted in sexuality being seen as “the primary source of men’s
oppression of women” (56).
The Republic of Gilead reflects these radical feminist claims, positioning men’s
sexuality as synonymous with sexual coercion and violence. At the Red Centre, Aunt
Lydia informs the Handmaids that in the pre-Gilead era they had freedom to do as they
pleased, but now they are “being given freedom from” (34). The ‘from’, here implies
harassment or harm of some sort, particularly of a sexual nature. Offred remembers that
in the time before women’s bodies were being found in the woods or ditches, some
having been “interfered with” (66). Implicit in Aunt Lydia’s preaching at the Centre is the
belief that: “Men are sex machines […] and not much more. They only want one thing”
(153).
In order to overcome ‘the force of the penis’, some of the wives of the elite (those
whose husband is provided with a Handmaid) are able to avoid sexual intercourse due
to the monthly impregnation Ceremony. During the Ceremony the Handmaid lies
between the outspread legs of the Commander’s wife, resting her head on her stomach.
The Commander then fucks the Handmaid. As a result wives who have been assigned a
Handmaid no longer have to endure the ‘degradation’ of the sex act as they substitute
another woman’s vagina for their own. Offred comments: “Serena Joy grips my hand as
if it is she, not I, who’s being fucked” (105).
Dworkin’s notion that all men are potential rapists is questioned in The Handmaid’s
Tale through the character of Fred, Offred’s Commander. When Offred is first
summoned to the Commander’s library she is not certain what for, but her statement,
“we aren’t concubines, geisha girls, courtesans” (146), suggests she thinks it is for sex.
Later she ponders: “What had I been expecting, behind that closed door, the first time?
Something unspeakable, down on all fours perhaps, perversions, whips, mutilations?”
108
(163). While Offred’s conversion to the Republic of Gilead’s way of thinking is
incomplete, the teachings at the Centre have caused her to believe the Commander’s
only interest in her is for sex. The Commander’s behaviour towards Offred upon her
arrival at his office, however, rejects Gilead’s (and Dworkin’s) positioning of men as
nothing more than ‘sex machines’. When he pulls out a chair for her to sit in and retreats
behind his desk Offred comments: “What this act tells me is that he hasn’t brought me
here to touch me in any way, against my will. He smiles. The smile is not sinister or
predatory” (148). Instead of forcing her to take part in perverted sex acts, the
Commander wants her to play the board game, Scrabble, with him. He admits that he
wished to meet with Offred (and also her predecessor) in an effort to make their lives
“bearable” (197).
Dworkin’s association of heterosexual sex with women’s subordination also denies
or negates women’s sexual pleasure in heterosexual relationships. As Segal comments,
“sex as pleasure had fled from feminist platforms by the close of the 1970s” (174).
Lesbianism was proposed as an alternative to heterosexuality, on the basis that it
provided “gentler, non-possessive, non-competitive, non-violent, nurturing and
egalitarian relationships” (Segal 52). In The Handmaid’s Tale, the Aunts challenge the
radical feminist notion that relationships between women (both sexual and non-sexual)
are immune from violence and power imbalances 101 . The Aunts’ main role in Gilead is to
indoctrinate the Handmaids into their new role. They achieve this through the
domination, humiliation and torture of their subjects. Handmaids who disobey have their
feet and hands beaten with steel cables frayed at the ends. The Aunts are also
permanently armed with cattle prods. There are a number of suggestions in the novel
that some of the Aunts may be lesbians. Moira says of Aunt Lydia: “How much you want
101 Women as the persecutors of other women is a familiar theme in Atwood’s novels. Most notably in Cat’s Eye, where
the protagonist is tormented by other girls during her childhood.
109
to bet she’s got Janine [fellow Handmaid] down on her knees? What you think they get
up to in that office of hers? I bet she’s got her working away on that dried-up hairy old
withered –” (234). Moira’s claim is again hinted at in Aunt Lydia’s statement to the
Handmaids: “All of us here [Aunts at the Red Centre] will lick you into shape” (124). By
suggesting that some of the Aunts are lesbians Atwood questions Dworkin’s view that
lesbianism is synonymous with non-violent and egalitarian relationships. This is also
explored in the way Moira (a lesbian) carries out her relationships in the pre-Gilead era.
While Moira disapproves of Offred’s relationship with Luke (at the time a married man)
she does not feel the need to follow similar rules in her relationships. Offred comments
on how during their college years Moira had “no scruples about stealing them [women]
or borrowing them when she felt like it” (180).
Similarly, the relationship Offred has with other members of her household refutes
the spirit of camaraderie among women proposed by radical feminism and the Republic
of Gilead. Aunt Lydia’s explanation of how one day the women of Gilead will “live in
harmony together […] Women united for a common end! Helping one another in their
daily chores as they walk the path of life together” (171-2) is a stark contrast to the
current climate of Offred’s household. On arrival at her new position Offred is informed
by the Commander’s wife she wishes to see as little as possible of her. While Offred
dreams of being able to sit in the kitchen with the Marthas drinking coffee, exchanging
remedies for ailments, gossiping 102 or making bread, her interactions with them are far
from friendly. Rita disapproves of Offred’s position as a Handmaid and also envies her
the walk outside to collect the shopping. Her resentment is shown by her either
undercooking or overcooking Offred’s meals. Offred reveals that rather than being a
source of friendship to the Marthas she is nothing more than “a household chore” (58).
102 For a discussion of gossip in the The Handmaid’s Tale see Johnson.
110
Through Offred’s relationship with the Commander and later Nick the chauffeur,
Atwood explores the possibility of women’s sexual desire and pleasure in heterosexual
relationships. When Offred discovers the Commander wishes to only play Scrabble with
her, she admits to feeling “a letdown of sorts” (163). Her response suggests an interest
in participating in some of the kinds of sexual acts she assumed he wanted her to
perform. The games of Scrabble and, later, reading of magazines and novels become a
substitute for sex. Offred likens her voracious reading to “a swift furtive stand-up in an
alley somewhere” (194) and comments that when the Commander watches her read it is
“a curiously sexual act, and I feel undressed while he does it” (194). When Offred
wonders what Nick thinks she gets up to on her visits she once again likens reading to
sex: “The Commander and me, covering each other with ink, licking it off, or making love
on stacks of forbidden newsprint. Well he [Nick] wouldn’t be far off at that” (191). While
the Commander provides Offred with sex substitutes it is with Nick that she regains real
sexual pleasure.
While Offred’s first visit to Nick’s room is arranged by Serena Joy for impregnation
purposes, Offred returns repeatedly, on these occasions for sex and even love. Kimberly
Verwaayen suggests that in Gilead appropriating jouissance in heterosexual sex rather
than lesbian sex “might be especially subversive, since handmaids are forced to have
sex with men but are forbidden the pleasures of lovemaking” (49). Howells comments:
“Heterosexual love is the excess term which the Gileadean grand narrative can neither
accommodate nor suppress, and its stubborn survival continually subverts the regime’s
claim to absolute authority” (“Free-dom” 43) 103 .
103 Susan Jacob suggests that Serena Joy’s “repressed sexuality breaks out in her garden, where in spite of her arthritis
she grows a range of “subversive” flowers” (34).
111
Like the Republic of Gilead’s ban on sex for pleasure, the regime’s censorship laws
can be seen as deriving from extreme versions of radical feminist attitudes towards
pornography. Dworkin and Katherine MacKinnon define pornography as:
the graphic, sexually explicit subordination of women whether in pictures or in
words that also includes one or more of the following: women are presented
dehumanized as sexual objects, things, or commodities; or women are
presented as sexual objects who enjoy pain or humiliation; or women are
presented as sexual objects who experience sexual pleasure in being raped; or
women are presented as sexual objects tied up or cut up or mutilated or bruised
or physically hurt; or women are presented in postures of sexual submission; or
women’s body parts are exhibited such that women are reduced to those parts;
or women are presented being penetrated by objects or animals; or women are
presented in scenarios of degradation, injury, abasement, torture, shown as
filthy or inferior, bleeding, bruised, or hurt in a context that makes these
conditions sexual. (Dworkin, “Against the Male Flood” 29)
The breadth of Dworkin and MacKinnon’s definition of pornography is problematic in that
it applies to objects/instances that many would not consider pornographic. For example,
women’s magazines could be labelled pornographic as the advertising and fashion
photography they contain often feature women in sexually submissive postures or being
reduced to body parts. Women’s magazines, however, provide a source of enjoyment for
many women, the vast majority of who would not consider them to be pornographic.
The danger of censorship based on such broad definitions is dramatically presented
in The Handmaid’s Tale. In the beginning of the regime the Pornomarts and Feels on
Wheels vans are shut down. These changes are met with general approval: “We all
knew what a nuisance they’d been” (183). However, the ban quickly progresses to
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women’s magazines such as Vogue and Mademoiselle. When the Commander offers
Offred a seventies Vogue to look through in his study, she remembers how such
magazines used to function in the pre-Gilead era. They were bought to read in dentists’
offices, on planes and hotel rooms and then thrown away. Offred comments on how they
were “infinitely discardable, and a day or two later I wouldn’t be able to remember what
had been in them” (165). Offred’s memory of women’s magazines serves to highlight
the fanaticism of the Republic of Gilead’s censorship laws in which seemingly innocent
magazines are perceived as having a dangerous influence.
The connection between radical feminist positions on pornography and widespread
censorship of other reading/viewing matter is suggested by the two bonfire references in
the novel. The first is Offred’s childhood memory of going to a book burning of
pornographic magazines with her mother and the second, the burning of women’s
magazines confiscated in house to house searches under the Gilead regime.
The Republic Of Gilead’s portrayal of pornographic films as ‘real’ also shares
similarities with Dworkin and MacKinnon’s views. At the Red Centre the Handmaids are
shown “old porno film[s] from the seventies or eighties” (128), depicting women tied up
or chained or with dog collars around their necks and women being raped, beaten or
killed. Rather than shown as examples of how images of women being abused were
considered ‘entertainment’ in pre-Gilead era, the movies are represented as women’s
everyday experiences in that era. Aunt Lydia tells the Handmaid’s: “You see what things
used to be like?” (128). While Offred is able to identify the images she is being shown as
an ‘old porno’, future generations of Handmaids will not be able to and, therefore,
believe the images to be ‘real’ 104 . Such a blurring of fictional and ‘real’ events is evident
in Dworkin’s discussions of pornography: “In the photographs and films, real women are
104 The exception to this is the snuff film in which women are tortured and killed.
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used as porneia and real women are depicted as porneia” (Pornography 201). In a
discussion of a photograph of a woman bound across the bonnet of a car, Dworkin
comments on how such an image should evoke fear in the female observer unless she
“refuses to believe or understand that real persons posed for it” (Pornography 27).
The Handmaid’s Tale also challenges the absolutism of certain proponents of
radical feminism and their approach to reproductive technologies. While the Handmaids
have little choice regarding their role in Gilead, they are not just ‘passive dupes’ but
resist the regime in their own way. Resistance is a central feature of the dystopia and
Atwood explores it on a number of levels. Many critics, however, have failed to interpret
any of Offred’s behaviour as acts of resistance. Elaine Tuttle Hansen says of Offred:
“What do we make of such a heroine, whose stupidity and complicity (or at least a failure
to fight back) seems to be, as she says in one of the last of her self-criticisms, “the
point”?” (34). Jenny Wolmark comments that Offred’s “most outstanding characteristic
appears to be her passivity” (101) and Jamie Dopp discusses the “fatalistic passivity of
the protagonist” (44). Sandra Tomc concludes that Offred’s “sole resistance goes on
inside her head, a resistance at once indistinguishable from passivity and masochism
and uncomfortably synonymous with traditional stereotypes of feminine behaviour” (77).
Responses of this kind depend on a privileging of active forms of rebellion such as
attempts to escape or kill the enemy. Offred is at times herself guilty of this by the way
she reacts to her college friend and fellow Handmaid, Moira. Moira’s behaviour under
the regime is characterised by active resistance. Although her first attempt at escaping
the Red Centre fails, her second is temporarily successful as she manages to reach the
Underground Femaleroad 105 , a group of safe houses used to smuggle people out of the
105 The Underground Femaleroad is a reference to the Underground Railroad which assisted runaway slaves to escape
from the United States to Canada. Several critics address Atwood’s use of the African-American slave narrative. See
Lauret 182; and Dodson.
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Republic. When Moira is recaptured she chooses to become a prostitute at Jezebels
rather than being sent to the Colonies. Offred expects more of her when she meets her
at Jezebels: “I don’t want her to be like me […] I want gallantry from her, swashbuckling,
heroism, single-handed combat. Something I lack” (261). Here, Offred is shown as also
thinking of rebellion in the narrow sense of active ‘combat’.
The privileging of active forms of resistance is most evident in the film version made
of Atwood’s The Handmaid’s Tale. Directed by Volker Schlondorff, the film substitutes a
Hollywood-style ending for the somewhat ambiguous ending of the novel. In the film,
Offred does in fact participate in ‘single-handed combat’ by slitting her Commander’s
throat with a knife. She escapes the regime to a safe place where she awaits the birth of
Nick’s child. The film takes its inspiration for the killing of the Commander from Offred’s
fantasy in the novel of killing the Commander with the sharp lever from the toilet (the
weapon Moira uses to ambush one of the Aunts): “I think about the blood coming out of
him, hot as soup, sexual, over my hands” (150). In the novel, however, the description of
Offred’s fantasy is qualified by an interjection: “In fact I don’t think about anything of the
kind. I put it in only afterwards. Maybe I should have thought about that, at the time, but I
didn’t” (150). Offred’s clarification and the alternative ending of the film demonstrate how
active forms of resistance are portrayed as the expected response to oppression. Jane
Armbruster comments on the film’s ending: “The film’s scenario suggests to me another
patriarchal road out of Gilead” (152) 106 . The only legitimate forms of resistance, escape
and killing the enemy, therefore, appear to be those most often associated with the male
hero.
Critics’ claims of Offred’s passivity appear to ignore her initial attempt to escape
over the border into Canada with Luke and her daughter. In the early days of the regime
106 Other critics that explore the film version of The Handmaid’s Tale are Cooper 57-60; and Willmott.
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the trio, armed with fake passports, try to leave on the pretence of going on a picnic for
the day. When they reach the checkpoint, Luke sees one of the guards pick up the
phone and he reacts by reversing the car and driving into the woods where they flee on
foot. Offred and her daughter are captured and Luke’s fate is unknown. This failure and
its disastrous consequences make Offred cautious of another attempt. Her fears are
intensified by Moira’s torture after her first escape attempt and the belief that her family
could be punished in her absence 107 . Offred’s location, as Jonathon Bignell describes it,
“at the centre of the nation’s geographical space” (11) also makes an active escape
attempt difficult. Offred explains that while around the edges of the Republic there are
“attacks and counterattacks”, she is in “the heart of Gilead […] the centre, where nothing
moves” (33).
With little opportunity for actual freedom, some of the Handmaids choose suicide as
a way of escaping the regime. Offred explains how at the Red Centre there were
“incidents in bathrooms at first; there were cuttings, drownings” (72). The framed picture
in Offred’s room does not have any glass in it and the window opens only partly and is
made of shatterproof glass. Offred acknowledges: “It isn’t running away they’re afraid of.
We wouldn’t get far. It’s those other escapes, the ones you can open in yourself, given a
cutting edge” (17-8). Offred discovers the previous handmaid hung herself from the lightfitting in their room. Later, Ofglen hangs herself after realising her involvement in the
Mayday resistance movement has been discovered. While Offred contemplates suicide,
even going as far as locating an anchor in her room from which she could hang herself,
she does not follow through. As Malak points out Offred instead decides to resist the
regime by being a “sly, subversive survivor” (13).
107 This possibility is referred to in the Historical Notes section by Professor Pieixoto: “More than one incautious refugee
was known to receive a hand, ear, or foot, vacuum-packed express, hidden in, for instance, a tin of coffee” (323).
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Apart from taking one’s own life, the other possible escape is madness. This is
graphically depicted by the character of Janine, one of the other Handmaids at the Red
Centre with Offred. Her complete compliance with the Aunts’ indoctrination results in her
descending into a trance-like state, repeating a phrase she used as a waitperson in the
pre-Gilead era. As a Handmaid Janine suffers a late miscarriage and then gives birth to
a ‘shredder’. She is last seen at the Particicution ceremony, smeared with blood and
clutching a clump of blonde hair: “smiling, a bright diminutive smile. Her eyes have come
loose […] she’s let go, totally now, she’s in free fall, she’s in withdrawal” (292). Offred
regards Janine’s madness as an “[e]asy out” (292) and guards against losing her mind in
such a way: “Thinking can hurt your chances, and I intend to last” (17). She explains:
“Sanity is a valuable possession; I hoard it the way people once hoarded money. I save
it, so I will have enough, when the time comes” (119).
While Offred appears to comply with her new role in Gilead she is always resisting
the regime’s ideologies, in small ways at first and then later, more blatantly. As Lucy
Freibert suggests: “The boldness that stimulates her creativity and risk taking comes
slowly” (286). At the Red Centre the Handmaids are forbidden to speak with each other
so they learn to communicate through low whispering, the touching of each others palms
and lip-reading. They also meet secretly in the toilet to whisper through a hole between
the toilet stalls and to take delight in the graffiti “Aunt Lydia sucks” on the toilet wall:
“There is something powerful in the whispering of obscenities, about those in power.
There’s something delightful about it, something naughty, secretive, forbidden, thrilling.
It’s like a spell of sorts” (234).
Another act of defiance that begins at the Red Centre is the identification of women
by their real names. Offred says of her name: “I keep the knowledge of this name like
something hidden, some treasure I’ll come back to dig up, one day. I think of this name
as buried. This name has an aura around it, like an amulet, some charm that’s survived
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from an unimaginably distant past” (94). The importance of knowing a Handmaid’s
original name is demonstrated when Offred’s original shopping partner, Ofglen, is
replaced by another woman. If the Handmaids do not communicate using their original
names they become lost when they are moved to a new post and take on that
Commander’s name. Offred says of the original Ofglen: “I never did know her real name.
That is how you can get lost, in a sea of names” (295) 108 . The inability to trace women’s
identities through names is suggestive of women giving up their maiden name in
marriage.
The Handmaids also overcome the ban placed on beauty products by making use of
what is available to them. To aid her dry skin Offred hides a small piece of butter from
her dinner tray in one of her shoes so she can smooth it onto her face later. The use of
butter as moisturiser is a trick Offred learned while at the Red Centre: “As long as we do
this, butter our skin to keep it soft, we can believe that we will some day get out, that we
will be touched again, in love or desire. We have ceremonies of our own, private ones”
(107). By looking forward to a different and better time the Handmaids refuse to fully
accept their current role in Gilead.
As well as wishing for a different future, Offred also reminisces about a past she is
supposed to have forgotten. Linda Kauffman comments: “Offred neither forgives nor
forgets; she rebels by keeping the past alive. What the regime would eradicate, she
reinscribes” (231). Offred’s narration of life as a Handmaid in Gilead is constantly
punctuated by her memories of the past. The shopping trips are filled with memories of
what was housed in the buildings previously. ‘Lilies’ was once a movie theatre that held
a Humphrey Bogart festival every spring, ‘Soul Scrolls’ was a lingerie shop and another
108 Several critics have commented on the symbolic meaning of Offred’s name. See Raschke 265; Lacombe 7-8; and
Kaler 47.
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shop used to be an ice-cream parlour. Offred recalls having a garden, going to the
laundromat, dropping water bombs, visiting hotels and making dandelion chains.
She also chooses to return to her past deliberately, as a form of escape from her life
in Gilead. Howells explains how Offred manages to “transform her room into an escape
route out into the spaces of memory and imagination” (“Dislocations” 15). Heidi
Slettedahl Macpherson also comments that: “Mental escapes routes, channeled through
memory and desire, take the place of physical ones” (180). Lying at night in the room
allocated to her, Offred ponders: “the night is my time out. Where should I go?
Somewhere good. Moira, sitting on the edge of my bed, legs crossed, ankle on knee, in
her purple overalls” (47). As Armbruster suggests: “Memory awakens and nurtures the
spirit of resistance” (150).
Offred and some of the other Handmaids believe the lack of ‘available’ women in
Gilead means there is a chance they could use their bodies to negotiate an escape. This
belief is behind Moira’s plot to fake sickness and be taken away from the Red Centre in
an ambulance (in which she is accompanied by two men). When gaining entry through
one of the many checkpoints in the regime, Offred raises her face so the Guardian is
able to see her eyes under the white wings which frame her face: “It’s an event, a small
defiance of rule, so small as to be undetectable, but such moments are the rewards I
hold out for myself […] Such moments are possibilities, tiny peepholes” (31). She also
moves her hips a little when she walks to tease the Guardians who are lowly ranked
and, therefore, are not yet allowed to marry: “It’s like thumbing your nose from behind a
fence or teasing a dog with a bone held out of reach […] I enjoy the power; power of a
dog bone, passive but there” (32). The possibility that her sexuality will provide a means
of escape is also one of the reasons she agrees to visit the Commander: “To want is to
have a weakness. It’s this weakness, whatever it is, that entices me. It’s like a small
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crack in a wall, before now impenetrable. If I press my eye to it, this weakness of his, I
may be able to see my way clear” (146).
On their first meeting, Offred is given the opportunity to use the written language in
the game of Scrabble 109 . In the Republic of Gilead all women (with the exception of the
Aunts) are forbidden to read or write, with three offences resulting in a hand being cut
off. Even the shop signs have been replaced by pictures of what they sell 110 . To Offred,
Scrabble is “forbidden”, “dangerous”, “indecent” and, therefore, “desirable” (149). She
compares the Commander’s offering of a game of Scrabble to that of drugs. The
forbidden desire of the written word is obvious in Offred’s experience of the Scrabble
letters: “I hold the glossy counters with their smooth edges, finger the letters. The feeling
is voluptuousness. This is freedom, an eyeblink of it […] The counters are like candies,
made of peppermint, cool like that […] I would like to put them into my mouth […] The
letter C. Crisp, slightly acid on the tongue, delicious” (149).
In subsequent meetings the Commander allows Offred to read now banned copies
of women’s magazines. Offred’s desire for the magazine the Commander holds, “I
wanted it with a force that made the ends of my fingers ache” (164), is another instance
of her longing for the written word. Offred comments: “He has something we don’t have,
he has the word. How we squandered it, once” (99). When Offred asks the Commander
to translate the Latin inscription, Nolite te bastardes carborundorum scratched into her
cupboard she has to write it down to make herself understood. With the pen in her hand
Offred experiences the power associated with the written language: “The pen between
my fingers is sensuous, alive almost, I can feel its power, the power of the words it
109 Apart from being word-based, the other point of interest in Scrabble as the chosen board game is the fact that it is not
based on luck (with the exception of the letters allocated). The object of the game is to make the best choices (words) out
of the given circumstances (allocated letters). For a further discussion of Scrabble in The Handmaid’s Tale see Grace,
“Gender as Genre” 196-199.
110 For a further discussion of the shop signs see Raschke 257-8.
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contains. Pen Is Envy, Aunt Lydia would say” (196). The reference to Freud’s concept of
penis envy describes Offred’s wish for the Commander’s access to language.
While playing a children’s game and reading and writing may not appear to be too
rebellious, as Offred states, “[c]ontext is all” (154). The magnitude of playing Scrabble in
the Commander’s office must be considered in relation to the strictness of the regime
they are both living under. By establishing the seriousness of such breaches initially,
Atwood is then able to then demonstrate the significance of Offred’s other violations of
Gilead’s rules. Offred’s next ‘escapade’ is to collude with the Commander’s wife to visit
Nick, the chauffeur, in an attempt to fall pregnant. Despite the obvious dangers, Offred
continues to see Nick following the arranged meeting for sexual pleasure and
companionship. If Offred’s relationship with Nick were to be discovered, the seriousness
of the offence would certainly see her executed or sent to the Colonies. Offred describes
taking Nick as her lover “would be like shouting, it would be like shooting someone”
(109).
Serena Joy’s arrangement for Offred to use Nick as a substitute for her husband
demonstrates how all the women in the Republic of Gilead find ways to bend the rules of
the regime. It is revealed that using other men other than Commanders as impregnators
is not uncommon: ‘“Women do if frequently. All the time’” (215). Other evidence of
women’s resistance is the Salvaging event that Offred and all the other women from her
district attend. At a Salvaging the crimes of female dissidents are usually read out before
the women are hung. However, in the most recent Salvaging that Offred attends Aunt
Lydia explains that such details will no longer be shared as it is “invariably followed by a
rash, if I may call it that, an outbreak I should say, of exactly similar crimes” (287). Offred
and the other handmaids are disappointed by the change: “The crimes of others are a
secret language among us. Through them we show ourselves what we might be capable
of, after all” (287).
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Howells proposes that Offred’s story also “presents a mosaic of alternative female
worlds which undermine Gilead’s patriarchal myth of women’s submissiveness and
silence” (Margaret Atwood 134). Apart from the Handmaids, the other women in the
Republic of Gilead also take part in acts of defiance against the regime. In exchange for
agreeing to the arranged visit with Nick, Serena obtains a photograph of Offred’s child. It
is one of the Marthas in the other household who obtains the photograph for Serena.
This act is significant because the regime is structured in a way that discourages
communication between women of different ranks. As well as arranging other men for
impregnation duties, the Wives pretend to be sick in order to visit each other outside the
official ceremonies: “They take turns. There is some sort of list, invisible, unspoken.
Each is careful not to hog more than her share of the attention” (163). The Wives use
sickness as a way of resisting the isolation that comes with having to stay in the sanctity
of the home. Visiting other ‘sick’ Wives is one of the few reasons they are allowed to be
out at night. The Wives also obtain banned items like cigarettes and hair dye through the
black market.
Although the women at Jezebels exist for male pleasure, their role is still an
alternative to the strictly defined role for women in Gilead: “The official creed denies
them, denies their very existence, yet here they are. This is at least something” (247).
When Offred gets a chance to talk to her old friend Moira at Jezebels she finds there are
a number of benefits including access to alcohol, cigarettes, drugs and face cream.
Sexual relationships between prostitutes are also allowed, if not encouraged. While
Moira explains this is partly as a sexual turn on for the Commanders who like “women on
women” (262), for her, a lesbian, it allows a legitimate space for sexual pleasure.
The Historical Notes section of the novel, which follows the main narrative, reveals
Offred’s final act of resistance, the recording of her story. The Notes section purports to
be a partial transcript of the proceedings of the Twelfth Symposium on Gileadean
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Studies, at the University of Denay, Nunavit, on June 25, 2195. We learn that the
narrative we have been reading is in fact a transcription from thirty audio-cassette tapes
discovered in an old army foot-locker. Professor James Darcy Pieixoto and Professor
Knotly Wade have been responsible for deciphering the tapes and establishing their
current sequencing. Pieixoto believes the series of tapes were actually made inside the
borders of Gilead, perhaps in a ‘safe house’ that was part of the Underground
Femaleroad.
As Offred herself attests, she did not have to record her story: “I don’t have to tell it.
I don’t have to tell anything, to myself or to anyone else. I could just sit here, peacefully. I
could withdraw” (237). Story-telling, including the creation of a hypothetical listener,
provides Offred with a sense of hope: “By telling you anything at all I’m at least believing
in you, I believe you’re there, I believe you into being. Because I’m telling you this story I
will your existence. I tell, therefore you are” (279). Karen Stein explains that in creating a
narrative, Offred is reclaiming her subjectivity: “To speak, to write, is to assert one’s
personhood, inscribe one’s subjectivity” (270). Similarly, Howells suggests Offred’s
storytelling is “her private act of resistance against the tyranny of Gilead which
condemns Handmaids not only to sexual slavery but also to silence” (“Dislocations” 10).
The fact that Offred’s narrative is recorded orally is significant because while all women
(with the exception of the Aunts) are forbidden to read or write in Gilead, the Handmaids
also have restrictions placed on their speech. Their communication with other
Handmaids is supposed to be limited to set sayings such as “Blessed be the fruit” and
“Praise be” (29). At the Red Centre one of the Beatitudes played is “Blessed are the
silent” (100). Conversations with others in the regime are largely restricted to replying
when spoken to first.
Besides indicating that Offred did indeed escape the Commander’s household, even
for a short period of time, the Notes section of the novel serves a number of other
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important functions. Annette Kolodny refers to it as “an inspired device” providing
Atwood with “a mechanism for offering information to which her first-person narrator
could not have had access” (46). Through the Notes we hear how the elite of the
Republic of Gilead took part in the Sons of Jacob Think Tanks, where the “philosophy
and social structure of Gilead were hammered out” (318). We also are given information
on the origins of some of ceremonies central to the regime such as the Particicution and
Salvaging and how the Aunts were named after commercial products. The details of the
two possible identities of Offred’s Commander serve as a reminder of his prominence, a
fact that Offred suspects but is never able to truly determine: “I don’t know what he’s a
Commander of” (195).
The Notes section also demonstrates that although the Republic of Gilead has been
overcome, some of its ideologies still remain in 2195. Patrick Murphy comments: “The
most serious point raised about the present in terms of the future, not that of Gilead but
of the liberal post-Gilead culture, is how little has been learned” (34). The Chair of the
conference is Professor Maryann Crescent Moon. Together with another conference
delegate, Professor Johnny Running Dog, her position suggests native Americans have
reached senior appointments in academia. However, with the introduction of the keynote
speaker, Professor James Darcy Pieixoto of Cambridge University, it becomes clear that
these developments may only be superficial. Marlene Dolitsky points out: “in spite of
these enormous changes […] there will always be an England, with Oxbridge as the
jewel in the crown of academia” (122). Sharon Rose Wilson comments: “Although more
racially and ethnically diverse, however, the societies represented by the scholars still
appear to be colonialist and sexist” (“Beyond Colonization” 129). Pieixoto opens his
paper with a sexist joke involving the Chair: “we all enjoyed our charming Arctic Char
last night at dinner, and now we are enjoying an equally charming Arctic Chair” (312).
This pun is followed by another concerning the title of the manuscript under question,
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The Handmaid’s Tale. We discover the term ‘tale’ was chosen not only in homage to
Geoffrey Chaucer but also in reference to the “archaic vulgar signification of the word
tail” (313).
Pieixoto’s main line of investigation concerning the recovered tapes involves trying
to establish the identity of the Commander ‘Fred’. He declares that tracking the narrator
by her name is useless because “[s]he does not see fit to supply us with her original
name” (318). His comment not only displays a lack of awareness of the dangers this
would have posed if the tapes got into the wrong hands, but also highlights his poor
analytical skills. Foley states that “even in one of the temples of liberal democracy,
namely the Western university, the deeply rooted sexual, racial or other biases of
academics can anesthetize their critical faculties” (44). Offred does in fact provide her
real name disguised among a list of original names whispered back and forth at the Red
Centre: “Alma. Janine. Dolores. Moira, June” (14). Of the names included, the only
woman that is not referred to in Offred’s narrative is June, suggesting this is her real
name (or at least an alias). Pieixoto and his colleague overlook this evidence because
their interest is not in the narrator’s identity but in her Commander’s. In addition,
Pieixoto’s inability to locate a woman named Serena Joy or Pam does not lead him to
question his theories on who the Commander is but rather, claim the name/s supplied by
Offred are “a somewhat malicious invention by our author” (321).
Macpherson suggests there are a number of discrepancies in Pieixoto and Wade’s
ordering of Offred’s narrative. Many involve Offred’s narratives about her college friend
and fellow Handmaid Moira. Macpherson asks why Offred would begin her first story of
Moira with the words: “Here is a different story, a better one. This is the story of what
happened to Moira”, when she knows the final outcome is not really favourable.
Similarly, when Offred tells of Moira’s escape from the Red Centre dressed as an Aunt
she states: “Moira didn’t reappear. She hasn’t yet” (143). Moira also tells Offred when
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they are together at Jezebels that she had her tubes tied, years ago. Macpherson asks
the question: “if Moira were indeed sterile, why was she sent to the Red Center in the
first place?” (188).
Lastly, the Notes section draws attention to the problems associated with privileging
only active forms of resistance. Professor Pieixoto’s paper discusses the two resistance
groups mentioned in Offred’s narrative, the Mayday underground and the Underground
Femaleroad. Despite the significance of the Underground Femaleroad to Offred’s story
(it is suggested that Offred was perhaps hidden in this group of safe houses after her
‘escape’) it is largely ignored in the research conducted by Professor Pieixoto and Wade.
Instead their focus is on the Mayday operations and the men involved. Pieixoto’s
trivialising of the Underground Femaleroad is furthered by his anecdote about how
“historical wags” have dubbed it the “Underground Frailroad” (313).
Professor Pieixoto laments the lack of information that Offred has left them, wishing
for “even twenty pages or so of printout from Waterford’s private computer” (322). This
attitude shows both an ignorance of Offred’s circumstances – obtaining and hiding
computer printouts would not have been easy as well as a distrust of oral history.
Pieixoto favours official documents over oral history which is often considered a feminine
source. He comments on the many gaps in the story and how they Offred could have
filled them, “had she had a different turn of mind” (322). Pieixoto trivialises the content of
her story as though the many details included are unimportant and uninteresting. Her
story is not valued for itself, but for the small pieces of information it provides about the
elite men in Gilead. This is reflected in Pieixoto’s sarcastic comment: “However, we must
be grateful for any crumbs the Goddess of History has designed to vouchsafe us” (322).
The Handmaid’s Tale engages with an important debate in the women’s health
movement, the use of assisted reproductive technologies (ARTs). Atwood utilises the
popular genre of science-fiction to draw attention to the disturbing similarities between
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the views of radical proponents of the women’s movement and those of the New Right.
Gilead’s reproductive brothel does not result from modern medicine’s use of ARTs to
usurp women’s reproductive role, but the adoption of radical feminist arguments
celebrating this role. Initially Gilead appears to exemplify Foucault’s earlier concept of
‘power is everywhere’ and, therefore, inescapable. The depiction of both collective and
individual acts of defiance, however, is a reference to Foucault’s later model of power
which recognises the role of resistance. Offred occupies a victim Position Three,
deciding what of her position is possible to change. Through her exploration of
resistance in The Handmaid’s Tale, Atwood rejects the notion that women who
participate in ARTs are passive dupes.
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PART THREE: Preface
As the women’s movement’s advocacy around issues such as abortion and birthing
practices was successful in bringing about change, the focus shifted to other topics. One
of the areas of inquiry was women’s weight. Many women it seemed became dissatisfied
with their body size and shape as they failed to achieve the feminine ideal of thin and
beautiful. Writers like Kim Chernin and Susie Orbach contended that the abundance of
images of thin women in the mass media, advertising and beauty and fashion industries
made women who did not conform to this ideal feel inadequate. As a result, women
resorted to dieting and other forms of body modification.
The potential danger associated with this pursuit of thinness was portrayed most
graphically in the emaciated figure of the anorexic, someone whose dieting had spiralled
out of control. Women who diet or develop an eating disorder, therefore, are depicted as
mindless readers, passively consuming the images of women in magazines, on the
television, in films and on the catwalk. In the case of the anorexic, this reading practice is
not just passive but also disordered. The anorexic is inherently more susceptible to
images and will stop at nothing in her pursuit of the thin ideal.
Women’s willingness to conform to the thin ideal has been analysed by feminist
scholars as an example of Foucault’s concept of self-surveillance. Faced with the thin
images of women’s bodies perpetuated in society, women turn the inspecting gaze to
their own bodies. Self-surveillance leads women to modify their bodies in a number of
ways including weight loss, the use of beauty products and cosmetic surgery. Sandra
Lee Bartky explains: “The woman who checks her makeup half a dozen times a day to
see if her foundation has caked or her mascara has run […] who, feeling fat, monitors
everything she eats, has become, just as surely as the inmate of the Panopticon, a selfpolicing subject, a self committed to a relentless self-surveillance” (81). The anorexic is
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seen as someone who has taken self-surveillance and the pursuit of thinness to the
extreme.
While the mass media, advertising, fashion and beauty industries are no doubt
influential, to suggest they are the primary cause of eating disorders in women appears
overly simplistic. A growing body of work by feminist media scholars suggests that such
an argument suffers from the same limitation as the notion that women are coerced into
a medically managed birth or into using IVF; it portrays women as dupes with no sense
of agency. It also takes for granted that the different institutions are unified in their
presentation of unrealistic images and narratives, that there are no variations or
alternatives shown. Finally, the notion that women are disordered readers fails to
consider their ability to resist or challenge the portrayal of images of thin women.
In keeping with her victim position theme, Atwood challenges the notion of women
as disordered readers in, arguably, one of her most comic novels, The Edible Woman.
In this way, Atwood moves from the concept of self-surveillance which informs Chernin
and Orbach’s discussions of women’s weight to Foucault’s later discussions of power
which acknowledge the possibility of resistance. Atwood shares with writers like Susan
Bordo, Elspeth Probyn and Abigail Bray, in the recognition that the anorexic’s body is a
site of protest rather than the passive conformity to a thin ideal.
The protagonist Marian’s job in a market research company makes her an expert in
the construction and interpretation of images. She is, therefore, far from a passive
consumer of what she reads and views in her society. Her disordered eating, which at
times closely resembles aspects of anorexia nervosa, is not the result of an over
consumption of thin images but is a non-verbal means of protest against a particular
type of femininity. Disordered eating allows Marian to shore up her body’s boundaries
against the threat of the abject, symbolised in the novel by the mature (fat) body and the
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maternal body. Marian refuses to be a fated victim of Position Two, but is instead making
decisions about how much of her situation can be changed (Position Three).
The obese woman is also portrayed as someone who suffers from society’s
obsession with feminine thinness. Her larger than life size results in both her ridicule and
also her invisibility, particularly as a sexual being. Efforts to attain the ideal through
dieting are unsuccessful and unachievable as the ideal gets progressively thinner. While
Orbach’s Fat is a Feminist Issue initially discusses fatness as a means of protest it
ultimately rejects this as a suitable strategy for women. Instead Orbach advocates for
women to locate their inner (thin) self.
In Lady Oracle, Atwood opposes the notion that the real self is thin through the
protagonist, Joan. Unlike in The Edible Woman, where fat is abject, in the Lady Oracle
fat takes on a new meaning. Excessive fatness, like the anorexic body, becomes a way
of escaping the traditional, feminine role. Joan deliberately increases her weight as a
way of rebelling against the life her mother has planned for her. While weight loss brings
financial independence, Joan mourns her lost fat self. Atwood draws on the Rabelaisian
grotesque body, as discussed by Bakhtin, to demonstrate the transgressive potential of
being fat. Joan’s creation of new identities, including that of Costume Gothic writer,
allows her to overcome the feelings of being diminished that weight loss produced.
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PART THREE: ‘SCREW My Femininity’: Disordered Eating in The
Edible Woman
Margaret Atwood’s The Edible Woman was originally written in the spring and summer
of 1965, “on empty examination booklets filched from the University of British Columbia”
(Atwood, The Edible Woman 7). The manuscript was mislaid by a publisher for two
years and was eventually published in 1969. The novel, therefore, significantly predates
the ‘epidemic’ of anorexia nervosa of the 1980s and 1990s. Despite obvious differences
between the protagonist’s behaviour and the experiences of anorectic women, The
Edible Woman provides a useful critique of the ‘disordered reading’ approach to
anorexia nervosa. The Edible Woman challenges the notion that anorexia nervosa is the
result of young women losing control of their attempts to emulate the thin ideals
presented in the mass media, advertising and the fashion and beauty industries.
Anorexia nervosa was first identified by William Gull in 1873 111 . While it must be
recognised that the disorder Gull identified differs from that afflicting young women in the
last few decades 112 , elements of his work are influential in the representation of today’s
anorexic. Gull believed recovery from anorexia nervosa was as simple as eating
regularly. Patients who did not comply with the basic treatment of nourishment were,
therefore, considered willful and difficult. Erin O’Connor explains how Gull equated
weight loss with “the loss of good nature” (559). Gull describes one of his anorexic
patients, previously a “good-natured little girl”, as “most loquacious and obstinate” (27).
The anorexic patient, therefore, was seen as not only lacking in her appetite but also in
111Gull read two cases of anorexia nervosa to the Clinical Society of London in 1873, with the paper being published the
following year in Transactions of the Clinical Society of London. At a similar time, French physician, Charles Lasègue
published a paper, “On hysterical anorexia” in the Medical Times and Gazette, September 1873 (O’Connor 535, 541). For
a further discussion of Gull and Lasègue’s work see MacSween 13-16; and Vandereycken and Van Deth 153-161.
112 Both Ellmann and MacSween warn against too closely linking cases of self-starvation today with self-starvation in the
past (5; 4). Ellmann explains: “the meanings of starvation differ so profoundly according to the social contexts in which it is
endured” (4).
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moral qualities. This is reflected in Gull’s treatment recommendations for his patients:
“should be fed at regular intervals, and surrounded by persons who would have moral
control over them” (26).
Gull’s positioning of anorexia nervosa as a loss of moral qualities that can be
overcome with appropriate guidance shares some similarities with today’s approaches to
eating disorders. The behavioural model, which forms the basis of some hospital
treatments for anorexia nervosa, follows the somewhat simplistic approach of eating =
weight gain = cure. The behavioural model works on the principle that anorexia nervosa
is a learned response and, therefore, can be ‘unlearned’ (MacSween 24). Marilyn Duker
and Roger Slade state: “links are reinforced between the stimulus of particular situations
and specific responses by the individual. In therapy undesirable links may be
extinguished” (69). Treatment involves an extremely intensive and structured program in
which patients are rewarded for gaining a specific weight. Failure to eat meals (and,
therefore, reach a desired weight) and other ‘inappropriate’ behaviour like compulsive
exercising results in a loss of privileges such as phone calls or watching television. The
constant surveillance employed in such treatment programs positions the anorexic as
childlike and willful 113 .
The medical approach also views the disorder as a malfunction at the level of the
individual through its search for an organic cause for anorexia nervosa. While proposed
causal theories are numerous, levels of chemicals in the body and the brain, brain
patterns and genetic predisposition have been the primary focuses (Russell 224) 114 .
Some practitioners argue that chemical imbalances trigger the actual development of
anorexia nervosa, while others suggest that starvation in turn causes imbalances which
113Such representations are characteristic of A Current Affair’s coverage of Bronte, arguably Australia’s most famous
anorexic. Much of Bronte’s story involves her depiction as childlike, throwing tantrums, playing with her food (hiding it up
her sleeves or down her bra) and generally being the source of disruption to the rest of the household (“Bronte’s Story”).
114 For a review of evidence into a genetic predisposition to eating disorders see Bulik.
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disturb thought patterns (MacSween 35-36). Treatment, therefore, tends to centre on refeeding as a means of establishing normal thought patterns and the use of medications
like selective serotonin reuptake inhibitors (SSRIs) 115 , in combination with psychological
treatment.
Feminist perspectives on anorexia nervosa rightfully suggest that as approximately
90% of sufferers of anorexia nervosa are women, there is a need to examine the role of
gender in the condition. Simply re-establishing a person’s weight and biochemical
balance does not address women’s relationship with food and their bodies. Feminist
approaches examine women’s representation in society and how this may impact on
women’s affliction with conditions like eating disorders. A key feature of feminist
perspectives is the use of historical examples of female figures featured in the mass
media and other discourses to document the shift to a thin feminine ideal. The
voluptuous curves of 60s icon Marilyn Monroe, a size 14, are contrasted to the waif look
made popular in the 1990s by supermodel Kate Moss. Orbach comments: “Since the
1960s women’s bodies – as reflected in fashion magazines, glamorous serials on
television and the media in all its forms – have been getting slimmer and slimmer and
slimmer” (Hunger Strike 52).
It is argued that equating slenderness with beauty and desirability pressures women
to achieve the thin ideal. For many women this body shape will only come through
dieting. The body however, responds to a reduction in kilojoules by slowing its
metabolism, making the maintenance of a new, trim figure difficult. Failing to lose weight
or keep lost weight from returning can result in women developing a low self-esteem and
poor body image. Feminists argue it is from this world of obsessive dieting and body
115 A recent Cochrane review article reported limited evidence to support the use of anti-depressants like SSRIs in the
treatment of anorexia nervosa. This may influence the future treatment of the disease (Claudino et al).
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dissatisfaction that the anorexic is created. Wolf explains: “The weight-loss cult recruits
women from an early age, and eating diseases are the cult’s bequest” (The Beauty Myth
148).
While many women diet, only a very small percentage develop an eating disorder.
Despite the focus on society’s role in eating disorders, the feminist argument, therefore,
also tends to place some of the blame or deficiency with the individual. This provides an
explanation as to why, if the pressure to be thin is so persuasive, some dieting women
turn anorexic while others do not. As Orbach explains: “it is the dramatic nature of their
response to the call for slimness which marks out the anorectic from other women”
(Hunger Strike 66). Orbach’s statement clearly defines the anorexic as being ‘different’
from other women. The ‘diet gone wrong approach’ to anorexia nervosa constructs the
anorexic as someone who is incapable of managing her dieting. She is not able to
determine when she has lost enough weight and, therefore, when she should stop the
diet 116 . As Susan Bordo clarifies: “The prevailing understanding is that culture provokes,
exacerbates, and gives distinctive form to an already existing pathological condition of
some sort” (“Eating Disorders” 197).
The notion that the anorexic is unable to read her body’s weight is most strikingly
portrayed in a particular symptom of anorexia nervosa, body image distortion. As Bordo
notes the symptom, characterised by an inability to realistically determine one’s own
body size, has captured the attention of both popular and medical discourses of anorexia
nervosa. This “perceptual defect” (Bordo, “Eating Disorders” 200), is often illustrated by
getting the anorexic to select their body size from a series of line drawings or pictures.
The anorexic typically chooses a much larger figure than that of her emaciated body.
116 The anorexic as deficient dieter is a feature of much of the popular discourses on anorexia nervosa. An article in the
women’s magazine Cosmopolitan carries the abstract, “Forget exams. These days the most frightening thing that’s
happening in schools is the number of girls on diets that can lead to death” (Brooks 19).
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The emphasis placed on this characteristic of anorexia nervosa functions “to emphasize
the discontinuity between anorexic and “normal” attitudes towards weight and bodyimage” (Bordo, “Eating Disorders” 200).
A related aspect is the notion that the anorexic is inherently more susceptible to the
thin ideals portrayed in society. The anorexic’s response to thin women in the movies or
pages of magazines is somehow deeper. Orbach, for example, claims “[t]he anorectic
woman appears to show enormous receptivity to culturally sanctioned messages about
physical femininity” (Hunger Strike 129). The anorexic’s disturbed consumption of
images, therefore, is said to lead to her disturbed consumption of food.
Historically, the reading practices of women have often been subject to scrutiny and
regulation. The entry of increasing numbers of middle class women into college
education created a further concern. Those opposed claimed that higher education
would have a detrimental effect on women’s reproductive abilities. Ehrenreich and
English discuss how the medical establishment assumed that “[e]ach body contained a
set quantity of energy […] Thus there was inevitably a tension between the different
functions, or organs – one could be developed only at the expense of the others” (For
Her Own Good 126). ‘Brain dominated’ women lost their feminine characteristics
becoming muscular, angular and even losing their breasts (Ehrenreich and English, For
Her Own Good 129).
Kate Flint’s The Woman Reader details how in the nineteenth and early twentieth
centuries women were thought to be susceptible to the content of reading matter. The
rise in the popularity of the novel heightened the anxiety surrounding what women were
reading. Of particular concern were French, romance and sensation fiction and later the
‘new woman’ fiction. Flint details the proliferation of advice manuals instructing adult
women on not only what to read but how to read it (91).
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The theory that anorexia nervosa arises from the passive consumption of mass
media images continues the tradition of misgivings about women’s ability to ‘read’.
Abigail Bray and Claire Colebrook discuss how such an approach “sustains a Cartesian
anxiety about the corruption of mind by an alien matter” (53). In addition, the deficient
reader approach to anorexia nervosa relies on a portrayal of the female reader as naïve
and passive. Both Bray and Elspeth Probyn comment on how research into television
violence centres on its potential impact on women and children (Bray 421; Probyn, “The
Anorexic Body” 203). The research reflects a general attitude that women are as
impressionable and vulnerable to these media images as a small child. As Bray
suggests, the ability of women to “resist media interpellation” is devalued (420).
Alternative feminist perspectives on anorexia nervosa question whether the illness is
about achieving the thin ideal at all. They suggest anorexia nervosa is in fact a protest
against women’s role in society. Bordo explores in anorexia nervosa “the dimension of
protest against the limitations of the ideal of female domesticity […] that reigned in
America throughout the 1950s and early 1960s” (Unbearable Weight 159). She also
acknowledges, however, that such a protest can be seen as reinforcing the very cultural
norms it sets out to question: “Paradoxically – and often tragically – these pathologies of
female protest […] actually function as if in collusion with the cultural conditions that
produced them” (Unbearable Weight 159). Rebecca Lester also comments on the
complexities in women using anorexia nervosa as a means of protest: “thinness in
American culture is overdetermined and carries multiple significances. Women cannot
simply make thinness mean whatever they want it to mean” (487). Bordo concludes that
“[a]s a feminist protest, the obsession with slenderness is hopelessly counterproductive”
(Unbearable Weight 160).
While the limitations of anorexia nervosa as a form of protest must be recognised
(anorexia nervosa can lead to serious health problems and even death), dismissing it as
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hopelessly counterproductive also risks positioning patriarchy as a monolithic force that
cannot be challenged. Such an argument is reminiscent of Atwood’s Two Position, in
which any rebellion is deemed “foolish” (Survival 37). Dismissing anorexia as a valid
means of protest also involves privileging certain forms of resistance over others.
Anorexia, a non-verbal protest which takes place at the site of the body is not thought of
as being an effective strategy.
The Edible Woman challenges a number of theories surrounding anorexia nervosa.
The protagonist Marian McAlpin 117 displays a number of characteristics similar to the
illness, including decreased food intake and associated weight loss, phobic fear of fat
and a desire to prepare food for others 118 . However, a significant difference between
Marian and women with anorexia nervosa is found in the ease with which she returns to
eating. Although she finds eating her first mouthful of food “odd” she concludes it is
“most pleasant to be actually tasting and chewing and swallowing again” (272). Marian’s
return to eating is so swift she is even able to eat a steak for lunch within a few days.
Her seemingly unproblematic resumption of eating is markedly different to the
experience of the majority of women with anorexia nervosa. It is, therefore, more
accurate to refer to Marian’s relationship with food as ‘disordered eating’ 119 rather than
anorexia nervosa as this avoids the implication that recovery from anorexia nervosa is
simplistic and, that all eating problems are associated with anorexia nervosa.
117 Two spellings of Marian’s surname appear in the novel, McAlpin and MacAlpin. The spelling McAlpin will be used
here as it is the one favoured by most critics.
118 Cameron’s article also examines the similarities between Marian’s symptoms and anorexia nervosa. Her account
relies heavily on the theory that family relationships, characterised by enmeshment (unclear of fluctuating boundaries), are
a significant contributing factor to the illness. The enmeshment theory, however, is not one supported by the novel as
Marian’s childhood and family life are only briefly referred to. Similarly, Howells’ suggestion that Marian “has no phobic
fear of fat and she suffers no weight loss” (Margaret Atwood 46) ignores a number of instances which suggest otherwise.
119 This term is taken from Furst and Graham’s Disorderly Eaters: Texts in Self Empowerment.
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Marian’s disturbed relationship with food begins with her inability to finish a rare
piece of steak. The following day she is unable to eat pork chops and in the next few
weeks she discovers “not only were things too obviously cut from Planned Cow inedible
for her, but also the Planned Pig and the Planned Sheep were similarly forbidden” (152).
She is also afraid to try chicken due to its “unpleasantly complete skeletal structure”
(153). Gradually, Marian’s list of allowable foods diminishes until she is able to eat
nothing at all.
The strategies Marian employs to avoid eating are textbook examples of how
anorexics hide their non-eating from others. When organising a dinner party for friends,
Marian plans a menu that will allow her eating habits to go unnoticed. She settles on a
mushroom-and-meatball casserole, “which would disguise things effectively” by allowing
her to “dish herself a very small helping, eat the mushrooms, and roll the meat balls
under one of the lettuce leaves” (177). When presented with meat shishkebabs at a
dinner party Marian considers hiding them under the tablecloth, in her purse, down the
front of her blouse or up her sleeves. Eventually she scrapes the sauce off the meat
chunks and tosses them across the table to her friend Duncan. Marian’s behaviour
shows remarkable similarities to Orbach’s description of how anorexics avoid eating in
the company of others: “She hides the food on her plate under the lettuce leaves […]
Sometimes it is dropped into a convenient handbag or receptacle of some kind situated
on her lap. She becomes extremely adept at flicking food here and there” (93).
Marian also develops the characteristic paradoxical relationship to food, in which
she enjoys preparing food for others but restricts her own intake. Orbach explains how
the anorexic “shows concern for the food needs of those close to her” (82). When an old
college friend, Len Shank, rings Marian before coming over to her apartment she is
engrossed in her “largest cookbook” (152). Upon his arrival she asks him if he wants
anything to eat: “She wanted to prepare something for him, if only a bacon-and-tomato
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sandwich” (155). Marian observes how “[e]ver since her own relation to food had
become ambiguous she found she took a perverse delight in watching other people eat”
(155). Marian also begins to day-dream about food: “a fleeting vision of a large globular
pastry, decorated with whipped cream and maraschino cherries, floating suspended in
the air above Joe’s head” (235). The entire novel is permeated by food metaphors.
Women’s hair is described as “the colour of a metal refrigerator-tray” (20) and “a delicate
pear-pale yellow” (236), a chair cover is said to be “egg-yolk yellow” (75), dust, “like
chunks of mouldy bread” (76) and a person’s face, “the flat whitish-grey colour of
uncooked piecrust” (235).
While Marian herself states that “she hadn't really lost much weight” (221), her
weight loss is suggested by a saleswoman persuading her to buy a corset to wear with
her party dress: ‘“Of course you're very thin dear, you don't really need one”’ (221). J.
Brooks Bouson suggests that Marian’s thinness is actually figured in Duncan’s “long
famished body” (“The Anxiety of Being Influenced” 233). Duncan, an English graduate
student Marian meets while conducting a survey for work, functions as her double
throughout the novel 120 . When Marian puts on Duncan’s grey dressing gown, he
comments, ‘“you look sort of like me in that”’ (144). Portrayals of Duncan’s body,
therefore, can be seen as reflections of Marian’s weight loss. Duncan is described as
“cadaverously thin” with ribs that “stuck out like those of an emaciated figure in a
medieval woodcut” (48). He is also likened to “a starved buddha” (51) and as having the
“gaunt shape of a starved animal in time of famine” (171). Marian wonders “how anyone
could be that thin and still remain alive” (144). Duncan also shares in Marian’s disturbed
120 Other critics that comment on Duncan being Marian’s double include Greene, “Marian’s double, representing the side
she has repressed in the interests of “normalcy” (“Margaret Atwood’s The Edible Woman” 108) and Stow who describes
Duncan as a “doppelgänger or dark twin” (100).
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relationship with food, ‘“I’ve always thought eating was a ridiculous activity anyway. I’d
get out of it myself if I could’” (192).
Marian’s weight loss is also hinted at through similarities between herself and the
mummies in the Egyptian room at the Museum. The description of a mummy, “still
covered in places with skin, lying on its side with its knees drawn up” (188) is
reminiscent of the foetal position Marian’s assumes when she is in bed with Duncan:
“She sank back, still with the sheet clutched around her and her knees drawn up” (254).
Similarly, the appearance of her eye make-up for Peter’s party, “egyptian-lidded and
outlined” (222), is a reminder of the “stylized eyes, edged with dark-blue lines” (186) of
one of the Egyptian mummies.
Marian also shares the anorexic’s phobic fear of fat. At the Christmas party of
Seymour Surveys, the market research company where Marian works, she ponders the
meaning of the word mature: “You were green and then you ripened: became mature.
Dresses for the mature figure. In other words, fat” (166). The gathering gives Marian the
opportunity to study the bodies of her older female colleagues:
she could see the roll of fat pushed up across Mrs. Gundridge’s back by the top
of her corset, the ham-like bulge of thigh, the creases round the neck, the large
porous cheeks […] one plump crossed leg, the way her jowls jellied when she
chewed […] and the others too, similar in structure but with varying proportions
and textures of bumpy permanents and dune-like contours of breast and waist
and hip. (167)
Marian is repulsed by the women’s bodies and also by the realisation that her body is
well on its way to becoming like theirs: “she was one of them, her body the same,
identical, merged with that other flesh that choked the air in the flowered room with its
sweet organic scent; she felt suffocated by this thick sargasso-sea of femininity” (167).
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While Marian displays many symptoms of anorexia nervosa, her disordered eating
does not conform to the various causal theories on the illness. Psychological theories
are parodied in the novel, primarily through the character of Ainsley, Marian’s
psychology-major flatmate. Ainsley is described as being fond of “paper-back books by
anthropologists about primitive cultures” (41). The topics on which Ainsley offers her
psychological interpretations are often ridiculous, therefore, questioning the relevance or
validity of such approaches. For example, she theorises that people in Quebec are
constipated due to their “collective guilt complex” or because of “the strain of the
language-problem” (23) 121 . Marian avoids telling Ainsley about her eating problem
because she knows Ainsley would put it down to “some traumatic experience in her
childhood” (204). The inadequacy of such an explanation is humorously demonstrated in
Len’s response to the news of Ainsley’s pregnancy and his impending fatherhood. He
becomes “hysterical” (160), recalling an incident when as a child, his mother made him
eat a boiled egg that he believed contained a baby chicken.
Behavioural model theories are shown as being equally irrelevant. Ainsley explains
to Marian how behaviourists “could cure diseases like alcoholism and homosexuality, if
the patients really wanted to be cured, by showing them images associated with their
sickness and then giving them a drug that stopped their breathing” (204). Ainsley’s
explanation reveals how such an approach pathologises behaviours considered morally
unacceptable (homosexuality) and places the responsibility of getting well back onto the
individual (“if the patients really wanted to be cured”). Ainsley’s admission that patients
often switch their addiction or “commit suicide” (204) raises more doubts about the
suitability of behavioural based treatments.
121 Ainsley also makes Peter, Marian’s boyfriend, endure a “theoretical speech about liberating the Id” at their first
meeting (67).
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In addition to examining psychological theories, The Edible Woman also challenges
the notion that women’s deficient reading practices contribute to disordered eating. The
society in which Marian lives is still clearly suspicious of women’s participation in
‘reading’, namely through higher education. Marian’s own parents are decidedly relieved
when she gets engaged, “as though their fears about the effects of her university
education, never stated but always apparent had been calmed at last” (174). Their fears
are presumably that a college education may have resulted in following a career rather
getting married and having children.
Marian’s reading practices are, however, far from ‘disordered’ or ‘deficient’. As an
employee of a market research company, Marian is in a unique position to understand
the way mass media images, particularly those used in advertising campaigns, function.
She is well aware of the artificiality of images and the tricks used to try to make a
product appeal to the consumer. Marian’s knowledge means she is far from being a
docile and passive ‘reader’. The significance of other aspects of Marian’s life also brings
into question the importance placed on the role of the mass media in influencing
behaviours.
The first indication that Marian’s job provides her with unique insights is her
involvement with pre-testing a phone survey for Moose Beer. Marian admires the
subtlety of the phrase ‘just old-fashioned relaxing’ used in the commercial. She notes the
phrase is used “so the average beer-drinker, the slope-shouldered pot-bellied kind,
would be able to feel a mystical identity with the plaid-jacketed sportsman shown in the
pictures” (26). When she conducts the pre-test on her long weekend, one of her
respondents is Duncan. Duncan’s answers to the free association part of the
questionnaire are so bizarre Marian contemplates what would happen if they were run
through the IBM computer back at work. For Duncan, the phrase ‘healthy hearty taste’
brings to mind a Grimm fairytale in which a husband kills his wife’s lover, baking the
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heart into a pie. Similarly, ‘long, cool swallow’ is ‘“a bird, white, falling from a great
height. Shot through the heart, in winter’” (52). The originality and individuality of
Duncan’s answers question the notion that people are simply passive consumers of the
mass media. Although he confesses that his answers have been contrived to liven up
Marian’s day and to relieve his own boredom, they show how different people respond to
images or descriptions in different ways. Duncan’s answers are vastly different to those
of an earlier participant who “gave the sort of enthusiastic response for which a whole
seminary of admen had no doubt been offering daily prayers” (47). Marian’s reaction to
this participant’s answers shows her awareness of what the admen are trying to achieve
by the various phrases in the Moose Beer advertisement.
Marian’s work at Seymour Survey also provides her with an awareness of the
artificiality of images used in advertising. When she sees the print advertisements for
Moose Beer she recognises that the photographs have been manipulated to avoid
anything considered ‘upsetting’: “The fisherman wading in the stream, scooping the trout
into his net, was too tidy […] the fish also was unreal; it had no slime, no teeth, no smell;
it was a clever toy, metal and enamel” (150). Marian’s perceptiveness demonstrates how
she would be unlikely to miss the artificiality of the thin women portrayed in different
discourses. She would both realise that such thin women are a small minority in society
and the photographic tricks used to make people look slimmer and younger.
Marian’s awareness of concepts used in marketing is most evident in her trip to the
supermarket to buy groceries. The sequence satirises Vance Packard’s The Hidden
Persuaders and its discussion of the shopping habits of housewives. According to
Packard a study of the eye-blink rates of female supermarket shoppers found they went
“down and down, to a very subnormal fourteen blinks a minute […] a hypnoidal trance
[…] the first stage of hypnosis” (93). The hypnosis similarities continue with Packard
declaring: “a good package design should hypnotize the woman like a flashlight waved
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in front of her eyes” (94). Marian explains that “if she wasn’t careful” she was also at risk
of falling into a trance, “pushing the cart like a somnambulist, eyes fixed, swaying
slightly, her hands twitching with the impulse to reach out and grab anything with a bright
label” (172). She is also suspicious of the music played in the supermarket: “She
resented the music because she knew why it was there: it was supposed to lull you into
a euphoric trance, lower your sales resistance to the point at which all things are
desirable […] she remembered an article she had read about cows who gave more milk
when sweet music was played to them” (172).
Unlike the female shoppers Packard describes who reach the check-out with little
recognition of what they have selected, “the women did not have enough money to pay
for all the nice things they had put in the cart” (94), Marian resists the supermarket’s
marketing strategies. She defends herself with a carefully prepared shopping list with
items printed in block letters. Armed with the list she is able to “buy nothing, however
deceptively-priced or subliminally-packaged, except what was written there” (172). When
she feels particularly susceptible to the supermarket’s strategies she uses a pencil to tick
off the individual items in turn.
Interestingly, Packard identifies the demise of shopping list writing as one of the
reasons why housewives buy more: “the mid century shopper doesn’t bother to make a
list or at least not a complete list of what she needs to buy” (92). Marian’s list appears to
be an effective strategy as she appears to only purchase the included items. She does
not, for example, buy three cans of pineapple for sixty-five cents. This is despite the sign
advertising the pineapple being displayed adjacent to a promotional poster for a store
competition to win a free weekend trip to Hawaii. Marian even declines to enter the
competition, seeing through the prize as a simple attempt by the supermarket to lure
more customers.
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Marian is also aware that there is “no real difference” (173) between brands of a
product. This knowledge allows her to analyse why she chooses certain brands over
others: “maybe it had something to do with the pituitary gland. Which detergent had the
best power-symbol? Which tomato juice can had the sexiest-looking tomato on it”(173).
Marian’s careful consideration of her choice of products demonstrates her interpretative
skills and further problematises the notion that women passively respond to images they
are confronted with.
Marian’s comments concerning an advertisement on the bus for girdles also
suggests that she is not by any means alone in her perceptiveness: “I wondered for the
first few blocks what sort of person would have enough response to that advertisement
to go and buy the object in question […] perhaps the purchasers thought they were
getting their own youth and slenderness back in the package” (93). Marian’s thoughts on
who possibly might respond to such an advertisement implies that many women will not
respond in the way the advertisement intends them to. It is, therefore, not only women
who work in market research companies that have the skills to ‘read’ the images they
are presented with in society.
Marian’s work at Seymour Surveys also challenges the idea that only women are
susceptible to images. The Moose Beer Survey that Marian pre-tests indicates that men
are also the subject of advertising campaigns using artificial images and promising
improvements (in this case the beer promises to make men more masculine). Marian’s
boyfriend, Peter’s sexual fantasies are shown to be influenced by popular men’s
magazines. Marian puts the sex she has with Peter in a field down to “a hunting story
from one of the outdoorsy male magazines” and the sex on a sheepskin rug to “one of
the men’s glossies, the kind with lust in pent-houses” (60). Her thoughts on why Peter
feels the need for these sexual escapades is similar to her thoughts on why a woman
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would respond to the girdle ad: “Perhaps an attempt to assert youthfulness and
spontaneity” (60).
Marian’s disordered eating, therefore, does not arise from the passive consumption
of images. As Bray explains, such a theory: “suggests that women only come to know
themselves through the media, ignoring the significance of work, sexual relationships or
motherhood as means to corporeal knowledge” (419). In Marian’s case her work, living
arrangements and relationships with friend Clara and boyfriend Peter all play a role in
her disordered eating. As Cameron argues, Marian’s job at Seymour Surveys and her
cohabitation with Ainsley are both situations where she finds she has limited control (50).
Although Marian has worked at Seymour Surveys for four months, she is unable to
clearly establish her role: “its limits are still vaguely defined” (19). While employed to
revise the wording of questionnaires she finds herself conducting pre-test interviews on
her long weekend, tasting canned rice pudding, answering letters of complaint and
handing out pretzels on street corners. It seems that college education has not
necessarily resulted in better job prospects for women (fellow graduate Ainsley, works
as a tester of defective toothbrushes).
Marian’s living arrangements with Ainsley are similarly characterised by a lack of
definition. Marian pays for half the scotch even though she never drinks much, conducts
all negotiations with the landlord and allows Ainsley to include her clothes when she
goes to the laundromat. Finally Marian is forced out of the apartment (and her own
bedroom) on the night of Ainsley’s seduction of Len: “She was beginning to feel
homeless and dispossessed” (121).
It is Marian’s friendship with Clara, however, that provides one of the most
significant contributing factors to her disordered eating. Clara is a friend of Marian’s from
school and is now the mother of two and seven months pregnant. Clara’s life is
represented as chaotic, restrictive and suffocating. When Marian leaves Clara’s house
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following a visit, she comments: “My skin felt stifled, as though I was enclosed in a layer
of moist dough” (37). For Marian, Clara provides a graphic representation of what life as
a wife and mother will be, one in which her individual identity is lost.
These fears are demonstrated in Marian’s descriptions of Clara’s pregnancy as
taking over her body. Clara’s pregnant body is referred to as a “boa-constrictor that has
swallowed a watermelon” (31), “a strange vegetable growth, a bulbous tuber” (32), a
“gigantic pumpkin-like growth that was enveloping her body” (114), and a “parasitic
growth, like galls on trees, or elephantiasis of the navel” (114). Marian also refers to
Clara as a “swollen mass of flesh with a tiny pinhead, a shape that had made her think of
a queen-ant, bulging with the burden of an entire society, a semi-person” (115).
The less than idyllic representations of maternity are shared by Clara herself:
‘“Never believe what they tell you about maternal instinct,’ she added grimly to us. ‘I
don’t see how anyone can love their children till they start to be human beings’” (33).
Clara describes her youngest child as a “little leech […] all covered with suckers, like an
octopus” (31). She also refers to her children as “barnacles encrusting a ship” (36) and
“limpets clinging to a rock” (36). Marian’s discomfort with her reproductive potential is
heightened when Ainsley decides she is going to have a child and raise it as a single
mother. Marian shows the first signs of her disordered eating following the evening
surrounded by Clara’s domestic life and Ainsley’s announcement: “I got into bed, feeling
unsettled” (43).
It is significant that Marian has such an extreme reaction to the pregnant body. The
pregnant body is a clear example of what Julia Kristeva refers to as the abject: “what
disturbs identity, system, order. What does not respect borders, positions, rules. The inbetween, the ambiguous, the composite” (4). The pregnant body challenges borders by
encompassing another self. The placenta connects the woman to the foetus, allowing
the exchange of both nutrients but also waste. As Barbara Creed explains, the womb
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“represents the utmost in abjection for it contains a new life form which will pass from
inside to outside bringing with it traces of its contamination – blood, afterbirth, faeces”
(49). Marian’s description of Clara being engulfed by her pregnancy reflects this
breakdown of borders.
Marian’s fear of the abject can also be seen in her uneasiness with bodily wastes.
Mary Douglas discusses how bodily wastes and, in particular, the body’s orifices
highlight the fluidity of the body: “We should expect the orifices of the body to symbolise
its specially vulnerable points. Matter issuing from them is marginal stuff of the most
obvious kind. Spittle, blood, milk, urine, faeces or tears by simply issuing force have
traversed the boundary of the body. So also have bodily parings, skin, nail, hair clippings
and sweat” (121). Bodily fluids and waste draw attention to the margins of the body and
the boundary between inside and outside.
While clearly both men and women produce waste matter, it is the bodies of women
that have come to be associated with fluidity. Elizabeth Grosz notes how the female
body has been constructed as “a leaking, uncontrollable, seeping liquid; as formless
flow; as viscosity, entrapping, secreting […] a formlessness that engulfs all form, a
disorder that threatens all order” (203). It is primarily women’s reproductive role that has
prompted such a construction.
Marian is clearly very uncomfortable with bodily fluids and waste and all they
represent. She admits to cleaning away the ring around the tub in the shared bathroom
after Ainsley has used it and is embarrassed by Clara’s children’s excrement when they
come to her apartment for dinner. She also dislikes the way Emmy, one of the ‘office
virgins’, constantly sheds bodily products, “her lipstick sloughs off in dry scales, she
sheds wispy blonde hairs and flakes of scalp on her shoulders and back; everywhere
she goes she leaves a trail of assorted shreds” (22). Marian glances “with distaste” (174)
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at the varieties of tissues and toilet papers in the supermarket, at the greasy print her
mouth leaves on a glass (230) and at the “waste-strewn trail” (255) of early breakfasters.
At the office Christmas party, she finds herself watching the other women eating:
“the continual flux between the outside and the inside, taking things in, giving them out,
chewing, words, potato-chips, burps, grease, hair, babies, milk, excrement, cookies,
vomit, coffee, tomato-juice, blood, tea, sweat, liquor, tears and garbage….” (167). This
passage reveals how Marian makes a connection between what the body takes in
(potato-chips, cookies, tomato-juice, tea, liquor) and what the body gives out in the form
of waste (burps, grease, hair, excrement, vomit, blood, sweat, tears and garbage).
Interestingly, ‘babies’ are also included in the list. As something that the body gives out,
they are associated with waste.
While watching the women, Marian begins to feel suffocated by “that liquid
amorphous other” (167). The use of the word ‘amorphous’ here is reminiscent of
Douglas’ discussion of viscosity: “The viscous is a state half-way between solid and
liquid. It is like a cross-section in the process of change. It is unstable but it does not
flow. It is soft, yielding and compressible […] Its stickiness is a trap, it clings like a leech;
it attacks the boundary between myself and it” (194) 122 .
Prior to the X-mas party, Marian explains she had thought of the women in her office
as being like the office furniture, “objects viewed as outline and surface only” (167). The
older women in the office such as Mrs. Grundridge and Mrs. Grot are always heavily
corseted, “their fluidity sustained somewhere within by bones” (167). The shared lunch,
122 Here Douglas is summarising Sartre’s “essay on stickiness” (Douglas 38). Sartre’s discussion of viscosity, or slimy as
he refers to it, is closely connected to the feminine. He states: “It is a soft, yielding action, a moist and feminine sucking”
(609). Marian also sees viscosity or the amorphous as feminine. She explains how “she wanted something solid, clear: a
man; she wanted Peter in the room so that she could put her hand out and hold on to him to keep from being sucked
down” (167).
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however, allows Marian the opportunity to view the women’s bodies differently 123 , to see
the previously disguised bulges of fat and to recognise their porousness.
Marian’s discomfort with the fluidity of women’s bodies is one shared by her collegefriend Len. When he discovers Ainsley is pregnant to him he is horrified: ‘“Birth,’ he said,
his voice higher and more distraught, ‘birth terrifies me. It’s revolting’” (157). His horror is
clearly associated with fluidity: ‘“Now I’m going to be all mentally tangled up in Birth.
Fecundity. Gestation. Don’t you realize what that will do to me? It’s obscene, that
horrible oozy….’” (159). Len also fears the polluting effects of the pregnant body, yelling
at an approaching Ainsley, ‘“Don’t come near me! […] You’re unclean!’” (160).
Like the pregnant body, food is also an example of Kristeva’s abject. When food is
consumed it enters the body, crossing the boundary between inside and outside. Food is
similar to the foetus in that it is part of the body, but also separate from it. Its inclusion in
the body is only temporary, eventually being expelled as waste. Lupton discusses how
the incorporation of food into the body is “inextricably linked to subjectivity” and,
therefore, can become “the source of great anxiety and risk” (Food, the Body and the
Self 17). Marian’s consumption of food in the beginning of the novel is uneventful. She
appears to eat food without giving it much thought. As Lupton explains, however, food
“becomes abject when it is ambiguous” (Food, The Body and the Self 113).
In addition to her friendship with pregnant Clara, Marian’s relationship with her
boyfriend Peter contributes to her growing apprehension about taking on the roles of
wife and mother. Peter is a “good-looking” (32) lawyer in his articling year, who lives in a
partly completed high rise apartment complex. At drinks with Peter, Len and Ainsley it
becomes obvious to Marian that her relationship has become more serious than she
123 Women’s bodies are similarly exposed in Cat’s Eye. Grace passes on information she gleans from having two older
sisters to Elaine and Cordelia. Elaine comments: “these bodies are revealed in their true, upsetting light: alien and bizarre,
hairy, squashy, monstrous” (93).
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thought. This realisation is accompanied by a feeling of panic and an urgent need to
escape. When the group leaves the bar Marian lets go of Peter’s arm and runs off into
the night 124 . After she is ‘recaptured’ by Peter they all return to Len’s apartment. With no
means of actual flight available, Marian ‘escapes’ by sliding underneath Len’s bed where
she becomes stuck and has to be rescued. Peter’s superior attitude angers her and she
decides to make her own way home. Her decision provides a hint of what is to come: “I
had broken out; from what, or into what, I didn’t know. Though I wasn’t at all certain why
I had been acting this way, I had at least acted” (78).
Marian is forced to abandon her defiant walk home when a storm brews, instead
accepting a lift in Peter’s car. Following an argument and a near accident, Peter asks
Marian to marry him and, surprisingly she accepts. Although at first Marian appears to
be conforming to convention by agreeing to the proposal, she is about to engage in an
alternative strategy of ‘escape’. Marian recognises the hopelessness of her previous
escape attempts involving running or hiding. These attempts were interpreted by others
as “hysterical” (74) and “nonsense” (80). Such “public” (72) demonstrations are
unacceptable, leaving Marian to turn to a private means of voicing her dissatisfaction
with the limited roles available to her. Marian will use self-starvation to gain the control
that eludes her in other aspects of her life and to reduce her reproductive potential.
By limiting what transgresses her body’s boundaries (food), Marian will reduce the
fluidity of her body. Her continued self-starvation will not only reduce bodily wastes but
also lead to the loss of menstruation. Lester argues:
an anorexic’s refusal of food allows her to solidify her physical boundaries, her
ideal to permit no substances to enter or leave her body […] She will be totally,
completely self-contained, a closed system […] Through a solidification of the
124 Interestingly, this is one of the few occasions in the novel where Marian appears extremely happy, grinning and
waving at others she sees on the streets (72).
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body boundary through fasting (and the accompanying physiological conditions
such as amenorrhea) the anorexic woman may literally redefine the boundaries
of the self. (486-7)
Marian’s use of disordered eating as a form of protest is reflected in a comment
from Duncan: ‘“you’re probably representative of modern youth, rebelling against the
system; though it isn’t considered orthodox to begin with the digestive system’” (192).
While Marian’s self-starvation is unorthodox, for her it is one of the few avenues left
available. The ‘system’ has made it difficult for her to legitimately refuse Peter’s marriage
proposal. After all he is good-looking and has wonderful career prospects. We are
reminded of Marian’s parents’ fears about her prospects as a college educated woman.
If she does not accept this proposal she may not receive a further one, leaving her a
maiden aunt.
The morning following her engagement, Marian comments that her mind was “at
first empty as though someone had scooped out the inside of my skull like a cantaloupe
and left me only the rind to think with” (83). When Peter turns up at the apartment
unannounced, already assuming impromptu visiting rights, Marian comments that he
sounds as though “he’d just bought a shiny new car. I gave him a tender chrome-plated
smile […] my mouth felt stiff and bright and somehow expensive” (88). When he asks
her about a wedding date Marian is astounded to hear her reply in a “soft flannelly voice
I barely recognized […] ‘I’d rather have you decide that. I’d rather leave the big decisions
up to you’” (90). It is on this morning that Marian also shows her first signs of hesitancy
toward food: “I was wondering whether I could face an egg” (83). Although she does
manage to eat her boiled egg, her description of it “sending out a white semi-congealed
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feeler like an exploring oyster” (84), previews her later fears of certain foods still being
alive 125 .
Marian’s engagement to Peter sees her increasingly objectified. She is obliged to
attend social occasions with Peter’s friends, including a lunch with lawyers where she
sits “the whole time silent and smiling” (176). Her suggestion that now “she had been
ringed he [Peter] took pride in displaying her”, sees her compared to a prized bull (176).
Eventually we find Marian posing as a coffee-table substitute 126 , “resting on her
stomach, eyes closed, an ashtray balanced in the hollow of her back where Peter had
set it” (203).
Marian’s changed circumstances are signalled by a switch in narration from first
person in Part One to third person in Part Two: “Marian was sitting listlessly at her desk”
(107). W.J. Keith argues that: “Marian has resolved to view her own actions from an
external perspective” (43). Similarly, Catherine McLay suggests “[h]er body is now seen
as external and can be observed from the outside by her mind; the two are no longer
parts of a unified self” (127). This is clear in a comment in Part Three which sees a
return to first person: “Now that I was thinking of myself in the first person singular again”
(278). Marian experiences her body as acting autonomously 127 : “Whatever it was that
had been making these decisions, not her mind certainly” (152), and: “She was
becoming more and more irritated by her body’s decision to reject certain foods. She
had tried to reason with it, had accused it of having frivolous whims, had coaxed it and
tempted it, but it was adamant; and if she used force it rebelled” (177-8).
125Several critics explore the significance of food and eating as a theme in Atwood’s other novels. See Parker; and
Sceats.
126Marian’s use a coffee table is a further similarity between her and Duncan. After inviting Duncan to Peter’s party she
begins to worry about how he may behave and pictures him sitting cross-legged in the centre of the room, “as though he
were a coffee table” (228).
127 Earlier incidences include her surprise “to find my feet moving, wondering how they had begun” (72) when she runs
from Peter outside the Park Plaza and her experience of her hand moving to touch Duncan in the cinema, “she noticed a
peculiar sensation in her left hand […] Its will seemed independent of her own” (125).
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Marian’s objectification is also signalled by changes to her eating habits. The more
she transforms into Peter’s ideal woman, the less she eats. Out at lunch with the three
office virgins from work Marian find she “wasn’t even hungry”, despite having been
“starving” earlier (112). Her decreased appetite appears to coincide with the decision to
tell the three women about her engagement to Peter. At a restaurant with Peter, Marian
declares she is “ravenous” (147) but finds she is unable to finish her Filet Mignon. Her
failure to eat the steak follows a discussion on how to raise children in which Peter
dismisses Marian’s opinion and accuses her of having led a sheltered life. As Marian
watches Peter cut his steak in a “violent action” (150) she begins to think about the true
origins of what she is eating: “a hunk of muscle. Blood red. Part of a real cow that once
moved and ate and was killed” (151).
Significantly, Marian’s initial dietary changes consist of the elimination of most meat.
Carol J. Adams, a feminist vegetarian, establishes a connection between vegetarianism
and “the rejection of male acts of violence, identification with animals, repudiation of
men’s control of women….” (245). Adams cites The Edible Woman as one of a number
of literary texts in which “[m]ale dominance is seen to cause women’s oppression, war,
and meat eating” (248). Adams’ themes at first appear to be connected to Marian’s
decision to leave the remainder of her bloody steak on her plate. Although Marian’s
rejection of meat could be read as an identification with animals, acts of violence and
control in the novel are not exclusive to men. Atwood challenges the dichotomies of
female/prey/pacifism and men/hunters/war that Adams’ argument relies on.
The women in The Edible Woman are not just the prey but also the hunters. Lucy,
one of the office virgins, suggests eating out at a more expensive restaurant in hope of
attracting the attention of some of the male diners. She trails herself “like a many-plumed
fish-lure with glass beads and three spinners and seventeen hooks through the likelylooking places” (112). When Marian tells the office virgins she is engaged, Lucy asks,
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‘“How on earth did you ever catch him?’” (113). At Peter’s party the three office virgins
surround Len, who they have identified as being one of the few single men in
attendance: “They had him backed against the wall […] two of them on the sides cutting
off flank escape and the third, in front” (235).
Ainsley’s attempts to snare a suitable man to impregnate her are also described as
predatory. When Ainsley turns up at drinks uninvited, dressed in pink and blue gingham
to appeal to Len’s preference for younger women, Marian asks ‘“getting your sights
set?’” (70). The use of the phrase can be seen as a reference to the story about rabbit
hunting that Peter related earlier. Marian also compares Ainsley’s plan to ‘“bird-liming, or
spearing fish by lantern’” (70). At Len’s apartment Marian describes Ainsley’s inert
patience as “that of a pitcher-plant in a swamp with its hollow bulbous leaves half-filled
with water, waiting for some insect to be attracted, drowned, and digested” (75).
Ainsley’s behaviour is also described in terms of war metaphors. Marian comments that
in calculating her prime fertility time, Ainsley “bore a chilling resemblance to a general
plotting a major campaign” (85). The metaphors continue with Ainsley’s plan to alert
Marian to the possible occupancy of her bedroom by using Len’s tie as a signal. For
Marian the tie suggestion creates a “disturbing vision of a trophy room with stuffed and
antlered heads nailed to the walls” (122). When Len discovers Ainsley’s plan to
deliberately get pregnant his protest identifies women as the hunters: ‘“All you clawed
scaly bloody predatory whoring fucking bitches can go straight to hell!’” (215).
Far from endorsing vegetarianism, The Edible Woman challenges the extreme
philosophies of certain proponents of the movement. When Marian finds her body will
not eat certain meats her reaction is: ‘“I’m turning into a vegetarian […] one of those
cranks”’(153). After a short time on her no meat diet she begins to find salads “tiresome”
and longs to “become again a carnivore, to gnaw on a good bone!” (173). Marian’s
choice of what foods are inedible can be seen as satirising the work of vegetarian
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campaigner, Peter Singer. Singer initially calls for a rejection of meat products produced
by intensive farming but then asks if this is going far enough: “Where exactly do we draw
the line? […] How far down the evolutionary scale shall we go? Shall we eat fish? What
about shrimps? Oysters?” (170,171). His response is that “the only legitimate boundary
to our concern for the interests of other beings is the point at which it is no longer
accurate to say that the other being has interests” (171). While not wishing to condemn
the way in which individuals take up Singer’s practices, Probyn discusses the moralism
involved in Singer’s work, questioning “the limitations of a politics that sets out blanket
norms, and organises societal problems under the sole rubric of meat eating” (Carnal
Appetites 53).
Marian’s own brand of vegetarianism can be seen as a hilarious send-up of Singer’s
definition. Her list of inedible foods expands beyond beef, pork and lamb to a boiled egg
which she believes is still alive: “when she opened her soft-boiled egg and saw the yolk
looking up at her with its one significant and accusing yellow eye, she found her mouth
closing together like a frightened sea-anemone. It’s living; it’s alive, the muscles in her
throat said, and tightened” (161). Marian’s recognition of ‘the interests of other beings’
leads her to even reject canned rice pudding: “her eyes had seen it as a collection of
small cocoons. Cocoons with miniature living creatures inside” (203) and a piece of
Valentine’s Day cake, “spongy and cellular against her tongue, like the bursting of
thousands of tiny lungs” (207).
To determine whether a being ‘has interests’ Singer examines its behaviour when
under threat, “whether it writhes, utters cries, attempts to escape from the source of
pain” (171). He continues by suggesting that beings may vocalise pain in a way that “is
not audible to our ears” (172). Marian’s experience with a carrot comically demonstrates
the issues with such a broad definition. When Marian begins to peel the carrot for her
salad she starts to think: “they come along and dig it up, maybe it even makes a sound,
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a scream too low for us to hear, but it doesn’t die right away, it keeps on living, right now
it’s still alive […] She thought she felt it twist in her hands” (178). Finally, Marian decides
against washing the dishes in the sink because “[p]erhaps the mould had as much right
to life as she had” (217).
Marian’s list of ‘allowed’ foods continues to shrink as she begins preparations for
Peter’s party. At his request to buy something ‘“not quite so mousy’” (208), Marian
purchases a dress that is “short, red, and sequined” (208). This is vastly different from
her usual outfits which Ainsley describes as a “camouflage or a protective colouration”
(14). Marian also goes to have her hair professionally styled with the entire visit being
compared to undergoing surgery. The receptionist is “disturbingly nurse-like”, the hairwashing sink is like an “operating-table” and the young male hairdresser, “the doctor”
(209). Marian feels like “a slab of flesh, an object” with her body becoming “curiously
paralysed”, like someone who has been administered anaesthetics (209). With her head
resembling a “mutant hedgehog” (209) she is placed under a dryer where she observes
other women: “Inert; totally inert. Was this what she was being pushed towards, this
compound of the simple vegetable and the simply mechanical?” (210). When her hair is
set she is returned to the doctor’s chair to have “the stitches taken out” (the rollers
removed) (210). Upon returning home Marian undergoes a further “procedure” (222),
with Ainsley doing her make-up.
Marian recognises the artificiality of her new look when she observes herself in
Peter’s mirror: “She held both of her naked arms out towards the mirror. They were the
only portion of her naked flesh that was without a cloth or nylon or leather or varnish
covering, but in the glass even they looked fake, like soft pinkish-white rubber or plastic,
boneless, flexible….” (229). Her appearance is reminiscent of the young girl image
Ainsley invents to snare Len: “like one of the large plump dolls in the stores at
Christmas-time, with washable, rubber-smooth skin and glassy eyes and gleaming
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artificial hair” (68) and of a doll she has kept since childhood with its “long washable hair
and a rubbery skin” (103).
While Marian’s new look could be seen as her final objectification, the elaborateness
of her transformation also suggests a parody or mimicry of the feminine. Bouson
comments: “even as Atwood shows Marian submitting to the masquerade, she
constructs a feminist reading position by focusing on femininity-as-masquerade” (Brutal
Choreographies 28). The sequined red dress, fake eyelashes and fingernails, intricately
styled hair and large dangly earrings are ‘over the top’. Carole Ann Tyler explains, “the
female mimic denaturalizes ideology by calling attention to the conventions that encode
her as a woman; she repeats femininity with a playful difference that is a critical
difference, producing knowledge about it: that it is a role and not a nature” (38). Mary
Russo continues, “To put on femininity with a vengeance suggests the power of taking it
off” (70).
Like Judith Butler (139), Tyler questions how parody or mimicry can be
distinguished from ‘the real thing’: “The difference between being resigned to femininity
and re-signing femininity is not so clearly visible” (28). Despite a woman’s intentions to
repeat femininity with a difference, this difference may not be obvious to others and the
mimic, “could find herself in the same old story” (Tyler 28). This appears to be the
problem that Marian encounters. At the party the office virgins and Trevor, one of
Duncan’s flatmates, inform Marian she ‘“should really wear red more often’” (239).
Similarly, Peter tells her she looks marvellous: “The implication had been that it would be
most pleasant if she could arrange to look like that all the time” (228). Marian’s mimicry,
therefore, is missed by Peter and others. As a result she risks becoming fixed in the
vision of femininity that she is attempting to parody. Significantly, the only person who
recognises the artifice of the new image, besides Marian herself, is Duncan who arrives
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at the party but refuses to come in. On seeing Marian at the door he says, ‘“You didn’t
tell me it was a masquerade […] Who the hell are you supposed to be?’” (239).
Marian’s realisation that her new image has been perceived as ‘the real thing’
causes her to panic when Peter starts taking photos of the guests. She is terrified that if
she is ‘captured’ on film she will lose the power to ‘take off’ the femininity: “Once he
pulled the trigger she would be stopped, fixed indissolubly in that gesture, that single
stance, unable to move or change” (245). Peter’s comment: ‘“That red [dress] ought to
show up well on a slide’” (231) is a reminder of the earlier rabbit hunting story in which
Peter and friends shoot and gut a rabbit: ‘“the trees were red for yards […] we got some
good shots of the whole mess’” (69). Marian’s perception that she is an object of prey is
emphasised by other hunting imagery. Her party dress provides her with a “protective
camouflage”, allowing her to make her way to the door “behind the concealing trunks
and bushes of backs and skirts” (245).
With her attempt at mimicry failing to achieve the desired effect, Marian returns to
fleeing as a method of escape. She manages to leave the party undetected and runs off
in the direction of the laundromat. Marian decides that Peter, the “dark intent marksman”
had been there all the time, “hidden by the other layers, waiting for her at the dead
centre : a homicidal maniac with a lethal weapon in his hands” (246).
Like many of Atwood’s male characters, Peter is depicted as double in nature.
When Marian believes she recognises one of the doctors in the hospital when visiting
Clara, “[i]n spite of the mask there was something familiar about him” (135), we are
reminded of previous comparisons of Peter and medicine. He runs his hands over
Marian’s skin, “almost clinically” making her feel “that she was on a doctor's examination
table” (149). He also smells of soap all of the time, a smell Marian associates with
“dentists' chairs and medicine” (61). Marian also entertains the idea that Peter is the
Underwear Man, a man who, posing as a Seymour Survey interviewer, rings women to
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ask questions of a personal nature. Marian’s boss, Mrs. Brogue’s description of the
offending man as “probably some nice ordinary man” (116) recalls the description of
Peter as “ordinariness raised to perfection” (61). Peter’s duplicitous nature is also
revealed in Marian’s concern over his reaction to the news that she has invited her
friends to attend his party: “blind rage and blind ecstasy on his part seemed equally
possible” (226).
After locating Duncan at the laundromat Marian spends the night with him at a
seedy motel. The following morning at a grimy coffee shop Marian discovers she is
unable to eat anything at all, not even a glass of orange juice: “Her body had cut itself
off. The food circle had dwindled to a point, a black dot, closing everything outside….”
(257). Marian cannot face going back to her flat and the inevitable questions from Peter
and her family so Duncan takes her on a last ‘escape’ down into one of the city’s
ravines. It is here that Marian reconsiders her strategy of self-starvation: “she didn’t see
any point in starving to death. What she really wanted, she realized, had been reduced
to simply safety. She thought she had been heading towards it all these months but
actually she hadn’t been getting anywhere” (263). Marian realises she can no longer rely
on the tactics of running away and self-starvation as forms of communication. With
directions from Duncan she climbs out of the ravine and returns home to her flat.
When Peter calls demanding an explanation for her disappearance she asks him
over for tea in a few hours. Marian’s interaction with Peter is significantly different to
before the party, with her controlling the direction of the conversation and making the
time for the visit. While her voice sounds “sweet, conciliatory” (266) it is simply a ploy to
ensure he attends: “She was conscious of her own craftiness” (266). Despite her
increased assertiveness over the phone, Marian still feels the need to continue to
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communicate with Peter in non-verbal ways 128 : “What she needed was something that
avoided words, she didn’t want to get tangled up in a discussion” (267). She decides to
bake Peter a cake in the shape of a woman. The preparations for the baking of the cake
further signal Marian’s newly found confidence and direction.
Jane Patterson’s analysis of the two shopping trips and food preparation scenes in
the novel highlights the change in Marian’s behaviour. The first scenes are those
surrounding Marian’s dinner party for Clara and Joe and the second those related to the
baking of the cake. Patterson discusses the different lengths of the shopping trips, five
pages for the first trip compared to a brief paragraph for the second trip. In the first trip
Marian agonises over different brands of products and generally appears to take a long
time. In the second trip Marian walks “methodically up and down the aisles […] picking
the things off the shelves” (267). In the first trip Marian also relies on a list to help her
buy just what is needed but on the second trip she abandons writing a list, declaring
“[s]he knew what she needed to get” (167).
The cake baking also signals an important change in Marian’s relationship to food.
Prior to this occasion Marian shows little interest in food preparation. At the dinner party
she holds for Joe and Clara her main concern is making a recipe that will allow her to
hide her unusual eating habits. Other cooking examples include “frozen peas and
smoked meat, the kind you boil for three minutes in the plastic packages” (63) and TV
dinners. Marian’s eating habits are synonymous with her single lifestyle. Cooking, in
particular baking, is associated with married women. This is clearly evident at the office
X-mas party where the “food had all been brought [home-made] by the ladies
themselves” (162). Marian in fact buys her contribution, chocolate brownies, and puts
them in a different bag. The expectation that married life will result in the ability and
128Marian’s choice of non-verbal communication with Peter occurs throughout the novel, including the scene in which
they have sex in the bathtub. When he suggests another sexual fantasy, ‘“I’d bet you’d look great in a kimono” (62-3),
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interest in making Orange-Pineapple Delight 129 is hinted at in Peter’s protest, ‘“Why
can’t you ever cook anything?’” (63) over Marian’s dinner of boiled meat. This makes
Marian’s choice of a cake to communicate with Peter all the more significant. Marian
uses one of the very symbols of femininity to voice her dissatisfaction.
Marian’s cake-baking also signals a rediscovery of baking, not as a wifely duty, but
as something pleasurable. Marian admits that it has been “a long time since she had
made a cake” (268). When she begins, however, she finds it a satisfying exercise: “she
almost hummed with pleasure” (268), “[w]hile making it she had been almost gleeful”
(270). Marian’s pride in her cake making is demonstrated by her deliberating over the
most appropriate mixture and icing and ensuring the cake is cool enough before it is
iced.
The decoration of the cake is reminiscent of Marian’s transformation for Peter’s
party. She begins to “operate” (269) on the cake as she was operated on in the
hairdressers. The “scooped out part” (269) of the cake that becomes the head recalls
Marian’s description of her head the morning following Peter's proposal. The pink dress
and “masses of intricate baroque scrolls and swirls” (269) are a recreation of Marian’s
red sequined dress and professional hairdo. As John Lauber suggests, the cake is “a
caricature of Marian at her most artificial […] Symbolically, it represents woman as
simply an object for male consumption” (28). Similarly, Stow proposes the cake woman
is “a deliberate symbol of her artificial womanhood which her world has tried to impose
on her” (90). In this way, Marian’s cake becomes the mimicry or parody of femininity that
she previously attempted through her appearance at Peter’s party.
When Peter arrives, angry and demanding an explanation, ‘“Now what’s all this…’”
(270), Marian cuts him off by asking ‘“Why don’t you go into the living room and sit
Marian turns the cold water tap on with her feet.
129 This, along with a Luscious Fruit Sponge, are two of the contributions at the office X-mas party.
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down?’”(270). He is clearly taken aback by Marian’s assertiveness as, she suspects, “he
must have been expecting an awkward apology” (270). Marian presents Peter with the
cake woman: ‘“You’ve been trying to destroy me, haven’t you,’ she said. ‘You’ve been
trying to assimilate me. But I’ve made you a substitute, something you’ll like much better.
This is what you really wanted all along, isn’t it?’” (271). By presenting Peter with a
substitute made out of cake, Marian is stating her refusal to become the pliable wife
figure he desires (her decision to make the cake a sponge is quite significant). Wilson in
her discussion of fairytale intertexts in The Edible Woman states: “Like Gretel, Marian
tricks the trickster, finding a substitute victim and escaping the oven” (86). Mervyn
Nicholson also refers to Marian’s cake making as a trick: “the woman-shaped cake […]
suggests a substitute offering to avoid being eaten, a kind of trick to placate the powers
that be, whether of society or superego” (40).
Before Peter arrives Marian proposes that if Peter merely laughs at the cake she will
know it means her fears about a future with him are just “silly” (270). Peter, however,
takes the presentation of the cake woman very seriously: “His eyes widened in alarm.
Apparently he didn’t find her silly” (271). Peter does not find Marian’s cake, ‘silly’ as ‘silly’
implies it is nonsensical and, therefore, non-threatening. For Peter, the presentation of
the cake woman does not only signal Marian’s assertiveness but also her possible
madness 130 . It is this that Peter finds most alarming causing him to leave “quite rapidly”
(271). Peter initially chooses Marian as his girlfriend because she has “common sense”
(61) and is “such a sensible girl” (89) (he declares this is the first thing to look for when
130Keith is one of the few critics that refer to Peter’s fast retreat as the result of him thinking Marian is mad: “For Peter,
we may reasonably infer, it [the cake woman] is a symbol of her [Marian’s] madness- or, at least, of her unsuitability as the
wife of a rising young lawyer” (65).
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picking a wife). Her ‘madness’ is not conducive to being the wife of a lawyer with
prospects.
There is some suggestion that Peter may find Lucy a suitable alternative. At the
party Marian finds her in Peter’s bedroom telling him, ‘“You’re even handsomer than you
sound on the phone’” (238). Lucy also volunteers to help Peter look for Marian at the end
of the party. Howells observes that an earlier description of Lucy displaying her
“delicious dresses and confectionery eyes” (112), is reminiscent of Marian’s pliable, cake
woman (Margaret Atwood 53).
Despite Marian’s claim that “[a]s a symbol it [the cake] had definitely failed” (271), it
does allow her to end her relationship with Peter with minimal discussion: “they didn’t
have much of a conversation after all” (271). Marian's cake woman not only brings about
the end of her relationship with Peter but also the end of her starvation. After Peter
leaves she feels “[e]xtremely hungry” (271) and begins to eat the cake woman, feet first.
When Ainsley returns home to discover Marian eating a piece of thigh she exclaims,
‘“You’re rejecting your femininity’” (272). Marian replies, ‘“Nonsense […] It’s only a cake’”
(273).
The significance of the cake-eating scenes in the novel has been widely debated 131 .
Gloria Onley claims Marian’s eating of the cake both “destroys a false image and
reabsorbs her culturally split-off female self” (74). MacLulich argues that in eating the
cake Marian is “accepting her femininity by incorporating the feminine cake-woman or
cake-child into herself” and even “symbolically impregnating herself, or at least accepting
the possibility of pregnancy” (195). Marian’s statement ‘It’s only a cake’, suggests that
for her the cake has served its symbolic purpose and now it is nothing more than an
131 In an interview with Gibson, Atwood compares the ghost in Surfacing, to the cake woman in The Edible Woman: “I
could give you all kinds of theories as to what I think they’re doing in there, but my guess is really as good as anybody
else’s […] You can make of it what you will” (18).
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elaborately iced sponge. Bouson believes the scene is “designed to puzzle readers and
force them to interpret” (“The Anxiety of Being Influenced” 235). He suggests the text’s
reference to the cake as a ‘symbol’ but also as ‘only a cake’ is “a manoeuvre meant to
entice and frustrate literary interpreters” (235).
Bouson’s explanation is in keeping with other elements in the novel, in particular
Fish’s hilarious reading of Lewis Carroll’s Alice in Wonderland. Fish’s lengthy reading
invites a comparison between Carroll and The Edible Woman, a reading taken up by
several critics 132 . However, the absurdity of Fish’s speech and of the dinner party in
general, also suggests Atwood is in fact satirising literary interpretations. One wonders
whether the purpose of the cake woman scene is to merely encourage what Bouson
refers to as “the academic tendency to overinterpret literature” (“The Anxiety of Being
Influenced” 231). Trevor’s dismissal of Fish’s interpretation of Alice in Wonderland, ‘“The
very latest approach to Alice is just to dismiss it as a rather charming children’s book’”
(195) may be a hint for those attempting to find meaning in the cake woman.
Ildiko de Papp Carrington comments that many critics “confine their analysis to the
meaning of Marian’s offering the cake to Peter and then eating it herself” (‘“I’m Stuck’”
68), therefore, ignoring the significance of Duncan’s eating of the cake. Part Two ends
with Marian severing the head and body of the cake woman with a fork. Part Three sees
a return to first person for Marian who is cleaning up the apartment a few days later. She
is interrupted by a call from Duncan who is enquiring about the whereabouts of his
flatmate Fischer (who has married Ainsley after meeting her at Peter’s party). Marian
invites Duncan over for tea and offers him the leftover cake. After finishing the last piece
he says ‘“Thank you […] It was delicious’” (281). Unlike Peter, Duncan appears not to
take any notice of the shape of the cake and its possible significance: “the cake was
132 See Stow; Harkness; and Nodelman.
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absorbed without exclamations of pleasure, even without noticeable expression” (281).
MacLulich discusses how Duncan’s vocation as an English graduate student makes him
“[s]killed in the analysis of symbols” and also someone who “knows when not to carry
out an over-elaborate analysis of hidden meanings” (195). Duncan’s reaction to the
cake, as nothing but food, is then perhaps a further hint that the cake woman should not
be overinterpreted.
Critics have also speculated on the novel’s somewhat ambiguous ending, in
particular the fate of Marian. Several critics assume she will now enter into a relationship
with Duncan. Ellen Peel explains that Marian, “has taken up with Duncan, who is
certainly more interesting and self-aware than Peter, but Duncan is hardly less selfabsorbed” (112). Likewise, Marge Piercy’s comment assumes Marian has chosen
Duncan over Peter: “The relationship into which Marian seems headed is […]
conventional in the subculture and basically about as masochistic” (55). There are,
however, few indications that Marian is going to pursue a romantic relationship with
Duncan. She appears disinterested in his phone call, confessing she had “more or less
forgotten about him” (277). She is also annoyed at his complete self-absorption: “I found
my own situation much more interesting than his” (278).
Ainsley and Fischer’s marriage provides the required ‘happily ever after’ ending,
leaving Marian free to be single, at least for the moment. Marian’s options are limited as
the society in which she lives remains unchanged. As Atwood explains in the
introduction to the novel: “It’s noteworthy that my heroine’s choices remain much the
same at the end of the book as they are at the beginning: a career going nowhere, or
marriage as an exit from it” (8). Although we do not find out what Marian will be “when
she grows up” (Greene, “Margaret Atwood’s The Edible Woman” 111), there is an
understanding that the possibilities are not endless. It is probable that if faced with
similar circumstances she might even resort to disordered eating again. Pamela S.
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Bromberg comments: “She is more self-assertive and healthy, but for how long?” (20).
Similarly, Tracy Brain suggests “Marian’s own “recovery” at the novel’s end needs scare
quotes, for the conditions which produced Marian’s anorexia nervosa remain, and so the
illness might reemerge” (309).
The character of Ainsley, however, suggests that Marian may be able to make
different choices. At the novel’s conclusion Marian and Ainsley have, in effect, switched
roles. Ainsley has conformed to convention by marrying Fischer and honeymooning at
Niagara Falls. Marian, on the other hand is newly single and looking for a new job.
Perhaps her new occupation will be more like Ainsley’s previous occupation which
Marian envied because it was “more temporary” (17). Marian may even take up Ainsley’s
initial plan to have a baby and bring it up as a single mother.
Atwood’s literary portrayal of a woman’s problematic relationship with food provides
a critique of popular discourses on anorexia nervosa, in particular the notion that the
anorexic is a deficient reader. As an employee of a market research company, Marian
possesses the knowledge and skills to interpret the images of the ideal woman she is
presented with. As the society Marian lives in is an example of the victim Position Two,
her opportunities for change are limited. Societal expectations that women will marry and
have children and Peter’s apparent suitability as a future husband provide Marian with
few alternatives. While Marian appears to exemplify Foucault’s concept of selfsurveillance by conforming to representations of an ideal woman, she is in fact involved
in an act of resistance. Marian chooses disordered eating and the mimicry of the
feminine as non-verbal protests against the limited roles available to her in society.
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PART THREE: Fat is the Self: Obesity and Multiplicity in Lady
Oracle
Atwood’s Lady Oracle engages with many of the themes of The Edible Woman,
most notably the use of the body as a protest, women’s reading abilities and popular
psychology. Lady Oracle follows the life of Joan Foster, from an obese child and
adolescent to secret Costume Gothic writer and author of an acclaimed book of poetry.
When a blackmailer threatens to expose her secrets, Joan fakes her own death and
escapes to Terremoto, Italy.
The opening paragraph of Lady Oracle signals an important element of the novel,
Atwood’s use of Bakhtin’s concept of the carnivalesque:
My life had a tendency to spread, to get flabby, to scroll and festoon like the
frame of a baroque mirror […] I wanted my death, by contrast, to be neat and
simple, understated, even a little severe, like a Quaker church or the basic
black dress with a single strand of pearls much praised by fashion magazines
when I was fifteen. No trumpets, no megaphones, no spangles, no loose ends.
(7)
The contrast of a flabby and festooning life and a neat and simple death is a reflection of
Bakhtin’s grotesque and classical body. In his study of folk humour in the work of
Rabelais, Bakhtin discusses the concept of grotesque realism and its essential principle,
degradation, “that is, the lowering of all that is high, spiritual, ideal, abstract; it is a
transfer to the material level, to the sphere of earth and body” (19). The grotesque
concept of the body, therefore, is associated with the lower stratum of the body, the
genital organs, the belly and the buttocks (Bakhtin 21). Additionally, there is an
emphasis on the “those parts of the body that are open to the outside world, that, is, the
parts through which the world enter the body or emerges from it, or through which the
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body itself goes out to meet the world” (Bakhtin 26). The open mouth, breasts, the nose
and the functions of eating, drinking, defecation, copulation, conception, pregnancy, birth
and death are all associated with the grotesque body. Most importantly, the grotesque
body is “unfinished, outgrows itself, transgresses its own limits” (Bakhtin 26). In stark
contrast to the grotesque body is the classical body which is associated with the upper
body stratum, such as the face or the head. It is closed, completed, and devoid of any
indication of the “unfinished nature of the body” (Bakhtin 29).
Bakhtin is careful to distinguish between the grotesque realism of the Middle Ages
with the Romantic grotesque. In the Middle Ages, grotesque realism was linked to folk
culture and, therefore, had a strong regenerative element. Humour, for example was
both mocking but also reviving and renewing (Bakhtin 11). Similarly, terror was present
but in the form of “comic monsters, who were defeated by laughter” (Bakhtin 39). In the
Romantic grotesque, however, laughter loses its regenerative powers and instead
became entirely negative, reduced to “cold humour, irony, sarcasm” (Bakhtin 38). Terror
takes on a more sombre definition, with the familial and secure becoming the source of
fear. Bakhtin suggests that the transformed meaning of the grotesque found in
Romanticism is evident in the Gothic novel.
The Gothic is an important theme in Lady Oracle, with the plots of Joan’s Costume
Gothics, interspersed throughout. Lady Oracle is consistently described by critics as a
parody of the Gothic novel, in the tradition of Jane Austen’s Northanger Abbey (Grace,
Violent Duality 111; McMillan 49; McKinstry) 133 . Atwood’s parody of the Gothic can also
be seen as a rejection of the Romantic grotesque in favour of Bakhtin’s grotesque of the
Middle Ages. Sybil Korff Vincent alludes to Atwood’s interest in the pre-Romantic
grotesque in her discussion of terror in Lady Oracle: “The reader is too busy laughing at
133 McMillan refers to Lady Oracle and Northanger Abbey as belonging to the genre of “mixed gothic” (49).
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the predicaments and observations of the heroine to feel anything like terror” (153). Lady
Oracle’s defeating of terror with laughter and humour is, therefore, reminiscent of
Bakhtin’s concept of grotesque realism. Atwood’s engagement with the carnivalesque
and grotesque body in Lady Oracle also allows an exploration of the transgressive
potential of fat. In Bakhtin’s carnival, the grotesque body of the Fat Lady symbolises a
body that is overabundant, incomplete and multiple. The Fat Lady of the carnival is not
simply a source of a source of mockery and derision but of regeneration and renewal.
As a baby Joan is “merely plump” (43) but as she grows older she fails to lose her
baby fat, continuing to grow in size. Joan’s mother reacts to her daughter’s size by trying
to render her invisible, beginning with the discontinuation of a photographic record.
When Joan reaches the age of six the pictures of her in the family album, “stopped
abruptly” (43). Joan explains how her mother “no longer wanted my growth recorded.
She had decided I would not do” (43). Joan’s mother’s also conspires with ballet teacher,
Miss Flegg, to limit Joan’s participation in the annual spring dance recital. Miss Flegg is
described as having a “spiny exterior, long bony hands, hair wrenched into a bun” and
“almost as slender and disapproving as my [Joan’s] mother” (43). Miss Flegg, like Joan’s
mother, represents the classical body, static hard and complete with no loose ends (for
example, wisps of hair) 134 .
Miss Flegg choreographs three numbers for the seven year old girls including ‘The
Butterfly Frolic’, in which the girls are butterflies, complete with short gauzy skirts,
spangled antennae and coloured cellophane wings. On the advice of Joan’s mother,
however, Miss Flegg decides Joan’s figure in the Butterfly Frolic costume does not
achieve the desired effect. Joan’s body in the butterfly costume represents Bakhtin’s
134 Other women which represent the classical body include Marlene, one of the girls that tormented Joan as a child and,
as an adult, a political activist friend of Arthur. Marlene is described as being “slim and muscular” (231). However, like
Joan’s mother, Marlene’s classical body is shown to be indeterminate. After her affair is discovered she is “no longer neat
and tidy; her eyes were dark-circled, her hair stringy, her nails ragged from biting” (248).
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grotesque body: “jiggly thighs and the bulges of fat where breasts would later be and my
plump upper arms and floppy waist, I must have looked obscene, senile almost,
indecent; it must have been like watching a decaying stripper” (46). The emphasis in the
description is of the lower bodily stratum; the breasts, thighs and stomach.
Joan’s butterfly-costumed body is also reminiscent of the example Bakhtin uses to
explain the grotesque body, the Kerch terracotta figurines of senile, pregnant hags. He
states: “There is nothing completed, nothing calm and stable in the bodies of these old
hags. They combine a senile, decaying and deformed flesh with the flesh of new life,
conceived but as yet unformed” (25-26). Joan’s body is described in this way, as
combining both a senile body of the old and decaying with that of new life, indicated by
the fat that will become her breasts.
The buttocks and the belly of the grotesque body feature strongly in the novel.
Joan’s first ‘sexual experience’ involves a teenage boy who kneels in front of her and
buries his face against her “enormous stomach” (98) 135 . Joan ponders on his actions
and proposes that “it might have been an instinctive act of belly worship” (98) or that he
might have perceived her as “a single enormous breast” (99). Joan’s buttocks are also
highlighted in the scene where she is shot in the behind with an arrow at the Sportmen’s
Show. When Joan meets Marlene as an adult she feels her old fat self returning: “my
belly bulges out like a Hubbard squash” (229).
Miss Flegg makes Joan give up her butterfly wings to become a mothball, consisting
of a white teddy bear costume from one of the previous dance groups. The mothball
costume is designed to disguise Joan’s body but also results in its accentuation. Joan’s
reaction to being turned from a beautiful butterfly with wings into a smelly insect repellent
is the first example of her refusal to be reduced and diminished. Although she has not
135 Bakhtin explains how “[t]his traditional gesture of the head ramming the abdomen or the buttocks is essentially
topographical. Here once more we have the logic of the opposites, the contact of the upper and lower level” (309).
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been given steps to her mothball dance, Joan creates her own very loud and fast paced
routine in order to compensate for her loss of wings. The audience’s response is also a
representation of carnival laughter, in that Joan’s fatness is not simply the subject of
ridicule and mockery but a laughter that is “joyful and triumphant hilarity” (Bakhtin 38).
There is both laughter and applause from the audience and several people shout,
“‘Bravo mothball!’” (50).
As Joan gets older she fully recognises her mother’s anguish over her size and the
power that comes with the growth of her body 136 . Upon reaching her teens her weight
gain has become deliberate and methodical: “By this time [at thirteen] I was eating
steadily, doggedly, stubbornly” (69). Joan explains how her mother thinks of her as a
“one-holed object, like an inner tube, that took things in at one end but didn’t let them out
at the other: if she could somehow uncork me I would deflate, all at once, like a dirigible”
(87). Drawing a connection between eating and defecating is characteristic of the
grotesque body. The image of Joan being uncorked of her accumulated shit is a highly
amusing one.
Joan’s growing body is contrasted with the classical body of her mother. A recurring
image of Joan’s mother is one of her dressed in a navy blue suit with a white collar and
gloves. The house she keeps serves as an extension of her classical body. The sofa,
rug and lampshades are all encased in plastic and all members of the family must wear
slippers to prevent any markings. Joan explains her mother wanted the house “static and
dustless and final” (70).
The classical body of Joan’s mother is not only emphasised by comparisons to Joan
but also to her sister-in-law, Aunt Lou. Aunt Lou wears clothes that highlight rather than
hide her large figure: “bulky fur coats and heavy tweeds, which made her look even taller
136 A novel which also explores deliberate weight gain as a means of power is Kate Grenville’s Lilian’s Story.
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and fatter” (81). She is described as being “befurred […] Wisps escaped from her head,
threads from her hems” (89), while Joan’s mother’s hair is “carefully arranged” in “stiff
immaculate curls” (89). If Aunt Lou wore pearls, it was “never just one strand” (85), a
reference to the “single strand of pearls” of the classical body, described in the opening
paragraph of the novel (7).
Like Joan’s mother’s home, Aunt Lou’s home is also an extension of her body. It is,
however, the very opposite of Joan’s sterile and orderly home, being described as
“frequently dusty and always cluttered” (82). Most significantly, Aunt Lou is head of
public relations for a sanitary product company. Her job of answering questions on
menstruation and the whereabouts of the vagina sees her associated with the lower
bodily stratum.
One of the most striking examples of the contrast between the grotesque body and
the classical body is the statue of Diana of Ephesus that Joan views in the gardens at
Tivoli. Statues are most often associated with the classical canon. As Peter Stallybrass
and Allon White explain the classical statue was “always mounted on a plinth which
meant that it was elevated, static and monumental” (21). It shows the body to be closed
and complete. The statue of Diana of Ephesus is not on a plinth, however, but positioned
as though “rising from a pool of water” (Lady Oracle 253). Most notably Diana of
Ephesus “was draped in breasts from neck to ankle, as though afflicted with a case of
the yaws: little breasts at the bottom, big ones around the middle. The nipples were
equipped with spouts, but several of the breasts were out of order” (Lady Oracle
253).The breasts firstly symbolise the lower bodily stratum, particularly as they are
designed to spout water, emphasising them as openings. In addition the number of
breasts represent the multiple and abundant nature of the grotesque body 137 . The
137 We are also reminded here of Joan’s comment to the Royal Porcupine after they have sex for the first time: ‘“What
were you expecting […] Three buttocks. Nine tits” (244).
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reference to the skin condition yaws and the fact that some of the nipple spouts are not
functioning also introduces the element of decay and disease, often associated with the
grotesque body.
Joan’s mother names her after the movie star Joan Crawford 138 , someone who
symbolises to her everything a woman should be, thin and beautiful. Joan Crawford’s
appeal is also that she “worked hard, she had willpower, she built herself up from
nothing” (42). Joan decides on a more literal interpretation of her namesake’s attributes,
choosing to ‘build her body up’ to great proportions. Like The Edible Woman’s Marian,
Joan uses her body as a site of protest against images of ideal femininity.
Joan’s weight gain as a source of rebellion is emphasised by the use of war
metaphors: “I swelled visibly, relentlessly, before her very eyes, I rose like dough, my
body advanced inch by inch towards her across the dining-room table, in this at least I
was undefeated” (70). Here, Joan’s body is described as being like an advancing army.
The war metaphor is continued in her statement: “The war between myself and my
mother was on in earnest; the disputed territory was my body” (69).
Joan accentuates her size through her choice of clothing, a reaction against having
to give up her butterfly costume. Fashion experts have a number of ‘rules’ that larger
women are encouraged to follow in order to disguise their size. The rules include
wearing simple clothes, dark in colour and without pleats or other styling that may draw
attention to ‘problem’ areas. Large prints and horizontal stripes are to be avoided in
favour of small, granny prints. This fashion style is also in keeping with the classical
body.
138 Joan Crawford is most remembered for her role in the film noir, Mildred Pierce (1945) in which she plays a woman
who tries (unsuccessfully) to establish an identity outside of the traditional roles of wife and mother. The film is notable for
its use different sequences, some in classic film noir style while others are in the style of a melodrama (Cook, “Duplicity in
Mildred Pierce” 71).
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Joan deliberately breaks all the rules by choosing clothes “of a peculiar and
offensive hideousness, violently colored, horizontally striped” (87). While her mother
provides her with a clothing allowance to buy clothes that make her “less conspicuous”
(87), Joan prefers clothes that make it impossible for her not to be noticed. Joan
explains her buying strategy: “The brighter the colors, the more rotund the effect, the
more certain I was to buy. I wasn’t going to let myself be diminished, neutralized, by a
navy-blue polka-dot sack” (88). Some of Joan’s outfits include a red felt full skirt with an
appliqued black telephone and a lime-green car coat with toggles down the front.
When Joan arrives home one day in her car coat “flashing like a neon melon” her
mother cries “hopelessly, passively” (88). It is the first time Joan’s mother cries in front of
her and although Joan is dismayed she also feels “elated too at this evidence of my
power, my only power” (88). Joan has used one of the few avenues available to her, her
body and her clothing to resist the future her mother had planned for her: “I had defeated
her: I wouldn’t ever let her make me over in her image, thin and beautiful” (88).
Joan’s mother’s public crying can also be seen as a momentary collapse of her
classical body. Previously, Joan described her mother as being “flint-eyed, distinct,
never wavery or moist” (57) in comparison to her own frequent “oozing” (58) 139 . Crying,
in particular that which involves blowing the nose, is associated with the grotesque as it
emphasises the openings in the body. Joan differentiates between “[d]ecorous weeping”
(10) which produces “no smears or streaks” (9) and her style of crying which results in
being “snotty-nosed” (62) and having eyes “the colour and shape of cooked tomatoes”
(10) 140 . As she cries, the body of Joan’s mother is described as going “slack as if she
had no bones” (88), a departure from her usually rigid body. In addition, Joan’s mother
139 Joan’s crying is described as being so melodramatic that she is also seen as “amusing, a figure of fun” (10).
140 Other episodes of crying see Joan “wiping my mucous nose on the back of my mittens” (58).
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has also lets her appearance slip, still being dressed in her housecoat and slippers and
“her hair could have been cleaner” (88).
Joan’s mother’s lapse in behaviour also serves to demonstrate that the classical
body and the grotesque body are not completely distinct from each other. Although
Bakhtin focuses on their differences he states “these canons [grotesque and classical]
were never fixed and immutable […] the two canons experience various forms of
interaction: struggle, mutual influence, crossing, and fusion” (30) 141 .
Bakhtin’s explanation also explains Joan’s mother’s behaviour towards Joan’s
eventual weight loss. Joan’s mother goes on baking sprees, leaving pies and cookies
lying around the house to tempt her. As Joan’s weight diminishes her mother becomes
frantic and starts to drink more heavily. Her conversations with Joan continue as if Joan
is still overweight: ‘“Get out of here, the sight of you makes me sick’” and ‘“if I were you
I’d be ashamed to show my face outside the house’” (123, 124). Joan comments: “While
I grew thinner, she herself became distraught and uncertain” (123). Joan’s mother is
concerned with the potential loss of her body’s definition as thin and classic. Huff
comments: “because all bodies contain some fat, the boundaries of the norm are never
quite secure. Each individual body harbors the potential for corpulence […] the boundary
between fat and thin is an anxious one” (52). Joan’s diminishing body destabilises her
mother’s identity as thin.
The space dedicated to Joan’s childhood in Lady Oracle has encouraged a number
of psychoanalytical readings of the novel. Judith Spector, for example, claims that:
“Atwood gives Joan a psychological history which explains Joan’s sexual hostility
towards men and towards herself as a woman” (34). Similarly, Frank Davey argues that
141 Peter Stallybrass and Allon White claim that Bakhtin’s work in fact incorporates two modes of the grotesque and the
fair [carnival] (44). While the first model situates the grotesque as “simply the opposite of the classical” the second model
sees the grotesque formed through “a process of hybridization or inmixing of binary opposites, particularly of high and
low”) (44).
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Atwood: “gives us a large view of Joan Foster’s early life and makes it clear that most of
Joan’s difficulties with adult relationships are caused by the transferences and
projections from childhood experiences” (156). Sarah Shieff, however, warns that
although an exploration of the overlap between novels on eating and popular psychology
and self-help literature can be “helpful in reading fiction” it can also lead to “interpretive
banalities. It becomes too easy to glibly psychologize the texts” (216). Shieff explains “a
critical reader needs to be more than a talk-show psychologist to these fictional
characters” (217).
The possibility of playing talk-show psychologist is made difficult in Lady Oracle by
Atwood’s clear parodying of psychological theories. As Carol Osborne argues in her
revealing article on Atwood’s reflections on therapy, “Atwood shows that not only has
she been attuned to the impact that the psychotherapeutic industry has had on society,
but also that she has become increasingly critical of its claims and influence” (181). One
of Atwood’s major contentions with psychotherapy is that it encourages a person to take
on the role of victim: “One of the possibly harmful psychological advantages of being a
“victim” is that you can substitute moral righteousness for responsibility; that is, you can
view yourself as innocent and your oppressor as totally evil, and because you define
yourself as powerless, you can avoid doing anything about your situation” (Second
Words 134).
While Lady Oracle does not refer to any psychological theories specifically, Joan’s
mother is depicted as “pretending to read a book on child psychology” (70) 142 . The focus
of Lady Oracle’s critique of popular psychology appears to be directed at the notion that
events in a person’s childhood can be used to explain their adult behaviour. The
publication of Lady Oracle in 1976, suggests Arthur Janov’s primal scream theory could
142 She is actually reading a historical novel, “about the Borgias” (70).
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be an influence. Janov’s theory contends that traumatic experiences in childhood
(including actual birthing) can lead to neuroses in adulthood. First published in 1970,
Janov’s work became popular in the early 1970s after media coverage and high profile
clients such as John Lennon.
Atwood parodies this type of psychological theory by providing the character of Joan
with a ridiculous number of traumatic events in her childhood and adolescence. The vast
majority are described humorously rather than tragically. The events include the
absence of Joan’s father until she is five, the humiliation of the Butterfly Frolic, bullying
from a group of older Brownies, an encounter with a flasher in one of the city’s ravines,
the death of her pet goldfish (ironically from over-eating), being shot in the behind with
an arrow and the loss of her beloved Aunt Lou.
The final traumatic event occurs when Joan’s mother reacts angrily to the
announcement that Joan intends to move out: “‘God will not forgive you! God will never
forgive you!’ Then she took a paring knife from the kitchen counter – I had been using it
to spread cottage cheese on my RyKrisp – and stuck it into my arm, above the elbow”
(124). Although Joan is “badly frightened” it is not by the knife (it only pricks the flesh)
but “by my mother’s religious sentiments […] she had never been a religious woman”
(124). The comical nature of the scene undermines the possibility of it being interpreted
as a traumatic event that will have long lasting effects. Joan’s “surreal” (122) interview
with the school’s Guidance Counselor and a visit to a psychiatrist who asks her ‘“Don’t
you want to get married?’” (83), provide further examples of Atwood’s critique of the
benefit of psychological theories.
Joan’s thoughts on the reaction of others if she were to confess her Butterfly Frolic
story provide a hint to the way her traumatic childhood events are to be interpreted:
“Instead of denouncing my mother’s injustice, they would probably laugh at me […] the
image is simply too ludicrous” (52). Wilson confirms: “Joan’s precarious balancing act,
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both ludicrous and tragic, is so characteristically narcissistic that it might almost seem
psychoanalytic parody as well” (“The Fragmented Self” 53). Similarly, Grace asks what
is to be made of the maze structure in Lady Oracle and concludes: “Atwood’s mixture of
comedy, satire and parody does not allow soul-searching interpretations” (Violent Duality
123).
The parody of popular psychology, however, does not deter Kim Chernin from
playing talk-show psychologist. Chernin’s discussion of Lady Oracle never
acknowledges the comic nature of the novel, instead representing it as a serious
exploration of being fat. Chernin, for example, cites the passage, “She [Joan’s mother]
clearly didn’t believe I would ever be molested, and neither did I. It would have been like
molesting a giant basketball”, to exemplify how Joan has become fat “to protect herself
against male sexual aggression” (72). The humour in the selected passage undermines
her argument 143 .
Lady Oracle also challenges self-help books like Susie Orbach’s Fat is a Feminist
Issue. Orbach claims that as sex objects for men, women must conform to an ideal
image that is seen as desirable. As a result women, “become prey to the huge fashion
and diet industries that first set up the ideal images and exhort women to meet them”
(Orbach, Fat is a Feminist Issue 8). At the centre of the ideal is thinness. In this context
Orbach argues that becoming fat is a strategy that women use to respond to the
inequality of the sexes. Women get fat to avoid being positioned as sexual objects and
having to take on certain social roles. Orbach also claims that fatness also allows
women to be taken seriously when they participate in work outside the home (Fat is a
Feminist Issue 13). Ultimately, though Orbach sees fatness as an: “unsatisfying personal
143 Many critics miss the humour in Lady Oracle. Jensen quickly dismisses the humour to argue that underneath the
novel “conveys a serious message about the problems confronted by a woman who believes that she can have both a
successful, rewarding career and “the love of a good man”” (29). Also see Bök; York; and Patton.
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solution and an ineffectual political attack” (Fat is a Feminist Issue 23). She rejects
fatness as an unsatisfactory mechanism of protest.
Despite Orbach claiming that fat is a “social disease” (Fat is a Feminist Issue 6) her
solution to compulsive eating and weight gain is not to change society’s views on
thinness being the ideal, but rather to help fat women find the thin woman inside
themselves 144 . Orbach’s suggestion that compulsive eaters do not eat in response to
physiological cues has the effect of reducing obesity to a biological cause. In a critique of
Orbach’s Fat is Feminist Issue, Nicky Diamond argues that Orbach’s emphasis on the
biological hunger mechanism resorts to using a disease model to explain fatness. She
suggests the use of such a model has the effect of positioning fat as “an unnatural
pathological state for women” (48). By positioning fat as unnatural, Orbach in turn
positions ‘thin’ as ‘natural’ or free from disease.
Orbach’s statement, “[i]n giving up the size you are making an exchange – you
swap the fat for your own body” (Fat is a Feminist Issue 89), indicates her perception
that the fat body is also a foreign body, with the thin body being ‘real or ‘true’. To suggest
a person’s body is more their own because it is thin is extremely problematic. Orbach’s
belief that the fat body is simply covering over the ‘real’ body is reflected in her
statement, ‘“My fat says ‘screw you’ […] If you are really interested in me, you can wade
through the layers and find out who I am’” (Fat is a Feminist Issue 9). Here the ‘me’ is
not fat but a thinner self hiding under layers of fat.
Orbach also claims that “when you lose weight, you will not feel you have lost a
protective covering; you will feel you have become compressed” (Fat is a Feminist Issue
89). Diamond contests that Orbach is suggesting that by losing weight, “what is
144 The quote from The New York Daily News, “Throw away your diet books” which appears on the back cover of
Orbach’s book is no doubt suggesting that women need not diet any more. However, it could also be taken to mean that
Orbach’s book is the ultimate diet book.
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uncovered is a compact true self within, an inner core more pure and transcendent” (57).
In the sequel to Fat is a Feminist Issue, Orbach’s positioning of the thin body as the
‘true’ body is continued but is now referred to as the ‘organic body’. Orbach explains that
the thin self will be “a new body size that you’ve been preparing for and that is
organically you” (Fat is a Feminist Issue II 72).
Orbach’s concept that ‘inside every fat body is a thin body trying to get out’ is one
also used extensively in the weight loss industry. Weight loss programs or products rely
heavily on the use of before and after images, with the before image usually in black and
white featuring the person dressed in either overly tight clothes or baggy clothes. The
after image is always in colour and has the newly thin person dressed in vibrantly
coloured clothes, new hairstyle and make-up. Here, the after images represent the thin,
‘true’ body that was waiting to be released from the fat body. The idea is further
emphasised by having the newly thin person standing inside their former fat clothes.
Le’a Kent proposes such images imply “the self, the person, is presumptively thin, and
cruelly jailed in a fat body. The self is never fat” (135) 145 .
Joan’s weight loss challenges Orbach and the weight loss industry’s notion that the
thin self is the ‘real’ self and uncovering it through weight loss will lead to an improved
existence. Although Joan’s weight loss brings with it the sexual attractiveness so often
promised by the weight loss industry, it is not something that she welcomes. As a fat
woman Joan is rarely ‘seen’: “fat women are not more noticeable than thin women;
they’re less noticeable […] I must’ve appeared as a huge featureless blur” (82). Joan is
not only thought of as being sexually unattractive but as also having no sexual desires of
145 The ‘self is never fat’ argument is also what informs many popular weight loss diets. Peter D’Adamo’s ‘Blood Type
Diet’, for example, suggests that people have only gained weight because they have been eating the wrong food for their
blood type. Such diets are popular as they reassure some biological mechanism is to blame. Sandra Cabot’s ‘Body Shape
Diet’ is another example.
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her own 146 . In conversations at school about the mysteries of sex she is excluded, “out
of respect, as one would exclude a nun or a saint” (97). Joan comments: “Though
immersed in flesh, I was regarded as being above its desires” (94) 147 .
Following her weight loss, Joan experiences what it is like to be sexually attractive
or visible to men 148 . When she is thinner men begin to look at her differently, “like a dog
eyeing a fire hydrant” (123). When Joan goes on bus excursions to nearby cities she is
confronted by men who put their hands on her thigh. She is so unused to such advances
that she does not know how to react. These new circumstances leave Joan longing for
her old body: “there was something missing in me. This lack came from having been fat;
it was like being without a sense of pain, and pain and fear are protective” (139).
Unlike the women featured in numerous ads for weight loss products, Joan is not
elated at being thin: “I also longed to be fat again. It would be an insulation, a cocoon.
Also it would be a disguise. I could be merely an onlooker again, with nothing too much
expected of me. Without my magic cloak of blubber and invisibility I felt naked, pruned,
as though some essential covering was missing” (141). Rather than experiencing her fat
body as covering over her ‘true’, ‘organic’ body as Orbach suggests, Joan actually
experiences her fat body as her ‘real’ body. Her description of her thin body as pruned is
reminiscent of Orbach’s ‘compressed body’ idea. For Joan, however, pruning her body
has been a negative experience.
146 In a study which looked at the perceived impact of body weight on sexuality, respondents reported that an obese
woman was less sexually attractive, less desirable as a sexual partner, less sexually skilled, less sexually warm, less
sexually responsive, less likely to have a sexual partner and less likely to experience sexual desire than a normal weight
woman. Interestingly, respondents did not see there would be any difference between an obese man and a normal weight
man’s sexual experiences” (Regan).
147 Joan’s apparent asexuality provides her with employment opportunities as she is “cheap as a woman” but does not
“cause the disruption among male employees and customers other women did” (96).
148 One man finds Joan attractive when she is fat. Significantly he is a “bright-eyed foreigner” at a restaurant where she
waitresses. A similar scenario is also featured in Atwood’s short story, “The Man From Mars”. It tells the story of Christine,
also overweight, who is pursued by a man from a foreign country. See Boynton for a discussion of the foreign men in Lady
Oracle and ‘Man From Mars’ and their “[m]isreading of the female body” (59).
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Although society is more accepting of her now that she is thin, Joan continues to
have difficulties coming to terms with her thin body. Her comment “there were really only
two kinds of people: fat ones and thin ones” (214), implies that a person can only ever
belong to one category. Even though Joan is technically no longer one of the ‘fat ones’
she still thinks of herself as such. She experiences her lost fat as still present,
surrounding her now thin body: “The outline of my former body still surrounded me, like a
mist, like a phantom moon, like the image of Dumbo the Flying Elephant superimposed
on my own” (214).
Catherine Rainwater perfectly describes Joan’s relationship with her lost fat self:
“like an “amputee” who still feels the presence of a phantom limb, she continues to
experience her body as fat” (16). Grosz describes the phantom limb as, “a libidinal
memorial to the lost limb, a nostalgic tribute strongly cathected in an attempt to
undermine the perceptual awareness of its absence” (41). Atwood plays with the
concept of the phantom limb by not only giving Joan a phantom fat self that surrounds
her like a mist, but also a true phantom in the apparitions of the carnival Fat Lady.
As a child Joan always longed to visit the Freak Show tent at the Canadian National
Exhibition which claimed to hold the fattest woman in the world, but her Aunt Lou would
never permit it. Joan’s phantom fat becomes her (ph)antasy of what the Fat Lady looks
like. In Joan’s initial daydream of the Fat Lady she appears in “pink tights with spangles,
a short fluffy pink skirt, satin ballet slippers and, on her head, a sparkling tiara” (102).
Here, the Fat Lady’s attire resembles the outfit Joan was to originally wear in her
Butterfly Frolic dance routine. Later, Joan thinks she sees The Fat Lady appear as a
competitor in the Olympic doubles figure-skating championships being broadcast on
television. When the Fat Lady’s partner throws her into the air she floats: “although she
was so large, she was very light, she was hollow, like a helium balloon” (273). The Fat
Lady’s hollowness and floating nature are both characteristic of the phantom limb (fat).
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The Fat Lady’s representation of Joan’s former fat self is further suggested by the “huge
moon of her rump” (274) and the comment that she will have to be harpooned down.
Both are reminiscent of the incident at the Sportsmen’s Show in which Joan is shot in
her “moonlike rump” (116) by an arrow, while working at the archery range.
Joan’s phantom fat, symbolised by the Fat Lady, is her way of trying to retain a
sense of her former self, her self as fat. Grosz explains the phantom limb is “an
expression of nostalgia for the unity and wholeness of the body, its completion […] a
psychical attempt to reactivate a past body image in place of the present reality” (73).
In addition to representing Joan’s longing for her former fat self, the Fat Lady
provides a positive alternative to traditional stereotypes of the fat woman. The Canadian
National Exhibition symbolises Bakhtin’s fair or carnival. It, for example, includes eating
and drinking in abundant amounts. Joan describes the “wads of pink cotton candy and
greasy popcorn we would stuff into ourselves” (89). Bakhtin’s carnival spirit also involves
an overturning of hierarchal ranks and “comic crownings and uncrownings” (11). This is
expressed in Joan’s memories of the Pure Foods pavilion which every year features a
cow made of butter, but “one year they made the Queen instead” (89) 149 . The Exhibition
also features the important element of carnival laughter. Bakhtin proposes that carnival
laughter “is gay, triumphant, and at the same time mocking, deriding. It asserts and
denies, it buries and revives” (11-12). Significantly, the other midway place Joan
remembers is the “one with the giant mouth on the outside, from which canned laughter
issued in a never-ending stream. “Laugh in the Dark,” it was called” (90).
In the context of the carnival the Fat Lady takes on a new meaning. In an
exploration of Katy Dierlam (alias Helen Melon), a modern day Fat Lady, Sharon Mazer
149 A second reference to the Queen which is an example of the carnvialesque involves the Royal Porcupine hanging a
photo of himself, “in costume, holding a dead mouse by the tail”, next to a “formal portrait of the Queen and Prince Philip,
with decorations and tiaras” (244).
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offers a different view of the Fat Lady from one of passively sitting in a sideshow. Mazer
suggests that for Dierlam, taking on the persona of Helen Melon allows her to “represent her body as a sign of social and erotic power. What might generally be
perceived as a liability in life could become an asset at the sideshow” (261). Joan also
recognises this explaining that the Fat Lady “made her living from their [National
Exhibition goers] curiosity” (90). In her schoolyard daydream of the Fat Lady, Joan
pictures her escaping the constraints of the Freak Show tent to be an individual
performer. Joan imagines her crossing a high wire stretching across the country.
Although initially jeered, she wins over the crowd with her great skill: “people would rise
to their feet, the roar of their voices her tribute” (103) 150 .
As Mazer discusses, The Fat Lady’s commodification of fleshy excess also mocks
“the erotic exchange between male spectator and female stripper or topless dancer”
(258). This is clearly evident in Joan’s confusion as to whether the National Exhibition’s
Freak Show tent and the Dancing Girls tent are one and the same or different: “were
there two tents, or was there only one? The man with the megaphone sounded the same
for freaks and dancing girls alike” (90). Not ever having seen the Fat Lady at the
Exhibition, Joan imagines she is dressed as a dancing girl, in gauze pants and a maroon
satin brassiere. In one of Joan’s dreams the Fat Lady even changes from dancer to
stripper: “she’d start taking off her clothes […] removing her veils, one after another”
(251).
Joan’s final vision of the Fat Lady occurs when she is in Terremoto. She imagines
that the clothes worn in her faked drowning that she buried under the flat are coming to
life as the Fat Lady:
150 Apart from the carnival’s Fat Lady Joan also recognises the potential of fatness as an opera singer: “Even though
they were fat they could wear extravagant costumes, nobody laughed at them, they were loved and praised” (78).
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I could hear the clothes I’d buried there growing themselves a body […] a
creature composed of all the flesh that used to be mine and which must have
gone somewhere. It would have no features, it would be smooth as a potato,
pale as starch, it would look like a big thigh, it would have a face like a breast
minus the nipple. It was the Fat Lady. She rose into the air and descended on
me as I lay stretched out in the chair. For a moment she hovered around me
like ectoplasm, like a gelatin shell, my ghost, my angel. (321)
The return from the earth symbolises the regenerative characteristics of the grotesque
body and the lower bodily stratum. Bakhtin’s description of abundance in banquet
images can also be applied to the Fat Lady’s return. He explains that the images appear
as though yeast has been added, “They rise, grow, swell with this leaven until they reach
exaggerated dimensions” (278). This is reminiscent of the earlier portrayal of Joan
putting on weight in her youth in which she “swelled visibly” and “rose like dough” (70).
The combination of food (potato) and body images and the giant breast reference are all
reference to the lower bodily stratum.
Bakhtin further describes the grotesque body as “a body in the act of becoming. It is
never finished, never completed; it is continually built, created, and builds and creates
another body” (317). This describes Joan’s time of weight gain but also her actions after
she loses weight. Her grief for her lost fat self centres on the way her fat body allowed
her to be simultaneously ‘larger than life’ but also invisible: “I had been an exception,
with the limitations that imposed; now I was average, and I was far from used to it” (144).
As a result Joan builds and creates a number of new ‘bodies’, or identities in order to be
‘more’ and as a way of keeping parts of herself hidden.
The multiple identities of women in Lady Oracle are often overlooked in favour of the
men who at first appear more obviously duplicitous. Joan’s father, for example, shot
fakes in the Intelligence during the war but is now an anaesthetist whose specialty is
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saving suicide victims. The real name of Paul or the Polish Count, is Tadeo. Joan
suspects he may have other identities when she finds a hidden revolver. After Joan ends
her affair with artist Royal Porcupine he discards his cloak and top hat for jeans and a
Honda T-shirt and informs her he is going by his original name, Chuck Brewer. Even the
pervert who exposes himself to Joan as a child appears to have a double nature. When
Joan is tied up by her Brownie tormentors in the same ravine she is rescued by a man,
similarly dressed in a tweed coat. Joan wonders: “Was the man who untied me a rescuer
or a villain? Or, an even more baffling thought: was it possible for a man to be both at
once?” (64). Joan asks herself: “Was every Heathcliff a Linton in disguise?” (269). Joan
also starts to believe that Arthur may be behind the strange phone calls, threatening
letters and dead animals she has been receiving: “Every man I’d ever been involved
with, I realized had had two selves […] Why should Arthur be any exception?” (292).
While the men in Lady Oracle are double, the women are often more than double.
Leda Sprott, for example, first appears as a Reverend at the Jordan Chapel where Joan
visits with her Aunt Lou. Significantly, she is also “quite fat” (112). When Arthur makes
arrangements for his and Joan’s wedding he selects from the phone book an E.P.
Revele to marry them. When they arrive, E.P. Revele turns out to be a Leda Sprott, who
now goes under the name Eunice. Joan wonders whether ‘Eunice’ is her real name and,
if so, why she used another name at the Jordan Chapel. Joan’s comment on why people
change their name is revealing: “men who changed their names were likely to be conmen, criminals, undercover agents or magicians, whereas women who changed their
names were probably just married” (203). As John Thieme reveals, Eunice’s revelation
that she owes money puts her into Joan’s first category, therefore, also making her
gender ambiguous (77). Her possible maleness is also suggested by Arthur’s belief the
person he spoke with on the phone when organising the nuptials was a man.
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Joan’s multiple identities are signalled by her purchase of a dressing table with triple
mirrors, similar to the one her mother used to own. Barbara Godard comments that the
use of triple mirrors in Lady Oracle “disrupt any temptation to dualism” (17). We learn
that the mirror creates not only three reflections but if positioned in a certain way,
multiple reflections. When Joan places a candle in front of the dressing table in an
attempt to do some automatic writing she reports: “If I moved the two sides of the mirror
toward me there would be an infinite number of candles, extending in a line as far as I
could see” (220).
Joan’s relationship with Arthur sees her create a number of new identities. She
correctly tells Arthur that when she was younger she used to be waitress but also adds
being a cheerleader, going steady with a basketball player and being third runner-up in
the Rainbow Romp, queen-of-the-prom contest. Her loss of virginity to Paul is
transformed into a narrative involving summer camp and a sailing instructor from
Montreal. In order to prevent Arthur from discovering her living arrangements with the
Polish Count she invents a flatmate who is “fat and homely, and who became quite
unhappy and depressed if I asked any men into the flat” (165). She also tells Arthur her
mother died of the rare disease lupus and that the person in a photo with Aunt Lou
(actually Joan herself), is her Aunt Deidre: “already I’d devised an entire spurious past
for this shadow on a piece of paper […] my own shucked-off body” (91).
After marrying Arthur, Joan has a collection of experimental writings published as
book of poetry, “Lady Oracle”. The success of the book results in a number of television
appearances and fan mail. Joan Foster the popular author is born. Joan comes to see
this new identity as a separate person with her own agenda: “it was as if someone with
my name were out there in the real world, impersonating me [... ] my dark twin, my
funhouse-mirror reflection. She was taller than I was, more beautiful, more threatening.
She wanted to kill me and take my place” (250-1).
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Joan also assumes a further identity, the lover of artist Royal Porcupine whom she
meets at a party thrown by her publishers. After sleeping with him Joan acknowledges
her increasingly complicated identities: “This was the beginning of my double life. But
hadn’t my life always been double? There was always that shadowy twin, thin when I
was fat, fat when I was thin, myself in silvery negative […] I was more than double, I was
triple, multiple, and now I could see that there was more than one life to come, there
were many” (246).
Joan’s identities continue to grow when the Royal Porcupine accompanies her on a
promotional tour for her book. So as not to have their affair discovered they assume
other identities when checking into their accommodation: “we dressed up in middle-aged
tourist outfits, bought at the Crippled Civilians, and registered under assumed names”
(257). Joan’s increasing multiplicity is demonstrated by the message in Marlene’s
fortune cookie, which she believes was meant for her. It reads, “It is often best to be
oneself”, leaving Joan to wonder, “[b]ut which one, which one?” (231).
Joan’s most significant separate identity, however, is that of Costume Gothic writer.
After leaving Toronto to live in London, Joan finds she needs a source of income. She
asks the Polish Count to bring home an example of a Costume Gothic from the publisher
of his nurse novels, Columbine Books (a reference to the hugely successful, Torontobased romance publisher Harlequin). Joan has her first Costume Gothic, The Lord of
Chesney Chase published under her late Aunt’s name, Louise K. Delacourt. With the
exception of the Polish Count, Joan keeps her identity as a Costume Gothic writer secret
from everyone. When married to Arthur she writes her novels while he is out or invents
courses she has enrolled in so she can shut herself away without being disturbed. While
initially Joan writes Costume Gothics for financial reasons she comes to enjoy the dual
identity associated with it:
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It was only after I got married that my writing became for me anything more
than an easy way of earning a living […] but now it was important. The really
important thing was not the books themselves, which continued to be much the
same. It was the fact that I was two people at once, with two sets of
identification papers, two bank accounts, two different groups of people who
believed I existed. (213)
As Thieme argues, the inclusion of passages from Joan’s Costume Gothics also
makes Lady Oracle “a carnivalesque comedy in the Bakhtinian sense. Bakhtin argues
that carnivalization of form takes place when the popular forms of the market-place and
oral culture invade the domain of literature” (79). Lady Oracle challenges the distinctions
made between the ‘trash fiction’ of romance novels 151 and classic literary works. The
Polish Count’s bookshelves, for example, include works by Sir Walter Scott, Dickens,
Harrison Ainsworth, Wilke Collins and, additionally, fourteen nurse novels, “the mushy
kind”(153). The Polish Count’s pseudonym for writing nurse novels, Mavis Quilp is in fact
inspired by Quilp, a Dickens character. When Joan reads one of the Polish Count’s
books in the bath she comments: “Seductive ringlets, tendrils and strands, they always
featured in Paul’s [the Polish Count’s] books, as in Milton’s” (284) 152 . A further example
is Joan’s interpretation of Tennyson’s poem, “The Lady of Shalot”, as being about ‘The
Lady of Small Onion’, after she looks up ‘shalot’ in the dictionary, only to find shallot
(143).
Joan considers the real differences between her Costume Gothics and the books
her social activist husband, Arthur reads, “which always had footnotes” (34): “I offered a
151 Germaine Greer refers to romance fiction as “romantic trash” (212). For more positive discussions of the romance
novel see Flint; Krentz; Modleski; and Radway.
152 Other examples of trash fiction include the fotoromanzo, Italian illustrated romantic stories, which Joan buys in Rome.
While Joan finds interpreting them “fascinating”, Arthur thinks it is “faintly degrading” (184). A further example is the
movies Joan watches with her Aunt Lou. Joan’s mother, a representative of the classical body, declares that movies “were
vulgar” (80).
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vision of a better world […] I couldn’t see that it was much different from the visions
Arthur and his friends offered, and it was just as realistic” (35). In an extremely
humorous sequence, Joan admits to incorporating the political leaders featured in
Arthur’s books into her latest Costume Gothic: “I thought Lord Russell had a very
appealing face, though, and I immediately gave him a bit part in Escape from Love as a
benevolent old eccentric” (166-167). Similarly, Joan’s fantasies about Mao are rich with
carnival imagery:
I pictured him wolfing down huge Chinese meals, with relish and no guilt […]
He was like an inflated Jolly Green Giant except yellow, he wrote poetry, he
had fun. He was fat but successful and he didn’t take any shit about it […] He
encouraged jugglers and spectacles, he liked the color red and flags and
parades and table tennis; he knew the people needed food and escape, not
just sermons. (167-168)
Joan also incorporates classic literary works into the text of her Costume Gothics. In
Stalked by Love her heroine Charlotte is forced to defend herself from the unwanted
advances of the hero, Redmond with “a weighty copy of Boswell’s Life of Johnson”
(129). Flint reveals that such a technique was used in nineteenth century sensation
novels as a way of countering accusations that these novels “jaded the palate for more
demanding works” (282). Flint details how the novels of Mary Braddon and Rhonda
Broughton “are studded with quotations from writers ranging from Shakespeare to Victor
Hugo, Chaucer to Milton, Longfellow to Frances Ridley Harvergal” (282).
As the Polish Count advises, escape literature “should be an escape for the writer
as well as the reader” (155) 153 . For Joan writing Costume Gothics firstly provides her
with an escape from the boredom of spending weekday evenings with the Polish Count
153 Radway explores how romance fiction provides the reader with a source of escape. She explains how reading
romance novels enables women to escape some of the duties of being wife and mother (92).
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who is always working on his latest nurse novel. One of Joan’s specialities is including
“historical details” (33). This allows her the freedom to visit places such as the Victoria
and Albert Museum and the Portobello Road markets for research. The significance of
Joan’s escapes to these places is demonstrated by the fact that upon her return Paul
suspects she has taken a lover. Later, in her marriage to Arthur, Joan’s Costume
Gothics become an important source of stimulation 154 . Arthur is permanently
preoccupied with his latest cause and appears to pay little attention to Joan’s desires. In
addition, his frugality means they are forced to live in a succession of depressing
rooming houses and apartments. Joan’s comment that, “[w]ar, politics and explorations
up the Amazon, those other great escapes, were by and large denied them [her
readers]” (34) not only refers to the women which read her Costume Gothics, but also
her own situation.
The significance for Joan of writing Costume Gothics is revealed when her ability to
write is restricted by Arthur being home all the time: “As long as I could spend a certain
amount of time each week as Louisa, I was all right, I was patient and forbearing, warm,
a sympathetic listener. But if I was cut off, if I couldn’t work at my current Costume
Gothic, I would become mean and irritable, drink too much and start to cry” (213). Joan’s
comment on her readers’ needs for romance fiction can be equally read as a description
of her need to write them: “the desire, the pure quintessential need of my readers for
escape, a thing I myself understood only too well […] Escape wasn’t a luxury for them, it
was a necessity” (34).
Although Joan downplays the financial rewards of her Costume Gothic career, it
clearly provides her with a greater sense of freedom. For example, the money earned
from the publication of Love, My Ransom enables her and Arthur to take a holiday in
154 In her interviews with readers of romance, Radway finds that many believe romance fiction provides them with
opportunities to “expand their horizons and add to their knowledge about the world” (111-112).
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Terremoto, something they could not otherwise have afforded. The time they spend
there appears to be some of the happiest in Joan’s marriage and she thinks back on it
fondly. Finally, the money and flexibility of Joan’s career as a Costume Gothic writer
allows her final escape to Italy. Joan’s explanation of how she will send her publishers
her next novel with a note saying she has moved to Italy due to her health, demonstrates
the relative freedom such a career provides.
In addition to providing her with time away from the “soggy domestic atmosphere”
(257) of her marriage, Joan’s Costume Gothics allow her to create further identities by
giving the female characters her characteristics. The initial description of Felicia, the
villainous wife of Stalked by Love, “flame-red hair […] green eyes […] small white teeth”
(31) repeats Joan’s description of herself when she leaves home: “I’d been growing my
hair for a year and it was shoulder-length, dark red […] I had green eyes and small white
teeth” (136-7). Similarly, Estelle of Love, My Ransom is described as having “small white
teeth” and “dishevelled red hair” (218).
The importance of Costume Gothic writing to Joan is fully revealed when this
identity is at risk. Joan is uneasy with the success of her book of poetry, “Lady Oracle”
as she fears her notoriety will result in someone discovering her other selves (her
Costume Gothic writer self and her former fat self): “Now that I was a public figure I was
terrified that sooner or later someone would find out about me, trace down my former
self, unearth me” (251) 155 . Her fears are realised when Fraser Buchanan, a poet turned
blackmailer, discovers her past and requests twenty percent royalties from “Lady Oracle”
in return for his silence. Although Joan manages to steal Buchanan’s black notebook
containing all the information he has on her (and others) she is still afraid her past
identities will be exposed.
155The ‘unearth me’ comment is a reference to the lower bodily stratum which is connected to the earth (21).
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Such fears are exacerbated by the appearance of the Polish Count who has tracked
Joan down after reading about her success with “Lady Oracle” in a newspaper. He
believes Joan has been brainwashed by Arthur and plans to return to rescue her: ‘“at the
right moment, I will strike’” (281). Joan is also being bothered by hate mail, nuisance
phone calls and dead animals on her doorstep. She at first thinks they are the work of
the Royal Porcupine but then starts to suspect Arthur. Joan’s increasingly complicated
situation leads her to fake her own drowning in Lake Ontario, with the help of friends
Marlene and Sam, and fly to Italy. Critics have interpreted Joan’s decision as an attempt
to bring an end to her multiple identities. Jerome Rosenberg explains that, “the complete
and true Joan Delacourt Foster will emerge” only when Joan brings the separate parts of
her life together (118). Similarly, Davey writes that Joan’s faked drowning provides the
opportunity “from within which a new and more authentic self can emerge” (163) 156 .
There is little evidence, however, that Joan wishes to integrate her different
identities. In fact she believes this could have disastrous consequences: “If I brought the
separate parts of my life together (like uranium, like plutonium, harmless to the naked
eye, but charged with lethal energies) surely there would be an explosion” (217). I would
argue that Joan stages her own drowning because she is afraid her other lives are about
to be discovered and she will be reduced to a single identity. This is reflected in her
comments “[t]he thought of going on with the same kind of life for ever and ever
depressed me, I wanted to have more than one life” (141) and “I pretended to die so I
could live, so I could have another life” (315). Nathalie Cooke writes: “To read Joan
Foster’s narrative as a call for restraint is to provide the kind of reading that is satirized
and disrupted throughout, to play the role of Joan’s mother” (“The Politics of
156 While Davey likens the faked drowning in Lady Oracle to the Surfacing’s “symbol of descent into the unconscious”
(163) the richness of parody in the novel suggests otherwise. As Grace suggests the “mock drowning and surfacing are
tongue-in-cheek jibes at so-called Atwood obsessions” (Violent Duality 124).
194
Ventriloquism” 227). By escaping to Terremoto, Joan is able to keep secret her identity
as a Costume Gothic writer, her affair with the Royal Porcupine and her previous fat self.
Upon successfully reaching Terremoto, Joan is, however, characteristically
discontent with a single identity. She begins to create new identities, the first inspired by
the adjectives on a box of hair dye 157 she buys in Rome: “the birth of my new personality
(a sensible girl, discreet, warm, honest and confident, with soft green eyes, regular
habits and glowing chestnut hair)” (184). When the landlord, Mr. Vitroni, tells her a man
calling himself a reporter has been asking about her, Joan invents another identity. She
explains to Mr. Vitroni that she is a rich woman who is being pursued by someone who
wants to kill her for her money. When Sam sends her an envelope of newspaper
clippings about her ‘drowning’, she discovers her Joan Foster identity is undergoing
changes even after her ‘death’. The media have decided her drowning was suicide and
consequently have portrayed her as having a “morbid intensity”, “doomed eyes” and “fits
of depression” (313).
Joan’s desire to continue her multiplicity is also reflected in her attempts to finish her
latest Costume Gothic, Stalked by Love. Joan starts to identify with the character of
Felicia, the wife in the narrative who traditionally goes insane or dies, leaving her
widowed husband free to marry the heroine. Joan, however, is finding it difficult to get rid
of Felicia and is becoming bored with the heroine, Charlotte. Charlotte represents the
‘classical’ body with her “intact virtue and tidy ways” (319), whereas Felicia represents
Bakhtin’s grotesque body: “her figure that spread like crabgrass, her hair that spread like
fire, her mind that spread like cancer or public lice” (319). Joan’s wish that Charlotte
would “fall into a mud puddle, have menstrual cramps, sweat, burp, fart” (319),
demonstrates her preference for the grotesque body.
157 In Germaine Greer’s attack on the popular romance novel she refers to advertising for hair colouring as “always made
with an eye on the escapism of women, a new, crazy you will result, new possibilities will open up” (210).
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When Joan writes an ending which sees Charlotte characteristically enter a maze,
only to be rescued by Redmond she finds it “no longer felt right” (333). In an alternative
ending which Joan imagines, Felicia replaces Charlotte as the protagonist and it is she
who enters the maze. In this ending the fictional world of Joan’s Costume Gothics and
the ‘real’ world become hopelessly blurred. When Felicia reaches the centre she finds
four women sitting on a stone bench. While two of them resemble her (presumably the
first two Lady Redmonds that were lost in the maze), the third resembles Aunt Lou,
wearing a ratty fur around her neck. The fourth woman is “enormously fat” (341) and is a
hybrid of the Fat Lady and Joan dressed in her Butterfly Frolic costume. The women all
claim to be Lady Redmond, “every man has more than one wife. Sometimes all at once,
sometimes one at a time, sometimes ones he doesn’t even know about” (341).
Joan wakes from the dream when the reporter knocks on the door of her flat. She
hits him on the head with a Cinzano bottle, knocking him unconscious and leaving a
gash requiring stitches. The reporter’s injuries has her adopt the role of caring nurse,
similar to that portrayed in the Polish Count’s nurse novels. Joan moves from Mr.
Vitroni’s flat into a cheap little pensione close to the hospital from which she can walk for
visiting hours. She also starts to think of the man as a possible romantic partner, “there
is something about a man in a bandage” (345).
Joan also tells the reporter her story, but it is not certain as to which version he
receives: “I didn’t tell any lies. Well, not very many. Some of the names and a few other
things, but nothing major” (344). Despite her intentions to return to Toronto to clear Sam
and Marlene’s name (they have been arrested for Joan’s murder) it is not clear if this will
ever eventuate. She appears in no hurry to return and set them free: “Right now, though,
it’s easier just to stay here in Rome” (345).
There is little indication that Joan has brought her different identities together. Her
confession that she has lied about some of the details in her story to the reporter
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suggests she may have even invented further selves. Vincent argues, “Atwood’s
conclusion is too reassuring to be reassuring. We suspect that Joan is once again
adopting a disguise” (163). Similarly, Hite states, “Instead of recognition, a final moment
of self-coincidence, Joan seems once again to disperse” (“The Other Side of the Story”
165).
The ambiguity of the ending maintains Joan’s body as grotesque, as never finished,
never completed. It is unlikely that she will conform to one identity regardless whether
she returns to Toronto, stays in Italy or ‘escapes’ elsewhere. As Joan comments: “I don’t
think I’ll ever be a very tidy person” (345). Her career as a Costume Gothic writer
provides her with financial independence and the ability to relocate without any
significant disruption. Although Joan states she may “try some science fiction” (345), it is
difficult to believe this genre will hold the same interest for her as Costume Gothics.
Atwood’s Lady Oracle examines popular feminist discourses on weight gain and
again reveals their contradictions. Calls for the acceptance of all women’s body shapes
and sizes are accompanied by attempts to determine an organic cause for excess
weight. Joan’s experience of her lost weight as a phantom limb rejects Orbach’s notion
that inside every fat body there is a thin, ‘true’ self waiting to emerge. Bakhtin’s work on
the Rabelaisian grotesque body and the carnivalesque is utilised in order to demonstrate
the transgressive potential of fat. As a child and adolescent Joan uses weight gain as a
form of protest against traditional feminine roles. The abundance of Joan’s obese body
is later replaced by the multiplicity of several identities, including Costume Gothic writer.
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PART FOUR: Preface
The last few decades of the twentieth century have seen an increase in the
publication of personal accounts of illness. Ann Hunsaker Hawkins refers to this ‘new’
genre as pathography 158 , “a form of autobiography or biography that describes personal
experiences of illness, treatment, and sometimes death” (1). While forms of pathography
can be found throughout history, Hawkins suggests this recent proliferation of narratives
around illness is a reaction to the contemporary medical model: “Pathography restores
the person ignored or cancelled out in the medical enterprise […] returns the voice of the
patient to the world of medicine” (12).
The pathography, therefore, has played an important role in the women’s health
movement, a movement which has long been critical of modern medicine’s tendency to
forget the individual (woman) in its medical treatments. The movement’s very origins are
centred on women sharing their experiences of modern medicine with other women.
Expressing one’s experience of illness through writing is a strategy encouraged and
supported by the movement. Pathography is seen to serve several purposes, the actual
writing process is considered therapeutic and the final product provides others with a
viewpoint other than that provided by modern medicine. Kay Cook’s autobiographical
account of her breast cancer exemplifies this role: “I cannot find myself in official
laboratory reports […] I need desperately to balance the official discourse about this
disease with a story, with a life experience […] autobiography--communal, oral, written -fills those dark and awful spaces left by the public discourse about this disease” (85-6).
Pathography also provides a powerful means of advocating for changes to current
medical practices or treatment. Women’s negative experiences of treatment warned
158 A. Hawkins explains how the term ‘pathography’ appears to have been first used by Freud in Leonardo Da Vinci and
a Memory of His Childhood (178).
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other women of the potential dangers or pitfalls and at the same time called for
improvements to be made. Batt details how women’s experiences of radical mastectomy
were one of the influential factors in a shift to less aggressive forms of surgery (64-67).
Similarly, Edward Brody discusses how the pathographies of people born with intersex
conditions have resulted in the rethinking of the practice of simply assigning an infant a
particular sex (141-2).
While pathography was extremely useful to the women’s health movement it also
had a number of limitations. Pathographies tend to represent a narrow range of women,
predominantly white women of middle to middle-upper classes. Similarly, the standard
format means it is difficult for people with different experiences to express their views.
Atwood’s Bodily Harm challenges the narrow requirements of the genre. The protagonist
Rennie’s illness narrative, for example, critiques the idea that healthy-mindedness is the
only legitimate responses to a breast cancer diagnosis. Bodily Harm also examines how
support services for breast cancer sufferers appear to encourage concealment of the
disease.
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PART THREE: Bodily Harm: An Alternative Breast Cancer
Pathography
Breast cancer has become one of the most written about medical conditions for the
popular reader. A search of the topic on Amazon’s online bookstore, reveals 2 556 titles.
The number of books published every year on breast cancer is perhaps one indication of
the immense fear that the disease instils in women. Although substantially more women
die of heart disease every year than breast cancer, it is a diagnosis of breast cancer that
women dread. While many publications focus on prevention there is also a large genre
of personal accounts of breast cancer or, pathographies.
Hawkins identifies three distinct types of contemporary pathography, testimonial
pathographies, angry pathographies and pathographies advocating alternative modes of
treatment (4). Testimonial pathographies are generally those written in the late 1960s
and the 1970s and aim to provide a personal account of an illness with the purpose of
helping others. They usually have a positive attitude towards the discipline of medicine.
In contrast the angry pathographies of the 1980s, “testify to a medical system seen as
out of control, dehumanized, and sometimes brutalizing” (A. Hawkins 6). The third
pathography type is concerned with pursuing alternative forms of treatment, in particular
those which take into consideration the power of the mind and emotions in healing (A.
Hawkins 9).
Hawkins suggests that breast cancer pathographies “almost always” fit into the
testimonial category (A. Hawkins 4). Women who write personal accounts of having
breast cancer wish to share their experiences with other breast cancer sufferers but also
to raise awareness about the disease in general. As G. Thomas Couser comments, the
line between breast cancer pathography and self-help book is often blurred with
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pathographies containing supplementary resources and self-help books containing
references to pathographies (37).
While pathographies have played an important role in raising awareness of breast
cancer, the genre has a number of limitations. It is, for example, dominated by personal
accounts from women who have similar backgrounds and circumstances. Couser writes:
“Those who narrate their illnesses are generally white women of the middle-and uppermiddle classes who have the literacy, leisure, and inclination to write their stories – and
the contacts to get them published” (38). This is not to say that these particular women’s
pathographies are not of value, but rather that their narratives should not be taken as the
definitive experience of breast cancer.
The actual format of breast cancer pathographies also tends to be similar. The
pathography generally includes the initial diagnosis, facing treatment with courage and
determination and finally an attempt to find some meaning in the illness. The format
becomes so fixed it leaves little space for pathographies of people whose experience
has been different in some way. Paradoxically, the narratives heralded by the women’s
health movement for providing an alternative to medical discourse have themselves
become a discourse which excludes other types of narratives. The issue is similar to that
associated with the natural birthing movement’s attempts to provide women with an
alternative to medicalised birth. The movement itself became so prescriptive that for
many women achieving a successful natural birth was as daunting as a medically
managed birth.
Like the natural birthing movement, many pathographies assume that all women
have the same resources available to them. They take for granted that people have the
knowledge and skills to research their condition, that they are able to access both
conventional and alternative therapies and that they have the unconditional support of
their partner, family and employer. Pain, discomfort and negative feelings in general are
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rarely discussed. Couser comments on how the ill woman in breast cancer
pathographies “has an unusual array of resources – emotional, social and financial” and
how “no published narrative, to my knowledge, tells of a woman suffering in isolation, as
many women must” (38).
Dorothy Broom also discusses the “powerful conventions governing the presentation
of an illness narrative”, specifically those involving breast cancer (262). She suggests a
wider variety of published breast cancer pathographies: “from every western nation and
geographical region, any occupation, every religious and political persuasion, and
claiming the range of prognosis from complete cure to imminent death” (261), but
believes the strong conventions still leave some women “constrained or silenced” (262).
Broom sees breast cancer pathographies as being dominated by stories which “enjoin
courage, coping and camouflage of mutilation” (262).
Petrea King’s Spirited Women: Journeys with Breast Cancer provides examples of
the types of narratives Broom describes. In her introduction King explains her book is
“brimful of ideas and extracts from women’s stories to help you not only live effectively
with breast cancer but to gain greatly from your experience […] In fact, most women will
say they’re grateful for what they’ve learnt from having the disease” (xiii). Similarly,
Ehrenreich cites Cindy Cherry, quoted in the Washington Post as saying: “If I had to do it
over, would I want breast cancer? Absolutely” (“Cancerland” 49). The ‘every cloud has a
silver lining’ notion is also evident in an article published for Breast Cancer Awareness
Week, 2002. The woman featured, Shaz Dayle, is described as “bubbly”, “vivacious” and
as having an “incredibly infectious enthusiasm for life” (Fynes-Clinton 3). Shaz’s breast
cancer is described as a “gift” and a “great opportunity not everyone gets” (FynesClinton 3). Surgery provides a chance to “buy a whole new wardrobe” and cancer
treatment means a trip to the city where she can “shop until I drop” (Fynes-Clinton 3).
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Atwood’s Bodily Harm is a breast cancer pathography that not only defies the
conventions of the genre but exposes its very limitations. While the protagonist, Rennie’s
narrative contains some of the standard scenarios (diagnosis, surgery, body image
concerns) there are also differences. Rennie lacks support from her partner, family,
friends, employer and medical staff and appears not to consider a prosthesis or breast
reconstruction. Most significantly, Rennie’s pathography challenges the notion of positive
thinking in both modern and alternative medicine.
The novel is comprised of six parts with each part being further divided into short
sections. Accounts of Rennie’s childhood, relationship with boyfriend Jake, breast
cancer diagnosis and surgery, and imprisonment on the Caribbean island St. Antoine,
intersect with dreams and narratives from Lora, a woman she meets on the island, and
friend Jocasta 159 . The fragmented nature of the novel serves as a reminder of Rennie’s
breast cancer surgery. Rennie’s comparison of surgery and being murdered and “buried
one piece at a time instead of all at once” (23), hints at the novel’s structure. Rennie’s
narrative is not presented as a single, chronologically-ordered whole but is instead
“scattered here and there” (23).
In the vast majority of breast cancer pathographies the woman’s partner 160 is able
to come to terms with the situation, providing the necessary love and support. Popular
statements are ‘breast cancer has brought us closer together’ and ‘breast cancer has
made our relationship stronger than before’. Rennie’s relationship with Jake serves to
highlight that not all women diagnosed with breast cancer are in satisfactory
relationships at the time. Through the course of the novel Jake, a package designer, is
159 A number of critics suggest the stories are all those shared by Rennie and Lora in jail. For example, Carrington
writes: “To stave off their fear and panic, the two imprisoned women […] have been telling each other their life stories”
(“Another Symbolic Descent” 52). Several instances, however, cast doubt on such a theory. Rennie confesses she does
not wish to talk to Lora: “She doesn’t want to tell Lora anything. She would like Lora to vanish” (220). She is also “instantly
bored” (68) by Lora’s suggestion she could write a story about her life. Finally, Rennie admits she is having difficulty
“thinking up anything about her life that Lora might find interesting” (270).
160 Broom notes that partners in pathographies are overwhelming ‘he’s’ (258).
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depicted as a misogynist who attempts to ‘repackage’ Rennie to his satisfaction. He likes
Rennie to pretend she is being raped during sex and sends her obscene letters
composed of words clipped from the newspaper. The sex Rennie has the night before
her surgery is not tender and loving but instead resembles the operation itself. Rennie
lies “waiting for something to be done to her. A procedure […] Her body was nerveless,
slack, as if she was already under the anaesthetic” (21). The description of the sex being
long and painful and of Jake gathering “skin and muscle, wrenching, twisting” (21),
continues the sex/surgery analogy. After a failed attempt to resume their sexual
relationship following the surgery, Jake admits he is having a ‘thing’ with another woman
and moves out of the apartment.
Rennie also finds little support from other people in her life following her breast
cancer diagnosis. While in hospital she realises “most of her friends were really just
contacts” (16). Her best friend, Jocasta appears to deal with the situation by avoiding
discussing it altogether: “Politely, elaborately, she avoided the subject of Rennie” (163).
When Jocasta has lunch with Rennie she uncharacteristically picks up the tab, an
indication of her discomfort: “That meant she thought Rennie was in terrible shape, on
the brink of death in fact, since ordinarily she never paid for anything” (167). When
Rennie asks her boss for a writing assignment somewhere in the sun it is revealed that
she has refrained from telling her work colleagues about her illness. Rennie is also
unable to tell her own mother about the breast cancer diagnosis as she believes she will
blame her for the illness.
Rennie’s breast cancer experience is also made difficult by inadequate or
inappropriate support from medical staff. Initially she is given little time to take in the
news of her breast cancer diagnosis: “It had been too sudden; she’d been told, she’d
told him [Jake], the operation had been scheduled, all in the same day” (21). Following
her surgery she is given a pamphlet, “Mastectomy: Answers to Down-To-Earth
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Questions” (34). Rennie comments: “Down to earth. Who wrote these things? Nobody in
her position would want to think very hard about down or earth” (34). Despite its title the
pamphlet appears to avoid covering more sensitive issues: “Are there any restrictions on
sexual activity? she read. The pamphlet suggested that she ask her doctor” (34).
Rennie’s doctor, Daniel Luoma also fails to adequately discourage Rennie’s romantic
interest in him. Despite initially explaining to Rennie it would be “unethical” (143) for him
to have an affair with her he continues to meet with her for lunches and the occasional
dinner. When Rennie calls him at work in order “to give the impression of someone on
the verge of suicide” (237) he goes to her apartment and has sex with her. Rennie does
not feel rescued as she thought, but instead “raped” (238). Rennie’s dissatisfaction with
her medical care is evident in her thoughts on alternate meanings for the word
‘doctored’: “Doctored, they say of drinks that have been tampered with, of cats that have
been castrated” (101).
Rennie’s breast cancer pathography also rejects the camouflage of mutilation that
Broom describes. Broom discusses how women who have breast cancer surgery and
treatments such as chemotherapy are encouraged to keep any signs of breast cancer
hidden from view so as “not to spoil public optimism about breast cancer by getting very
sick or dying” (260). An apparent lack of acceptance of breast surgery scars means that
few women feel comfortable exposing them and, therefore, even fewer women ever see
a woman with a mastectomy scar 161 . The ‘Look Good Feel Better’ program is a further
example of ‘camouflage’. The program provides cancer sufferers with advice on how to
deal with the skin changes and hair loss resulting from their breast cancer treatments.
While there is no doubt the program is beneficial for many women, the strong emphasis
161 Representations of mastectomy scars are limited. The two most well-known are Hella Hammid’s 1977 photo of Deena
Metzger, titled “The Warrior” and Matushka’s self-portrait, “Beauty Out of Damage”, which appeared on the cover of the
New York Time Magazine on the 15th August 1993. For a further discussion of these images see Cartwright. For other
examples see Wilkinson.
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on appearance is perhaps questionable. One must ask if the program is only about
making the cancer sufferer feel better, or whether it is also to disguise signs of ill health
from others.
In addition to concealing the side effects of breast cancer treatments, women are
also encouraged to look ‘normal’, that is ‘two breasted’, when fully clothed. Audre Lorde
tells of being chastised by her doctor’s nurse for not wearing her prosthesis and being
instructed to wear it to future appointments, as “otherwise it’s bad for the morale of the
office” (59). A prosthesis is positioned as a necessary (and even compulsory) part of a
woman’s post-surgery recovery. Researcher Sue Wilkinson states: “Not a single woman
among my research participants described thinking about whether she would wear a
prosthesis after surgery – the possibility of not doing so was simply not an available
option” (272).
The pressure to maintain a two-breasted, symmetrical appearance comes not only
from the medical profession but also from support services for breast cancer sufferers. In
Canada, the Cancer Society established the Reach to Recovery program which involved
sending breast cancer survivors to visit women in hospital. On the first visit the volunteer
commonly offered women a temporary prosthesis in the form of a lambswool puff to put
in their nighties. The failure to allow a woman to remain lopsided in the confines of a
hospital ward following major surgery demonstrates the strong desire for concealment.
Reach to Recovery volunteers were themselves obliged to wear a prosthesis with a
volunteer instructed to give up her hospital visits if she did not wear one (Batt 230). Not
only were two breasts a requirement for volunteers but the breasts also needed to be
emphasised. The manual for volunteers instructed “Wear casual clothes. Must be wellfitted over the bustline” (Batt 232).
Breast reconstruction is often promoted as a superior option for women. While a
prosthesis can shift or float away while swimming, reconstruction promises to hide the
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physical signs of cancer forever. The term breast reconstruction, however, is in some
ways a misnomer as often the breast is not ‘reconstructed’ to its previous shape but
modified to fit an ideal. The reconstructed breast is typically firmer and sits high on the
chest. To achieve perfect symmetry, surgery may be performed on the healthy breast so
that it more closely resembles the reconstructed breast (Love 391). More recent breast
reconstructions use a flap of skin, muscle and fat from a woman’s stomach or buttocks
to create the new breast for a more ‘natural’ look (Love 392-398). This requires other
areas of the body to undergo surgery, increasing the length of recovery and the risks of
infection and scarring.
Couser comments on how shopping for a prosthesis and/or wig to hide the signs of
breast cancer treatment “is a common scene” in breast cancer pathographies (42). A
prosthesis or breast reconstruction is, however, conspicuously absent from Rennie’s
pathography. Her pathography challenges the notion that women must camouflage the
physical evidence of their breast cancer surgery. This is not to suggest that Rennie is
completely comfortable with her scar, but that given time she may adjust to her altered
body image without the need for a prosthesis or breast reconstruction 162 . Lorde claims
that breast reconstruction or prosthesis may actually rob a woman of an important part of
the healing process: “we are allowed no psychic time or space to examine what our true
feelings are, to make them our own. With quick cosmetic reassurance, we are told that
our feelings are not important, our appearance is all, the total sum of self” (57). Iris
Marion Young suggests that in the same way a woman becomes adjusted to being
breasted as a teenager and the changes brought on by pregnancy, a woman can
“reconstitute her body identity and learn to love herself with one breast” (229). The
162This third choice, not using a prosthesis or having a breast reconstruction is not often discussed. One exception is Dr
Susan Love's Breast Book which states: “Before you decide on one of these options, you might want to consider a third
possibility – not disguising your mastectomy at all. It’s not a choice many women make, but there are a few women who
do choose it, and are happy with the choice” (Love 384).
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insistence that women wear a prosthesis or have breast reconstruction means women
are not normally given the chance.
The character of Rennie demonstrates the possibility that women could learn to love
(or at least live comfortably) with their post-mastectomy bodies. When Rennie goes to
bed with Jake for the first time following her surgery she comments: “She wanted to
wear something and knew she had to” (198). The statement, ‘she knew she had to’,
demonstrates how Rennie initially feels her scarred body is somehow indecent 163 .
However, later in the novel when she is about to have sex with another man, Paul 164 ,
she decides against pre-warning him about the surgery scar. Rennie has come to accept
her scarred breast and no longer feels a responsibility to protect others from its view.
The most significant departure Rennie’s narrative has from the genre of
pathography, however, is the rejection of what Hawkins refers to as “healthymindedness” 165 (127). There are several interrelated aspects of the concept. Firstly, that
a person’s personality and behaviour is the cause of illness and, secondly that the body
has the ability to heal itself. Recovery from illness, therefore, relies upon the active
involvement of the person, in particular thinking positively.
The idea that a person’s personality could be directly responsible for disease was
popularised in the 1970s and 1980s. In 1974, Myer Friedman and Ray H. Rosenman
proposed two main personality types, Type A and Type B 166 . Type As were defined as
163 This is a thought also shared by Broom who finds she is hesitant about exposing her mastectomy scar in the
swimming pool’s changing room: “Unlike the scar on my hip [from a recent hip replacement], these wounds were
somehow shameful or obscene” (254).
164 This scene could also be seen as a typical characteristic of the pathography genre – the resumption of sex signalling
recovery. Broom comments on how medical literature focuses considerable attention on breast cancer’s threat to a
woman’s ‘femininity’. She states the implication is “that sexual availability is the criterion of recovery” (259). Rennie’s first
sexual encounter with Paul is presented in this fashion: “she’s solid after all, she’s still here on earth, she’s grateful, he’s
touching her, she can still be touched” (204). Paul’s disappearance by the end of the novel resists this idea some what.
165 Hawkins explains how she has borrowed the term from American psychologist and philosopher, William James (A.
Hawkins 127).
166 Friedman and Rosenman had been researching the concept since 1959, but it was not until 1974 that they published
the findings in a book for the lay person, Type A Behaviour and Your Heart.
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always hurrying, competitive, impatient, hostile and as taking work very seriously. They
were said to be at higher risk of coronary heart disease (CHD) (Friedman and
Rosenman 67). Conversely, Type Bs were defined as more relaxed, easy going, less
competitive and at lower risk of CHD (Friedman and Rosenman 67).
In addition to the CHD personality, a ‘cancer personality’ or Type C, was suggested.
A Type C person had an increased risk of cancer due to their tendency to repress
emotions and a helpless or hopeless attitude (Temoshok). The connection between
cancer and repression is also taken up in Susan Sontag’s Illness as Metaphors. She
explains that while tuberculosis is often associated with too much passion, cancer is
thought to be “a disease of insufficient passion, afflicting those who are sexually
repressed, inhibited, unspontaneous, incapable of expressing anger” (22).
If a person’s personality can lead to disease it follows that their thoughts and
behaviour can play a role in their recovery. The notion that a positive outlook could
actually boost a person’s chance of recovery from cancer was confirmed by research
findings. A study found that a particular coping style, identified as ‘fighting spirit’, was
associated with a longer survival from breast cancer, while the
helplessness/hopelessness coping style led to a poorer outcome (Greer, Morris and
Pettingale 785). The belief that healthy-mindedness can have a direct impact on survival
rates has since been enthusiastically adopted in both medical and popular discourses on
breast cancer 167 .
The medical profession has a number of interests in encouraging healthymindedness in patients. Susan Wendell proposes that medicine supports the mind’s role
in overcoming illness because it maintains “the illusion of medical omnipotence” (100). In
addition, patients who have a healthy-mindedness outlook are generally easier to treat
167 In 2002, a systematic review of studies investigating psychological coping styles and survival and recurrence in
cancer patients rejected the association, concluding: “There is little consistent evidence that psychological coping styles
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as they are more likely to comply with treatments and less likely to complain. To the ill
person, healthy-mindedness appeals as it provides them with the sense that they are
participating in the treatment process. They may be unable to decide how much of their
breast will be removed or how much radiation or chemotherapy they are to have, but by
maintaining positive thinking they are ‘doing their bit’.
The work of alternative therapist Louise Hay takes healthy-mindedness to the
extreme. Hay’s publication, Heal Your Body lists diseases, mental patterns that are their
probable cause, and the new thought pattern that will rid the person of the disease.
Hay’s ‘causes’ appear to ignore all known medical and scientific knowledge. AIDS, for
example, is not caused by the human immunodeficiency virus but rather, “[d]enial of the
self. Sexual guilt. A strong belief in not being “good enough”” (6). Similarly, ringworm is
not the result of a fungal infection but “[a]llowing others to get under your skin” (29) and
urinary infections are literally caused by being “[p]issed off. Usually at the opposite sex
or a lover” (33) 168 .
While Hay’s philosophy is to “stop blaming life and other people for what is wrong in
my life and my body” (4), it instead lays the blame with the sufferer of the disease. Hay
explains that for people to be cured of an illness they must change the mental patterns
that caused the illness: “When cancer or any other illness returns, I do not believe it is
because the doctor did not “get it all out”, but rather the patient had made no mental
changes and so recreates the same illness” (1). Healthy-mindedness is, therefore, not
presented as something a person might consider as part of their recovery, but as a
play an important part in survival from or recurrence of cancer. People with cancer should not feel pressured into adopting
particular coping styles to improve survival or reduce the risk of recurrence” (Petticrew, Bell, and Hunter 1066).
168 Hay claims breast problems are the result of “[o]ver mothering. Over protection. Over bearing attitudes. Cutting off
nourishment” (11), while cancer is caused by “[d]eep hurt. Long-standing resentment. Deep secret or grief eating away at
the self. Carrying hatreds” (12).
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“moral obligation” (Wilkinson and Kitzinger 806). Not thinking positively is not only seen
a failure to give yourself a chance but also a failure to act responsibly in society.
Rennie’s upbringing in the town of Griswold colours her initial response to her breast
cancer diagnosis. In Griswold, illnesses are usually viewed as being the result of
inappropriate behaviours. For the residents of Griswold such an outlook provides
reassurance – if one leads an exemplary life they will be immune from disease and
disaster. Consequently, illnesses like cancer are discussed in the same way as immoral
activities: “Cancer was a front-parlour subject, but it wasn’t in the same class as a
broken leg or a heart attack or even a death. It was apart, obscene almost, like a
scandal; it was something you brought upon yourself” (82).
Sontag confirms that a certain element of secrecy still surrounds a cancer diagnosis:
“Cancer patients are lied to, not just because the disease is (or is thought to be) a death
sentence, but because it is felt to be obscene – in the original meaning of that word: illomened, abominable, repugnant to the senses” (8-9). Similarly, Broom details the
different reactions to her hip replacement and breast cancer diagnosis: “The voices of
many of my friends and colleagues fell away to embarrassed whispers when they spoke
of breast cancer. People – from my son to my hairdresser – were distressed by cancer in
a way they had not been by the hip replacement” (252-3). She also speaks of how,
unlike her hip replacement which quickly became public knowledge, the news of her
breast cancer was not passed on to others along the grapevine. She suggests that such
a difference implies that news of breast cancer was stigmatising to her personally (253).
Rennie’s knowledge of Griswold’s attitudes towards illness results in her not telling
her mother, still a resident, of her breast cancer diagnosis. Rennie believes her mother
would see the cancer as her fault: “Other people think that too, but in different ways […]
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Sexual repression. Couldn’t act out anger” (82) 169 . Rennie’s upbringing leads her to
consider the role her emotions have played in her ill health: “The body, sinister twin,
taking its revenge for whatever crimes the mind was supposed to have committed on it”
(82). Before her cancer diagnosis Rennie had taken steps she thought would reduce her
risk of illness. When it becomes apparent that these actions have not protected her, her
response is to feel anger towards her body: “Nothing had prepared her for her own
outrage, the feeling that she’d been betrayed by a close friend. She’d given her body
swimming twice a week, forbidden it junk food and cigarette smoke, allowed it a normal
amount of sexual release. She’d trusted it. Why then had it turned against her?” (82).
Rennie’s frustration at getting cancer despite ‘doing the right thing’ is shared by women
interviewed by Julianne Oktay and Carolyn Walter. One woman comments: “I was a very
careful eater. I haven’t eaten bacon in 20 years. I never ate anything like beef. No fat. I
exercised. I took walks” (90). Another explains: “I’ve tried to take care of my body […]
After all those years of never drinking a Coke, never doing all this bad stuff, and I get
cancer!” (90).
Rennie’s feeling that she is somehow to blame for her cancer is heightened by the
fact that she is young to get breast cancer. Despite the mass media’s preoccupation with
young breast cancer sufferers, it is relatively rare to get the disease under the age of
40 170 . Breast cancer is most prevalent in women aged fifty and over. While Rennie’s
exact age is never revealed, at a lunch with Jocasta she wonders if she will “ever be
forty” (163), suggesting she is in her mid to late thirties. When the major identifiable risk
factor for breast cancer, age, is absent there is a greater tendency to look for other
169 Significantly, the two reasons Rennie identifies for getting cancer are also those identified by Sontag.
170 In the United States only about 5% of breast cancer cases occur in women under the age of 40 (National Breast
Cancer Coalition,)
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contributing factors. If one is too young to get breast cancer then there must be another
‘good reason’.
Causal theories of breast cancer draw heavily on historical constructions of
women’s bodies as inherently pathological. Many of the risk factors for breast cancer are
concerned with one underlying factor, the female hormone oestrogen. Early
menstruation, late menopause, reproductive history, breastfeeding, alcohol
consumption 171 and obesity 172 all increase oestrogen exposure 173 . Too much oestrogen
increases a woman’s risk of breast cancer. As this potentially carcinogenic hormone
occurs naturally, every female body is viewed as a possible source of disease.
This is exactly Rennie’s experience of her body, as infested and as also a source of
contagion. Confronted by a centipede in a hotel bathroom Rennie reflects: “The creature
looks far too much like the kind of thing she’s been having bad dreams about: the scar
on her breast splits open like a diseased fruit and something like this crawls out” (60).
Rennie also dreams she is “full of white maggots eating away at me from the inside” and
confesses to her doctor Daniel, “I don’t feel human any more […] I feel infested” (83).
When Jake and her attempt to have sex for the first time after her operation she finds
that Jake does not touch her above the waist, even supporting himself so that his torso
does not come in contact with hers. Rennie interprets Jake’s actions as not just a
concern that he may hurt her, but as a result of fear: “He was afraid of her, she had the
171 While a causal relationship between alcohol consumption and breast cancer has long been debated a recent
reanalysis of epidemiological studies confirmed that women who drank alcohol daily increased their risk of breast cancer
(Collaborative Group on Hormonal Factors in Breast Cancer 1234). Interestingly, the study reported that “the possibility of
a threshold dose of alcohol cannot be reliably assessed from the data” (1242). A reluctance to provide a level of alcohol
that may be ‘safe’ effectively suggests that for women all alcohol consumption may be ‘risky’. This is perhaps a reflection
of different societal attitudes towards alcohol consumption by men and women.
172 The role of obesity and dietary fat in breast cancer incidence is still being debated. As with abortion and alcohol
consumption, the attempts to establish obesity as a breast cancer risk is both socioculturally and politically constructed. It
is no coincidence that the risk factors which receive the most interest are those associated with women defying the
traditional feminine role.
173 The Right to Life movement claims that abortions cause an increase in breast cancer. The association between
abortion and breast cancer has widely been dismissed in scientific circles. Most recently, a re-analysis of 53
epidemiological studies concluded: “Pregnancies that end as a spontaneous or induced abortion do not increase a
woman’s risk of developing breast cancer (Beral et al 1007).
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kiss of death on her, you could see the marks. Mortality infested her, she was a carrier, it
was catching” (201).
While it is not clear how risk factors like early menstruation and alcohol pertain to
Rennie, delayed chilbearing is a possible contributing factor to her breast cancer.
Numerous studies suggest that women who have their first child at a young age have a
lower risk of breast cancer than women who do not have children or have their first child
at age 35 or older (Rosner, Colditz and Willett; Pike et al; Henderson, Pike and Ross).
Career-minded women who put off having a baby until later in life are, therefore, often
depicted as putting their lives at risk. Lupton reports on how headlines in the Australian
press media, ‘Career Girls Face Highest Risk of Cancer’, ‘Cancer Biggest Threat for
Yuppie Women’ suggested that “women who refused to adopt the traditional feminine
maternal role and chose instead a professional, well-paid career were courting disaster”
(“Femininity, Responsibility, and the Technological Imperative” 75). Despite the enormity
of the decision to start a family, some researchers and public health officials have made
recommendations for women not to delay childbearing in order to reduce their breast
cancer risk. Lupton details the Western Australian Health Commissioner’s
announcement in 1988 that the incidence of breast cancer would fall by a third if all
women had a baby before the age of 25 (“Femininity, Responsibility, and the
Technological Imperative” 75) 174 . Comments such as these assume all women will have
a child, it is just a matter of when.
Such an assumption is held by Rennie’s gynaecologist who for the last six years has
asked her if she is “[r]eady to have babies?” (27). While Rennie may not be considered a
‘yuppie’ her life until now has been focused more on her career rather than impending
motherhood. Rennie’s personal circumstances reveal a major fault in the
174 Interestingly, the other requirement for the reduction was that women maintained their ideal body weight (Lupton,
“Femininity, Responsibility, and the Technological Imperative” 75).
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recommendation for women to have babies earlier, men’s contribution to delayed
childbearing. It is often taken for granted that women are firstly in a relationship and,
secondly, the relationship is with a man who is willing to have children. Rennie is
representative of women who may have considered having children earlier, but whose
relationship circumstances prevented it. On the one occasion Rennie discusses the topic
with Jake he suggests she shouldn’t limit her options too soon, “as if it was only her
options that would be limited, it had nothing to do with him” (126). Jake’s lack of
commitment to their relationship is perhaps a reason why Rennie has delayed having
children.
While having a baby earlier in life is considered to be protective of breast cancer,
having a baby following a breast cancer diagnosis is “a risk” (Atwood, Bodily Harm 126).
The pathological nature of women’s bodies is further explored through Rennie’s
questions about the possibility of having a baby following her recovery. When Rennie
asks if she will ever be able to have a baby, her doctor Daniel replies: “It’s not a question
of whether you can or not […] Of course you can, there’s nothing physical that would
stop you. You could probably have a perfectly normal, healthy baby” (126). His comment
that Rennie could have a normal, healthy baby in turn positions Rennie’s own body as
abnormal and unhealthy. The ‘probably’ also suggests that Rennie has the potential to
pass on her own diseased state to her ‘innocent’ foetus.
Historically, women have long been blamed for the health and well-being of their
babies. In the seventeenth century, several medical professionals popularised the theory
of maternal impressions. As Rosi Braidotti explains the theory “attributes to the mother
the capacity to undo the living capital she is carrying in her womb; the power of her
imagination is such that she can actually kill or deform her creation” (145). In order to
avoid the possibility of damaging her unborn child, women were instructed to avoid
situations where they might experience disturbing events and to suppress any strong
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emotions. The theory of maternal impressions provides one of the first significant
examples of women being depicted as potentially sickening to their unborn child.
While her doctor is not concerned about the effects of Rennie’s imagination, his
comments do display a general lack of confidence in her ability to produce a healthy
child. Daniel, like the seventeenth century theorists, is afraid of what Braidotti refers to
as “monstrous births” (145), the birth of children with deformities. If Rennie’s pregnancy
was to coincide with a return of her breast cancer, further treatments could jeopardise
the health of her unborn child. Rennie’s potentially cancerous body is, therefore, seen as
a threat to her unborn child.
The notion of women’s bodies polluting the otherwise ‘healthy’ body of the foetus is
also a feature of the so-called ‘breast cancer genes’, the gene mutations BRCA1 and
BRCA2. These genetic mutations can be passed on to family members (National Cancer
Institute). For women diagnosed with breast cancer a common concern is that they may
have given the genetic mutations (and, therefore, an increased risk of the disease) on to
their daughters: “I felt a lot of guilt for that, that I’d put everybody through so much pain
and that now my children had a greater risk. Even though I knew I didn’t do it on
purpose, I still felt a lot of guilt” (Oktay and Walter 66).
Rennie’s reaction to her breast cancer diagnosis is typical of someone who is
suddenly labelled ‘at risk’. While Rennie’s cancer is treated, as with many cancer
sufferers there is a risk of recurrence. Petersen and Lupton explain how the experience
of being ‘at risk’ is “highly personal, often confronting the individual with the possibility of
serious illness or death and changing notions of the embodied self” (50). Rennie’s
reaction is to take an extreme interest in germs and other potential sources of disease.
On her flight to St. Antoine she picks out the lettuce in her sandwich so as to avoid
amoebic dysentery. When the hand blow-dryer in the washroom claims to be a
protection from disease, Rennie dutifully uses it. She refers to the contents of her toiletry
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bag as “pieces of cleaning and sterilizing equipment” and explains how the phrase
‘Prevention of Decay’ is “no longer just a slogan” (48). Rennie’s heightened
consciousness of disease also sees her question other people’s ‘risky’ behaviour. While
waiting for a boat to visit the reef Rennie watches two young girls sunbaking in their
bikinis and thinks “Skin cancer” (80). She herself is wearing a neck-high dress to avoid
the sun damage, even though it is too warm.
Rennie also questions the stability of her body. She comments on the bodies her
doctor Daniel has operated on: “we’ve been resurrected […] we’re not all that well glued
together, any minute we’ll vaporize. These bodies are only provisional” (143). Having
had her body opened up in surgery leaves Rennie feeling that her body no longer has
fixed boundaries. During her stay on St. Antoine, Rennie does not go swimming for she
fears: “the scar will come undone in the water, split open like a faulty zipper, and she will
turn inside out” (80). While carrying her camera bag Rennie feels an ache in the scar on
her breast but is afraid to look down in case she sees “blood, leakage, her stuff coming
out” (22). She is also revolted at the chewed fingers of Lora, a woman who befriends her
on the island: “She doesn't like the sight of ravage, damage, the edge between inside
and outside blurred like that” (86).
Rennie’s distorted body boundaries are an example of Kristeva’s abject. As Jackie
Stacey explains cancer clearly fits Kristeva’s definition of the abject. Unlike a virus or
bacterium, a malignant cell is: “produced by the body, it is of the body, and yet it is a
threat to the body. Neither self nor other, it is both the same as and different from its host
[…] It should be an expelled object, but it remains part of the system” (Stacey 77-8).
Cancer, therefore, disrupts a person’s sense of order, of inside and outside. The body
does not identify the cancer cells as foreign or other and expel them, instead it allows
them to remain inside.
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The intrusion of cancer into Rennie’s body is paralleled in the novel by an intruder
breaking into her apartment, only fleeing after a neighbour alerts the police. The
intruder’s entry while Rennie is out reflects on how Rennie is oblivious to the initial entry
of cancer into her body. For Rennie there were no warnings that her body had been
invaded by cancer: “Her body was in the mirror, looking the same as ever” (20). She only
becomes aware of the intruder/cancer’s presence when alerted by others
(policemen/doctors). The policeman’s warning that the intruder of Rennie’s apartment
will most likely return, “[t]hat kind always comes back” (14) also symbolises the
possibility of Rennie’s cancer returning. Just as Rennie can no longer be certain of the
security of her apartment she has no guarantee that the cancer treatment will remove all
traces of the cancer from her body. The policeman also tells her she is “lucky” (14), and
expression that her doctor Daniel also uses.
The policemen’s response to Rennie’s apartment break-in also implies Rennie is in
some way responsible for the intrusion, in the same way people are often blamed for
getting cancer. One of the policeman starts to question Rennie about her relationships
with men and whether she closes the curtains when showering and getting dressed.
Rennie thinks: “He wanted it to be my fault, just a little, some indiscretion, some
provocation” (15).
Initially, Rennie tries to ignore the feelings of infestation and dissolution by taking on
the obligatory ‘positive attitude’. While in hospital recovering from surgery a nurse
advises Rennie: “He [doctor Daniel] says a lot of it has to do with attitude, you know?”
(35). Rennie sets herself a number of goals and schedules such as doing her arm
exercises and learning to brush her hair again. She also goes to see light-hearted films
with Jake to “cheer herself up” (83). When Rennie goes to see her doctor to have her
stitches out she wears “a red blouse, to show Daniel what a positive attitude she had,
and sat up straight and smiled” (83). When Daniel congratulates her on how well she is
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doing, however, she begins to cry. Rennie’s response demonstrates the inadequacies of
the healthy-mindedness approach often promoted in breast cancer pathographies. For
some people, wearing red and going to see comic films are insufficient ways of dealing
with a cancer diagnosis.
Rennie eventually rejects the healthy-mindedness approach, returning to the
fatalistic attitude she had when facing surgery. She had been reluctant to have surgery
because she believed “she was doomed anyway, so why waste the time?” (23).
Rennie’s pessimistic attitude extends to believing that she will die during the operation,
despite the relatively small risks. Later, when a St. Antoine local, Dr. Minnow, asks her if
her husband will be joining her later Rennie assures him she will “be fine” (31). It is
explained, however, that this “is not what she believes” (31). This attitude is in stark
contrast to the usual ‘positive thinking, fighting spirit’ approach expressed in other
pathographies.
Following her surgery Daniel gives Rennie “an earnest lecture” about how her
cancer is the start of a new life (84). Daniel’s spiel shares many similarities with breast
cancer pathographies: “This was the second part of her life. It would be different from the
first part, she would no longer be able to take things for granted, but perhaps this was a
plus because she would see her life as a gift and appreciate it more. It was almost like
being given a second life” (84). Rennie’s thoughts on his lecture clearly demonstrate her
opinion of this type of outlook: “what a lot of facile crap he was talking […] Where does
he get this stuff, she thought, The Reader’s Digest?” (84). She responds by asking,
“what am I supposed to do with it? All this time I’ve got. Sit around waiting till it gets me?
You know it’s going to, sooner or later” (85).
Rather than feeling like her cancer is a new beginning, Rennie feels as though she
is living on borrowed time. Stacey explains how a cancer diagnosis brings people a
sudden awareness of their own mortality, an awareness that never truly goes away:
219
“Once diagnosed, death becomes part of life and refuses to be banished. It becomes a
constant companion. A new certainty. The only certainty” (73). Prior to the discovery of
cancer in her body Rennie worried about living to the age of her grandmother, who was
affected by dementia in old age. Following the cancer, however, Rennie's speculations
on her life expectancy are modified to whether she will make the age of forty. When Paul
tells Rennie he will tell her about his time as an agronomist, “sometime”, Rennie notes
how he is “assuming the future; which is more than she can do” (47). Similarly when Dr.
Minnow asks her to cover the local election Rennie thinks to herself: “I’m dying […] Don’t
count on me” (137).
Rennie rejects healthy-mindedness, not only because it does not reflect her feelings
following a cancer diagnosis but also because of its dangerous flipside, one of blame.
When Daniel informs her, “[w]e don’t know why, but it [hope] helps, or it seems to […]
The mind isn’t separate from the body; emotions trigger chemical reactions and vice
versa, you know that” (82), Rennie replies “[s]o it’s my fault if there’s a recurrence? I
have cancer of the mind?” (82). Rennie’s statement demonstrates that she feels the
concept of healthy-mindedness unfairly leaves people with the responsibility of getting
well.
Rennie’s concern is one shared by Batt who, after a breast cancer diagnosis,
became interested in the mind-body question but, “was offended by the underlying
implication of these questions: that some personal failing of my character had caused
me to get cancer and that – if I really wanted to live – I would quickly perform the
necessary major surgery on my life, if not my basic essence” (148). Like Rennie, Batt
finds the concept of positive thinking unsettling. It implies that a complete cure is
available if the person just has the right frame of mind. While the power of the mind is
definitely a reality, as evidenced by the placebo effect, proposing the mind has complete
power over the body is problematic. It has, for example, significant implications for those
220
whose health does not improve or for those facing death. They may believe they did not
think positive enough thoughts and, therefore, their continued ill health is a result of not
trying hard enough.
Rennie’s scepticism of positive thinking is also reflected in her attitude towards
alternative therapies, which commonly incorporate healthy-mindedness concepts.
Rennie’s reference to alternative therapies is limited to the more obscure ‘cancer cures’
that have been promoted over the years: “extract of apricot pits, meditation on the sun
and moon, coffee enemas in Colorado, cocktails made from the juice of cabbages, hope
in bottles, the laying on of hands by those who say they can see vibrations flowing out of
their fingers in the form of a holy red light? Faith healing” (60). The fact that Rennie’s list
of alternative therapies is dominated by quack cures indicates her lack of faith in such
therapies. This is reinforced by her description of people who seek out such cures as
“odd wanderers, the desperate ones” (59).
The events surrounding an old woman treating a tourist for stepping on a sea urchin
also questions the validity of alternative therapies. After treating the injured foot the old
lady starts massaging the tourist’s ‘good’ foot, explaining that she has received a blow
when she was little and if the poison is not moved it will turn into cancer. Lora, however
pronounces the woman an “old fake” (193). Visualisation, a technique extremely popular
in alternative approaches to cancer is also challenged in Bodily Harm. Visualisation for
cancer usually involves the person visualising the cancer cells in their body
disappearing. They may imagine that their immune system or cancer drugs are hunting
down and killing the cancer cells in their body (Batt 144). Rennie’s thoughts are a
complete contradiction of such techniques. She instead imagines the cancer cells
invading her body: “the other cells, the evil ones which may or may not be there, working
away in her with furious energy, like yeast” (100).
221
In addition to challenging notions of support, camouflage and healthy-mindedness
common in breast cancer pathographies, Rennie’s narrative also acknowledges the
tenuous conclusion of such stories. As Couser explains many breast cancer
pathographies could be said to be a “misrepresentation of the disease” due to the
“inevitable lag between the creation and the reception of a book narrative closure is
always out of date: the condition of the author is not necessarily the same as that of the
narrator, who typically “recovers” at the end of the story” (40). The ambiguous
conclusion of Bodily Harm is an attempt to avoid such a lag.
At the conclusion of the novel Rennie is trying to comfort Lora who has been badly
beaten by guards following their imprisonment for suspected involvement in a local
political uprising. Paul, Rennie’s holiday lover has vanished leaving the two women with
little chance of a rescue. The only escape narrative provided is one imagined by Rennie.
It involves her being rescued by a government representative and flying home to
Canada. Significantly, Lora is absent from Rennie’s imagined ending, although a picture
in the in-flight magazine hints at her fate: “A blonde in a low-riding tie-dye sarong, the
splotches reddish” (300). The concluding sentence adds to the ambiguity: “She will
never be rescued. She has already been rescued. She is not exempt. Instead she is
lucky, suddenly, finally, she’s overflowing with luck, it’s this luck holding her up” (301).
By not confirming Rennie’s fate, Bodily Harm defies any attempts to fix Rennie in a
particular stage of her illness or recovery. Grace Epstein comments on the novel’s
conclusion: “Events remain, after all, permanently in the middle, while endings represent
only points at which the teller chooses to stop” (90). This perfectly reflects Rennie’s story
as a cancer sufferer, someone who does not know where or how their narrative will end.
Although Rennie’s cancer had been in remission, Daniel’s suggestion she should have
further tests introduces a level of uncertainty. Rennie leaves for her working holiday
before attending her appointment and so is unsure if her cancer has returned. The
222
reference to ‘luck’ in the concluding sentence also suggests Rennie may have finally
been able to abandon the notion that a person has control over their health status.
Rennie recognises that people’s fortunes and misfortunes are simply random
occurrences rather than the result of an individual’s (mis)behaviour.
Atwood’s Bodily Harm examines pathography and its role in allowing women to
share their experience of breast cancer. While stories of sickness can provide women
with sources of inspiration and hope they also have their limitations. The format of
pathographies has become so fixed that some women’s stories do not ‘fit’, leaving them
constrained or silenced. Rennie’s breast cancer narrative provides an alternative
pathography, one that details her lack of support during her breast cancer diagnosis and
her rejection of the notions of concealment and healthy-mindedness.
223
CONCLUSION
From the publication of The Edible Woman in 1969 to The Handmaid’s Tale in 1985,
Margaret Atwood’s early fiction provides a unique exploration of the women’s movement
and, more specifically, the women’s health movement during this time. Atwood’s novel,
Surfacing, engaged with health issues that were the central to the establishment of the
movements, most notably abortion, safe and reliable contraception and birthing. The
exploration of these issues saw Atwood’s work adopted by the women’s movement.
Subsequently, much of Atwood’s other fiction has often been typecast as second wave
feminist tracts.
It is worthwhile revisiting Atwood’s early fiction to re-investigate her portrayal of
women’s health issues and the women’s health movement. A renewed look at this work
reveals a more complex engagement with the women’s health movement than is first
recognised or represented. In Surfacing, for example, the inadequacies of contraception
and problems associated with medically managed birth are both addressed, but not
without an inquiry into the validity of an absolute rejection of modern medicine’s
involvement in the reproductive role. Atwood explores issues affecting women and their
health but is opposed to the extremism associated with some proponents of the
women’s health and women’s movements. Atwood is critical of any movement or faction
that dictates to women what they should think and how they should behave. In addition,
she exposes the contradictions and limitations of the women’s health movement.
Atwood critiques the women’s health movement’s extremism through her rejection
of the concept that women are simply victims of the patriarchal institution of medicine. In
order to demonstrate the extent of women’s oppression, the women’s health movement
has tended to depict medicine as an inescapable and monolithic force. This falls into
Atwood’s Position Two: “To acknowledge the fact that you are a victim, but to explain
224
this as an act of Fate, the Will of God, the dictates of Biology (in the case of women, for
instance), the necessity decreed by History, or Economics, or the Unconscious, or any
other large general powerful idea.” (Survival 37). By depicting the institution of medicine
as “vast, nebulous and unchangeable” (Survival 37), the women’s health movement
suggests to women that changes are impossible.
Atwood instead explores in her fiction the possibility of change offered by Position
Three: “To acknowledge the fact that you are a victim but to refuse to accept the
situation that the role in inevitable.” (Survival 37). Atwood’s Position Three
acknowledges that victimisation occurs but refuses to accept that it is inevitable. A
person in Position Three is able to decide how much of their position can be changed.
The female protagonists of Atwood’s early fiction all enter Position Three at some stage.
They use a range of strategies to resist circumstances they find unacceptable. From
escaping through memory in The Handmaid’s Tale to creating an obese body in Lady
Oracle, the women in Atwood’s novels engage in subtle and often unconventional
resistances. By refusing to accept the fate of victimhood and participating in resistance,
Atwood’s protagonists avoid positioning patriarchy and its institutions as monolithic
forces that can never be challenged.
In Surfacing, the switching of the medicalised birthing description to one of abortion
draws attention to the conflict in advocating for access to safe abortions while
celebrating women’s reproductive role. The short story “Giving Birth” demonstrates how
Atwood’s position on some women’s health issues changes over time. While Surfacing
appeared to support natural birthing methods, in “Giving Birth” these methods receive a
more critical eye. Atwood explores the prescriptive tendencies of the natural birthing
movement’s guidelines for a successful birth, in particular those surrounding pain
management. The extent of natural movement’s guidelines suggests they are as rigid as
225
those of medicalised birth. “Giving Birth” also examines the birthing experiences of
women of colour and poor women.
In The Handmaid’s Tale, Atwood turns her attention to infertility and assisted
reproductive technologies and to the similarities between the ideologies of the new Right
and that of radical proponents of the women’s movement. In the Republic of Gilead, the
condemnation of assisted reproductive technologies (ARTs) has formed the basis of a
Right-wing regime which celebrates its own version of natural conception. In addition,
anti-pornography demonstrations have been the inspiration for the elimination of not only
pornography, but all reading material for women.
In The Edible Woman, Atwood examines the issue of eating disorders through the
protagonist, Marian. Marian’s job in a market research firm and her awareness of
advertising and the mass media, refute the belief that women with anorexia nervosa are
disordered readers. Marian uses starvation as of a way of protesting against the limited
roles of wife and mother available to her. Joan in the Lady Oracle also uses her body as
a site of resistance, putting on weight as means of gaining power over her mother.
Atwood critiques Susie Orbach’s concept that the real self is thin through her depiction of
Joan’s lost weight as a phantom limb. Bakhtin’s exploration of the carnivalesque and the
grotesque body also serve to highlight the transgressive potential of being fat.
In Bodily Harm, the women’s health movement’s holistic approach to women’s
health is scrutinised through the use of complementary and alternative therapies in
treating conditions like cancer and the concept of healthy mindedness. Bodily Harm also
illustrates the limitations that surround women sharing their experiences of breast
cancer, a concept central to the women’s health movement. Atwood demonstrates that
the content and style of such pathographies must conform to particular criteria.
A return to Atwood’s early fiction also provides a valuable clue for reading the last
two decades of her work. Approaching Atwood as purely an F-word female risks
226
overlooking a significant and interesting aspect of her work. Demonstrating the often
subtle ways in which Atwood critiques the women’s health and women’s movements
warns the reader against superficial readings. First impressions may indicate the
straightforward depiction of women’s oppression in society. However, a closer look may
reveal a more complex state of affairs. It is common, for example, for the victimisers of
women in Atwood’s fiction to be other women, disturbing the traditional victor/victim
dichotomy.
Applying the same approach used in the examination of Atwood’s early fiction to her
latest novel, Oryx and Crake, would be particularly valuable. Oryx and Crake sees a
return to speculative fiction, eighteen years after the Republic of Gilead captured
people’s imagination. As well as the choice of genre, the novel also prominently features
the disciplines of medicine and science. The female character of Oryx provides perhaps
Atwood’s best example yet of a woman who refuses to take on the victim role. Other
areas for further research could include the ageing body in The Blind Assassin and the
exploration of psychiatry in Alias Grace.
The analysis of Lady Oracle and The Edible Woman should also suggest to the
discerning reader of Atwood’s later fiction that it should not always be taken too
seriously. Humour often plays an important role in her work and a failure to recognise it
can result in misinterpretations. For example, when parody is read straight the work may
be said to support an issue when it is in fact being ridiculed. Atwood’s parodying of
popular psychology in both Lady Oracle and The Edible Woman provides an obvious
example. Marian’s declaration that the cake woman in The Edible Woman is ‘“only a
cake” (273), also serves as a caution for the reader intent on deciphering the richness of
symbolism in Atwood’s work. At times it appears as though certain elements may have
been included in order to deliberately confuse the reader or perhaps, even more
mischievously, to set them up.
227
Atwood’s early fiction provides a valuable insight into the women’s health movement
and its discourses on modern medicine. Atwood’s position as a fictional writer provides
her with an exemption from having to pose solutions to any questions raised. This
status, along with her rejection of the feminist label, allows her the space to make a
unique contribution to emerging debates on women’s health issues. While Atwood’s
work supports many of the philosophies of both the women’s health and women’s
movement, it also exposes elements that are contradictory or problematic. In particular
she highlights inconsistencies in the depiction of women’s maternal role, examples of
essentialism and the dangers of fanaticism. Most significantly, Atwood critiques the
positioning of women as victims of modern medicine without acknowledging the
possibility for resistance.
228
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