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The Medicalisation of Women's Health

By Denice Finnegan

Both the Victorian and the modern medical systems reclassify aspects of healthy femaleness into grotesque abnormality. Victorian medicine treated pregnancy and menopause as diseases, menstruation as a chronic disorder, childbirth as a surgical event.

Naomi Wolf "The Beauty Myth" p223, Vintage, London, 1993

What, indeed has changed in today's medical systems?

Medical science has researched better and more efficient means of mining our natural resources, with (literally) bloody little concern for the true health, comfort, nurturance, or even survival of those resources..We must begin, as women, to reclaim our own flesh..education is the first step, since all that fostered ignorance and self contempt dissolve before the intellectual and emotional knowledge that our female bodies are constructed with beauty, craft, cleanliness, yes, holiness.

Robin Morgan, The Word of a Woman Virago Press, 1993, London

What's this About?

This paper is about reclaiming our own flesh, our profession, our medicines, our health. These things are being taken away through the process of medicalisation.

Medicalisation: the practice of defining life's problems and experiences as medical problems. It treats all discomforts and complaints with complex medical procedures and technology. It medicates normal life events. The events of women's lives, including the normal processes and risks of life, such as menstruation, pregnancy, childbirth and aging, are frequently converted into diseases that need treatment.

Medicalisation defines illness by its physical aspects only, ignoring the social, economic and political context of health, and the concept of vitalism, or life force. Instead it uses the frameworks of science, materialism, reductionism, and power.

As Natural Therapists, we operate within the same societal framework that creates medicalisation. We must understand this framework - the values that underlie medicalisaton - so we don't use these same values in the way we practice Natural Therapies.

The values that underlie medicalisation have evolved throughout the centuries. Prior to the Middle Ages, a persons life experiences, including their health, were defined and explained in religious terms. People saw themselves as spiritual beings, comprised of a body, mind and spirit that were inseparable. As Western civilization developed, science replaced religion as the main source of authority and knowledge. Now the framework to understand the world was a scientific one. The human being was split into two parts: the body (which was to be the province of the medical profession), and the spirit (which was the domain of religion). Bio-medicine was the branch of science that explained disease in physical terms, and the medical professional became the expert in the bodily sciences.

These bio-medical experts base their actions on four value systems:

Scientific Method

The scientific method is when the expert gathers information from objective sources. That is, from the accepted body of scientific knowledge, from tests carried out on the patient, from machines, and from other experts that is specialists. An expert will draw the main source of information, for example, from double-blind crossover, placebo controlled experiments, carried out with large numbers of people, or rats, or cultures on a petrie dish. Medical testing procedures are claimed to be an objective source of information, that are valid because they are measuring an observable outcome or physical function, such as blood hormone levels.

Materialism

Materialism holds that only material objects, things of the physical world, are important. The expert gathers information on the physical: those parts of the body that can be seen, observed and tested. Illness and diseases are defined as being of organic origin. Many women suffered for decades from the combination of exhausted adrenals and struggling immune and nervous systems, that was later called Chronic Fatigue Syndrome. No recognition was given that these women had a valid complaint, until physical evidence was ‘discovered that a microbe was ‘causing a medical syndrome.

Reductionism

Reductionism occurs when a person is reduced to an organ, system or set of symptoms. When a woman sees an obstetrician for her pregnancy, the whole woman is reduced to a uterus. Usually they will acknowledge that the uterus has blood pressure.

Power

An expert is exercising power over the patient when they assume control of that patients body. This happens when the expert makes an assessment, name a disease, decide a treatment, and act upon the patient, who remains a passive recipient in this process. The process of taking a PAP smear is the best illustration of power over the patient. Just lie back and relax, the woman is told. As someone's hand intrudes inside her body, assessing, she must remain passive. Then after the procedure she is told –this is the diagnosis, you have CIN 2 (a disease), this will be the treatment, you must have diathermy. The most active part she plays is paying the bill.

These four value systems – The scientific method, Materialism, Reductionism and Power over are supported by an economic system called economic rationalism - where value is measured by economic value. Women and hormones equal big business these days. Women are being treated for conditions that are not an illness or disease, because the condition has been re-classified in order to sell a product. Hormone manipulation, such as the oral contraceptive pill, injected contraception, hormone replacement therapy and assisted-fertility programs, allows many women's health issues to be targeted in this way.

Within the allopathic system, the common female experience of menstruation is marketed as undesirable, uncomfortable, unnecessary, and ultimately dangerous, in order to sell medicines that artificially change hormones, such as the oral contraceptive pill. Some medical practitioners have suggested it is healthier to reduce the number of menstrual cycles a woman experiences in her lifetime, as this reduces dangerous, disease producing conditions in the body. The role played in women's health by multiple abusive factors of modern life and environmental pollutants such as xenoestrogens, is ignored. Medicine has convinced women that menstruation itself is the problem.

Patient exposure to marketing, through scientific studies, media advertising, patient handbooks and ‘human interest stories has convinced young women they are better off not menstruating, and that it is their right to choose not to have periods. 25 years ago, depo provera was banned as dangerous and possibly carcinogenic. Now, depo provera injections have become the contraceptive of choice for many young women, widely used to stop the menstrual cycle completely. Next page >>