On the Medicalization of Women’s Bodies

Women’s subjectivities are exchanged for their childbirthing ‘responsibilities’, their bodies only gateways to their reproductive parts in the eyes of the state. In her book “Reproductive Justice: The Politics of Health Care for Native American Women,” Barbara Gurr argues that the reproductive-health care system is anchored in these “heteropatriachal assumptions about women as reproducers...which privilege the production of babies as the social objective of women’s biology” (Gurr 39). The essentializing of womanhood as motherhood guarantees that women are never quite recognized as human beings or as valuable beyond their ability to bear children; their bodies are never whole, never seen in their fullness. The healthcare system continues to neglect women before they enter and after they are past their childbearing years. The most obvious example of this is the way women’s general health is always intertwined with and even disappeared into child, maternal and reproductive health; medical services for women are relegated to obstetrics and gynecology even when their health conditions have nothing to do with reproduction. 

Gurr traces the history of institutionalized medical practice and research along with the induction of midwifery (now obstetrics and gynecology) into this professional medicine. She explicates how standardizing medicine through medical schools, integrating medical practice with research, establishing professional associations, and developing rigid legislation and licensing criterias grounded in academia has effectively constricted what kinds of medicines and healers can be considered legitimate and which people are able to participate in medicine (Gurr 41). These various processes have made organized medicine the only site of medical knowledge and health care as well as they served to link governmental procedures with the medical field, affording the government authority over medical structures and thus over bodies. Not only that but the assimilation of midwifery into professional medicine meant the medicalization of women’s bodies. It was an exercise of male power over women which disassociated women from their own bodies and increased the doctor’s authority over their female patients. This served to enhance the state’s ability to manage them through physicians.

In the process of the medicalization of reproduction, women’s bodies were dismembered, distorted, and then alienated from them. I use “dismembered” to describe the fragmentation women continue to suffer at the hand of biomedicine which treats women like the ‘womb on legs’ and rarely like whole human beings, while I say “distorted” and “alien” to mean that women’s bodies became something else, something foreign even to themselves. By locating medical knowledge production, dissemination and practice - especially that which pertained to women’s health (really maternal health) - in the elite medical academy, medical professionals became the gatekeepers to medical funding and the authority on women’s bodies. They became the only approved avenue through which women could receive health care, learn and talk about their bodies as well as make decisions about them. Unsurprisingly, these medical systems are a great deal less accessible to disadvantaged communities economically and because they privilege middle class heterosexual white health experiences. 

A discourse of fear was erected around childbirth (and in many ways the female body itself), constructing it as an “...unpredictable...and dangerous...pathological process from which only a small number of women escaped permanent damage” (Gurr 42-43).  In a study of medical shows, documentaries and reality television by Judith A. Lothian, she found that the  “maternity ward-ization of birth” (as she called it) was in the business of “marketing fear” to women about childbirth (and since childbirth is deemed women’s sole purpose in life, fear of childbirth naturally facilitated fear of their bodies). It normalized and naturalized “medical births” and marginalized all other forms of giving birth that do not involve maternity wards (e.g. non-medicated or home births, the involvement of midwives and doulas). 

Under this assumption, the female body is the unknown; it is inherently fragile, unstable and always on the verge of needing medical intervention and childbirth is a dangerous medical condition rather than a normal process. The body becomes a medical technology only the doctor is knowledgeable on; he/she can act on it and manipulate it in much the same way as their medical instruments. Female anatomy becomes enshrouded in mystery which is compounded by the fact that medical treatments and general medical knowledge are garnered from male anatomy. This leaves chasms in our understanding of female biology beyond reproductive processes, and this information poverty continues to support assumptions of women solely as reproducers and doctors as the “all knowers”. I say “information poverty” to highlight that power exists in the epistemology of women’s bodies, structures that determine what we know, don’t know and what the medical field chooses to know about female biology thus controlling the discourse around it.

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It is no wonder that there has also been a growing body of knowledge, through studies and personal narratives, discussing gender bias in the medical field that regards and treats women’s pain less seriously leading to large disparities in health outcomes between men and women. The study “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain” by Diane E. Hoffman and Anita J. Tarzian found that doctors were more likely to dismiss female patients’ symptoms as imaginary or due to emotional or psychological factors. The study found that doctors most often believed that men’s pain was organic, rational and real in contrast to women’s pain which was seen as psychological, and so male patients were likely to receive pain medications versus women who were more likely to receive sedatives. Due to this, women are hesitant to seek health care lest they be accused of overreacting or hysteria. More information on this gender gap in health care and its effects can be found here.

The fear rhetoric along with the mystique that has surrounded women’s health since midwifery was introduced into organized medicine, ensures that women are not only fearful of their bodies but that they feel that only medical professionals are able to interpret the enigma that is their form. Women are encouraged to trust medical practitioners (who could never reside in their bodies or understand fully what it is like to do so) and medical intervention as well as to distrust and ignore their own intuition or embodied experiences. “We don’t trust women to be the experts on their own bodies, or to be reliable narrators of their own lives” (Thinkprogress). Doctors assert their authority and exercise their medical knowledge as a mechanism for silencing women and disciplining them into docile and passive recipients of care. Not only that, but their social role over women’s lives is magnified, “incorporating functions of educator and guardian of morals and customs” as they increasingly begin to prescribe, behavioral and lifestyle changes rather than work to disrupt social barriers to women’s positive health outcomes and disparities between women and men, and then among women across difference.

Perhaps then before we adopt the rhetoric of choice and rights, a closer interrogation is needed of the regimes of power (those I mention in this article and even those not mentioned) that function to govern how we talk about women and their bodies, thus governing how it is women seek and receive medical care.