Women’s Rights Perspective in Health – dangerous?

At a training program in Delhi, organized by the VV Giri National Labour Institute, I spoke on birth, breastfeeding and health from a women’s rights perspective.  I gave the presentation to two groups – one comprised 36 PhD students from universities and institutes in various parts of India and the other comprised a similar number of health officials and physicians from developing countries outside India.

We sometimes talk about the inadequacies of the biomedical model of health and birth, insofar as it excludes social, psychological, environmental and spiritual factors.   What we notice less often is the possibility that the biomedical model may itself depend on metaphors that are influenced by cultural stereotypes.

In the first part of my talk, I discussed gender stereotypes in the medical descriptions of women’s bodies and of reproduction.  For this I relied on Emily Martin’s work The Woman in the Body and in particular “The Egg and the Sperm: How Science Has Constructed a Romance Based on Stereotypical Male-Female Roles.”  (Signs, Vol. 16, No. 3 (Spring, 1991), pp. 485-501.

Drawing from several standard medical textbooks, Emily Martin shows that descriptions of women’s bodies reflect the values of industrial capitalism as well as gender bias and stereotype.  Take away these values and substitute gender equality and women’s rights, and you would describe these processes quite differently.

I presented some of her examples  and quoted from her article to explain each one. In summary these are:

Biological process	Standard Medical Textbooks	Why not
conception	journey of the sperm	interaction of egg and sperm
ovum	passive, fragile, dependent, waiting	connecting with sperm
sperm	active, strong, heroic, autonomous	connecting with egg
ovulation	overstock inventory	just-in-time maturation
spermatogenesis	amazing feat	excess
menstruation	failed production	indicator of fertility
menopause	factory shutdown	golden years

I continued to talk about how we had the choice to look at these processes in a way that grants women autonomy over their bodies and reproductive health, and this could help us to take a rights-based approach to women’s health.  Just as I was about to move along to a discussion of women’s rights in birth, several hands flew up.

“The processes are described this way because that is the function of the reproductive organs,” one doctor said.  I replied that we could look at the process differently if we did not assume that the objective of every woman and every menstrual cycle was to have children.

Why are you calling menopause “Golden years?”  several men asked.

I answered that it signals a transition in life and that each phase of life could be appreciated on its own terms rather than regarding the woman’s body only through its child-bearing function.  It is not to imply that earlier phases of life are less “golden” but simply to use a positive and respectful term.

“These ideas would be all right coming from a Western Perspective,” commented a physician from Sri Lanka.  “But you being from our culture, should not be spreading these ideas.  This kind of thought, if it spreads would be very dangerous,” he said.  “It would cause a disruption in our society.”   A physician from Afghanistan agreed with him and added,  “In our culture motherhood is not a burden, it is a privilege.”    One more health official from an African country added that menopause should not be called golden years and went on to explain that men could continue to reproduce for the whole of their lives.

I asked, “Can we hear from any of the women in the room?”

No one spoke up.  The physician from Sri Lanka said, “I am speaking on behalf of the women.”

I was stunned that no one objected to such a statement.   Nevertheless, I stayed on message and reiterated that a woman has the right to decide whether to have children and that having children was not the only, primary, or necessary purpose of a woman’s life and by extension, women’s health.  To address women’s health from a women’s rights perspective, one must recognize the value of the body without limiting it to its capacity for childbearing.   One must also respect women’s rights when addressing women’s reproductive and maternal health needs, including during pregnancy, labour, birth and beyond.

During the break several women approached me and said, “Your lecture is very interesting.  Some of our colleagues are from very patriarchal backgrounds.”  I said that they should speak up during the discussion.   Later in the evening, I thought of I should have replied to those who cautioned against the social disruption that feminist ideas may cause.  In order to make progress on women’s health issues, we must change our ideas and practices, and be prepared for the disruption that such change would cause.

In the remainder of the seminar, I presented on three themes:

Birth Models that Work.

Breastfeeding Models that Work.

Food Models that Work.

(to be continued …)