Social Attitudes Towards Women in Medicine: have we changed?

1. Social Attitudes Towards Women in Medicine:have we changed? 91017467 MHL 2013

2. Social attitudes have influenced medical practice from the ancient civilizations of Egypt and Greece, all the way through to today. What society thinks about sex, gender, religion, social class and science has a big impact on how doctors and patients behave. Most people agree that social attitudes in medicine have changed a lot over the years… But how do we know? What exactly has changed? And what does this mean for doctors and patients today? This resource will introduce some medical authors from the past, and give you some examples of social attitudes towards women in their times. When you have finished using the resource, you can decide what you think the answers to the questions above are.

3. Meet the authors: • 515 BC Pythagoras: Greek mathematician and philosopher, who also tried his hand at medicine • 430 BC Hippocrates: Greek doctor nick-named the “Father of Modern Medicine” • 1683 Francis Mauriceau: French obstetrician • (a doctor who specializes in the area of medicine that deals with pregnancy and childbirth) • 1834 James Blundell: English obstetrician

4. Inequality between the sexes: “…Pythagoras. He supposed, that from the brain and nerves of the male… similar parts of the embryo were formed. These were thought to be the seat of the soul, and of course the parts from which all the senses were derived. All the grosser parts… were composed of the blood and humours contained in the uterus.” The quotes all seem to indicate that societies in the past viewed men and women differently. Men and women did not do the same jobs, and people thought that men were more important to the process of making a baby. These views were common in Pythagoras, Mauriceau and Blundell’s times. This is a quote from Mauriceau’s 1683 book, “The diseases of women with child and in child-bed..” Mauriceau is saying that Pythagoras believed that when a couple had a child, the child’s soul and mind came from the father, while the basic body parts came from the mother. “It is also necessary I should mention the vernacular terms by which bones of the pelvis are commonly called in our maternal tongue, because female practitioners, with whom you must occasionally meet, use them in preference to technical names.” What do you think it all means? This quote is from Blundell’s 1834 book, “The principles and practice of obstetricy..” Blundell is saying that female midwives are trained differently to male doctors, and use simple language instead of technical medical terms. Here, Blundell explains that society in his day thought that if a couple could not have a child, it was the woman’s fault, but if a couple were successful at having children, the man was congratulated on his ability. “When women are sterile, we generally ascribe the defect to their part of the genital apparatus, and I believe with good cause, but when they are unusually fruitful, we are willing to arrogate the merit to ourselves.” Image of a male skeleton in a pose that was meant to show off the perfect male form. Image of female skeleton in a pose that was meant to show off perfect female beauty.

5. Society’s expectations of women: Infants born with “red and livid spots, which very much disfigure the faces of some of them”is due to “the Mother’s longing to drink Wine.” The societies that Mauriceau and Blundell lived in had certain expectations of women. Unmarried women were expected to behave modestly and avoid sexual relationships. Pregnant women were expected to be strict with themselves and avoid alcohol and other vices. Again, these views were common at the times when our authors were writing. In Mauriceau’s day, birthmarks or deformities on a baby were believed to be due to the mother’s thoughts while she was pregnant. The author says that women should control their thoughts while they are pregnant, and especially not think about vices such as drinking alcohol. What do you think it all means? Blundell is explaining that he agrees with the poet Matthew Prior, who says that young women should be taught to protect their virginity before marriage and keep good morals. Society viewed women who had sex before marriage as corrupt. “I am of Matthew Prior’s opinion, that you should put the padlock on the mind, and that the hymen alone is but a very poor protection to maidenhood- a frail outwork of little avail, if the citadel within is treacherous and unfaithful.” Drawing of a child in the womb, by William Hunter.

6. Role of Religion in Medicine: “Most people believe that there is no other reason for the cause of this Evil, but because God hath so ordained it, and that woman, according to his Word, must bring forth with pain because of her sin, according to what is written in the third chapter of Genesis.” Mauriceau explains that society in his day thought God had ordered that women must suffer pain in childbirth to make up for what they had done wrong; this is the story told in the Old Testament of the Bible. In the past, religion has played a central role in every part of society, including medicine. Childbirth is a good example of how this affected women at the time. What do you think it means? 1774 drawing of a child in the womb by William Hunter, a male midwife.

7. The Class System in Healthcare: “But because there are several that either will not, or cannot suckle their own children, whether it be to preserve their beauty, as all Persons of Quality, and most of the Citizens do; or that their husbands will not suffer them, nor be troubled with such a noise…” Upper class and lower class people in 17th Century Europe had different traditions to do with their health. How much money someone had made a difference to the healthcare he or she was given. In France and other parts of Europe, upper class women did not breastfeed their babies because they thought it would them less beautiful. Instead, they would hire a wet-nurse to feed their babies. Lower class women did not have enough money to pay a wet-nurse, so often breastfed their babies. What do you think it means? Painting of a Dutch upper class family in the 17th Century. Painting of a lower class woman in France in the 17th Century.

8. Then and Now:Do we have anything in common? Doctors today give overweight women exactly the same advice as Hippocrates gave; they tell women to lose weight if they want to have a baby. The only difference is that doctors today know more than Hipocrates did about why being overweight makes it difficult for women to have babies. This is just one example of an idea in medicine that has stayed the same over the years, even though society has changed. There are many more examples of this. “Women exceedingly fat do not conceive, because the Cawl compresseth the orifice of their womb, neither can they till they grow lean.” Do you think this is different or similar to the advice doctors give women today? This quote describes the opinion of Hippocrates, the famous ‘Father of Modern Medicine’ from 430 BC Greece. Hippocrates thought that women with too much fat on their bodies could not have babies. He told overweight women who were trying to have a baby to lose weight. Drawing of tools used by midwives in the 17th century. Modern tools used by obstetricians.

9. What have you learned from this resource? • Social attitudes towards women have changed a lot over the years. •Social attitudes have an effect on medical traditions. • •Some areas where attitudes have changed are: • •How men and women are treated differently • •What society expects from women • •The role of religion in medicine • •The role of the class system in medicine •Even though society has changed, some ideas in medicine have stayed the same.

10. Now it is time for you to decide what you think. Thank you for using this resource.

11. References and further reading: • All images from Plymouth Medical Society Historical Collection and Wiki Commons • Plymouth Medical Society Historical Collection. Available at: http://www.plymouthmedicalhistory.org.uk/ • Mauriceau F, Chamberlain H. The diseases of women with child and in child-bed. London, 1683 • Blundell J, Castle T. The principles and practice of obstetricy. London, 1834 • Ellis H. James Blundell, pioneer of blood transfusion. British Journal of Hospital Medicine 2007:68;8. • Math Open Reference. Pythagoras. Available at: http://www.mathopenref.com/pythagoras.html • Venn J. Venn JA eds. Prior, Matthew. Alumni CantabrigiensesOnline ed. Cambridge University Press. Availabe at: http://venn.lib.cam.ac.uk/cgi-bin/search.pl?sur=&suro=c&fir=&firo=c&cit=&cito=c&c=all&tex=PRR683M&sye=&eye=&col=all&maxcount=50