Gender and Medicine: Blurring the Boundaries of Tradition

Nancy Rose Hunt. A Colonial Lexicon of Birth Ritual, Medicalization, and Mobility in the Congo. Durham, N.C.: Duke University Press, 1999. xix + 475 pp. ISBN 0-8223-2331-1 (cl); 0-8223-2366-4 (pb).

Ellen Leopold, A Darker Ribbon: Breast Cancer, Women, and Their Doctors in the Twentieth Century. Boston, Mass., Beacon Press, 1999. xi + 334 pp. ISBN 0-8070-6512-9 (cl).

Julie DeJager Ward. La Leche League: At the Crossroads of Medicine, Feminism, and Religion. Chapel Hill: University of North Carolina Press, 2000. xi + 227 pp.; ISBN 0-8078-2509-3 (cl). 0-8078-4791-7 (pb).

Elizabeth Dixon Whitaker. Measuring Mamma's Milk: Fascism and the Medicalization of Maternity in Italy. Ann Arbor: University of Michigan Press, 2000. ix +358 pp.; tables. ISBN 0-472-11078-0 (cl).

The history of women, medicine, and health has expanded in the last several decades to include a closer examination of patient experience, global dimensions of health care, and intersecting systems of power that shape women's access to modern medicine. Many historians are moving beyond stories of medical practitioners and policies and instead analyzing how female patients have shaped medical practice. Current scholarship is analyzing the impact of female experiential knowledge, patients' efforts to preserve traditions that benefited them, and their willingness to challenge conventional practices that did not. Moreover, as these monographs attest, contemporary examinations of women's health emphasize the significance of the international dimensions of women's health and the role that gender plays in constructions of health. Such histories of health and gender recognize that patients have been subjected to a number of patriarchal social, cultural, legal, and economic forces that shape their health care in a system historically controlled by male practitioners.

The four books reviewed here all direct attention to gender and power relations between medical practitioners, mothers, patients, the colonized, and the colonizers. Measuring Mamma's Milk and La Leche League contribute to the growing field of infant nutrition by offering examinations of breast-feeding patterns through radically different lenses and connecting them to broader political issues. Julie DeJager Ward exposes the interconnectedness of La Leche League International and pre-Vatican II Catholic doctrine while Elizabeth Dixon Whitaker demonstrates that fascist policies regarding health worked to regulate maternal behavior in Italy. Nancy Rose Hunt also examines Belgian Congo national politics in A Colonial Lexicon, revealing shifts in the local understandings of medicine throughout the colonial era. She introduces a new concept, the "middle figure," exposing historical actors who negotiated the boundaries of the Congolese and Belgium Empire. Her work complicates the boundary between the colonized and colonizer, presenting a model reflecting how social location, gender, and notions of nationalism shaped colonial medical practices. Finally, Ellen Leopold's ambitious project detailing the social history of breast cancer in America throughout the twentieth century introduces important questions about relationships between patients and their doctors. In particular, she questions the longevity of the radical mastectomy as the most appropriate, and also most mutilating, surgery for women with breast cancer.

In all four works, the authors explore the social, cultural, and political influences that frame women's health in a century when notions of science and modernity transformed traditional healthcare. This shift to modern sensibility is perhaps most obvious in the histories of breast-feedings presented by Ward and Whitaker. When Rima Apple concluded her foundational work on infant nutrition, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950, she encouraged future scholarship that might explore the post-1950 era. ¹ Apple traced shifts in infant nutrition sensibility between 1890 and the 1950s and analyzed the complex relationships between infant mortality trends, nutritional studies, and popular acceptance of "scientific" knowledge. She demonstrated that physicians scrutinized such traditional practices as breast-feeding as interactions between physicians and mothers became more frequent and science more legitimate.

Ward implicitly followed Apple's advice and situates...