Prescribed Norms: Women and Health in Canada and the United States since 1800 (review)

For not only tackling a gargantuan body of secondary literature, but then wrestling it into a sweeping synthesis as insightful and delightful as this, Cheryl Krasnick Warsh deserves a medal... maybe even two. In Prescribed Norms: Women and Health in Canada and the United States since 1800, she weaves together two hundred years of health history in two countries, unites women’s experiences as both patients and practitioners, and draws upon a multi-disciplinary literature that includes history, women’s studies, medicine, anthropology, psychology, philosophy, biology, law, literature, and indigenous studies. The result is a fascinating and multilayered history of North American women and health, which integrates subjects ranging from Aboriginal birthing practices to Ursula the Sea-Witch from Disney’s A Little Mermaid.

The book is organized into three sections of multiple chapters, each usefully prefaced with a brief introduction highlighting key themes: “Rituals” (menstruation and menopause), “Technologies” (childbirth past, present, and future), and “Professions” (medical education and nursing). The narrative moves quickly, and the book has a certain liveliness to it, thanks to chapters which vary in personality based upon the issues dealt with and sources used. The first two sections, “Rituals” and “Technologies,” speak to each other extensively through their focus on women’s reproductive health and women as patients. By contrast, the “Professions” section stands apart, emphasizing professional struggles and achievements. The shift is a bit jarring, but it was worthwhile to include both in the same book. The history of midwifery, which is woven throughout rather than appearing in its own chapter, provides some continuity.

This book will be particularly welcomed by teachers of the history of health, women’s history, and women’s studies. Its readability and breadth of subject matter make it a worthy adjunct to Jacalyn Duffin’s highly regarded History of Medicine: A Scandalously Short Introduction. Like Duffin, Krasnick Warsh blends the practical intricacies of medicine with the wider social, economic, political and cultural scope of history. With a few exceptions, she takes care to explain medical terms, illnesses and procedures for a lay reader, thus ensuring that her discussions, while grounded in medicine, remain accessible. The twenty-eight page bibliography will be a helpful starting point for students and scholars alike.

Prescribed Norms wears its feminist heart on its sleeve, and while (justly) castigating the historical and continued inequities which have so often hurt women where health is concerned, the book does not shrink from highlighting instances in which women have been their own worst enemies. The professional jockeying for position amongst women doctors, midwives, and nurses, for instance, makes it clear that professional goals consistently trumped the notion of a shared sisterhood. Throughout the book, Krasnick Warsh’s women are not disembodied sets of symptoms (as in so many medical texts of the past), but mothers, daughters, wives, consumers, producers (and re-producers), victims, advocates, educators, workers, health-care professionals, experts, and innocents: always impacted by race and ethnicity, class, age, marital status, and region.

Illustrations aside (five of the six are Canadian), this is a book which truly lives up to its geographical billing. Nearly every Canadian example is paired with an American one, or vice-versa, and the result is a balanced study in which neither gets short shrift. The transnational elements of western health history emerge clearly, even as national (and more often regional) differences are given their due. This is of course particularly relevant in the later twentieth-century, as the two countries’ approaches to paying for health care sharply diverged; but overall it becomes clear that women’s health-related experiences shared more commonalities than differences across the forty-ninth parallel. Krasnick Warsh also skilfully situates her narrative in a wider context of European, ancient, and Aboriginal health knowledge and practice.

Aside from its historical merits, the book also has a great deal to say about contemporary women and health. The chapter on “Future Childbirth” is particularly thought-provoking. As...