Bodies of Knowledge: The Medicalization of Reproduction in Greece (review)

This study of Rhodes, from the 1940s onward, looks at changes and continuities in beliefs about the female body, covering fertility control, safe pregnancy, successful birth, and management of the postpartum period. The author, an anthropologist, based herself in Rhodes Town but also covered the surrounding villages. She used a range of methods, including participant observation (not only on Rhodes, but also in an Athens hospital) and interviews. When she began her fieldwork in the early 1990s, there were no longer any local midwives, so she reconstructed their practices from the memories of her informants.

The first half of the book examines traditional beliefs about fertility and birth, with Georges arguing that "local medicine on Rhodes is best understood in conversation with far more widely broadcast bodies of medical knowledge and practice" (p. 27). A theme throughout the book is the relationship between textual and oral transmission, in the context of which she looks at the links between the local tradition known as the "iatrosophia" (medical wisdom) and the learned tradition of Byzantine medicine. She suggests that the Ottoman conquest reinforced Galenism; classical ideas not only survived in the oral tradition but also spread through handbooks and manuals. Menstruation was seen as essential for health, so any interventions that suppressed it would be unlikely to be adopted: pregnancy, as in Hippocratic medicine, was seen as opening up the body and helping the flow of blood. In this section, the materials drawn on are not always the best, drawing not only on recent scholarship but also on work produced for a general audience (Roy Porter's Greatest Benefit) or older work; for example, Monica Green's Ph.D. thesis of 1985 is used rather than her more recent monograph or articles. The continuities may be overstated; while prewar Rhodians regarded menstrual blood as "dirty" or "filthy," the Hippocratic texts claimed as giving "much the same meaning" (p. 91) to menstruation did not, in fact, regard menstrual blood as unclean. Georges follows Laqueur's misleading claims for a single "Galeno-Hippocratic procreation theory" (p. 97) in which both the man and the woman contribute a "seed" but notes that in Rhodes this coexisted with a one-seed theory; this coexistence is closer to the classical Greek situation.

Georges then investigates how biomedicine entered this arena. She demonstrates how the rise of biomedicine needs to be seen in terms of "transforming subjectivity" (p. 3), which is always a local phenomenon; the particular circumstances of Rhodes, and the traditions of its women, have led to a very specific form of medicalization here. Biomedicine has not replaced an earlier system but rather has fused with it in a specific way, with the women interpreting technology for their own purposes, selecting from those modern reproductive interventions offered to them. For example, young women dismiss the folk practices that remain—for example, beliefs surrounding pregnant women—and welcome hospital birth not only as safer but also as giving them some independence from their families. The area has a very high rate of fetal ultrasound scanning: monthly scans were the norm by 2000. The rate of cesarean section is one of the world's highest but only around 10 percent of women use medical contraception, with medical abortion being used extensively to supplement "being careful" (p. 234). This pattern is a local one, and Georges explores with her informants the reasoning behind the choices made.

This is a very readable and stimulating study, with much to offer those working on gynecology and obstetrics in other historical periods as well as having important insights into medicalization, modernity, national identity, migration, and education.