Beyond reproduction: Women’s health, activism, and public policy (review)

In the current political climate, understanding women’s health is necessary to achieve progressive and equitable health care reform. Women access the healthcare system more frequently and in greater numbers than men, and are more likely to vote at the polls.¹ Yet politicians, corporations, activists, and patients continue to disagree on the scope and definition of women’s health. In her book Beyond Reproduction: Women’s Health, Activism, and Public Policy, Karen L. Baird offers a retrospective analysis of the women’s health movement in recent decades. She discusses landmark legislation and examines how the movement has evolved in response to a changing social and political landscape. Baird’s text is both timely and pertinent, as it provides a historical framework for policy makers shaping the issue today, and helps to define the role of women’s health in the debate on health-care reform.

Beyond Reproduction focuses on the 1990s, when the women’s health movement experienced unprecedented advances in the areas of medical research, HIV/AIDS, breast cancer, and violence against women. Baird analyzes the strategies, context, and politics that spurred these successes, as well as their impact on the broader, evolving definition of women’s health. She frames the discussion by juxtaposing the women’s health movement of the 1990s against the women’s movement of the 1960s and 1970s. In the earlier struggle, female activists characterized the medical establishment as “other,” a patriarchal and oppressive institution to rise up against. The right to access contraception and abortion became a central tenet of this effort, as it was believed that women’s ability to achieve equality was contingent on their ability to control their reproduction. In this context, “women’s health became synonymous with reproductive health” (11).

By contrast, Baird argues, the women’s health movement of the 1990s saw a shift to insider politics. The 1960s and 1970s had set the stage for women to enter Congress and now a powerful lobby existed on behalf of women’s health. Activists co-opted the language of the political system they aimed to change, and worked from inside that system to influence health policy. Baird offers a compelling discussion of discursive politics, or the politics of meaning making, and the ways in which activists used the strategy to politicize women’s health (14). They repositioned the discussion from the medical to the political arena and reframed the issue as one of rights and equity. Importantly, she also addresses the ways in which the broader definition of women’s health changed during this time. She examines how the movement shifted away from reproduction and splintered into various issue-specific groups, focused on distinct health issues. This analysis is one of the most important contributions of the book, as it has powerful implications for defining women’s health in the new millennium.

Within this historical framework, Baird moves into a discussion of four issue-specific groups that achieved major success in the 1990s. Medical research, breast cancer, violence against women, and HIV/AIDS are each granted a chapter. Baird cleverly invited activists and experts in the field to write several of these chapters, bringing a fresh perspective to the text and real world experience that can be difficult to find in academia. Taken alone, each chapter provides a detailed discussion of the efforts to advance policies surrounding a specific health issue. Collectively, they offer substantial support for the arguments posited by Baird in the introduction, including the shift between insider-outsider tactics and the use of discursive politics. The structure is both useful and intuitive, as it offers the reader the flexibility to research a single health issue or to explore a broader understanding of women’s health in the 1990s.

Dana-Ain Davis’s experience in the field is evident in her chapter on violence against women. She has published several articles and a book on the subject, and works with foundations that support women’s issues. Davis approaches the...