Regulating Menstruation: Beliefs, Practices, Interpretations (review)

As the editors of this volume argue, "there is probably no society in the world where menstrual irregularity has not been a cause of concern for some women" (xiv). In order to address this immense topic, van de Walle and Renne have brought together innovative research from various disciplines aimed at assessing the options for regulating menstruation that women around the globe have used and currently have available to them. The result is a superb volume of fourteen thought-provoking essays that cover cultures from ancient Greece to present-day Guatemala. A serious component of this analysis, and the most interesting aspect of the book, is the attempt of many of the contributors to decipher the meaning of women's desire to manage their bodies.

The real strength of this volume is its attention to the cultural, social, economic, and political contexts that shape women's reproductive decisions. A recurring theme in many of the essays is the difficulty of assessing whether women's attempts to induce menstruation were motivated by the belief that regular menstruation was a sign of good health or the desire to avoid or end a pregnancy. Elise Levin's chapter offers a unique perspective on the question of motivations with its suggestion that the attempt to decide between health and abortion makes little sense in West Africa where, "as a cultural practice, it [inducing menses] is understood to accomplish both of these purposes" (158). A number of the book's authors suggest that this ambiguity is what enables many women to have reproductive freedom.

Oddly situated in the midst of this careful analysis is Stefania Siedlecky's essay, billed as the "biomedical view," which concludes from an anecdotal discussion of the danger of childbirth in the Australian outback that "it is no wonder ... that many women have dreaded pregnancy" (95). Such a sweeping, ahistorical assertion seems out of place in a volume that argues so artfully that views on menstruation are tied to a particular sociocultural context. Sangeetha Madhavan and Aisse Diarra's study of the Bamana of Mali illustrates how wrong Siedlecky is. The fact that "the failure to produce children can lead to divorce or the acquisition of a co-wife, both of which can greatly compromise a woman's position in her community," suggests that Bamana women view pregnancy with anything but dread (172).

This critique aside, Siedlecky's essay provides a wealth of information about numerous substances that have been used as emmenagogues and abortifacients. As such, her essay engages another important methodological issue—how to assess whether these substances really worked to induce menstruation. Siedlecky is at her best when she decries politics for the little scientific testing that has been done on these drugs. Other contributors suggest the impossibility of determining these substances' effectiveness by pointing to the limitations of laboratory tests that mitigate environmental factors that may contribute to a drug's effects or the impossibility of determining whether other ingredients were mixed with these drugs when they were sold in the past.

By bringing together scholars from various social science fields—notably anthropology, history, and demography—as well as the medical profession, this volume reflects the value of interdisciplinary work. Yet, the division of the book into two sections—the West and the rest— reinforces an old boundary that may have outlived its utility. A more thematic organization would have drawn out similarities between, say, van de Walle's analysis of ancient Greek physicians' views on menstruation and Patricia J. Hammer's observations on Quechua ethnophysiology. Nevertheless, this is a richly informative volume that students, general readers, and specialists alike will appreciate.