Women, Health and Nation: Canada and the United States since 1945 (review)

This exciting collection makes a significant contribution to the literature on women's health by addressing the question of how women's experiences with health and health care differed in Canada and the United States over the years that the two national systems of health care evolved and diverged. The question is dealt with in multiple ways and from different perspectives - often exploring points of difference within, as well as between, nations. Editors Georgina Feldberg, Molly Ladd-Taylor, Alison Li and Kathryn Morgan succeed admirably in opening a dialogue about the recent history of women's health care in the two countries, how it might be studied and what might be derived to inform policy and future activism. Throughout the book, contributors engage readers with nuanced, deeply interesting explorations of the multiple layers of women's activity and experience. We revisit the many ways in which the personal is the political, but are invited by Susan Reverby in her concluding chapter to understand the tensions that have always existed between the bodily experiences of individual women and the numerous (often divergent) routes taken in the span of five decades towards activism within the body politic. The chapters document change in all its guises, and in doing so invite reflection on potential approaches to contemporary issues.

Throughout the book's twenty chapters, five major themes recur: the power of the nation state; the authority of Western biomedicine; diversity; women's agency; and reproduction. These themes resonate and often intertwine in intriguing ways. The lead chapter provides an important comparative analysis of how the development of very different systems of health care in the United States and Canada held particular ramifications for women and women's health in the two countries. Subsequent chapters focus on specific dimensions of government policy, institutional structures and systems of entitlement, exploring how differently positioned and advantaged women have interacted with these national arrangements. The influence of biomedicine on women's health is mapped in relation to issues such as shifts in childbirth practices, pharmaceutical regulation and changes in gynecological care of adolescents. We see the interplay between biomedicine and discourses about gender as both evolved markedly through the postwar years. Several authors also deftly show that, despite the importance of comparing developments in women's health between the two countries, there is much to be gained by seeking out and studying the diversity of experiences within nations. In both countries, some women enjoyed full access to the privileges of health care, while others did not. It is perhaps these instances of differential privilege that offer the most compelling studies of women's agency and resistance in the collection. They allow instructive insights into the numerous layers and sites of activity that intersect at specific sociohistorical moments to destabilize - or further entrench - health policy. Approximately half of the chapters deal with reproductive issues, such as abortion and infertility treatment, where the struggles and lessons were the most intense. It could be argued that lessons learned in this arena informed subsequent activities in other fields.

Women's voices and concerns are prominent in most chapters. Compelling individual narratives (Ann Starr's 'Scenes from the Psychiatric Hospital,' or Vanessa Northington Gamble's 'A Black Physician Shares what it Feels Like to be on the Receiving End of Racial Prejudice' are among the several narratives) complement fascinating historical analyses of women's experiences as activists (Reagan's 'Crossing the Border for Abortions: California Activists, Mexican Clinics and the Creation of A Feminist Health Agency in the 1960's'), providers of health care (Feldberg's 'On the Cutting Edge: Science and Obstetrical Practice in a Women's Hospital, 1945-1960') and consumers of health services (Gutiérrrez's 'Policing "Pregnant Pilgrims": Situating the Sterilization Abuse of Mexican-Origin Women in Los Angeles County'). The contributors do not shrink from confrontation with the ambiguities of women's...