Field of Science

Women know something you don't


Three of my four grandparents were only children. Born early in the 20th century, in the period betwixt the great wars, coming of age in the Great Depression. Only children, in spite of having parents married for decades. Three of them. In all likelihood, their own parents, my great-grandparents--and I knew all of my great-grandmothers--consciously chose not to have more children because, well--it was the Great Depression.

The Great Depression was a hallmark of sorts in American history beyond the economics of the era. It also marked the first time in U.S. history that the population failed to achieve replacement levels of reproduction--the level required to replace existing people. Indeed, the birth rate fell by 15% during that period. It's true that many people delayed marriage--they couldn't afford it. But it's also true that divorce rates dropped, too, as couples couldn't afford either another child or maintaining separate households. How did my great-grandparents and the others who contributed to this 15% drop in population do it, especially in an age without 99% effective birth control?

I can't speak for my great-grandparents, but the realistic explanation for having one child over decades of marriage is either contraceptives or abortifacents. Make no mistake about it: In spite of efforts to quash women's right to control what happens with their bodies, women have always known about and used both for millennia. Outside the purview of men were the feminine oral histories of how to prevent pregnancy or induce abortion, either chemically or mechanically, and it's something women did. It wasn't considered an issue for discussion with anyone but the women. It was just something women knew, something they did, to maintain control over what happened with their bodies and their families.

One reason they did it, in addition to economics, was fear. Pregnancy has always been a killer of women. Since serious record keeping began in the Western world, in England and Wales, for example, maternal mortality peaked in the late 19th century at almost 700 women per 100,000 births. In the United States, the peak occurred in the early 20th century--in fact, about the time some of my grandparents were born--at over 900 women per 100,000 births. Nature, in the absence of cultural and technological assistance, is an indifferent actor, you see, but a great mathematician: As long as births are at replacement, all those deaths don't matter. But we're more emotional about our math: If something were killing 900 women per 100,000 births today in the United States, we'd consider it a plague. Is it any wonder that women, facing both a life-threatening event and economic straits, might turn to age-old contraceptives or abortifacents to ward off both?

Of course, some of this mortality had to do with medicine itself, the waves of childbed fever passing from childbirth attendant to mothers, sometimes like the plague itself killing 70 to 80% of infected women. If a woman didn't die from the pregnancy or birth--pre-eclampsia, pre- or post-partum bleeding, pelvic disproportion--the infections that followed could easily carry her off, a threat that lingered in Western society well into the 20th century.

In the midst of all this pain and death, all related to reproduction, women had their own remedies and felt no shame in that knowledge or its application among other women. After Charlotte Bronte died from hyperemesis of early pregnancy, her friend and biographer, Mrs. Elizabeth Gaskell, wrote that had she known, she could have given her friend something that would have cured the problem--in other words, an abortifacent.

The pharmacoepia of abortifacents stretches back into the ancient literature. Hippocrates (he of the oath) documented them. Soranus, ancient gynecologist, did, as well. Even in the absence of a clear understanding of physiology, they knew that there were ways to prevent pregnancy--contraceptives--and ways to end one--abortifacents. Sometimes, they arose from the same preventative.

The dual weapons against unwanted pregnancy even made their way into ancient Western mythology in the form of Myrrha. Myrrha was raped by her father (or tricked him into sex with her, depending on your source), the king. To escape her father's attacks (or her lust for her father, again depending on the source), she submitted to being transformed into the myrrh tree, which has long been used as a contraceptive and abortifacent. From this first myrrh tree, Myrrha's son, Adonis, was born. Her reputation is as a rescuer of female victims of incest.

Incest, rape, the repeated and intense pain of childbirth, death from birth or childbed fever...these have been the realities for women since women existed. Sex and reproduction were often necessary but sometimes deadly. There is no absence among women of an ability to grasp these realities and do what is necessary to deal with the potential consequences, even if addressing the reality was sometimes fatal, too.

A recent highly publicized report tried to link abortion and mental health issues with women. It is a review/meta-analysis that suffers accusations of having ignored literature finding no link. It also ignores the fact that abortion isn't a new phenomenon, that women have managed contraception, abortion, and pregnancy for thousands of years, on their own, among themselves. If deprived of safe, modern mechanisms for doing so, they will continue with the dangerous versions with benefits that, for women who turn to them, don't outweigh their risks. Make no mistake about it.

The headlines arising from that study, "Abortion increases mental health problems" and "Women who have abortions face double the risk of mental health problems," leave out the fact that the review in question failed to address whether or not mental health problems (and known risk factors for such, including abuse and addiction) instead are linked to increases in abortion. Actual population-based studies have found no link between induced first-trimester abortion and mental health. Having a baby, on the other hand, is a huge stress inducer and can adversely affect mental health. I know that all those politicians and others out there who are so concerned about women's mental health will take these findings to heart and act accordingly.

Snark aside, contrary to popular and persistent belief, women as a population can handle and have always handled stress with resilience, often thanks to the same network that was the female reproductive brain trust: other women. In the light of that, it's time to trash the canard that women are mental weaklings who can't decide things for themselves or deal with the consequences of their decisions. Having sex may be an outcome of a moment's heat for both men and women, but women don't make reproductive choices with the same shallowness of decisionmaking they might use to order at a fast-food drive through. Shockingly, they think about it deeply and are capable of managing the consequences. In fact, most women who have abortions in the U.S. already have children, so they are fully aware of that outcome.

Before women could read, before books were printed, women had among them their own version of Our Bodies, Ourselves, a real book that just passed its 40th birthday. Like the centuries-old oral version, Our Bodies, Ourselves was the product of a group of women, the Boston Women's Health Collective. By the time of its birth, it had become necessary as the collective of women's knowledge had become separated and isolated, as women's bodies had become not their own but political tools.

Women's bodies--you know, their very own bodies--continue to be under political and religious assault today both on the contraception and the abortifacent front. GOP candidate Mitt Romney has expressed support for a constitutional amendment stating that life begins at conception (does he think sperm are dead? Eggs?). Such amendments are receiving support in some states in a horrific and terrifying effort to erode any control women have over their own reproduction. By the way, when women have control over their reproductive health, the benefits to society are immeasurable. When the Taliban--or politicians--have control over women's reproductive health, the negative effects are bottomless.

Romney received a question from a woman a few days ago, asking if the former governor realized that because some forms of hormonal birth control act to prevent either implantation or conception, that such an amendment would, in effect, outlaw hormonal birth control, the most effective form of contraception available. His response showed a clear lack of understanding about how women's bodies function and about how birth control functions, compelling Rachel Maddow to invent a female anatomy and physiology chart just for the Man Cave.

In the days when men had nothing to do with reproduction but the sex act, men were, of course, generally ignorant about these things, and women did what they felt was necessary, using woman-disseminated (ha) knowledge. Now that men have a little knowledge, it's become a dangerous thing for women. But make no mistake: try as they might, they can't know everything because, try as they might, they cannot make individual women's bodies their own.

What Romney didn't grasp is that while most hormonal birth control prevents conception, sometimes hormonal birth control may also prevent implantation if fertilization occurs. So like the myrrh itself, it can act both as a contraceptive--causing a woman to cease ovulating so that no egg is present for fertilization--or as an abortifacent, hormonally preventing implantation of a fertilized egg in the uterine wall. Pardon me for a moment while I clarify that: In a woman's uterine wall. A person's uterine wall. The uterine wall of an individual woman, inside of her body.

Were there to be a constitutional amendment stating that human life begins at conception, all hormonal forms of birth control--with their either primary or secondary function of preventing implantation of a ball of dividing cells into a tissue called the uterine lining--could be illegal. Miscarriage could be considered criminal, ranging from homicide or involuntary manslaughter, and open to investigation for everything the woman has done that might have been related to it.

Any woman who's ever undergone the pain of a spontaneous abortion or miscarriage of a wanted pregnancy may be able to imagine how invasive, shaming, and horrific such an investigation into her privacy, her body, might be. Any woman who's ever had an abortion--for medical reasons or from choice--can imagine how invasive, shaming, and horrific such an investigation into her privacy, her body, might be. A married woman with only one child--like three of my great-grandmothers--would be an object of suspicion. How is she doing it? She'll never tell. But make no mistake about it: Those top-secret girl things that you suspect women know and you don't? We do. Sorry. Our bodies, our selves.

Ironically, according to Gawker, back when Romney was pro-choice and allowed inclusion of abortion coverage in the MA health care law, abortion rates actually fell. But the real key here is that this effort to prevent abortions by saying that life begins at conception would, in fact, result in increases in unwanted pregnancies. Unwanted pregnancies will lead, as they have for millennia, to women's turning to surgical abortion or abortifacents, safe or dangerous, whispered through the womanhood grapevine. Abortions will continue, but women will have become criminals for having them or suspected criminals for losing a pregnancy. Or, as is happening in Kenya, they will die.

Reduced access to contraception, the hijacking of a woman's tissues and organs as an incubator for the state, will lead to greater reliance on these ancient abortifacents and backstreet abortions, as has happened in Kenya, in the absence of access to the most effective form of contraception, hormonal interventions. Anti-abortion efforts and news media scare headlines that present women as vulnerable to mental illness, incapable of making serious, informed decisions about reproductive choices, or unable to have abortions without legal sanction are wrong on all counts. Women know this. They know a lot. Make no mistake about it.

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Photo via Flickr.

18 comments:

  1. Re: abortion and mental health. Normal pregnancy and birth can trigger mental health problems, but what proportion of women forced to have an unwanted pregnancy develop mental health problems? What about the unwanted children themselves? We never hear that side. The case for abortions is not that they are fun, but that they are better than the alternative.

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  2. These are good points, and if we were viewing outcomes without the overlay of religious morality, the conclusion might be that not having children is overall better for women's health. For example, in the UK, there was some consideration about counseling women considering an abortion that abortion is safer than childbirth, health wise, but there was, of course, an outcry. Even though it may be demonstrable, as questions of the mental health of women forced to bear children against their will can be, data don't amount to much in the face of emotional terminology about life and babies.

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  3. Thanks for giving the topic of reproduction, contraception, and abortion some historical perspective. A great post!

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  4. This an amazingly well-written and well-researched post. I am also very impressed by your arguments. I have often questioned the judgement of men who will never give birth, but yet feel that they have the authority to dictate our bodies. While I don't personally believe in abortion, I do believe that every case is different, and sometimes exceptions must be made. Once again, this is a great post, good job!

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  5. What a well constructed piece of powerful emotional advocacy. Remember the days when journalists and politicians used to write like that?

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  6. I am one of those with a religious overlay (12 years of catholic schooling)BUT I have never seen an article with this slant. You obviously think for yourself, and have carefully considered a very reality oriented look at women and how they consider their power over their womb. We do belong to a secret club that men will never enter. I've never considered that before reading this great post.

    I am naive enough to believe that we as women should work together, and all the screaming and finger pointing and sending people to hell does little good. I am also a mother because I was lucky enough to be one of the 1 in 40 infertile couples in 1993 who was able to adopt an infant, a member of a very select club. I'd be soul-dead without my son.

    It's hard. And I know the catholic church is a bastion of misogyny and hypocrisy.

    Well, anyhow, thanks. This was a very interesting article, and your honesty was enlightening.

    Y'all are hitting some kinda groove!

    Rose

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  7. Emily, this was simply beautiful. Thanks so much for writing such a coherent, intelligent, insightful post.

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  8. "Three of my four grandparents were only children."

    I think I saw that on "Big Love!"

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  9. Powerful post. Had to go back and find your epigram..

    Nature, in the absence of cultural and technological assistance, is an indifferent actor, you see, but a great mathematician.

    Lucid, compact prose.

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  10. In the 70's, when I was at Stanford, one of my professors was asked what his position was on the issue of abortion. His response was: "Ask my wife; as a man, I have no right to a position on this matter." That was, possibly, a bit extreme, but when one reads what the Romneys and Talibans of this world have to say - they who treat women and their bodies as chattel, it seems to me that women would do well to build their networks again. So much of the world, where we're concerned, is returning to the dark ages.

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  11. Actually, for a woman with regular periods, if you don't mind restricting sex to two weeks or so out of a month, the rhythm method can be very effective.

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    1. "The rhythm method is typically 75% to 87% effective."
      http://www.webmd.com/sex/birth-control/rhythm-method

      Not sure what that has to do with the post.

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  12. The condom also came into its own in the 20s and 30s with inexpensive, fairly effective latex versions replacing the less effective animal skin ones. Fortune had a good article on condoms back in the 30s, back when they weren't usually discussed in polite company. No one was making a big deal of them, but condoms were one of the big growth industries of the Great Depression.

    My father, who came of age in the 1930s swore by them. When he gave me "the talk" he mentioned a lot of brand names like Sheik, Trojans and Ramses that reeked of the roaring 20s. If they had been more respectable, Howard Carter would have been endorsing the King Tut brand. If my father's stories of the Borscht Belt were to be believed, young adults of the Great Depression really liked having sex. My mother's accounts were a lot less graphic, but the general theme was the same. I suppose this makes me one of those rare individuals whose parents actually had sex.

    I'm not saying that women didn't bear an awful lot of the burden of birth control, often using folk remedies and methods with varying levels of reliability. There were a lot of vaginal douches marketed as hygienic with a nudge and wink about their actual usage. I am saying that there were new birth control technologies rolling out in the 30s, and that many men, not able to afford raising children back when men were expected to be the breadwinners, took advantage of birth control in general and condoms in particular.

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    1. My grandparents were born from 1918 to 1924. Their parents--my great-grandparents--were born in the 1890s, so came of age during WWI; my grandparents came of age during the Great Depression and had baby boomer children. Most lived in very rural areas of Texas, farming etc. Not sure about how common condoms would have been among that crowd at that time. What I do know is that there was an awareness of what caused livestock to abort, etc., and while "polite company" may not have discussed these things, the women did.

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  13. "Two surveys conducted in New York in 1890 and 1900 found that 45% of the women surveyed were using condoms to prevent pregnancy. A survey in Boston just prior to World War I concluded that three million condoms were sold in that city every year."

    They also mention the reusable rubber condom being invented in 1855 so one would not have needed a large supply. Latex condoms were better and, indeed, were only produced after 1920.

    http://en.wikipedia.org/wiki/History_of_condoms

    Even the most rural areas had connections to the cities for such popular and vital supplies. I am sure abortifacients were used but find it difficult to believe they were the first choice for contraception in any but the most deprived areas and among the ignorant and very socially isolated.

    I have read several accounts of women taking nutmeg to achieve an abortion and they generally failed even if they did suffer a prolonged and horrible intoxication. Many herbs (and essential oils especially) carry warnings based on limited cases and historical use but it would be difficult to test the efficacy of these herbs ethically at the levels needed. Ergot is the only one I can remember that has been tested clinically. Very effective but difficult to administer at the correct dose without causing terrible side-effects.

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    1. This condom history is all fascinating, but this post really isn't primarily about the potential condom use of my relatives, who simply provide a framework for talking about suspicions that might arise around women who don't become pregnant in the absence of hormonal birth control and the things that women will always know about their own bodies that no one else will.

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  14. My mother recounted to me talking to a local shopkeeper who wasn't feeling well. Upon being asked why, she said it was the most recent abortion she'd just had. This was the bottom of the great depression and the lady in question was Italian American, living in a very Roman Catholic neighborhood in the shadow of a huge church. Nuns strolled the sidewalks frequently, but this lady did what she had to in a time of economic crisis.

    The information is out there, and so is the desperation. Obviously this woman chose to have sex with her husband rather than forgo it (which let's be honest, might have led to spousal rape or a beating). Regardless, she refused to tip her family into dire straits by bearing too many children.

    Lily

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