The Medicalization of Reproductive Health

10 Aug

A ways back, the Abortion Gangsters got into a fairly heated discussion on our private listserv about the topic of Herbal Medicine. I found this completely fascinating – not only herbal remedies themselves, which, being a little Jewitch, I am super into, but also the apparently very controversial nature of the subject itself.

We’re incredibly lucky to have a Doc on staff, and we rely on the Doc quite a bit, actually. When we send something around the listserv about medical procedures we ask the Doctor to give us whatever background they can, and we defer to their judgment when medical issues or related ethics seem to be skirting a gray area. But in this discussion of the potential for using herbal remedies to address reproductive health care, I felt that this inclination was, for the first time, to our collective detriment.

Coming from a queer community and multiple ethnic backgrounds that at one time or another fell under the less than benevolent gaze of eugenics, I have maintained a life-long and, I feel, healthy distrust of the medical profession in general. Over time, the Doc has demonstrated that they have not only a depth of knowledge and a willingness to share it, but also that they have the best interests of the patient, whoever that may be, very much at heart, that they aren’t given to judgment, and they’re aware of the multiple intersecting identities we all all labor under and the differences those identities make in terms of necessary medical care. So I put a trust in this particular Doc, and would actively encourage any reader to do the same, when it comes to their posts, comments, and analyses of reproductive care.

That said, as we talked about herbal remedies for reproductive care, I saw amongst us a lack of comfort with non-medicalized solutions to the needs of our lives and bodies. That’s not to say non-medical – the rhythm method of birth control, for example, is non-medical – but non-medicalized, as in solutions that have not had “proper study,” lengthy research, trials, and a variety of other trappings that would validate them in the eyes of what I must personally refer to as the Medical Industrial Complex.

I believe we need two extremes on every end of every issue, and a big area in the middle where people mill about, unconvinced and debating. We have the Doc, who has invested in medical school, is great to their patients, is great to us, and believes in medicine. We need an extremely curmudgeonly, rabidly unconvinced person on the other end of the spectrum who remains stubbornly, wholly convinced that the medical community is out to get us and can’t be trusted. And in the middle, we need the rest of us, debating how much of this is true, when to listen and when to jump into the discussion. And what we had during this debate, I thought, where a rabidly anti-Medical Industrial Complex person ought to be, was just me, merely suspicious and distrustful, and where a lot of milling-about and debating should have been happening, we had a lot of Trust in the Institution. In other words, in this extremely progressive movement, I think we lean heavily to the right on Medicine.

As a member of a hyper-medicalized, studied, and dissected community, I do not take to the idea that medicine is only valid when it has been studied and generated by the pharmaceutical industrial complex. I go to the lady-doctor and take my advil when I need it-I’m not a medical luddite, as it were-but the idea that the only way to validate medicine would be to have a phamaceutical company study it troubles me.

To this objection, one of my fellow writers responded, “It doesn’t need to be a pharmaceutical company. A college or university could do it. A hospital could do it. Anyone with credentials enough to understand how this research is conducted, what constitutes good research from bad, and can then share this information in a way that is repeatable would suffice.”

But does it have to be studied in these ways at all to ever be valid? So much of what is studied and what we’re told is true because Science Was Applied turns out to be a wash. Fitness is a great example. Studies about what to do, when to do it, and how effective it is for fitness turn out now to actually only have been tested on men, and the results turn out to be very different for women (I think carbo-loading before races is an example). Meanwhile, conventional wisdoms – “this is how I got in shape” – get passed around and work for some people and not for others, and may never be widely studied. Or birth control itself – some company dreamed up and tested the original IUDs, the ones that ripped women up*, and those were approved and widely distributed, until women objected en masse to being rendered infertile by something that was simply meant to get them not-pregnant for awhile, and they had to take them off the market, and then they sent them to developing countries where people couldn’t afford to object. Oh, migraines, how to cure migraines – everyone has a way that works for them, and most of it has never been widely studied, and what the medical field declares The Last Word in migraine treatment is constantly being re-written. Does it need to be validated by The Medical Community, an extremely exclusive institution whose existence, whose every building block, and whose experiments and solutions in the field are intensely, problematically, and historically terrifyingly raced, classed, and gendered, in order to even be considered for discussion?

In the context of what we were specifically discussing – herbal birth control, herbal abortifacients – a lot of the concern being expressed was liability: what if our discussing herbal remedies was seen as an endorsement? What if someone tried it and got hurt, or pregnant? Yet we never recommend that a particular individual do anything except what they – and their doctor – decide is best for them. But that’s the rub, isn’t it? We are, to a very large extent where our bodies, health, and lives are concerned, subject to a system in which profits are priority and we, as individual humans, are at the bottom of the barrel.

Research methods themselves have been developed over centuries and are perfectly valid. It’s who does the research, why, and to what end that so often presents a problem. The methods are sound, but they’re being applied within a health care system which was built within a racist, classed, gendered society. The system was not built for us. If the system’s priorities are different than ours, the system meant to care for us actively works against us. We may be an individual’s first concern – I know the Doc’s patients are certainly their first concern – but we place a great deal of emphasis on a system that does not care about our interests.

I grew up in the 90s Riot Grrrl scene, when there were zines instead of blogs, and people were passing around herbal ways to abort, drinking certain kinds of tea to bring on their period early, and using sponges instead of tampons, because bleached cotton is not necessarily a loving thing to stick up inside yourself. All the methods took a great deal of time attention, lavished on yourself, to determine what worked best for you, how, and why. They required an intimacy of knowledge of one’s own body that is often lost in translation when speaking with a medical professional and certainly when getting caught in the machinery of a pharmaceutical or insurance company. I was sincere when I said I am not a medical luddite, but, while I do not want to smash the machines, “nor do I want the machines to smash me.” I would like to see, in reproductive justice, an openness to solutions beyond those advocated or even supported by the Medical Industrial Complex. I would like to see open dialogue around solutions, or, best of all, demands that the system work for us. If we want to see which herbal abortifacients are effective, why not demand that the insurance companies that take (and take, and take, and take) our money study them? Why not inform one another of how our bodies work and find out what other people think, do, know? We’re a new wave of hope and fierce, intelligent passion on the cusp of ruling the world. Can we get a little radical about this? I want us to reclaim the trade on our own bodies that has been co-opted by systems that take our money and sell it back to us as services that we don’t want and don’t need. I just want us all to demand better, and be open to Different.

*I refer here to the Dalkon Shield. Of the claims made about the Shield, the Doc notes (I TOLD YOU WE RELY ON THE DOC): ” It’s true that any IUD can lead to perforation on insertion (not removal, as implied by article you linked to) but I can’t find any evidence that it’s more likely to cause perforation than any other IUD (link to a meta-analysis that looks at the other complications if you’re interested) .  One of the big problems with the Dalkon shield was that people were inserting it who didn’t have the proper training, leading to a higher failure rate of the device and a higher rate than expected of pregnancies, as well as a higher rate of infections after insertion due to lack of appropriate septic technique.  The horror stories were women who became pregnant with the device in, then had serious complications from septic abortions because the filaments provided a good environment for a certain, particularly nasty microbe to ascend into the uterus.  There is still disagreement about whether the problem really was the Dalkon itself, or if it was untrained providers inserting them.”

2 Responses to “The Medicalization of Reproductive Health”

  1. WentRogue August 10, 2012 at 1:55 pm #

    Two thoughts: 1) MENSTRUAL EXTRACTION. We should bring it back.

    And 2) a bit of a rant, unrelated to herbal remedies, on who can provide abortion care:the nursing model of care is different from the medical model, and it would be awesome to see more attention paid to expanding the scope of care in states where possible, and to train NPs and midwives up to do abortions. One reason why the new law in Mississippi regulating that physicians who perform abortions at the state’s sole clinic have local hospital admitting privileges is so dangerous is that it ALSO requires that those physicians be ob/gyns. WHAT? Dr. Tiller himself was not an ob/gyn. Primary care physicians of all stripes (family med, pediatrics, internal med, emergency med…) can and should be trained to provide abortion care and so should advanced practice clinicians, the nurse practitioners and midwives referenced near the top of my rant.

    • Oubli August 11, 2012 at 4:43 pm #

      This ↑

      I would love to learn how to preform a menstrual extraction, as a student midwife it would be great knowledge that might just save someone’s life one day.

      Also I just relied on herbal contraception for 6 months between IUDs (long story), 6 months of wild sex with my partner that resulted in no pregnancies – Rosemary for it’s anti-implantation properties and Penny Royal for it’s emmenagogue abilities.

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