Some people might say the women's health movement began with a book. It wasn't a particularly fancy document—no smooth pages filled with colored illustrations or shiny, plastic cover. But it was pivotal to the way that many women, over the last 35 years, would come to understand their bodies.
Our Bodies, Ourselves emerged from the forefront of the women's movement in 1970; the result of the combined effort of 12 women who met the year before at one of the first women's liberation conferences. As part of a workshop on "women and their bodies," they shared their medical and personal experiences, and came to realize that the one thing they knew for sure was that they didn't know much.
At a time when the medical industry was saturated with paternalism, sexism and ignorance, a woman's only choice when it came to her health was to take what the doctor ordered. Readable books on women's health didn't exist. The Internet was a thing of the future. In short, there were no options. And so these 12 women created them. Coming together from a variety of backgrounds, they did the research, talked to doctors, talked to other women and, after forming the Boston Women's Health Book Collective and co-authoring the first edition of Our Bodies, Ourselves (then named Women and Their Bodies), they stirred college campuses across the country.
Over the last three decades, a lot has changed. But the fight for accurate information in women's (and men's) health is far from over. Judy Norsigian, who has been with the group since 1971, is coming to the University of New Mexico Bookstore on Sept. 13 to give an author reading and talk about the newest edition of Our Bodies, Ourselves, updated for the first time in a decade to celebrate its 35-year anniversary. The book now has a companion website (ourbodiesourselves.org) that is constantly updated, and provides a long list of links, resources and supplemental reading material, free of charge.
Here, Norsigian talks with the Alibi about what's changed in women's health since the book was first printed, the current political climate and what every person should do to protect what started it all: their bodies.
What do you think has changed in women's health since the first edition of Our Bodies, Ourselves was released 35 years ago?
There really isn't a short answer to that. But I would say there are several things that are really important. One is the role of the pharmaceutical industry determining what information women get from the sources they use, which is not always accurate. It's a bit harder to get completely accurate information even though there's so much more information out there. You know what happens when you have direct advertising of consumer drugs—you get bombarded with ads. They don't always tell you exactly what you need to know. They exaggerate benefits and minimize risk. So you end up not being a well-informed consumer. That's been a problem for some time. [Accurate] sources of information are not as easy to come by.
The other thing is that there are certain aspects of women's lives that have become more medicalized. So retaining the normalcy of, say, childbearing or menstruation has become a greater challenge than it used to be. There is now something called female sexual dysfunction. Pharmaceuticals have created a category [that refers to a decrease in a woman's sexual drive or desire]; this is not to say that there aren't a small amount of women that have biomedical problems when it comes to sexual response or sexual pleasure. But women just need to communicate better. Understand their bodies better. Know what it takes to stimulate the orgasm; those kinds of things. And they need to have relationships that work for them. It is not about being dysfunctional in a way that requires a medical solution or a device. There are a few women for whom that is needed, but the way the media and literature has carpeted this, one would be led to think that 43 percent of the female population are suffering from something called female sexual dysfunction.
Of course, that's with one example. Another is with childbearing, and [the fact that] many more unnecessary cesareans are being done, to the point that nearly one in three [births are through cesarean], with no improvement in outcome. There's certainly a longer recovery time, and there are high rates of infection for the babies and for the mothers. And obviously, surgery is not a piece of cake. And there's another thing to think about, which is how we get to the point where many women even think of elected cesareans as a perfectly acceptable alternative to vaginal birth. Most obstetricians I know do not support the concept of elective cesareans.
Why do you think that the numbers have raised so much recently?
I think it's part of a larger cultural trend toward seeing one's life as a series of medical events, rather than a series of life events; giving birth, having sex, even birth control. These are things that are not largely medical, but they require an interaction with a medical care system. And there are some very subtle economic influences at play.
Barbara Perkins wrote a brilliant book about the economics of childbirth. In it, you find the intricate explanation for why this might be happening now. It's not about better medical care. It's not about better outcomes. But it's about somebody benefiting. And some of it's not just the physicians, and certainly not the system, because it's sometimes more expensive to do these interventions. But sometimes women see it as a matter of convenience because it's been pitched that way. And they say, "Oh well, why not choose a cesarean and [schedule] when I can have it, instead of it being an unknown factor in [my] life."
It's the same with breastfeeding. There's all the data out there that make it clear that bottle-feeding is not the equivalent of breastfeeding. Breastfeeding is far superior. Yet in this country we still have fairly low percentages of breastfeeding in women that give birth. Not true in Europe and other countries where they basically follow the science and you see much higher percentages of breastfeeding. And one of the reasons is [because] we're less supportive of women who breastfeed. I mean, we've put women away who breastfeed in public. That would never happen in Europe. Breastfeeding is a normal thing. People can feed anywhere and it's accepted. But in this country a women has to struggle to maintain the normalcy, the appropriateness, of breastfeeding. Then the benefits are downplayed. And women just don't get the proper information. Breastfeeding rates should be much higher than what they are now.
Was the rate of breastfeeding higher in the '70s?
Well, they were high up until 1997 and then they started dropping; then there was a slight climb a few years ago and they started to drop again. I think it's a cultural thing and it's really about obstetricians not understanding the importance of breastfeeding. Pediatricians usually do, but then it's too late. Once you've had your baby and you're going to see your pediatrician, you've already made that decision. So you really have to make this decision while you're pregnant.
Another thing is the obsession with thinness and body image is up much more than it was 20 years ago. The ideal body type for women is much skinnier than the hourglass figure [it used to be] and maybe four or five percent of the female populace can look like that naturally. This means that many more women have to starve themselves, contort themselves and have surgery to meet these norms.
If you just look at breast implants for cosmetic purposes, augmentation, and I'm not talking about breast reconstruction after breast cancer, it increases. And that's largely because of the marketing and the makeover TV shows that show that you've got to look like this or else. We're quite concerned about that and are trying to educate women about the concerns of silicon gel implants, in particular.
What do you think has fueled the thinness craze?
Oh, it's everything. Usually, a financial interest accompanies a product or a diet. It's a multibillion-dollar industry. The bottom [line] is that if you can convince women there's something wrong with them you can get them to buy a product or engage in a practice that will help them seek this "norm." If you don't convince them of this then they might not buy your product. It's not to say that there isn't some good stuff going on in the midst of all this. But trying to figure out what's good and what isn't is a real challenge.
What do you think are some of the good things that are happening in women's health?
I think there's certainly a lot more attention to some of the helpful alternatives. There are many more women who are looking at holistic alternatives. For example, homeopathy, chiropractics, naturopathy, herbal remedies. Women are also more aware of moving their bodies in a regular way and getting good food in your body; eating for pleasure. Women are thinking much more carefully about what they eat and getting exercise, and doing something pleasurable like taking brisk walks with a friend, turning it into a social event. I think there's more awareness about movement. A sedentary lifestyle is probably one of the best recipes for chronic diseases. So those are good things.
I read that it was important to you not to take any money from pharmaceutical companies, partially because of what you've been talking about. Are there other books out there about women's health and men's health that do take money from pharmaceutical companies? How much information out there can people really trust and how much is slanted?
Oh, it's very hard. This is a huge issue. You have to know the source of your information and you have to evaluate what you're reading. There are groups that sound like they're nonprofit sorts of advocacy groups that, in truth, are fronts for the drug companies. It's very difficult to tell. We do have a lovely section about using the Internet in the book. You know, discerning the good from the bad. It's useful. You can be sure that these quick fixes, magic bullets, take this and you'll be young forever, that these are not to be trusted. There are very few magic bullets in life.
Talking about people being well informed, how do you view what's happening in the country right now with sex education? Do you think the current system is adequate? Do you think it's backtracking at all?
Sex education has gone way down because of the current administration. It's just been unbelievably problematic. I don't know where to begin. Have you heard of the silver ring thing? It's this really kind of right-wing ethic extremist who started this whole project about being abstinent, and you take the silver ring and you promise you're not going to have sex until you're married. Anyway, they were using this as a front for proselytizing about religion; it's just a total violation of the constitution. They finally got defunded because the ACLU filed a lawsuit, and it just happened as of July 1.
This is exactly the kind of thing the Bush administration has supported. They weren't providing reasonable sex education; it was really a lot of misinformation, injection of particular religious viewpoints, totally inappropriate with federal funds. Anyway, we've got a lot of these abstinence-only programs that don't do the job, they don't educate young people, they teach that condoms increase HIV infection, which is not true. They teach them all kinds of lies and myths, and it's going to take very active parent groups in all of these cities and towns to turn this around.
Within that same realm of sex education and sexual freedom, what are your views on making emergency contraception available over-the-counter?
I definitely think it should be [over-the-counter]. It's a safe approach; it could prevent a lot of unwanted pregnancies. It's a lot of hormone but it's only used for a short period. The benefits of avoiding an unwanted pregnancy I think outweigh the tiny, tiny risks involved; they're really quite minimal. There's a lot of safety data on emergency contraception, and the fact that the FDA has been delaying and delaying, and not letting it go over-the-counter is one of the more anti-science positions they have taken.
How much danger do you think Roe v. Wade is really in right now, and what kind of affect do you think it would have on the country and on women's health if it were overturned?
I'm among those that think Roe v. Wade is in great danger. Not that it was the most terrific decision in and of itself, because it really didn't affirm a woman's right to choose in the way that many wanted. But it is in great danger. I am extremely worried about what's going to happen. On the other hand, maybe it's what's needed as a wake-up call for the many, many young women who don't think their reproductive freedoms and their right to choose are in jeopardy. Many young women don't know this; they're not paying attention. And I suppose that if it were to become illegal, that would galvanize another whole generation of young women to turn this around. Young women have not for the most part appreciated the tremendous risk that we face right now, losing these reproductive rights. And abortion is just the first thing. It's going to begin with abortion and end with contraception.
Do you feel that activism, or that America's youth today, has become relatively stagnant compared to what it was? It seems like there's a lot of complacency now.
It depends on who you're looking at. There's a very strong core group of activists; there's also some that are just not aware. There's so much media, there are so many interesting distractions out there, they're just not as politically astute or aware of what's going on, and those young people someday might be rudely awakened when they realize that their long taken for granted freedoms have become eroded. I mean, we are facing one of the most serious threats to democracy this country's ever faced, and it's different from all other eras, and I don't think the American public appreciates the way in which this administration has undermined democracy in the most basic way. And I think that will include access to healthcare, women's reproductive rights. It will include all of the efforts we've made to preserve the environment since 1970. You know, the environment is about human health and it's about preserving many aspects of the world; and it would be a shame to destroy it to the point where we can't restore it to a place where we can enjoy it and use it without risking human health and our future.
What advice would you give to the women of today?
The most important advice is don't ever do anything—take a drug, have a surgical procedure—without becoming well-informed. Use unbiased sources; sources that are not influenced by the pharmaceutical industry or any financial interest groups. Our [website] is a great place to start (ourbodiesourselves.org), because we link to a lot of these groups—the government websites, the nonprofit groups that are truly independent. Go and get as much unbiased information as you can before you make a decision.