This book presents the collective wisdom of a group of Obstetrician/Gynecologists (OB/GYNs) from around the world brought together at the 2012 meeting of the International Federation of Gynecology and Obstetrics (FIGO) to contribute their ideas and expertise in an effort to reduce maternal and neonatal morbidity and mortality and obstetric fistula in sub Saharan Africa (SSA). The discussions focused on how to increase human capacity in the field of obstetrics and gynecology. The meeting was hosted by the University of Michigan Department of Obstetrics and Gynecology Global Initiatives program and was supported through a grant from the Flora Family Foundation.
Within the pages of this document, the current status of women’s health and OB/GYN training programs in 10 sub-Saharan African countries are described, with a Call to Action and Way Forward to training new OBGYNs in country. These are the words of obstetricians in the field, some who work as lone faculty in fledgling OB/GYN departments. These committed people are charged with the task of not only teaching the next generation, but may be the only OBGYN per 500,000 population or more. Their tireless pursuits are recognized, and their yearning for collegial support is palpable.
Every country should have a cadre of highly trained OB/GYNs to teach the next generation, contribute to policy development and advocate for progressive legislation, conduct the research needed to solve local clinical problems, and contribute to the field of women’s health in general. But most of all, it must be recognized that women across the globe have the right to access a full scope and high quality obstetrical and gynecological care when and where they need it. These pages bring to light successes achieved and shared, and lessons learned that have already spurred new programs and given hope to those eager for a new way forward.
Childbirth is a quintessential family event that simultaneously holds great promise and runs the risk of danger. By the late nineteenth century, the birthing room had become a place where the goals of the new scientific professional could be demonstrated, but where traditional female knowledge was in conflict with the new ways. Here the choice of attendants and their practices defined gender, ethnicity, class, and the role of the professional.
Using the methodology of social science theory, particularly quantitative statistical analysis and historical demography, Charlotte Borst examines the effect of gender, culture, and class on the transition to physician-attended childbirth. Earlier studies have focused on physician opposition to midwifery, devoting little attention to the training for and actual practice of midwifery. As a result, until now we knew little about the actual conditions of the midwife's education and practice.
Catching Babies is the first study to examine the move to physician-attended birth within the context of a particular community. It focuses on four representative counties in Wisconsin to study both midwives and physicians within the context of their community. Borst finds that midwives were not pushed out of practice by elitist or misogynist obstetricians. Instead, their traditional, artisanal skills ceased to be valued by a society that had come to embrace the model of disinterested, professional science. The community that had previously hired midwives turned to physicians who shared ethnic and cultural values with the very midwives they replaced.
An eye-opening discussion of the ways disease shapes urban society
Disease may not discriminate, but it helps those who do. In this fascinating book, Susan Craddock examines the role of disease and health policy in the construction of race, gender, and class, and in urban development in nineteenth- and twentieth-century San Francisco. An absorbing look at the role of disease and health policy in the construction of race, gender, and class in urban development during nineteenth- and twentieth-century San Francisco. Susan Craddock considers tuberculosis, plague, smallpox, and syphilis as diseases whose devastations were derived in part from their use as political tools and disciplinary mechanisms
In 1859 a Hungarian obstetrician named Ignaz Semmelweis, reflecting on his years as resident in the Vienna maternity clinic, wrote a graphic account of his attempt to diagnose and eliminate the then epidemic scourge of childbed fever. The resulting Etiology triggered an immediate and international squall of protest from Semmelweis’s colleagues; today it is recognized as a pioneering classic of medical history. Now, for the first time in many years, Codell Carter makes that classic available to the English-speaking reader in this vivid translation of the 1861 original, augmented by footnotes and an explanatory introduction. For students and scholars of medical history and philosophy, obstetrics and women’s studies, the accessibility of this moving and revolutionary work, important both as an historical document and as a groundbreaking precursor of modern medical theory, is long overdue.
Semmelweis’s exposure to the childbed fever was concurrent with his appointment to the Vienna maternity hospital in 1846. Like many similar hospitals and clinics in the major cities of nineteenth-century Europe and America, where death rates from the illness sometimes climbed as high as 40 percent of admitted patients, the Viennese wards were ravaged by the fever. Intensely troubled by the tragic and baffling loss of so many young mothers, Semmelweis sought answers. The Etiology was testimony to his success. Based on overwhelming personal evidence, it constituted a classic description of a disease, its causes, and its prevention. It also allowed a necessary response to the obstetrician’s already vocal, rabid, and perhaps predictable critics. For Semmelweis’s central thesis was a startling one - the fever, he correctly surmised, was caused not by epidemic or endemic influences but by unsterilized and thus often contaminated hands of the attending physicians themselves.
Carter’s translation of this radical work, judiciously abridged and extensively footnoted, captures all the drama and impassioned conviction of the original. Complementing this translation is a lucid introduction that places Semmelweis’s Etiology in historical perspective and clarifies its contemporary value. That value, Carter argues, is considerable. Important as a model of clinical analysis and as a chronicle of early nineteenth-century obstetrical practices, the Etiology is also a revolutionary polemic in its innovative doctrine of antisepsis and in its unique etiological explanation of disease. As such its recognition and reclamation allows a crucial understanding, one that clarifies the roots and theory of modern medicine and ultimately redeems and important, resolute, pathfinder.
In Contraception and Abortion from the Ancient World to the Renaissance, John M. Riddle showed, through extraordinary scholarly sleuthing, that women from ancient Egyptian times to the fifteenth century had relied on an extensive pharmacopoeia of herbal abortifacients and contraceptives to regulate fertility. In Eve’s Herbs, Riddle explores a new question: If women once had access to effective means of birth control, why was this knowledge lost to them in modern times?
Beginning with the testimony of a young woman brought before the Inquisition in France in 1320, Riddle asks what women knew about regulating fertility with herbs and shows how the new intellectual, religious, and legal climate of the early modern period tended to cast suspicion on women who employed “secret knowledge” to terminate or prevent pregnancy. Knowledge of the menstrual-regulating qualities of rue, pennyroyal, and other herbs was widespread through succeeding centuries among herbalists, apothecaries, doctors, and laywomen themselves, even as theologians and legal scholars began advancing the idea that the fetus was fully human from the moment of conception.
Drawing on previously unavailable material, Riddle reaches a startling conclusion: while it did not persist in a form that was available to most women, ancient knowledge about herbs was not lost in modern times but survived in coded form. Persecuted as “witchcraft” in centuries past and prosecuted as a crime in our own time, the control of fertility by “Eve’s herbs” has been practiced by Western women since ancient times.
How did menopause change from being a natural (and often welcome) end to a woman's childbearing years to a deficiency disease in need of medical and pharmacological intervention? As she traces the medicalization of menopause over the last 100 years, historian Judith Houck challenges some widely held assumptions. Physicians hardly foisted hormones on reluctant female patients; rather, physicians themselves were often reluctant to claim menopause as a medical problem and resisted the widespread use of hormone therapy for what was, after all, a normal transition in a woman's lifespan. Houck argues that the medical and popular understandings of menopause at any given time depended on both pharmacological options and cultural ideas and anxieties of the moment. As women delayed marriage and motherhood and entered the workforce in greater numbers, the medical understanding, cultural meaning, and experience of menopause changed. By examining the history of menopause over the course of the twentieth century, Houck shows how the experience and representation of menopause has been profoundly influenced by biomedical developments and by changing roles for women and the changing definition of womanhood.
Responding to the growing need for tried-and-trusted solutions to the reproductive health care issues confronting millions of women worldwide, Obstetrics and Gynecology in Low-Resource Settings provides practical guidelines for ensuring the delivery of quality OB/GYN care to women in resource-poor countries. Including contributions from leading clinicians and researchers in the field, this welcome overview fills an important gap in existing medical literature on women’s health care and will be an invaluable resource for doctors, clinicians, and medical students at all stages of their careers who work in the global health arena.
The reproductive health risks that all women face are greatly exacerbated when health care facilities are inadequate, equipment and medications are in short supply, and well-trained medical staff are few and far away. Often in these settings, the sole doctor or medical professional on hand has expertise in some areas of women’s reproductive care but needs a refresher course in others.
This informative guide features hands-on, step-by-step instruction for the most pertinent OB/GYN conditions—both acute and chronic—that health care workers in the field confront. The authors examine a wide range of topics, including: strategies to reduce maternal mortality and stillbirths; infectious and sexually transmitted diseases, including malaria and HIV; cervical cancer; contraception; prenatal, delivery, and newborn care; and complications arising from gender-based violence and female genital cutting. Published in a convenient format with a durable binding, this reference will be an essential companion to health care providers throughout the world.
With the increasing demand for midwives, activists are lobbying to loosen restrictions that deny legal access to homebirth options. In Pushing for Midwives, Christa Craven presents a nuanced history of women’s reproductive rights activism in the U.S. She also provides an examination of contemporary organizing strategies for reproductive rights in an era increasingly driven by “consumer rights.”
An historical and ethnographic case study of grassroots organizing, Pushing for Midwives is an in-depth look at the strategies, successes, and challenges facing midwifery activists in Virginia. Craven examines how decades-old race and class prejudices against midwives continue to impact opposition to—as well as divisions within—women’s contemporary legislative efforts for midwives. By placing the midwifery struggle within a broader reproductive rights context, Pushing for Midwives encourages activists to reconsider how certain political strategies have the potential to divide women. This reflection is crucial in the wake of neoliberal political-economic shifts that have prioritized the rights of consumers over those of citizens—particularly if activists hope to maintain their commitment to expanding reproductive rights for all women.
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