Revolutionizing Women's Healthcare: The Feminist Self-Help Movement in America by Hannah Dudley-Shotwell
Hannah Dudley-Shotwell's Revolutionizing Women's Healthcare: The Feminist Self-Help Movement in America is an account of feminist health activism that emerged in the 1970s in response to the medical establishment's treatment of women patients to become a cornerstone of the women's health movement. Dudley-Shotwell is interested in grassroots projects that were expressly labelled "self-help" and in feminist health activists prominent in the self-help movement. These women, according to the author, shared a deep suspicion of mainstream medicine; a need to demystify the workings of their own bodies, minds, and lives; a variety of conflictual viewpoints with regard to self-help; and a desire to practise self-help to attain political equality and personal autonomy for women.
Any discussion of the feminist self-help movement is bound to bring to mind the American self-help classic Our Bodies Ourselves (1970) by the Boston Women's Health Book Collective. However, Dudley-Shotwell moves well beyond this oft-studied text to explore two major streams of self-help: one that focused on women's gynecological concerns and another that highlighted overall well-being for racialized women. Both were indebted to feminist consciousness-raising. In the case of "gynecological self-help," the author concentrates on its relationship to abortion, especially before the 1973 Supreme Court decision Roe v. Wade. Self-help activists turned to lobbying for the repeal of abortion laws, creating abortion referral networks, organizing workshops during which women learned to insert a speculum and examine their own cervixes, establishing a plethora of self-help groups and organizations, supplying abortion kits, publishing booklets and pamphlets about abortion, and experimenting with menstrual extraction using a flexible cannula-and-syringe-based contraption known colloquially as the "Del-Em," which some supported as an early abortion method and possibly even as a type of monthly birth control. After Roe v. Wade, feminist self-help extended to the launching of local clinics, some of which hired physicians to perform abortions, studied types of birth control such as the cervical cap, and were run on egalitarian principles to aid patients with their [End Page 224] medical concerns, both individually and collectively. Gynecological self-help benefitted heterosexual and lesbian women. Having learned about fertility cycles from the self-help movement, lesbian women were able to combine sperm donation with menstrual extraction technologies to impregnate themselves or their partners. Older women participated in meetings to discuss menopause and aging and distribute information that proposed alternatives to pharmaceutical interventions.
Racialized women required far more than gynecological self-help. Dudley-Shotwell makes a point of affirming that while gynecological self-help preoccupied white, middle-class feminist health activists, Black, Asian, Latina, and Indigenous feminist health activists took a more holistic approach, prioritizing the importance of physical and emotional health. These activists were well aware that non-white women's ill-health was exacerbated by poverty, a lack access to health care services, and the experience of racism. Conferences, workshops, publications, and discussion groups highlighted the prevalence of race-related stress and illness in non-white women and sought to empower them. What came to be known as "psychological self-help" was a fruitful approach because it acknowledged the intersection of classism, racism, and sexism and their impact on health and the health care system. This approach proved suitable for treating HIV/AIDS as an issue that was just as much social as medical. Psychological self-help also contributed toward the construction of a reproductive justice framework that encompassed gynecological self-help but did not necessarily prioritize abortion.
Throughout the book, Dudley-Shotwell illustrates repeatedly that the road the self-help movement travelled was rocky. Some self-help practitioners were charged and tried for practising medicine without a licence; licensed physicians were not always eager to work in clinic settings that ran on feminist principles; competition with Planned Parenthood arose; and cooperation between feminist health activists and the medical profession was often short-lived. However, conflicts within the self-help movement also took their toll. Self-help clinics and staff were not necessarily able to meet the needs of a diverse clientele, and fierce disagreements over self-help strategies and aims caused personal and professional ruptures. Efforts to broaden self-help beyond abortion were stymied because the rise of the pro-life lobby kept many self-help practitioners fully engaged in the abortion issue. In fact, the realistic fear that the pro-life lobby, Supreme Court decision making, and/or federal and state [End Page 225] legislation could curtail access to legal abortion services led to a re-popularization of menstrual extraction as an abortion method. Yet here too, there was disagreement over whether the self-help movement should throw its weight behind protecting reproductive rights or publicizing menstrual extraction as a method of abortion that could be used as a safe alternative to illegal abortion should Roe v. Wade be struck down.
Intentionally or not, what comes across in this book is the enormous amount of political space abortion occupies in the USA and the pitfalls of an American medical system that leaves so many women to manage health-wise on its margins. On that note, Dudley-Shotwell draws the book to a close with an epilogue that speculates all too briefly upon connections between self-help and a few contemporary areas of research. It would have been far more useful to conclude by analyzing the trend toward self-managed or DIY abortions. This trend is made possible by an abortion pill approved for use by the Food and Drug Administration in the year 2000 and by international feminist pro-choice networks operating online to disseminate information and advice in multiple languages about medication abortion and, in some cases, even the abortion pill itself. How might an alliance of medicine, feminist health activism, and internet technology revive or reshape the self-help movement not just in the USA but transnationally? Such a question has gained even more traction as we live through a global pandemic that has only exacerbated pre-existing physical, emotional, and reproductive health inequities among women.
