For nearly a decade now there has been a growing women's health movement throughout the countries of North America, Western Europe, New Zealand and Australia. The movement takes many forms, and would be too vast to deal with in detail within the scope of this bulletin. We are therefore reproducing two articles which describe the movement briefly, the first giving a panorama, and the second giving a more personal account of the development of one European group.
The movement has also generated books, pamphlets, films, photos - a vast stock of resources written by women for women. Again, we are limiting ourselves to listing just a very few of these excellent resources, since we will be publishing a Women's Health Directory jointly with the Boston Women's Health Book Collective in the near future (see the end of this section for detailed description). The Feminist Women's Health Centers in the USA are also preparing a publication for later this year which will deal with all aspects of women's self help, including a listing of women's health centers and projects.
This article by Anne Raulin from France is translated and adapted by Isis. Anne Raulin is one of the translators adaptors of Notre Corps, Nous-MAme, the French version of the now famous Our Bodies, Ourselves by the Boston Women's Health Book Collective (see resources for details). Her article came to us in mimeographed form, and although undated, is probably written during the first half of this year (1978).
Women's self-help groups began to be formed in the early 1970's in the USA as part of the struggle for abortion . The movement began in Los Angeles, then spread throughout the country following a trip from west to east by the women who had begun it -a trip which was financed by women wanting to learn about their bodies. At present there are about 1,200 such groups in the USA alone. Later these women were invited to several countries of Western Europe, to Canada, Mexico and New Zealand.
These groups were established as an attempt to break with the traditional doctor-patient relationships of the present medical system. They insist upon the absence of professional medical workers within their ranks. They emphasize the information which women can share among themselves, what they can discover by self-examination and the desire to find hygienic contraceptive and therapeutic methods which do not ruin their bodies.
Collective apprenticeship
A meeting of these groups often involves a pelvic self-examination. In the familiar atmosphere of one of their apartments, the women teach each other how to use a vaginal speculum, to observe the state of the vagina (colour, walls of the vagina, colour and position of the cervix, charting of the menstrual cycle by the state of the secretions) . Through looking in a mirror, each woman can achieve a visual know· ledge of her vagina throughout her cycle. Next the vagina is felt : covered with anti-septic gloves, two fingers are inserted and the neck of the uterus and the ovaries are touched. This examination permits the detection of possible abnormalities of the internal genital organs.
The breast self-examination to look for cancer is also learned in these meetings. The sessions include discussions, exchange of information, ideological debate, exchange of information, recent experiences, as for example on amenorrhea : how and under what conditions do women experience the absence of periods.
Research on ourselves
Within these groups, women are the subject of their own medical research . Groups have examined benign gynaecological disorders such as vaginitis, trichomonas, monilia, because of their widespread nature and the lack of satisfactory treatment. The answer of the medical establishment to this problem has been treatment with antibiotics. The use of antibiotics initiates a vicious circle because even though they kill the bacteria, they also destroy the fine balance of the vaginal flora, thus creating the ideal condition for new infections to flourish in.
Women from Montreal and Quebec (Canada) have particularly concentrated on this problem. They have found that many women had symptoms of vaginitis without the bacteriological analysis showing anything wrong. They explained this by a psychosomatic condition brought about by the proliferation of contraceptives which , although diminishing the fear of pregnancy, may increase situations where women have sexual intercourse without really wanting it. This state can often lead to a condition of hyperacidity in the vagina, making sexual relations painful. The cure then consists of understanding the reasons for this resistance, and the use of natural remedies. These remedies, which include teas, herbs, yoghurt, vitamins, have the advantage of bringing back the normal balance within the body without causing side effects. They have also used certain bacteria for curing vaginitis which have the same origins. They make sure that there is no venereal disease or other serious infection of the tubes or ovaries, and then treat the infection with one of these natural remedies, discovered by women. Self-help groups also spread this information as widely as possible to other women.
Inventive Contraception
Self-help groups have reacted very violently against being used as guinea-pigs for the pharmaceutical companies' re search. This is particularly true of the area of contraception, and for several years now, many groups have been active in denouncing the dangerous side-effects of the Pill and the IUD. Some women are concentrating on experimenting with "soft" methods of contraception on themselves. They prefer to take risks which they are in control of, rather than those given out by the pharmaceutical industry. So, for instance, a woman at the Rome Conference (June 1977) announced that she was pregnant after practicing the Billings method for more than a year (this method is based on observation of the vaginal mucus) . She preferred an entirely natural method which gave her a detailed knowledge of her body, without secondary effects even though it is fallible.
No method should be presented as a general solution for everyone. Self-help groups are not trying to establish one particular technique rather than another. Their aim is to enable every woman to get to know her own body and to study its particularities and evolution. Obviously this takes a certain amount of time, availability and a conviction that one's body is not just a heavy burden which must be passed off into the hands of "professionals". Each individual woman has to determine what is best for her and what she is prepared to undertake for herself. So, for instance, a woman might find at one period of her life that she cannot bear the idea of pumping chemicals into her body or having a foreign object in her uterus, or putting a rubber cap inside herself before intercourse. At other times she might accept these inconveniences because she finds other advantages for herself, knowing fully what the side effects are and what risks she is taking.
The need for information
Gathering and sharing information about risks is one of the major tasks of self-help groups. Many articles dealing with medical research, for instance, are photocopied and circulated . The Boston Women's Health Book Collective (authors of Our Bodies, Ourselves) emphasize the importance of this work, which they see as a priority. As Americans, they see themselves well -placed to get a maximum of recent information and to disseminate this throughout the world, where this would normally take 10 years to become known. They send bi-monthly "packets" to all interested groups, containing about 30 articles dealing with all aspects of women's health. These packets can be obtained (in English) from : BWHBC, Box 192, West Somerville, Ma. 02144, USA.
These articles should not give rise to panic, but rather to an opportunity for women to question and examine themselves. This may lead to a woman discontinuing the use of a particular contraceptive, or not. This knowledge can also help in the future to identify certain symptoms. For example some women who use an IUD suddenly become allergic to it after 2 years. Without knowing this, they usually try to find some other explanation. It can also help in the choice of other methods of contraception. It is obviously desirable that women not only gather this information but also generate it by keeping records of their own experiences. (The Boston packets also contain this kind of information) . There is a tendency in these groups for certain women to become health specialists because they have information and the others don't . The only way to avoid this phenomenon which happens in most institutions, is to ensure free access to all information and meetings. It is important that no one person's word become sacred and indisputable, but that each woman develop her own competence in regard to her own body. This is a continuing process.
Self-help is not limited to gynaecological conditions. In Rome, during an international women's conference on health (June 1977). information was exchanged on diabetes, eye deficiencies ... In the USA, groups of menopausal women have formed to deal with their specific problems (e .g. with estrogen therapy) . The Boston packets also contain information about natural tranquilizers, medicines, nutrition, women health workers, abort ion, rape, medicalized childbirth, home birth etc . Women's health centres also help encourage body work such as yoga, dance, massage.
These initiatives of self-help groups have sometimes given rise to repression, as with the arrest of Carol Downer of the Feminist Women's Health Center in Los Angeles for illegal medical practice, or defamatory press campaigns, as with the self-help group in West Germany. In Spring 1977 they gave a demonstration and were accused by the right-wing press of giving a "seance which corrupted young women by exposing themselves in positions which were clearly an invitation to lesbianism" !
Women's Clinics
Nonetheless, several women's health centres have been established, especially in the USA. These establishments are private initiatives, usually financed by donations, private funds, the consultations, and sometimes by federal funds. They are open to all women and run by women who have been members of self-help groups; some of these women are paid (e .g. US$ 500-700 for full time work), others work voluntarily . These centres are usually in buildings which are warm and welcoming, more like community houses than municipal health centres. In addition to gynaecological self-help, the centres perform pap smears to check for cervical cancer, check for venereal diseases, take diaphragm measurements, and perform abortions with the collaboration of a doctor. This is required by law in the USA, even though doctors have frequently had to learn the non-traumatic aspiration method from the women of the self-help groups themselves, since this is not taught in medical schools.
The situation is similar in France where women who were who were accused of the illegal practice of medicine in Aix-en-Provence in 1977, brought to their defense the fact that it was they who had taught the doctors. Self-help groups in France have been formed in different places. They are partly inspired by women from the MLAC (Movement or the Liberalization of Abortion and Contraception). who wish to maintain and improve the knowledge of their bodies. This was especially urgent before the liberalization of the abortion law ( 1975). Some groups have started performing abortions again because of the inadequacy of the law (many doctors refuse to practice abortion) and are trying to do this in the context of a wider health care similar to the women's health centres in the USA.
Italian women, in the midst of their struggle to legalize abortion (see article elsewhere in this bulletin), have also fought to get recognition for their health centres (consultori) which they have created with State subsidies.
In the USA, the law does not require a hospital structure for the practice of abortion. This has given rise to both alternatives run by women for women, and the more dubious development of gynaecological surgeries and private clinics whose primary interest is not women's health. The opening of any health centre has to be done in accordance with the laws governing medical licenses, which vary from state to state. The hygiene and facilities of the place have to be heckled; proof of the utility of such a centre in the specified neighbourhood is required as well as its economic viability, and an arrangement has to be made with the local hospital for emergency cases. Mostly, though, the legal criteria are not defined very strictly and women's health centres can often benefit from legal precedents.
They are not the only groups to put pressure on current legislation : there is a new wave of non-certified medical workers in the USA, such as healers, masseurs, practitioners of acupuncture, who are allowed to practice even without a license. In certain states even mid-wives can practice without a medical diploma.
Health is not only the absence of sickness
This is a situation where highly specialized medicine with its intricate techniques and undoubted efficacy in extreme and urgent cases, is being put in its place. We are witnessing a resurgence of preventive medicine - the practice of which fell into disuse at the onset of modern medicine - and of traditional concepts like that of hygiene which has less to do with the fight against bacteria as with a style of life which enables us to be in touch with our bodies.
Women are particularly favourable to this development because female physiology (e.g. periods, contraception, pregnancy, menopause) needs a more constant and consistent medical knowledge than the male physiology. Thus, it is important for both physical and mental health to be able to make a distinction between physiological evolution and a pathological state. It is by the spreading of this knowledge and the use of preventive health care - which does not have to be made "professional" - that the women's health movement fulfills a critical need.