Thesis ID: CBB308650357

Prescribing Pregnancy Loss: Women Physicians and the Changing Boundaries of Fetal Life in Nineteenth-Century America (2021)


This study examines the role the first cohorts of women physicians in the United States played in shaping the medical subfields of obstetrics and gynecology. Women were trained largely to provide clinical care for women patients in the mid- to late- nineteenth century, yet they entered the profession in a moment of profound ambiguity regarding pregnancy loss that could compromise their professional status. In the early nineteenth century, common law in the United States permitted pregnancy termination before quickening, or the moment of fetal movement. By mid-century, states began clarifying the common law doctrine of quickening and criminalizing termination at any point in pregnancy without providing clarification for instances in which termination may be clinically necessary. It was not uncommon for women to require pregnancy termination to save their life in instances of health complications like cancer or because a fetus was too large to pass through the birth canal before cesarean sections were widely practiced. These procedures would be tacitly illegal under the new laws. Legal ambiguity surrounding pregnancy termination was met with equally opaque guidance from the medical community and municipal authorities increasingly interested in tracking vital statistics. Medical and state definitions of pregnancy loss, including stillbirth, miscarriage, and abortion, were unaligned and made it difficult for these fields to track information in concert with one another. These fissures also created potentially dangerous situations for women physicians when questions regarding pregnancy loss were arbitrated in a court setting. Despite the role pregnancy loss played in the educational and clinical experiences of women medical students and physicians and how their experiences with the subject can redefine how we understand their role in the professionalization of nineteenth-century medicine, this subject has received little scholarly attention beyond noting women’s public-facing denunciations of pregnancy termination. By centering women physicians’ experiences of pregnancy loss and termination within individual educational and clinical settings, Prescribing Pregnancy Loss complicates the notion that the first cohorts of women physicians practiced on the margins of the regular medical profession. While women physicians publicly capitulated to mainstream views of pregnancy termination asserted by the American Medical Association to protect their professional reputation and gain purchase in mainstream medicine, in community settings they rendered clarity from the ambiguity of legal, medical, and state-sponsored definitions of pregnancy loss. Within the confines of private educational institutions, women physicians and medical students trained to protect themselves in courtroom settings, authored medical texts clarifying the morbid anatomy of pregnancy loss, and confronted it face-to-face while caring for women patients. In grappling with pregnancy loss in their medical education and clinical practice, women physicians helped shape the future of the nascent medical subfields of obstetrics and gynecology.

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Authors & Contributors
Reagan, Leslie J.
Daxenbichler, Maria
Cahn, Susan K.
Crellin, John K.
Demaitre, Luke E.
Duffin, Jacalyn M.
Journal of the History of Medicine and Allied Sciences
Berichte zur Wissenschaftsgeschichte
Bulletin of the History of Medicine
Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Dynamis: Acta Hispanica ad Medicinae Scientiarumque Historiam Illustrandam
História, Ciências, Saúde---Manguinhos
University of California Press
University of California, Berkeley
New York University
Northeastern University Press
State University of New York at Buffalo
L'Asino d'oro Edizioni
Medicine and gender
Reproductive medicine
Obstetrics and pregnancy
Physicians; doctors
Channing, Walter
Henry VIII, King of England
Trotula of Salerno
Time Periods
19th century
20th century, late
20th century
15th century
20th century, early
United States
Great Britain
Salerno. Schola Salernitana

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