Medicine, Modernity, and the Maternal Body

When I set out to write a synthesis of the history of motherhood in the U.S. back in 2008, I’d been teaching a course by that name for more than a decade. I didn’t anticipate that as I explored this history, I would soon witness a multi-faceted and partisan assault on reproductive rights. Perhaps this political context was part of the reason I found that, as I dug ever deeper into this scholarship, questions about the modernization of the maternal body and the various political tensions embedded within this process kept bubbling to the surface.

The development of modern ideas and practices concerning the maternal, or potentially maternal, female body was a process fraught with anxiety about the mysteries of reproduction, the promise of male-dominated allopathic (mainstream) medicine, and the future of the nation, particularly with respect to gender, race, and class. It was a process driven by both hope and fear: hope for improved maternal health, and fear about women’s power over reproduction. Modernization also meant that regulation of the female body became a broader societal concern, one that was linked to social anxieties about women’s roles and the make-up of the population as a whole. Those anxieties were especially evident in physician-led campaigns to criminalize abortion and in the twentieth-century eugenics movement, which resulted in many thousands of coerced sterilizations of women.

Since medicalization was a key component of modernizing the maternal body, so much of the story has to do with complex relationships between women and physicians. Despite the rudimentary state of nineteenth-century scientific medicine and its generally unimpressive results in treating women’s conditions, physicians consolidated allopathic medicine and began to appropriate formal knowledge of women’s bodies, displacing religious ideas with scientific ones. Around the mid-nineteenth century, they gained increasing credibility in areas of reproductive control, childbirth, gynecology, breastfeeding, sexuality, and infertility. Male physicians (and a few women) elbowed their way into the female domain of the birthing chamber, often casting aspersions on midwives as they did so.

The long process of bringing a modern science and medical authority to bear on women’s bodies began in the late eighteenth century and was fully consolidated by about the middle of the twentieth. The process changed not only the practices of women, but also the language used to describe the female body. Natural metaphors for women’s fertility were displaced by notions of illness, frailty, pathology, and danger. The colonists used agricultural metaphors to talk about women’s fertility and described pregnant women as akin to nature’s generosity itself, “flourishing,” “breeding,” “teeming,” and especially “fruitful.” But as Americans, especially women, embraced the idea of controlling fertility for reasons of women’s health and safety, these metaphors largely disappeared, and women used less intimate and more passive terms, referring to themselves when pregnant as “awaiting the little stranger.”

But the story of scientific medicine and maternal bodies is not just one of imposing medicalized ideas on women. Many women saw promise in the idea that modern science could alleviate human suffering. Scientific discourses displaced not only natural metaphors but also religious ones, in which childbirth’s pain had been seen as an appropriate punishment for Eve’s sin. As Americans modernized, not just physicians, but broad segments of the nineteenth-century population advanced the notion that people should be able to control the pain of childbirth, the travesty of maternal mortality, and even the disappointments of infertility, long considered a woman’s problem or God’s will.

Science offered promise, and this is why not just physicians, but many women embraced it. At times, women were even more enthusiastic than physicians about supporting new methods. This was certainly the case with pain relief in childbirth. And by the twentieth century, medicalizing the female body also had some benefits, most notably in vast improvements in maternal mortality in childbirth, which fell 97% between 1900 and 2000. Though science marginalized female knowledge of the body, eventually, it also offered antibiotics, immunizations, endocrinology, and more sophisticated scientific medical studies, all of which led to vast improvements in the health status of women and their families.

This broad historical process of medicalization and modernization fed upon Americans’ high ideals of progress and science, a belief that humans could control nature through discipline of the maternal body. This was an idea that resonated not just with professional men, but with mothers and their loved ones who hoped to save the lives of women. But for women to find their own voices in the process was always a tricky business. Through all these developments, American society defined women as fundamentally maternal, and their status as citizens, with a voice in making laws, or making contributions to scientific and medical knowledge of the female body and reproduction, was consistently marginalized. Nineteenth century women could neither vote nor, for the most part, could they gain entry into the ranks of the profession that claimed every greater authority over their bodies.

Still, even as allopathic medicine was formalizing medical training, there were women—and men—who voiced their opposition to the emerging notions of medical male authority over the maternal body. And the voices of dissent would pop up again and again. In the twentieth century, women would participate in growing waves of reclamations and reconsiderations, in calls for a return to the natural, to the woman-centered. To more broadly reclaim their voices, women would need to reconsider not just what modern scientific medicine had taken away from them, but also what it had made possible. This, of course, exposed the tensions of the present as well as those of the past. American women – and men – continue to wrestle with modernity. In truth, the hopes and fears of the past are not so far removed from our present concerns. There are many chapters yet to be written in the history of medicine, modernity, and the maternal body.

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Featured Image: Mary Cassatt, Mother combing child’s hair, 1879

Further reading: Rima D. Apple, Perfect Motherhood: Science and Childrearing in America (New Brunswick, NJ: Rutgers University Press, 2006); Janet Golden, A Social History of Wet Nursing in America: From Breast to Bottle (Cambridge: Cambridge University Press, 1996); Sylvia D. Hoffert, Private Matters: American Attitudes toward Childbearing and Infant Nurture in the Urban North, 1800–1860 (Urbana: University of Illinois Press, 1989); Susan E. Klepp, Revolutionary Conceptions: Women, Fertility, and Family Limitation in America, 1760–1820 (Chapel Hill: University of North Carolina Press, 2009); Wendy Kline, Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom (Berkeley: University of California Press, 2001); Molly Ladd-Taylor, Raising a Baby the Government Way: Mothers’ Letters to the Children’s Bureau 1915–1932 (New Brunswick, NJ: Rutgers University Press, 2001); Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 1750-1950 (New York: Oxford University Press, 1986); Marie Jenkins Schwartz, Birthing a Slave: Motherhood and Medicine in the Antebellum South (Cambridge, MA: Harvard University Press, 2006);  and Jacqueline H. Wolf, Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the 19th and 20th Centuries (Columbus: Ohio State University Press, 2001).

Jodi Vandenberg-Daves

Jodi Vandenberg-Daves is a professor of women’s studies and history at the University of Wisconsin-La Crosse, where she teaches courses on women’s history, the history of motherhood, the history of feminist thought, and women and leadership. This post previews one of the arguments she makes in her new book, Modern Motherhood: An American History (Rutgers University Press, 2014), which appears this month. Vandenberg-Daves is also the editor and co-author of History: A Guide to Historical Research Through the National History Day Program (ABC-Clio Schools, 2006) as well as numerous articles on women’s history and educational history.

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