In her comprehensively researched Women's Medicine: Sex, Family Planning and British Female Doctors in Transnational Perspective, 1920–1970, Caroline Rusterholz relates the engagement of women doctors with birth control activism during the mid-twentieth century. While her focus is primarily focused on Britain, Rusterholz uses a transnational, comparative perspective to showcase both the local relevance of her protagonists and their impact on the increasingly prominent international debates on birth control and family planning. The book threads the careers of women doctors—including Margaret Jackson, Joan Malleson, and Helena Wright, all qualified in the 1920s, plus a number of younger colleagues—into the history of the medicalization and institutionalization of birth control in Britain. In her conclusion, Rusterholz reveals that one of her aims was to bring these women doctors to the fore of family planning history, and in Women's Medicine she certainly accomplishes that task.
Rusterholz's key contribution is to make a composite analysis of two historical phenomena that, despite much recent attention from historians, have thus far been viewed separately. The first is the history of women within the medical profession, and to be more precise, the feminization of medicine in the twentieth century, especially after the end of the First World War. The second is the history of birth control and family planning, the medicalization of which has been most exhaustively explored in the US context. Scholars have often linked the medicalization of family planning with the introduction of the oral contraceptive pill in the late 1950s: a prescription drug firmly controlled by the medical profession. With the advent of the pill, birth control emerged or was consolidated as a legitimate element of medical practice in many countries of the Global North, including those where contraception bans had been in place, such as Ireland, Spain, and France.
In addition to situating Britain within these processes, Rusterholz meticulously documents the key roles British women doctors played in promoting the medicalization of contraception from the 1920s onward. In doing so, Rusterholz problematizes the very notion of medicalization, which feminist historiography and social studies of medicine and health have tended to conceptualize as an intrinsically negative process of institutional and symbolic control over women's bodies. Rusterholz provides nuance to this conceptualization by studying the adoption and advancement of medicalization by women (doctors) for the benefit of both their patients and themselves. Another of Rusterholz's key arguments is that British women doctors active in the mid-twentieth century constructed advice and research on birth control as a specific field of expertise. In their still marginalized position, women doctors could afford to explore risky themes and strategies, such as engaging in sexual counseling.
In fact, the second chapter, on the integration of treatment for infertility and so-called sexual disorders into the work of British family planning clinics during the interwar period, is perhaps the one I most enjoyed. Here, Rusterholz draws on publications by Wright, Jackson, and Malleson, along with recorded counseling sessions by the latter, to demonstrate how these doctors created new sexual expertise based on dialogue with patients and, before the late 1950s, rehabilitated the clitoris as a legitimate site of female sexual pleasure, albeit still within Freudian hierarchies. In other chapters, Rusterholz expands on themes such as women doctors’ leadership in elevating the status of birth control within British medical science and practice (chapter 1), where she shows how the British pioneers pursued their objective and helped secure their own professional futures. Chapters 3 and 4 examine the participation of British and French doctors in the international birth control movement. Here, Rusterholz traces the actions of her protagonists to the international conferences on birth control, insisting on their behind-the-scenes agency even at that stage, despite being overshadowed by more celebrated male speakers. Another contribution of this part of the book is Rusterholz's careful reconstruction of exchanges between British and French family planning movements, and the role played by British woman doctors in inspiring and supporting family planning in France, where contraception remained illegal until 1967. In the final chapter, Rusterholz explores Helena Wright and Margaret Jackson's involvement with the testing and prescribing of intrauterine devices between the 1920s and the 1960s and provides yet another glimpse into the gendering of contraceptive expertise during this period.
Overall, various audiences will find this book engaging. It fills important gaps in women's history and the history of medicine and health and is an outstanding contribution to the history of contraception. The rich source base and meticulous documentation underpinning Rusterholz's bold arguments make it a solid historiography, well organized and thus easy to follow. I therefore highly recommend Women's Medicine.