Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Ijeoma Opara

Second Advisor

Nicola Hawley

Abstract

Obstetrics and Gynecology (OB/GYN) is a medical subspecialty primarily concerned with birth care, reproduction, and gynecological health. OB/GYN practice plays a historically significant role in the treatment of infertility and reproductive disorders as cultural ideologies of fertility and motherhood have been co-constructed alongside the development of OB/GYN medical practice and knowledge. These constructs inform obstetric practice and serve as a framework for contemporary reproductive care. Modern birth care in the medical setting often reinforces a myriad of issues including stigmatization of birthing people’s bodies, over-medicalization of birth, obstetric racism, and obstetric violence. This paper focuses on the evolution of particular facets of obstetric thinking related to pain, stigma, harm, and power. These thematic domains serve as scaffolding for many of the persistent issues in OB/GYN medicine. There is substantial literature investigating contemporary issues of abuse and discrimination in obstetrics as well as qualitative work exploring the institutional framework of power which promotes these practices. However, there is less scholarship offering thematic analyses of the historical conditions which gave rise to crucial ideologies underlying institutional practices. To address this, I conducted a thematic analysis of literature published in the New England Journal of Medicine between 1935 and 1969. These decades encompass the beginning of infertility medicine’s rise to prominence up until the paradigm shift in the late 1960s as birth control became a focal point within reproductive medicine. The findings of this analysis indicate a thematic landscape of de-emphasizing women’s pain, stigmatizing conditions related to infertility, and utilizing authority to inflict dangerous and harmful “treatment”. These findings have implications for current OB/GYN practice as meaningful precursors to modern-day stigma, invalidation of pain, and harmful treatment.

Comments

This is an Open Access Thesis.

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