Women in medicine
The presence of women in medicine, particularly in the practicing fields of surgery and as physicians, has been traced to the earliest of history. Women have historically had lower participation levels in medical fields compared to men with occupancy rates varying by race, socioeconomic status, and geography.
Women's informal practice of medicine in roles such as caregivers, or as allied health professionals, has been widespread. Since the start of the 20th century, most countries of the world provide women with access to medical education. Not all countries ensure equal employment opportunities, and gender equality has yet to be achieved within medical specialties and around the world.
History
Ancient medicine
The involvement of women in the field of medicine has been recorded in several early civilizations. An Egyptian of the Old Kingdom of Egypt, Peseshet, described in an inscription as "lady overseer of the female physicians", is the earliest woman named in the history of science. Ubartum lived around 2050 BC in Mesopotamia and came from a family of several physicians. Agamede was cited by Homer as a healer in ancient Greece before the Trojan War. Metrodora was a physician and generally regarded as the first female medical writer. Her book, On the Diseases and Cures of Women, was the oldest medical book written by a female and was referenced by many other female physicians. She credited much of her writings to the ideologies of Hippocrates.Medieval Europe
During the Middle Ages, convents were a centralized place of education for women, and some of these communities provided opportunities for women to contribute to scholarly research. An example is the German abbess Hildegard of Bingen, whose prolific writings include treatments of various scientific subjects, including medicine, botany and natural history. She is considered Germany's first female physician.Women in the Middle Ages participated in healing techniques and several capacities in medicine and medical education. Women occupied select ranks of medical personnel during the period. They worked as herbalists, midwives, surgeons, barber-surgeons, nurses, and traditional empirics. Women healers treated most patients, not limiting themselves to treating solely women. The names of 24 women described as surgeons in Naples, Italy between 1273 and 1410 have been recorded, and references have been found to 15 women practitioners, most of them Jewish and none described as midwives, in Frankfurt, Germany between 1387 and 1497. The earliest known English women doctors, Solicita and Matilda Ford, date to the late twelfth century; they were referred to as medica, a term for trained physicians.
Women also engaged in midwifery and healing arts without having their activities recorded in written records, and practiced in rural areas or where there was little access to medical care. Society in the Middle Ages limited women's role as physician. Once universities established faculties of medicine during the thirteenth century, women were excluded from advanced medical education. Licensure began to require clerical vows for which women were ineligible, and healing as a profession became male-dominated.
In many occasions, women had to fight against accusation of illegal practice done by males, putting into question their motives. If they were not accused of malpractice, then women were considered "witches" by both clerical and civil authorities. Surgeons and barber-surgeons were often organized into guilds, which could hold out longer against the pressures of licensure. Like other guilds, a number of the barber-surgeon guilds allowed the daughters and wives of their members to take up membership in the guild, generally after the man's death. Katherine "la surgiene" of London, daughter of Thomas the surgeon and sister of William the Surgeon, belonged to a guild in 1286. Documentation of female members in the guilds of Lincoln, Norwich, Dublin and York continue until late in the period.
Midwives, those who assisted pregnant women through childbirth and some aftercare, included only women. Midwives constituted roughly one third of female medical practitioners. Men did not involve themselves in women's medical care; women did not involve themselves in men's health care. The southern Italian coastal town of Salerno was a center of medical education and practice in the 12th century. In Salerno the physician Trota of Salerno compiled a number of her medical practices in several written collections. One work on women's medicine that was associated with her, the De curis mulierum formed the core of what came to be known as the Trotula ensemble, a compendium of three texts that circulated throughout medieval Europe. Trota herself gained a reputation that spread as far as France and England. There are also references in the writings of other Salernitan physicians to the mulieres Salernitane, which give some idea of local empirical practices.
Dorotea Bucca, an Italian physician, was chair of philosophy and medicine at the University of Bologna for over forty years from 1390. Other Italian women whose contributions in medicine have been recorded include Abella, Jacqueline Felice de Almania, Alessandra Giliani, Rebecca de Guarna, Margarita, Mercuriade, Constance Calenda, Clarice di Durisio, Constanza, Maria Incarnata and Thomasia de Mattio.
Medieval Islamic world
For the medieval Islamic world, little information is known about female medical practitioners although it is likely that women were regularly involved in medical practice in some capacity. Male medical writers refer to the presence of female practitioners in describing certain procedures or situations. The late-10th to early-11th century Andalusi physician and surgeon al-Zahrawi wrote that certain medical procedures were difficult for male doctors practicing on female patients because of the need to touch the genitalia. The male practitioner was required to either find a female doctor who could perform the procedure, or a eunuch physician, or a midwife who took instruction from the male surgeon. The existence of female practitioners can be inferred, albeit not explicitly, through direct evidence. Midwives played a prominent role in the delivery of women's healthcare. For these practitioners, there is more detailed information, both in terms of the prestige of their craft and in terms of biographical information on historic women. To date, no known medical treatise written by a woman in the medieval Islamic world has been identified.Western medicine in China
Traditional Chinese medicine based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years. Western medicine was introduced to China in the 19th century, mainly by medical missionaries sent from various Christian mission organizations, such as the London Missionary Society, the Methodist Church and the Presbyterian Church. Benjamin Hobson, a medical missionary sent by the London Missionary Society in 1839, set up the Wai Ai Clinic in Guangzhou, China. The Hong Kong College of Medicine for Chinese was founded in 1887 by the London Missionary Society, with its first graduate being Sun Yat-sen.Due to the social custom that men and women should not be near to one another, Chinese women were reluctant to be treated by Western male doctors. This resulted in a need for female doctors. One of these was Sigourney Trask of the Methodist Episcopal Church, who set-up a hospital in Fuzhou during the mid-19th century. Trask also arranged for a local girl, Hü King Eng, to study medicine at Ohio Wesleyan Female College, with the intention that Hü would return to practise western medicine in Fuzhou. After graduation, Hü became the resident physician at Fuzhou's Woolston Memorial Hospital in 1899 and trained several female physicians. Another female medical missionary Mary H. Fulton was sent by the Foreign Missions Board of the Presbyterian Church to found the first medical college for women in China. Known as the Hackett Medical College for Women, this college was located in Guangzhou, China, and was enabled by a large donation from Edward A. K. Hackett of Indiana. The college was dedicated in 1902 and offered a four-year curriculum. By 1915, there were more than 60 students, mostly in residence. Most students became Christians, due to the influence of Fulton. The college was aimed at the spreading of Christianity and modern medicine and the elevation of Chinese women's social status. The graduates of this college included Chau Lee-sun and Wong Yuen-hing, both of whom graduated in the late 1910s and then practiced medicine in the hospitals in Guangdong province.
Midwifery in 18th-century America
During this era, the majority of American women whether European or African American, childbirth was considered a female event where female friends, relatives, and the local midwife gathered to support the birthing mother. Midwives gained their knowledge through experience and apprenticeship. Out of the different occupations women took on around this time, midwifery was one of the highest-paying industries. In the 18th century, households tended to have an abundance of children largely in part to having hired help and diminished mortality rates. Despite the high chance of complications in labor, American midwife Martha Ballard, specifically, had high success rates in delivering healthy babies to healthy mothers.Women's health movement, 1970s
The 1970s marked an increase of women entering and graduating from medical school in the United States. From 1930 to 1970, a period of 40 years, around 14,000 women graduated from medical school. From 1970 to 1980, a period of 10 years, over 20,000 women graduated from medical school. This increase of women in the medical field was due to both political and cultural changes. Two laws in the U.S. lifted restrictions for women in the medical field – Title IX of the Higher Education Act Amendments of 1972 and the Public Health Service Act of 1975, banning discrimination on grounds of gender. In November 1970, the Assembly of the Association of American Medical Colleges rallied for equal rights in the medical field.Throughout the decade women's ideas about themselves and their relation to the medical field were shifting due to the women's feminist movement. A sharp increase of women in the medical field led to developments in doctor-patient relationships, changes in terminology and theory. One area of medical practice that was challenged and changed was gynecology. Author Wendy Kline noted that "to ensure that young brides were ready for the wedding night, used the pelvic exam as a form of sex instruction."
With higher numbers of women enrolled in medical school, medical practices like gynecology were challenged and subsequently altered. In 1972, the University of Iowa Medical School instituted a new training program for pelvic and breast examinations. Students would act both as the doctor and the patient, allowing each student to understand the procedure and create a more gentle, respectful examination. With changes in ideologies and practices throughout the 70s, by 1980 over 75 schools had adopted this new method.
Along with women entering the medical field and feminist rights movement, came along the women's health movement which sought alternative methods of health care for women. This came through the creation of self-help books, most notably Our Bodies, Ourselves: A Book by and for Women. This book gave women a "manual" to help understand their body. It challenged hospital treatment, and doctors' practices. Aside from self-help books, many help centres were opened: birth centres run by midwives, safe abortion centres, and classes for educating women on their bodies, all with the aim of providing non-judgmental care for women. The women's health movement, along with women involved in the medical field, opened the doors for research and awareness for female illness like breast cancer and cervical cancer.
Scholars in the history of medicine had developed some study of women in the field—biographies of pioneering women physicians were common prior to the 1960s—and study of women in medicine took particular root with the advent of the women's movement in the 1960s, and in conjunction with the women's health movement.