Medicalisation and De-medicalisation of Abortion Essay Example

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3Medicalisation and De-medicalisation of Abortion

MEDICALISATION AND DE-MEDICALISATION OF ABORTION

Introduction

Medicalisation refers to the use of medical language to define a problem. It also refers to the definition of a problem using medical language or understanding the problem using a medical framework. Medicalisation may also refer to the use of a medical intervention to ‘treat’ the problem (Halfmann 2011). On the other hand, de-medicalisation refers to the resistance to medicalisation or the opposite of medicalisation (Davis 2006). The essay discusses the medicalisation of several issues in the society and how the issues have been de-medicalised over time. Medicalisation and de-medicalisation also occur as part of the bio-power operation. The essay focuses on the medicalisation and de-medicalisation discourses, practices and identities associated with pregnancy.

One of the contentious issues experienced during a woman’s pregnancy is abortion. Following a study conducted in the United States pertaining the medicalisation and de-medicalisation of abortion between 1860 and 1900 and between 1960 and 1973, it is evident that most Americans believed that the life of an unborn child did not start until the child started moving in the mother’s womb. The belief originated prior to the launch of the campaign against abortion in the United States. In most cases, the ‘quickening’ of the foetus commences between 16 and 21 weeks after conception. Therefore, Americans believed that any abortion procedures carried out before the period were legally and morally proscribed. It was not until towards the end of the eighteenth century that physicians began arguing that the life a foetus started at conception thereby the process of foetal development to be continuous from the conception to birth. Approximately a century later, the regulars advocated for the inclusion of the view into the law. At the onset of the nineteenth century, there were no proper tests for pregnancy. As a result, women considered the loss of menstrual period to menstrual blockage or pregnancy. Understanding the true status of the woman depended on whether the foetus presented quickening or not. Therefore, it is proper to opine that the development of the first pregnancy test in 1928 marked the onset of the medicalisation of pregnancy (Gunson 2010).

Before the advent of the pregnancy medicalisation practices, women relied on home medical guides, folk traditions and advertisements pertaining mail-order medications to understand the techniques and drugs necessary for restoring menses. The sources of medical information about the handling of pregnancy warned against the restoration of menses after the ‘quickening’ of the foetus, a process that was equivalent to abortion. There was medication for menstrual blockage provided by both regulars and irregulars. The regulars had undergone university education whereas the irregulars were considered low-class individuals that did not have any formal training. Both the regulars and irregulars provided abortion to their clients regardless of whether the foetus had already ‘quickened’ or not. However, the irregulars conducted the exercise to a much greater extent as compared to the regulars. A small percentage of the regulars conducted abortion in order to compete with the irregulars. The inability of the regulars to understand whether they were treating menstrual blockage or performing an abortion also provides an explanation for the abortions that the regulars carried out. It is also evident that both the regulars and the performed abortions so as to preserve the health of the individuals that underwent the procedure.

The American Medical Association was the first organisation that campaigned against abortion. The anti-abortion campaign intended to punish and professionalise the regulars as well as depriving the irregulars their profitable area. It is evident that the underperformance of the regulars in clinical effectiveness and the tremendous performance of the counterparts was the main reason that compelled the regulars to ban abortion. Therefore, prohibiting abortion did not emanate from the health concerns and the understanding of committing murder. On the other hand, it emanated from the desire to demonstrate that they were superior to their counterparts. They reclined on the Hippocratic Oath to assert that the ‘quickening’ of the foetus did not have any scientific evidence and influence on the process of foetal development. Moreover, the regulars advocated for the maintenance of the traditional gender roles on the basis that the action would prevent the ability of women to occupy certain ranks (Shermam 2015). According to Porter (2013), gender repress is equivalent to treating women as animals whereby the society expects them to perform certain inferior roles only (Porter 2013). Therefore, the regulars supported the idea that their perception claimed both ethical and moral superiority over the perceptions of their counterparts. Consequently, they accused immigrants and women for the prevalence of abortion that resulted in the decline in the population of the original inhabitants as compared to the ever rising population of the Catholic immigrants.

The campaigns against abortion resulted in the prohibition of abortion in all the states except Kentucky by 1900. The states prohibited abortion regardless of whether the foetus had ‘quickened’ or not. In essence, it was illegal to perform an abortion at any stage during the pregnancy. As a result, the enforcement of laws against abortion was strict thereby leaving the survival of the foetus to whether its survival would have an adverse effect on the mother or not (Rose 2006). Only the regulars had the permission to perform an abortion following the confirmation that the life of the pregnant woman was in danger without the abortion. Therefore, preserving the life of the pregnant woman was the only viable reason that permitted the regulars to perform abortions. It is proper to state that the new laws increased and decreased medicalisation through the discourses, identities and practices.

A review of the influence of discourses on the medicalisation and de-medicalisation of abortion highlights that the regulars attributed abortion to a special medical concern. In order to heighten the significance of the abortion issue, the regulars introduced a scientific discourse that prohibited the deviation of women from their traditional roles in the society (Foucoult 1975). According to the argument, women that embraced birth-control measures up to and including abortion, education, and employment would impact adversely on their capacities, reproductive organs, physical and mental health, their true nature and families (Szarewski et al. 2012; Repta & Clarke 2011). Furthermore, the doctors and regular physicians did not consider ‘quickening’ to be a scientific concept. They opined that the process of foetal development was continuous that did not have any identifiable stages. Therefore, the same reasons used to prohibit abortion in the later stages should also hold in the prohibition of abortion during the early stages of the pregnancy. As a result, the discourse replaced the traditional experience-based understanding of women about abortion with the scientific concept of pregnancy and abortion. In fact, the regulars did not support the decision of the court to base their judgment on the subjective opinions of women rather than utilising the scientific concept governing the issue of abortion and pregnancy. They considered ‘quickening’ to be a mere sensation rather than a scientific evidence.

According to the medical discourse, abortion was a medical illness that necessitated treatment in the event that it had the potential of causing the loss of the life of the affected person. The understanding of abortion created by the medical discourse was different from the conventional objectives that pregnant women intended to achieve using an abortion. It is apparent that most pregnant women used abortion as a way of terminating unwanted pregnancies even in the situation that the continuation of the pregnancy would not impact negatively on the their physical health. Therefore, women used abortion as a birth-control measure. It is proper to state that the treatment of menstrual blockage using abortion through stimulating menstruation was in practice even in the eighteenth century. However, at the dawn of the nineteenth century and following the decision of many states to prohibit abortion within their territorial boundaries, the law advocated for the treatment of the underlying causes for menstrual blockage rather than inducing menstruation that resulted into abortions.

Therefore, the law regarded abortion as a therapeutic exception rather than the treatment of menstrual blockage. Some of the pregnancy-related illnesses that permitted the use of abortion as a treatment encompass the threat of a potential heart attack, pernicious vomiting, and the increased chances of the loss of the life of the pregnant woman. The introduction of the new laws resulted into the medicalisation of abortion at both the micro and meso levels (Conrad 2007). The fact that regular physicians had substantial control over medical schools provided them with the advantage of developing medical professionals that opposed abortion by marketing anti-abortion campaigns. Therefore, it was imperative that the regulars had to determine the medical necessity based on the stated conditions before performing an abortion to save the life of the woman or treat an illness. Apparently, all the above-mentioned discourses increased the medicalisation of abortion. However, the ban imposed on the cure for menstrual blockage de-medicalised abortion since both irregulars and regulars used the treatment to cure the condition; yet it had been banned by the new law.

It is also evident that certain practices also medicalised abortion. For instance, it is evident that both regulars and irregulars used similar methods of inducing abortions. However, the emergence of a new medical method of abortion suffices to be a medical practice that medicalised abortion (Lee 2003). The fact that the new methods outperform the traditional herbal medicines used by both the regulars and irregulars indicates an increase in the medicalisation of abortion. The other new medical practices that prove the medicalisation of abortion encompass the use of curettage and dilation techniques. The methods were more dangerous and more effective in the event that the professional performed them using poor antiseptic techniques. The increase in the willingness of medical professionals to perform surgeries is the other evidence of the medicalisation of abortion. It is evident that currets and catheters were in practice in performing abortion. However, midwives preferred catheters to currets thus decreasing the danger associated with the use of currets to perform abortion. However, in the case of women that induced abortions personally, they relied on the herbal medicines and drugs to complete the procedure. It is proper to argue that the use of the new techniques to perform abortion increased the medicalisation of the procedure. However, the fact that the new law had yielded a decline in the frequency of utility of the medical procedures implies de-medicalisation of abortion emanating from the failure of the medical practice to utilise the new methods frequently.

The identity changes also claim responsibility for the increase of the medicalisation of abortion. For instance, the identity of the regulars favoured therapeutic abortions thereby opposing non-therapeutic abortions. The increase in the population of the regulars is the other reason for the success of the professionalization campaigns against abortion that resulted in the decline in the number of irregulars. The decline in the population of the irregulars also emanated from the fact that some of the irregulars enrolled in medical institutions thus resulting in their conversion from irregulars to regulars. At the onset of the twentieth century, 87% of the physicians’ population consisted of regular professionals; with the proportion of homeopaths being a mere 9%. However, the continued existence of midwives provided intense competition to the regular professionals since midwives still accounted for more than half of the deliveries. The proportion of the non-self-induced abortions carried out by regulars was in excess of 50% even though they considered midwives and abortionists to be scientifically and morally inferior. Therefore, medicalisation of abortion witnessed its increase following the emergence of the anti-abortion identity of doctors and the permission granted to therapeutic abortions (Rose 2007).

Conclusion

Medicalisation of abortion refers to the adoption of a medical framework to handle abortions. It also refers to the use of medical procedures to carry out abortions. The enforcement of the anti-abortion laws emanated from the battle of supremacy between the regulars and the irregulars. The regulars comprised of medical professionals that had undergone formal training in medical colleges and universities. On the other hand, the irregulars refer to the herbalists, druggists, empirics and homeopaths that have the knowledge required to perform abortion despite their lack of a formal training. Prior to the professionalization campaigns, the clinical effectiveness exhibited by the irregulars surpassed that of the regulars. The final result of the battle is the introduction of laws that permit therapeutic abortions aimed at treating an illness or saving the life of the pregnant woman rather than the use of abortion as a birth-control measure. The changes in medical discourses, attitudes and practices have increased and decreased the medicalisation of abortion.

Reference List

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Davis, J E 2006, ‘How medicalization lost its way’, Society, vol.43, no. 6, pp. 51–56.

Foucoult, M 1975, ‘Discipline and punish’.

Gunson, J S 2010, “More natural but less normal”: Reconsidering medicalisation and agency through women’s accounts of menstrual suppression. Social Science & Medicine, vol. 71, no. 7, pp. 1324-1331.

Halfmann, D T 2011, ‘Recognizing medicalization and de-medicalization: Discourses, practices, and identities. Health.

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Porter, N 2013, ‘Bird flu biopower: Strategies for multispecies coexistence in Việt Nam’, American Ethnologist, vol. 40, no. 1, pp. 132-148.

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