For centuries, traditional medicine has been infused with a masculine bias, often to the disadvantage of both doctors and patients. Women have always been central in providing medical care, whether offering remedies in the home, nursing or acting as midwives. However, the medical profession has been male dominated for most of its history. In Europe this came about from the 1400s, when many cities and governments decided that only those trained in universities were allowed to formally practice medicine. As women were not allowed into the universities they could not gain a license.
It was only in the 1900s, after much struggle, that women won the right to study and practice medicine in the same way as men. Despite being excluded from formal education, women provided many paid services that the public needed, including sick-nursing and wet-nursing, midwifery, minor surgery and general physics. Wet-nursing was unlicensed and remained a casual trade – although a very large one. Midwives were unable to form guilds, but they had to be licensed. However, male practitioners were gradually replacing women in their traditional roles – even in such areas as childbirth.
The Chamberlain brothers developed forceps in the early 1600s, which remained a family secret until the 1730s. Their use of a new tool and their professional training allowed such man-midwives to claim that they were more scientific than their female ‘competitors’. It was through nursing that women first made significant inroads into formal medical practice. Changes in nursing started with the hospital and prison reformers of the late 1700s. New training for nurses became available, notably at the Deaconess Institute at Kaiserworth in Germany (1836), which influenced Florence Nightingale.
Nightingale reorganised army hospital nursing during the Crimean War (1853-56), while Jamaican healer Mary Seacole attended the wounded in the camps and set up her own nursing home. Florence Nightingale helped promote nursing as a more respectable profession for young women. The nursing role was seen as an extension of women’s social role: caring and nurturing and Florence Nightingale believed nurses should be subordinate to doctors; she was against women healers and the registration of nurses and opposed the three year formal training of them. She also wouldn’t recognise mental health as a field for nurses.
The Nightingale effect emphasised the ‘female virtues’ and led people to think that the female characteristics were what made nursing what it was – a female occupation with no place for men. The same attitude was reserved for women who wanted to become doctors and it wasn’t until the end of the 19th century that women gained the right to study for the same qualifications as men. It was only during the First World War that the need for doctors combined with declining numbers of men in medical school saw women being encouraged to enter medical training.
In theory medical practice became open to all but in reality it continued to be dominated by male practitioners, and there are some that would argue that it has continued into the 20th century. Even today women’s competency as healthcare professionals continues to be challenged and they are being tested more often their male counterparts. There are roughly about 80% more male surgeons than female ones, even though the rates for women applying and being accepted into medical school are higher than for men.
This shows a clear indication that men are more likely to be promoted within the healthcare profession than women. An article in The Guardian revealed that female doctors working in the NHS are paid thousands of pounds a year less than their male counterparts as a result of widespread discrimination and ‘a hostile culture’ at work. Male NHS managers are being accused of taking advantage of the poor negotiating power of women, due to family commitments. Childbirth was once ‘women’s business’: women assisted births as well as bearing children.
Midwife, from the Old English, literally means ‘with woman’. Before the 1700s, childbirth was customarily a domestic event, attended by female friends, relatives and local women experienced in delivering children. A more technological approach to childbirth gained momentum during the 1700s. Professional medical men were the focus. Over time female midwives lost status and came to be portrayed as unenlightened, unhygienic and entwined with superstition and folklore. Modern obstetrics is a hi-tech hospital-based specialty of men and women but it’s origins are the appearance of so-called man-midwives.
Women dealt with straightforward births. However, male physicians were often called when complications needed physical intervention. They often carried destructive instruments to remove dead, obstructed foetuses. The most influential early man-midwife in Britain was William Smellie. He was a leading teacher of obstetrics, midwifery and forceps use. Despite growing professionalisation, man-midwives only found real respectability in the early 1800s, when they gained approval among the upper classes. Families who could afford their fees increasingly ‘called for the doctor’, invariably male. Female midwives became unfashionable, outmoded and associated with the poor.
This gradual shift was criticised. midwife Martha Ballard recorded her displeasure, and another midwife Sarah Stone complained about ‘young pretenders’. These were men who took credit for success but blamed women when things went wrong. Health and medicine seem to have become the new ‘religion’ of the late 20th century;
Doctors are the high priests of this new religion, and people are expected to consult their doctors before they do anything…from taking a walk around the block to putting their children to bed at night. Historically, medicine has maintained a position of dominance and power within the healthcare system. The medical model of health is based on knowledge of the physical and biological causes of disease and it acknowledges health as the ‘absence of disease’. The majority of doctors favour this model but sociologists are more interested in the impact and role of medicine in society.