I had a hysterectomy in 1975 when I was 25 years old. I didn’t have cancer or uterine cysts. What I had was dysmenorrhea, or menstrual cramps.
This was an operation I had actively pursued and I felt lucky to get it, taking advantage of the remnants of the US Public Health system before it was abolished by the Reagan administration.
Buckets of Blood
Like 80 percent of women, I suffered from menstrual pain. Like 10 percent of women, the pain was severe enough to disrupt my life. Menstruation, since the age of 13, had been a trial for me that only worsened by the time I got to high school. Huge gobs of clotted blood would gush from my body every three weeks for a week at a time. The pain was debilitating. By the time I got to college I was unable to work for two days a month when my period was at its worst, a terrible embarrassment for a young militant feminist who passionately believed that women were equal to men.
In high school I had friends who got pregnant and had to drop out of school, young women who gave up babies for adoption or had to get married. The lesson was clear to me: don’t get pregnant or you won’t get an education. Pregnancy, and marriage too, seemed like a kind of death. I was determined not to ruin my life. In high school I never had sex, but there wasn’t any boy I wanted to have sex with.
I asked my parents what they would do if I got pregnant. My mother said they would help me get an abortion. Much later, after she died, I learned that my mother had had at least two abortions. She never told me, even during the feminist campaign led by Ms. Magazine in which famous women publicly admitted to their abortions.
How I Got The Pill
By the time I got to college, I was embarrassed to be a virgin, so I set out to remedy that state of affairs. I was hanging out with a boy I met in bacteriology lab who seemed interested in me. I asked him if he wanted to have sex and he was happy to oblige. We shook on the deal. First, though, I wanted to be sure I was protected from getting pregnant and I didn’t want to leave that up to him. The Pill was newly available and I convinced a doctor at the student health clinic to give me a prescription. This was about 1968.
The Pill wasn’t all it was cracked up to be. The Pill makes your body think it’s pregnant, which meant for me morning sickness, bloating and sore breasts. And the periods were still bad. Only many years later did I learn that it’s not necessary to have a period when you’re on the Pill. That was the Catholic Church’s doing, part of a deal between the church and pill makers. The church agreed not to oppose the marketing of the Pill for birth control if certain requirements were met, one being that periods stayed. Even though I was never a Catholic, the church had an unseen hand in my reproductive life. Was I suffering for the sins of Eve? I was pissed when I learned that I could have controlled my painful periods by taking the Pill throughout the month if not for the Catholic Church. But at least by the late 60s the Pill was available to me and other unmarried women (for a time it was only prescribed to married women—another church requirement).
I’m Going to Throw Up
My menstrual periods continued to worsen, causing vomiting and diarrhea as well as pain. I developed a long-term relationship with the student health center, but they began to tell me and other female students that painful periods were not a health issue and that we would not be treated there. If I told them the reason, they would refuse to take me in, so I worked out a strategy where I would run into the clinic and say to the receptionist, “I’m going to throw up.” That got me into a room with a pan, and I was able to see a doctor. Not that they could do much for me. They gave me painkillers, usually a shot of something, and sent me home, where I would lie in bed for the rest of the day, still in pain, just duller pain. I was still useless.
This was no way to live. I resolved to do something about this devitalizing state of affairs. I began reading everything I could get on the subject of menstruation and birth control, frequenting the medical library at Washington State University. I learned about the effects of the female hormones estrogen and progesterone and how they control the menstrual cycle. I only understood about half of the medical terms, but could make out the general ideas. It seemed from my reading that I might have something called endometriosis, where the lining of the uterus gets into the body cavity and responds to hormones by bleeding into your insides.
At that time in the 1960s, research was still going on to refine the Pill. I read about different types of pills I could try and I convinced the one female doctor in the student health center to let me experiment on myself. She prescribed a kind of progesterone pill, but, as with previous experiments, the side effects cancelled out the positive. One day when I lay with my feet up suffering intense cramping and pain, I popped a progesterone pill. The pain stopped within minutes! Progesterone, my savior! Why didn’t women know about this? Why don’t women still know about this? Did the medical establishment want women to suffer just as the Catholic Church did? Reading the book, The Pill, I later discovered that developers of the Pill claimed to be developing a treatment for dysmenorrhea because it sounded better than birth control to the church and the powers that be. Too bad they didn’t tell the women like me who actually suffered from dysmenorrhea.
Taking Control of Our Bodies
My relationship with the medical establishment at WSU was not just based on my own complaints. Along with my Women’s Liberation group I had been working to help women get reproductive care. We set up a counseling center in the student union and I became a volunteer counselor. The typical “client” was a student who’d had sex once and gotten pregnant. She might be a rape victim. She’d had little or no sex education in school; she had never talked to anyone about sex or reproduction. She was confused and embarrassed. One young woman was so mortified that she ran out of the room soon after she’d walked in.
We set up underground networks to help women procure abortions and we worked with doctors in the community to provide reproductive care in the town and at the university. A book written by activists in Boston, Our Bodies Ourselves, reflected feminist organizing all over the country, even in small towns in the West. We were inspired to learn about our bodies and take control of our own health care.
During this time, women in Washington State organized to overturn the law criminalizing abortion and my Women’s Liberation group worked on that ballot campaign. Abortion became legal in Washington in 1970, three years before the Roe V. Wade Supreme Court decision legalized abortion nationwide. Washington was the first state in the country to make abortion legal by referendum.
If Men Could Get Pregnant Abortion Would Be a Sacrament
My search for the perfect method of birth control continued. I never liked condoms and felt that getting men to use them was not worth the effort, although I always carried one in my wallet. Still, I thought that men should be required to take responsibility for birth control. A popular feminist poster showed a picture of a big-bellied man and the slogan “If men could get pregnant, abortion would be a sacrament.” Feminists wanted control of our own reproductive lives. We wanted the freedom to have sex without guilt and without consequences, just like men had. But we certainly didn’t want to depend on abortion as a primary method of birth control. We wanted contraception that didn’t hurt and wasn’t a big hassle.
I Got IUD’d
IUDs (intrauterine devices) were becoming a popular form of birth control. It seemed like a great alternative to the Pill. You had to have it inserted by a doctor, but then presumably you never had to think about it again. Not so with me.
There were many types of IUDs, but the most popular at that time was the Dalkon Shield. I went to a health clinic in the community to have it inserted. The doctor there was an older man whom I’d worked with to help provide women with reproductive care. He was inserting the Dalkon Shield into many women’s uteruses. That part went smoothly, but soon I was in pain, which continued to worsen. The pain was constant. The pain radiated from the core of my body out to my limbs. No part of my body was free of the pain. I thought to myself at the time that I could not imagine any pain worse than that cramping, and I have never experienced anything close to it in my life. My uterus was trying to expel the IUD and so I was in constant labor. (Needless to say, sex was the last thing on my mind). But the Dalkon Shield was made to resist. You had to have it removed by a doctor, and after a couple of weeks of agony I did. When I visited the mild mannered old doctor again, he told me of anecdotal evidence that women were having some problems with the Dalkon Shield. He emphasized anecdotal. He was a science-based guy after all, and there were no studies. Still, I could see the worried look on his face and I celebrated being IUD free.
Later, of course, we learned of the terrible problems caused by the Dalkon Shield. Women suffered from pelvic inflammatory disease. Women were made infertile. Women died. We had been experimental subjects. I joined a class action lawsuit against the manufacturer and eventually received $750, a big sum of money for me then. The manufacturer, A.H. Robins Co., went bankrupt.
Birth control never failed me. I never got pregnant. But I was pissed that it was so difficult. Later, when I sat down to chronicle my torturous, painful attempts to keep from getting pregnant I got angry all over again. Even for a relatively privileged white, college-educated woman, birth control had been arduous.
The People’s Health Care System
In 1973 I left the little college burg of Pullman for the big city of Seattle. But I had carefully laid the foundation for continuing reproductive care in my new home.
The People’s Health Care System, a grassroots response to inadequate health care, acted like a safety net, doctoring the poor and insurance-free. Led by the Black Panther Party, activists in Seattle had created the system, which later included the Women’s Clinic at the YWCA where I volunteered and community-built clinics in the city’s poorer underserved neighborhoods. Country Doctor, one of the first community clinics, is still operating.
Seattle still maintained a merchant seamen’s hospital, part of the U.S. Public Health Service, where medical care was free. Over the years, military dependents, Coast Guard personnel, American Indians and medically indigent citizens were added to the patient load. The USP hospital in Seattle by the 1970s was a center of people’s health care activism.
I arrived in Seattle at an auspicious time for public health care. I had documented well my battle with endometriosis (or whatever it was—I never got a diagnosis except the general term dysmenorrhea). My doctor at the WSU health center had given a written recommendation for a hysterectomy. And I made connections with the network of activist health care providers by volunteering at the Women’s Clinic. They put me in touch with a doctor who agreed to oversee the operation.
The US Public Health Service
The Seattle Public Health Hospital building, an imposing Art Deco edifice built in the 1930s, still crowns Beacon Hill in the south part of the city. I was admitted to a ward reserved for women undergoing reproductive surgery. The huge open room housed perhaps 15 or 20 beds. You could pull a curtain to separate yourself from the others, but I wanted to be part of the action. I made an effort to meet and talk to the other patients, and the atmosphere was friendly. Most of the women were wives of Navy men in for hysterectomies or removal of ovarian cysts. But one young woman told me she was a fisher and was in for a (free) abortion.
This was a teaching hospital. Young interns performed many of the surgeries and probably also did mine. I engaged one of the female interns, asking about endometriosis and hormone studies. Her answer chilled me. Few studies existed regarding the female reproductive system, she said. “We just don’t know very much.” At that time women were seldom the subjects of medical studies, which were almost all about men.
As I was being wheeled into surgery and before the drugs took effect, I thought to myself that I should have told my parents about the hysterectomy. I had been told there was a small chance that I wouldn’t wake up from the general anesthesia. What if I were to die? My poor mother! I was her only daughter, a very selfish daughter. But I’d been afraid my mother would try to dissuade me and I hadn’t wanted to have the argument with her. I felt strongly that this was my personal decision.
At that time there was unbelievable pressure on women to have children. Everyone told you you’d change your mind when the maternal instinct kicked in.“Every woman wants children! It’s in your genes. You are a freak if you don’t want children,” we were told repeatedly. Young women were not allowed to have hysterectomies because doctors thought we didn’t know our own minds. At the public health hospital they believed me when I told them I really didn’t want children. I never changed my mind.
Only my uterus was coming out, not ovaries. The interns had explained to me that they would try to do a vaginal hysterectomy. They wouldn’t cut my abdominal muscles unless they had to. But they wouldn’t know until they got in there, so I wouldn’t know until I came out of surgery and the anesthesia wore off. Some of the women in the ward had pretty ugly incisions and of course I had to see them all. As it turned out, the hysterectomy was vaginal, so I was left with no scar.
Because I got an infection (a common thing for younger people, they said), I had to live in the ward for 12 days. In that time I got to know the staff and the patients pretty well. I wanted to know how they funded the surgeries of people like me who were not seamen, fishers or Navy. They told me money came from a fund for special or interesting cases. I thought that was funny since my case seemed pretty routine. Later I learned that :
Hospital Director Dr. Willard P. Johnson had found an obscure regulation in the Public Health Service Act that allowed a director to allocate up to five percent of the care offered at the facility for “special studies.” The provision was intended to allow the admission of patients with rare diseases for the benefit of the medical education program. Dr. Johnson decided to interpret it differently, admitting every person referred from a community clinic as a special studies patient. This decision was the origin of the long-standing affiliation with the region’s community health centers.
The PHS hospital, because of its close relationship with the neighborhood clinics, became the center of the People’s Health Care System in Seattle. It was part of a vital community movement for control of our own health care, which had far reaching effects. Women did gain a measure of control and also won changes in the health care system. The women’s clinics in Seattle, set up to help women access abortion and reproductive care, continued to operate for many years. But our most important community partner, the PHS hospital and its federally funded public health care system, died a tortured death.
Republicans Shut It Down
The Republican assault on health care is not a new phenomenon. When politicians grouse that we can’t afford Medicare for all, they forget that the U.S. once actually had a well-run public health care system. It was destroyed by Ronald Reagan.
The Seattle PHS hospital was part of a network of public health hospitals and federally-funded free clinics all over the country. Soon after he took office Reagan shut down all the public hospitals. In Seattle he had to fight the community as well as Washington’s powerful Senators Warren Magnuson and Henry Jackson, and Seattle’s mayor, but Reagan pretty quickly won the fight.
The assault was unremitting. Between 1980 and 1991, more than 250 community health centers were closed, 309 rural hospitals and 294 urban hospitals were shuttered. Nearly one million Native Americans lost access to Indian Health Service care when eligibility was narrowed. Reagan’s budget cuts hacked at school lunches, Medicaid, the food stamp program, WIC and AFDC. He caused a two percent increase in the poverty rate, and the number of children in poverty rose nearly three percent.
Forty years later it’s clear that the Republicans’ answer to the prospect of socialized medicine is, for a growing number of Americans, no healthcare at all. And the attacks on women’s reproductive care continue with the recent Supreme Court decision allowing religious exemptions for birth control. Soon Roe v. Wade may be overturned and we’ll be back where we started. For a brief window in time American women enjoyed the right to control our bodies and reproduction. Now it looks like that window is closing.