The wandering womb

Women's health nursing past and present

Women have long been seen as at the mercy of their biology.

In the ancient medical world it was believed that a 'wandering womb' caused suffocation and death. Menstruation and childbearing were thought to make women the weaker sex, both physically and mentally. By the late nineteenth century, it was deemed scientifically proven that women’s biology made them less rational than men, unfit to participate in many areas of public life.

Rising above these attitudes, a century ago, women began securing the right to vote in the UK. Around the same time, nursing was formalised as a predominantly female profession. Since then, nurses have taken a leading role in challenging assumptions of women’s health. Yet myths and misconceptions remain widespread. Social changes continue to alter women’s biology, as they start periods earlier and live longer beyond the menopause. What is ‘normal’ for women? And why has women’s health long been considered 'dirty' nursing?

Blood and biology

Decisions about women’s health have historically been made by men.

For the Victorians, the menstrual cycle was considered a disease. Women found all sorts of ways to find out more about their periods and learnt from female relatives. Some would even source secret texts on women’s health, often disguised in the dust jacket of more ‘acceptable’ reading material.

How did nursing change this? As the role of women in health care grew, so did an understanding about women’s health and biological cycles. Nurses became advocates for women, in a position to air previously hidden topics.

So what is a ‘normal’ amount for women to bleed?

Women today have more control over their periods than ever. Bolder attitudes have seen campaigns to abolish the ‘tampon tax’ and charities working to ensure all women get access to menstrual supplies. As more non-surgical options have become available for women, like mirena coils and hysteroscopy, nurses have been at the  forefront of embracing and delivering these treatments.







On display

Advice pamphlets for periods and contraception 1950s and 1960s

RCN Archive.

Dr Williams pink pills for pale people late nineteeth century

Advertised as an iron rich tonic for the blood, these pills claimed to be a miracle cure for a variety of ailments, including anaemia, hysteria and ‘change of life.’ On loan from the Royal Pharmaceutical Society.

Gold wishbone intracervical device 1880s

This stem pessary, developed in Germany, is an early example of an intra-cervical device . On loan from the Royal College of Obstetricians and Gynaecologists.

John Hoopers female pills early twentieth century

Dr John Hooper patented his ‘anti-hysteria’ pills in 1743, advertised as the best medicine for young women with a case of the irregularities. On loan from the Science Museum.

Modern sanitary items 2018

Tampons, pads and menstrual cup.

Obstetrics and Gynaecology for Nurses 1963

Aimed at the student nurse, this was a popular textbook written by a doctor and a nurse.

Sanitary napkins 19th Century

On loan from the Science Museum.

South London Hospital for Women 1920s

Opened in 1916 as a hospital for women who prefer to be treated by a member of their own sex. This was reportedly the largest hospital in the world to be staffed entirely by women. RCN Archive.

Stem pessary 1925 1953 and modern intrauterine devices IUDs 2018

Stem pessary, 1925 - 1953 and modern intrauterine devices (IUDs), 2018.

The Works of Aristotle the Famous Philosopher 1855 and RCN Womens Health pocket guide 2017

The dust jacket disguises this book’s contents, which cover uterine dropsy, labour and ‘testicles in women.’ Today, information is much easier to find.
Blood and biology case

Hot flush

A Victorian woman going through the menopause was often considered to be emotionally unstable. During this 'climacteric period', she may well have been prescribed leeching or bloodletting from the ankle. Her doctor would have advised against reading novels, going to parties and dancing. For a 45 – 50 year old Victorian woman, an onslaught of instability and madness was considered inevitable. Nursing now focuses on the holistic management of menopause. This can include managing lifestyle changes and advising on prescribed medication such as Hormone Replacement Therapy. Because the effects of menopause are so complex, Clinical Nurse Specialists are key at this advanced level of practice.

Womens health hot flush

In the Victorian age men were also diagnosed with climacteric insanity, as something that was defined as a broad spectrum of 'changes' in life. But men were not diagnosed as frequently as women. Today, the possibility of 'man periods' or the 'male menopause' are widely discussed, as hormone fluctuations in men are also recognized.

On display

Bottle for Progynon pills for menopause c1930

This hormone supplement first appeared in Germany in 1928, to control menopausal symptoms such as hot flushes and mood swings. On loan from the Science Museum.

Jar containing Lapis Aetites the Eagle Stone early eighteenth century

Believed to ‘facilitate birth if tied to the thigh of a woman in labour’ and ‘hinder miscarriages if tied to the arm.’ On loan from the Royal Pharmaceutical Society.

Jean Wilsons nursing notebook 1929

Gynaecological illustrations of the female genitals. RCN Archive.

Menformon Organon ampoules, c1938.

This hormone supplement first appeared in Germany in 1928, to control menopausal symptoms such as hot flushes and mood swings. On loan from the Science Museum.

Oestrogen gel packaging 2017

An example of hormone replacement

Pregnancy calendar used for tracking phases of gestation and a current cycle tracking app

It is now easy for women to keep track of their own cycles, logging a range of information from blood flow to changes in mood.

Womens Health Information Centre WHIC pamphlet 1983

The WHIC was part of the Women’s Liberation Movement, providing information and resources on women’s health issues. RCN Archive.
Wandering womb hidden loss case

Hidden loss

Pregnancy loss is more common than is discussed

Even today, some causes of miscarriage are not known. Plenty of preventative measures have been tried and tested by women all over the world for centuries. Ancient Egyptian women were known for placing protective amulets in the vulva and women of Ancient Greece would avoid bitter foods. Practically any action taken by a woman in the Middle Ages could be seen to prompt a miscarriage, making her choices wholly responsible for the outcomes of her pregnancy.

In the nineteenth century, anything from exercise, worry, even failure to meet the demands of home life was blamed. Whilst these beliefs are centuries past, the idea of miscarriage as being the ‘fault’ of the woman still exists. Stigma around miscarriage and ectopic pregnancy continues

Nurses are breaking this stigma.

The focus has shifted from the physical health of women to their emotional health. Specialist nurses within Early Pregnancy Units are leading on assessing, scanning and undertaking treatments. Counselling and strong links with support groups and charities are all part of providing expert care for their patients.

“By allowing my own experience to be reported I hope…that I might contribute in a small way to a future climate in which these matters are respected as entirely personal – rather than pored over and speculated about as they are now. .”

Nursing Times, 1918


Gynaecology and cancer 

In 1895, Dublin nurse Alice Beatty took her surgeon, Charles Cullingworth, to court.

Cullingworth operated on Beatty for 'ovarian disease', but removed both her ovaries rather than the one she had consented to. Beatty, engaged to be married and keen to start a family, claimed damages for a wrongly performed operation. She lost the case.

Victorian surgery, prescribed and performed by men, was often extreme. Hysterectomy was the treatment of choice for cervical cancer, even when death rates were high. Consent and the social and psychological effects on women were barely acknowledged. 

With the advent of new procedures, such as endometrial ablation, hysterectomy is no longer the only option. Now, Clinical Nurse Specialists (CNS) are essential in delivering and supporting these new treatments and at the same time, ensuring the rights and wishes of their patients are met.  Gynaecological cancers are complex and the nursing role is expanding. 

Nurses take the majority of smear tests. They have a large role in the diagnosis of cervical cancer, from screening through to colposcopy, as well as spotting cancer reoccurrence. A CNS remains with their patient for the whole journey, from diagnosis, treatment and managing the long term effects. Unlike Alice Beatty, women now have increasing opportunities to take more control over their own care.


“Am I, a nurse and a woman whose best years of life and health have been devoted to the relief of suffering in others, and whose health broke down in the service, to be debarred from all medical relief because forsooth, I claim a right over my own body? If so, will not steps have to be taken, in the interest of the people, to place hospitals under some other control?.”

Nursing Times, 1918


On display

Cervical screening kit 2018

This kit, familiar to most women, is what nurses use today to obtain cells that are then looked at for abnormalities.

Marvel Whirling Spray vaginal douche c1900

The booklet describes vaginal douching as ‘woman’s best safeguard against uterine cancer’ and asserts that ignorance of the use and importance of vaginal douching leads to ‘misery, woe and utter despair’. On loan from the Royal Pharmaceutical Society.

Robert Barnes notebook on cancers in women 1859

Research notes and illustrations compiled by gynaecologist Robert Barnes, including urogenital and breast cancers. On loan from the Royal College of Obstetricians and Gynaecologists.

Specula nineteenth and twentieth century

Various designs of specula have been tried and tested over the years. A speculum is used to hold vaginal walls open for procedures including cervical smears. On loan from the Royal College of Obstetricians and Gynaecologists.
Gynae and cancer case




DID YOU KNOW?

Gynaecology is a Greek term literally meaning 'the study of women'. And hysteria is derived from 'hystera' meaning womb. This linguistic association between women’s health and hysteria is still in use today in the term hysterectomy.

Hyesteria did you know UTO




 DID YOU KNOW?

In the Victorian age men were also diagnosed with climacteric insanity, as something that was defined as a broad spectrum of 'changes' in life. But men were not diagnosed as frequently as women. Today, the possibility of 'man periods' or the 'male menopause' are widely discussed, as hormone fluctuations in men are also recognised.



Did you find any of this dirty?

We all need to speak more openly about intimate health issues.
Women's biology has long been subject to speculation, comment and often control by others. It is now time for menstruation and menopause to be understood and celebrated as a normal part of female biology. 
In a field previously dominated by the perspectives of male doctors and physicians, all nurses now have a responsibility to advocate for women today. It is up to healthcare workers to recognise that each woman is different and that ‘normal’ means healthy.
Perhaps for the nurse, it is the ‘dirty’ nature of gynaecology which makes the role so unique, helping to transform a woman’s experience.
Do you think of menstrual blood, or afterbirth, or mucus as dirty? If so, we hope you leave this exhibition questioning where these attitudes came from.

 

You can visit the exhibition at RCN Library and Heritage Centre from 19 October 2018 until 22 March 2019.

It was curated by the RCN Women's Health Forum, the History of Nursing Society and Library and Archive Service. With thanks to our lenders: The Science Museum Group; Royal College of Obstetricians and Gynaecologists;  Royal Pharmaceutical Society and Pharmacopoeia duo Liz Lee and Susie Freeman.

For associated events, see our full listing.