This is a project about medicine and the history of a condition called premenstrual syndrome (PMS), its “discovery” and conceptual development at both scientific and socio-cultural levels. Since it was first mentioned in medical literature, PMS has been explored empirically as a medical condition and conceptually as a non-somatic cultural phenomenon. Many attempts have been made to produce scientific, empirical evidence to bolster the theory of PMS as a biological disease. Some non-medical perspectives argue that invoking biology as the cause of PMS medicalizes a natural function of the female reproductive system and shallowly interrogates what is actually a complex bio-psycho-social phenomenon. This thesis questions both sides of this debate in order to reveal how criteria for PMS were categorized despite disagreement surrounding its etiology.

In the fifteen years between the discovery of fetal alcohol syndrome, or FAS, in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. In this dissertation, I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol.

During the late 1800s through the early 1900s, physicians administered pelvic massages involving clitoral stimulation by early electronic vibrators as treatments for what was called female hysteria. Until the early 1900s, physicians used female hysteria as a diagnosis for women who reported a wide range of complaints and symptoms unexplainable by any other diagnosis at the time. According to historian Rachel Maines, physicians provided pelvic massages for thousands of years to female patients without it being considered erotic or sexually stimulating. After the Western Industrial Revolution, physicians began using electric machines in medicine, including the medical vibrator, which researchers theorize was used to more efficiently bring women to a hysterical paroxysm, the former medical term for a female orgasm. Until the 1920s, physicians used vibrating massagers as medical devices for treating hysteria at a time when doctors diagnosed women with hysteria as a sweeping diagnosis.

Breast augmentation involves the use of implants or fat tissue to increase patient breast size. As of 2019, breast augmentation is the most popular surgical cosmetic procedure in the United States, with annual patient numbers increasing by 41 percent since the year 2000. Since the first documented breast augmentation by surgeon Vincenz Czerny in 1895, and later the invention of the silicone breast implant in 1963, surgeons have developed the procedure into its own specialized field of surgery, creating various operating techniques for different results. By having varied incisions, implant placements, and improved ways of treating surgery-related complications, advanced technology has enabled women to undergo breast augmentations for aesthetic, medical, or reconstructive reasons. Trans women may also benefit from breast augmentations. Having the option of a breast augmentation gives women more control over their physical appearance, which may improve their self-image and boost their confidence.

In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the time, the Comstock Act was the first federal anti-obscenity law that targeted contraception. However, social acceptance of birth control changed at the turn of the twentieth century. In this thesis, I analyzed legislation, advocates, and literature pertinent to that social change to report on the events leading up to the decriminalization of contraception.

In “Beyond Menstrual Hygiene: Addressing Vaginal Bleeding Throughout the Life Course in LMICs,” hereafter “Beyond Menstrual Hygiene,” Marni Sommer, Penelope A. Phillips-Howard, Therese Mahon, Sasha Zients, Meredith Jones, and Bethany A. Caruso explored the barriers women experience in managing menstruation and other forms of vaginal bleeding in low and middle-income countries, which the researchers abbreviate to LMICs. The medical journal British Medical Journal Global Health published the article on 27 July 2017. As little literature existed at the time concerning the topic of vaginal bleeding for women in LMICs, Sommer and her team state that they were motivated to assess the topic in order to better understand how issues concerning the health of women and girls are managed in limited-resource contexts. In “Beyond Menstrual Hygiene,” the authors assert that females in LMICs need access to better resources, education, and supplies to manage menstruation.

In 2010, Sophia and Paul Grinvalds founded the organization AFRIpads in Kampala, Uganda, to provide reusable cloth pads to menstruating women and girls throughout the country. At that time, the Grinvalds wanted to help implement better menstrual health and hygiene in Uganda to encourage women and girls to engage in work and school. While living in Kampala, in 2010, they employed Ugandan women to sew cloth pads daily and sell to others living in the local village. In 2018, the United Nations Human Rights Council, or UNHRC, conducted a study in Uganda to test the efficiency of AFRIpads and found that a majority of women and girls studied favored reusable cloth pads. Since then, as of 2021, AFRIpads has expanded to collaborate with other organizations to distribute their reusable cloth pads to women and girls living in African countries. By doing so, AFRIpads has helped introduce a sustainable method for managing menstrual hygiene and teaching menstrual education in low-income countries.

In “Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use,” hereafter “Explaining Recent Declines,” researchers John S. Santelli, Laura Duberstein Lindberg, Lawrence B. Finer, and Susheela Singh discuss what led to the major decline in US adolescent pregnancy rates from 1995 to 2002. Working with the Guttmacher Institute, a reproductive health research organization, they found that the decline in US adolescent pregnancy rates between 1995 and 2002 was primarily due to improved contraceptive use. They published their article in 2007 after the US government had increased funding for abstinence-only education between 1998 and 2007. “Explaining Recent Declines” challenged US policies by asserting that there was minimal evidence to support abstinence-only sex education as the primary strategy to prevent adolescent pregnancy.

In 1976, midwife Ina May Gaskin published Spiritual Midwifery, with other editions published in 1980, 1990, and 2003. Spiritual Midwifery is a book about pregnancy, birth, and postpartum, or the time period after birth. During the 1970s, it was common for women to receive an epidural, a medication that reduces pain during labor, and for physicians to monitor a fetus’s heartbeat while separating women from their infants after birth. However, according to Gaskin, some women wanted to give birth outside of the hospital without medical interventions. Spiritual Midwifery is a collection of birth stories from women, information about pregnancy and giving birth, and instructions to midwives on how to care for women during childbirth and the period that followed. In Spiritual Midwifery, Gaskin introduced homebirth and midwifery to a broader audience, which helped repopularize midwifery in the US.

Science fiction works can reflect the relationship between science and society by telling stories that are set in the future of ethical implications or social consequences of scientific advancements. This thesis investigates how the concept of reproduction is depicted in popular science fiction works.

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