Feminist Book Updates Its Health Topics

Times Staff Writer

In 1966, when natural childbirth was still a bit avant-garde and feminism was in its infancy--it was the year the National Organization for Women was founded--Jane Pincus and Vilunya Diskin met in a childbirth preparation class. Both were to have daughters and go on to become members of an extraordinary writing collective whose big book has sold 3 million copies.

Pincus and Diskin are two of the original 12 members of the Boston Women's Health Book Collective, a coalition still intact (save for one dropout) 15 years after publication of "Our Bodies, Ourselves," a book by and for women that dared to talk about things like masturbation and lesbian sexuality at a time when, Pincus noted, "You didn't say those words out loud."

Attempts at Censorship

It also discussed in detail reproduction, rape, venereal disease, abortion and birth control and, although "Our Bodies, Ourselves" wasn't banned in Boston, there were widespread censorship efforts and public denunciation by the Moral Majority, which called it "secular humanistic garbage."

But the book, published first as a stapled 75-page newsprint volume by the little New England Free Press, two years later expanded in hard cover by Simon & Schuster, quickly established itself as the bible of the feminist health movement. Its message: Women can, and should, have some say about their treatment at the hands of a male-dominated medical Establishment.

Now there's "The New Our Bodies, Ourselves," exploring the '80s issues--the ethics of surrogate motherhood, donor insemination, sex pre-selection--dilemmas that didn't exist in 1970 when vegetarianism was for kooks and women didn't report to offices in dress-for-success suits and running shoes.

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In the spring of 1969 when the women who were to become the Boston Women's Health Collective met for the first time at a workshop on "Women and Their Bodies" at Emanuel College, writing a book, and a book that would make money --$200,000 annually for some years--wasn't even a fantasy.

But the workshop helped them to focus their frustration and anger as women who saw themselves, and other women, as pawns in a medical maze presided over by male doctors perceived as condescending, paternalistic and secretive.

The 12 women agreed to keep meeting; they would spend the summer researching topics of special interest to them and, in the fall, each would write a paper. The papers would be mimeographed and offered as a 10-week course to interested women.

Initial Critique

These were white, college-educated, middle-class women in their 20s and 30s; still, it was their first critical look at the medical hierarchy. In 1970, it is noted in the introduction to the new volume, "Many of us were still getting pregnant when we didn't want to."

The women were not medically trained (although one went on to become a therapist, two others to earn master's degrees in public health) and they were politically rather naive. But they knew their subject. As Pincus said, "I've had two kids, but I've also had a miscarriage and I've had infertility problems."

The book, Diskin said, was "a phenomenon. It came at the right time, for the right reasons. It filled a gap. We get hundreds of letters every week from women all over the world. (The book is in 17 foreign language editions.) We all share the same bodies; the same processes happen. And we all lack information."

A Growing Network

"There's a real women's health movement out there, and we're part of it," said Diskin, 42, who lives in Lexington, Mass., has two children, a master's in public health and has worked for health organizations in India and Mexico.

Pincus, 47, a former French teacher, mother of two and Batik artist, now lives in Roxbury, Vt. and only gets to the collective's weekly meetings in the Boston area once a month, but was drafted as coordinator for the new "Our Bodies."

And, "if I have anything to say about it," she noted, the new revision will be the last revision: "Having to edit your friends' writing is real hell, especially when your friends aren't writers."

There were 10 collective members who had final editorial approval, with Pincus and Wendy Sanford as "editors and midwives." (Ruth Bell, one of the original 11 members, lives in the Los Angeles area now and did not work on this book). And, Diskin said, "We called on a lot of other women to write things they knew about. There were some 88 writers."

Added Pincus, "And at least 400 people critiqued it, both lay people and medical people." There were a dozen doctors involved, half of them women, but, Diskin acknowledged, "The physicians we asked to read the book for the most part had the same philosophy we have."

Among the collective's goals: "To reach as many women as possible with the tools which will enable them to take greater charge of their own health care and their lives, deal with the existing medical system and fight whenever possible for improvements."

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Success has not spoiled the Boston Women's Health Book Collective. When the first contract was signed with Simon & Schuster, the collective stipulated that clinics and other groups providing health counseling services be offered a 70% discount on the book; that still applies.

Proceeds enabled the collective, a nonprofit organization, to give small start-up grants to health agencies and to set up a full-time office, with a staff of two, in Watertown, Mass. Later, collective members agreed to pay themselves for any health work they did (such as lectures). But, Diskin emphasized, "We don't take any share of the profits personally."

Both Diskin and Pincus said here, quite candidly, that they don't expect the new "Our Bodies" to be a runaway best-seller, which isn't what most authors say when on book promotion tours. But, they noted, there are a number of women's health books available today and, Diskin said, "people are less political today," more conservative.

A Political Philosophy

And "The New Our Bodies, Ourselves" is very political. "This edition is much more sophisticated politically," Diskin said, than either the 1973 or 1976 editions. "We've really learned how to critique the system in ways that sound more reasonable and rational."

In the process, they said, a few of their beliefs have been dashed. "In the early 70s," said Diskin, "we felt if only we could get more women into medical school this thing would turn around. But we've learned it takes a very strong person to retain her humanity" in the face of Establishment medical school pressures.

(The book states, "Glaringly absent from medical training are most of the values, concerns and skills often thought of as 'feminine': nurturing, empathy, caring, sensitive listening. . . .")

Consensus and Compromise

As their commitment to changing the system has been reinforced, so have the friendships among collective members, whose weekly meetings have been ongoing for 12 years. Never a collective in the living sense, the Boston women are friends who have cared for each other's children and been at each other's sides through family deaths.

They have not always agreed, but they have debated through to consensus or compromise. In preparation of the new "Our Bodies," there was heated discussion on three segments--psychotherapy, pornography and breast cancer.

"We had a big fight on the psychotherapy chapter," Diskin said. "A lot of us felt pyschotherapy shouldn't be in there. There'd been so many abuses between psychotherapists and their patients, women especially." In the end, said Pincus, "We didn't just say they're all terrific."

As for the pornography chapter, "We were all against pornography that depicts violence to women," Pincus said, but some insisted that "any form of pornography debases women" while others felt that "gentle eroticism can be attractive and stimulating." (Ultimately, while acknowledging that sexually explicit books and photographs can be stimulating, the editors distinguished between those showing sex that does not degrade anyone and pornography, which is defined as that showing "someone (usually a woman) being forced or degraded.")

The chapter on breast cancer went through 11 revisions over two years. "Some women were furious," said Pincus, that the book does not endorse radical or modified radical mastectomy, charging "you're killing people" if you advise them to explore options first.

"Our Bodies," while stating that neither of the above treatments has been shown to provide more protection than less extensive surgeries with radiation therapy, does not endorse one treatment over another but gives this advice: "In the end, each woman will make the decision in her own way, ideally with the most informed and friendly support possible."

The new "Our Bodies" borrows little from the original. There are segments on midwives and home births, on health and aging, on Madison Avenue and body image, alternatives to conventional medical care, women and their addictions, environmental and occupational health and international women's health issues such as corporate dumping of hazardous drugs, forced sterilization and sex as a tourist attraction.

A segment titled "Poverty, Racism and Health" speaks to malnutrition, stress and cutbacks in assistance programs that aggravate medical problems.

"This edition has a real public health perspective," said Diskin. "We're also more open in saying to women, 'There's a difference between medical care and health care. Medical care is something that's done to you," while health care is largely determined by factors such as life style.

To Diskin, "The New Our Bodies, Ourselves" is important because it offers women choices and gives them "a sense of entitlement" and it provides insight into "how hundreds of women experience these life processes. These are real voices."

Pincus hopes another message comes through: "You really can't do it alone. We urge women to talk with other women, form groups around an issue."

Neither of them sees this book as the last word on women's health issues. Both agree that much more needs to be said about the new reproductive technologies which, the text states, "involve a degree of invasiveness and medical manipulation of women's bodies, which alarms us. . . ."

Pincus would have liked to see a chapter devoted to adoption issues and, she said, "we left out entirely the subject of considering parenthood. We didn't talk much about preparing for pregnancy," considerations such as job planning.

Acknowledged Diskin: "We're weak in many areas. I don't think we talk enough about what poor women can do. This book can really put you off medicine, period. But a lot of poor women desperately need medical care and we don't tell them how to get it."

Pincus nodded and said, "We keep learning."

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