‘Women’s health means women’s freedom’

From periods to family planning to the menopause, women’s health has undergone seismic change, says GH’S health and wellbeing commissioning editor Arielle Tchiprout

One hundred years ago, we might have defined ‘womanhood’ by the workings of our bodies. From the first drop of blood at puberty, to pregnancy and raising children, through to the menopause, a woman’s value was intrinsically linked to her female bodily functions; and, therefore, her ability to fulfil her role as a baby-making member of society.

Thankfully, we’ve moved on considerably since then. Now, womanhood is more about the unique qualities that make us who we are – our intellect, our empathy, our talents and abilities. And I believe we have the huge developments in women’s health over the past century to thank for that. I am so proud that Good Housekeeping has been there to witness these momentous changes and has, in some cases, helped drive them forward.

PROGRESS FOR PERIODS

When GH first appeared in 1922, women had to fashion their own sanitary products out of bandages and cloths. Unsurprisingly, the uncertainty of leaking blood was enough to keep many at home during their period. The taboo surrounding menstruation was intense, and little was known about illnesses such as endometriosis. In 1931, the tampon was patented; perfectly timed for when women were starting to find their feet in the workplace. Since then, the stigma surrounding periods has been breaking down, albeit slowly. It was just recently, in 2017, that we saw the first advert (from Bodyform) portraying red ‘blood’ rather than blue liquid. Now, there’s a wealth of innovative products aimed at making menstruation easier: comfortable and absorbent period pants and even high-tech devices with small electrical pulses that claim to ease pain, drug-free. We’ve (hopefully) grown up with less shame about menstruation than our mothers, and our granddaughters will have even less than we had.

A woman’s value was linked to her female bodily functions

GROUNDBREAKING BIRTH CONTROL

Although the first Marie Stopes clinic opened in 1921, offering advice about birth control, this was only available to married women and options were limited and unreliable (such as scary-looking pessaries, and rubber contraceptive ‘sponges’).

That all changed in 1961, with the contraceptive pill. Using a combination of oestrogen and progesterone, it offered women the freedom to choose when to have children, resulting in greater opportunities outside the home.

In 1974, women could get a prescription regardless of marital status, and the pill turned out to help treat a range of issues, including painful periods.

That said, questions about the safety of the pill have been raised since its conception, and, in 1964,

GH published an article about the side-effects, including increased chance of developing blood clots. The risks, although tiny, are real, and many women opt for non-hormonal methods of contraception including the copper intrauterine device

(invented in 1967).

What was once a symbol of freedom is now sometimes seen as an unfair expectation placed squarely on women’s shoulders, and there has been increasing pressure for a male contraceptive pill.

BIRTH AND BABIES

A century ago, death during childbirth was commonplace. The rate was between four and five women per 1,000 births until 1935, most of which were caused by infections like sepsis, and pre-eclampsia.

Antibiotics and many advances in management of pregnancy and labour have helped this drop significantly since then. Between 2016 and 2018, 547 women died during or up to a year after pregnancy, of the 2.2m UK women who gave birth.

Meanwhile, in the 1920s, there was a fear of infertility and women who couldn’t have children were heavily stigmatised. We now have miraculous fertility treatments. In 1978, the world’s first IVF baby, Louise Brown, was born in Manchester, and now around 2% of babies born in the UK annually are a result of IVF.

ACCESS TO ABORTION

In 1922, if a woman became pregnant outside of marriage, or without the finances to support another child, she might have to seek a dangerous illegal abortion. These accounted for 15% of maternal deaths between 1923 and 1933. At this time, abortions were legal in very specific circumstances, but, even then, many doctors refused to perform them. In 1966, GH published an investigation into the devastating impact of such abortions and argued that the law should be changed to allow women freedom of choice. The next year, the Abortion Act was passed, which allowed more women, for a wider range of reasons, access to abortion on the NHS. Though still controversial 55 years later, thankfully abortion is safer than ever.

HRT first became available in 1965, allowing women to replace the oestrogen they were losing during the menopause

MENOPAUSE MOVES ON

At the start of the 1900s, women with menopausal symptoms were often written off as having ‘hysteria’. But in the late 1920s, the development of endocrinology led to the isolation of oestrogen, and hormonal prescriptions were soon developed for the treatment of menopausal symptoms. HRT first became available in 1965, allowing women to replace the oestrogen they were losing. The tide turned against HRT in the 1990s when a report linked it to an increased risk of certain cancers. But, with further advancements, the National Institute for Health and Care Excellence (NICE) now recommends HRT as an effective treatment.

Although menopause has remained an unspoken topic for decades, it is now coming out of the dark. Stores such as Cult Beauty have whole departments dedicated to menopause products, and last year, a menopause taskforce was created. Considering today’s woman can expect to live to 81 years old, the menopause can no longer be seen as the beginning of the end – but rather, as the start of a bright new chapter.