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Medical or Medieval: The Echoes of Medicalised Hysteria in Contemporary Law


Photo by Steve Eason via OpenVerse (licensed under CC BY-NC-SA 2.0)



On June the 17th, my journey from Embankment tube station to Strand was impeded; carnival sounds of whistles and drumming reached the lulled conversation shared by myself and a couple of friends, and as I squinted towards Charing Cross I noticed a flurry of banners. It was a protest, and quite a big one. My mind jumped instinctively to Extinction Rebellion, Just Stop Oil, or indeed the recent union action taken by university staff. When the slogan ‘Right to Choose’ appeared above the swarm of marchers, therefore, I was momentarily surprised.


As I stood on the pavement clapping the picketers, I couldn’t help but feel a creeping sense of self reproach. Apart from reprimanding myself for not knowing that the march - one I would have gladly partaken in - was going ahead, my ignorance to its cause was what most disturbed me. Whilst I am a pro-choice supporter and have qualms with the 24 week cut off point for abortion in England, Scotland and Wales - not to mention Northern Ireland’s 12 week policy - I was struck by my own presumption that my right to abortion is an uncompromised one. The idea that we are still fighting for reproductive rights on behalf of ourselves, rather than, say, on behalf of those directly affected by the likes of the overturned Roe v Wade, felt novel to me. I realised I had mentally catalogued abortion rights as something already fought for and, overall, won before my time.


A hand emerged out of the marchers, offering pamphlets up to the crowd assembled at either side of the thoroughfare: ‘44-year-old mother of three, jailed for carrying out a late abortion at 32-34 weeks’.


***


Carla Foster was originally given a 28-month sentence, half of which would be in custody, the other under licence. This was despite the Royal College of Obstetricians and Gynaecologists plea for leniency from the judge, believing that if the case was criminalised, those seeking abortion aftercare would be less likely to contact medical professionals. Since June - and since Foster underwent a 35-day incarceration period - this sentence has been appealed and reduced to 14 months. However, Foster technically remains sentenced under Section 58 of the Offences Against the Person Act; a law which theoretically carries a maximum sentence of life imprisonment.


On first reading the latter statement I was drawn up short. I googled the unamended Section 58 and, sure enough, the words ‘penal servitude for life’ popped up next to the lines ‘with intent to procure her own miscarriage’. Unsurprising, considering its writing was in 1861. Tradition’s very real hold over an organ that resides in over half of our population's bodies, however, suddenly felt - feels - magnified. It makes me think again of Roe v Wade, and the justification for its overturning: ‘a right to abortion is not deeply rooted in the Nation’s history and traditions [...] an unbroken tradition of prohibiting abortion on pain of criminal punishment persisted from the earliest days of the common law until 1973. It is time to heed the constitution’, said Justice Samual Alito. But surely, by this logic, every amendment made since the ratifying of the US constitution could be rendered invalid. It seems that it takes merely one nod to ‘tradition’ - a subjective term in its own right - to displace laws fought and won based on personal tragedy. In other words, Justice Alito’s concern was more for the re-sanctifying of a dated constitution; for preserving a deeply romanticised, historicised concept of America whose familiarity is mistaken by voters for security - not the material safety and autonomy of its citizens. In banning abortion, Alito re-establishes a narrative that deems the female body a site of danger. His pandering to the belief that historicised thinking effectively constitutes gospel, moreover, begs the question of how interwoven so-called contemporary law really is with that of myth, pop culture and historical prejudice.


Leading by Alito’s example - his entertainment of political dispositions influenced by 18th, rather than 21st century society - one could argue that the law, and thus medical treatment, remains more culturally bound than we realise. Whilst the need to exert control over the mind and body of people with wombs still resides somewhat in the media, the literary canon, the gender pay gap - etc etc etc - is it inevitable that medical law remains reflective of this? Is the unaltered state of laws like the aforementioned act of 1861 bolstered more, say, by the sentiment inspired by popular literary or cinematic characterisations of foetus and carrier as opposing entities - Lady Macbeth, Eva from Lionel Shriver's We Need To Talk About Kevin’ - than medical or moral reasoning?


And this is without considering the interweaving of inaccurate historical zeitgeist with medicalised language itself. The term ‘hysteria’, for example, originates from the ancient Greek ‘hystera’, meaning ‘womb’. Perceived as a disease affiliated exclusively with the womb from the time of the ancient Greeks, Hippocrates established it as a physical sickness caused by the womb’s literal movement around the body (thereby also initiating the theory of ‘the wandering womb’). Said movement was reported to provoke symptoms of acute anxiety, breathlessness, menstrual cramps and increased or reduced libido (a belief which incidentally prompted the invention of the vibrator in the 1880’s as a means to ‘curing’ hysteria). Incidentally, Hippocrates emphasis on the womb’s especial liability to ‘wander’ if its carrier was not being fulfilled sexually played a crucial part in stigmatising the sanity and sexual appetites of unmarried or widowed women whose wombs remained empty. Whilst then, the pregnant body was feared due to its ability to both evoke and end life, the empty womb was equally condemned. Though by the Victorian era the literal movement of the womb had been proved a physical impossibility, hysteria was classified as a mental condition, its unchanged name reiterating its apparent inherent connection to the womb. In other words, its position as a derogatory, gendered disorder was unchanged. Moreover, its contribution to gender bias in medicine - and the mistrust and anxiety it inspired towards people with wombs - arguably still reverberates in political and medical circles to this day.


Hysteria was eventually dropped as a medical term in the 1980’s, though expressions associated with hormonal changes such as ‘baby brain’ perhaps act as contemporary recastings of the word. The enormity of its impact, moreover, must not be underestimated, being exemplified most explicitly in the inordinate number of female lobotomies performed from the 1930’s until the popularisation of antidepressants. By 1972, 75% of all lobotomies performed by Freeman and Watts - the pioneers who established the practice - had been performed on women experiencing symptoms of hysteria or ‘disturbed’ behaviour. In Mary Kozial’s essay ‘Diagnosing Womanhood’, she cites Illich in saying that medicine has the ‘power to define normalcy and that which deviates from it’; rather, it seems, like gender. Indeed, in the same essay, Kozial examines transcripts of interviews with mentally ill patients, and found that use of harsh language by female patients was directly associated with gender nonconformity; thus rendering them insane, and thus legitimising their lobotomization. The measure of male patients' liability for treatment, meanwhile, was never linked with their gender performativity, nor was their harsh language as readily reprimanded.


I point this out not only to simply highlight historical gender bias in medicine, but to emphasise that for people with wombs, gender conformity was and is often crucial to maintaining liberty. Hysteria’s vast legacy can perhaps be attributed to the very relativity and broadness of its symptoms, and thus how easily employed its diagnosis was to subdue people with wombs when gendered expectations themselves were equally multitudinous.


And it appears that the fallout of dubiousness regarding female lucidity and emotional constraint is very much still with us. As pointed out by the Journal of Medical Ethics, women complaining of stroke symptoms are statistically more unlikely to receive immediate treatment than men, particularly those with a history of mental health conditions like anxiety. Whilst the autonomy of people with wombs is thus undermined by medical practice, moreover, it also remains engrained in medicalised language. To return to the case of UK abortion law, I refer to the wording of clauses such as ‘a doctor or nurse has the right to refuse to take part in abortion on the grounds of conscience’. Whilst I am not suggesting that this clause should necessarily be scrapped, the use of the word ‘conscience’ unsettles me. It infers that abortion is a practice that remains morally grey. That healthcare professionals can object on a matter of conscience, rather than unbiased medical opinion, both reinforces a sense of termination’s controversy or offensiveness. In short, the word presents it as a philosophical social dilemma rather than an unambiguous essential to bodily autonomy.


In reading the latter point back I can already see some gaping holes in my argument; if I’m pushing for bodily autonomy for all, then surely this would be undermined if medical professionals were forced to undertake procedures they found uncomfortable or traumatic. But the fact remains that to have an abortion in the UK, one must get permission from two doctors and justify their decision to terminate a pregnancy in medical terms (prove that their, or the childs, physical or mental health would be put in more jeopardy if the pregnancy is carried to full term than if it is terminated). And whilst healthcare professionals' attitudes towards abortion in the UK are generally in favour of an individual's right to choose - the NHS’s website states clearly that ‘the decision to have an abortion is yours alone’ - this is not matched by the law

 

Edited by Natalie Cheung, Essays Editor

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