Tuesday, May 22, 2012

booknotes: the morning after

After reading Bodies of Knowledge by Wendy Kline back in March, I decided to follow up one history of women and medicine with another: Heather Munro Prescott's The Morning After: A History of Emergency Contraception in the United States (Rutgers University Press, 2011). Part of the Critical Issues in Health and Medicine series, edited by Rima D. Apple (University of Wisconsin-Madison) and Janet Golden (Rutgers), The Morning After focuses on the development of pharmacological postcoital contraception beginning in the mid-twentieth-century, the ad hoc off-label distribution of contraceptives in emergency situations, and finally the process by which a dedicated emergency contraceptive pill was approved by the FDA for production and marketing. Her narrative ends in the recent past, when emergency contraception was approved for over-the-counter sale to those over the age of seventeen.

Prescott's history is a fairly straightforward narrative which, while valuable in its own way, could have benefited from more analysis and a stronger historical argument. One of the interesting changes Prescott observes over time is in the attitude of feminist/women's health advocates. During the 1970s and 80s were incredibly skeptical (due to a number of high-profile drug failures) about the FDA's interest in, and ability to, ensure the safety of contraceptives and other women's health-related pharmaceuticals. By the 1990s, feminist rhetoric had shifted from safety to one of women's agency: access to emergency contraception became something women had the right to access, once they had been fully and meaningfully informed about their options. This shift from the authority of medical professionals to the authority of women to control their own reproductive capacity is something that I would have liked to see developed further, with particular focus on how it re-formed the politics around emergency contraception.

The other aspect the history of emergency contraception in the U.S. that is touched upon in The Morning After but largely passed over is the shift within the religious right from being fairly neutral about birth control and family planning mid-century (with the exception of the Catholic church) to actually conflating the pharmaceutical birth control options with abortion. Not just in that the two are morally equivalent, but that taking birth control pills (including postcoital birth control) causes you to abort. While medically inaccurate this  blurring of the boundary between what is pre-pregnancy birth control and what is abortion expands the backlash on women's reproductive agency exponentially. Birth control advocates can no longer gain allies among anti-abortion activists by arguing (as they did throughout the twentieth century) that the birth control pill will lower the abortion rate by preventing undesired or mis-timed pregnancies. Because "birth control" as become synonymous with "abortion" in many anti-abortion circles. This is a rhetorical shift with on-the-ground consequences, and emergency contraception had no small part to play in this tug-of-war over women's lives. I would have liked to see this particular chapter in the history of EC given a little more time.

Overall, The Morning After is a solid history of a specific type of contraceptive technology, and one which I am glad to have read, as both an historian of feminism, gender, and sexuality, and as someone who tries to stay current in the world of reproductive justice activism.

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