42
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Race, class, caste, disability, sterilisation and hysterectomy

      research-article
      Medical Humanities
      BMJ Publishing Group
      History, cross-cultural studies, Gender studies, Medical humanities, reproductive medicine

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          This interdisciplinary historical paper focuses on the past and current state of diverse forms of surgical hysterectomy as a global phenomenon relating to population control and sterilisation. It is a paper grounded in historical inquiry but is unconventional relative to the norms of historical scholarship both in its wide geographical scope informed by the methodologies of global and intercultural history, in its critique of current clinical practices informed by recent feminist, race, biopolitical and disability studies, and by its engagement with scholarship in health sociology and medical anthropology which has focused on questions of gender and healthcare inequalities. The first part of the paper surveys existing medical, social-scientific and humanistic research on the racial, class, disability and caste inequalities which have emerged in the recent global proliferation of hysterectomy; the second part of the paper is about the diverse global rationales underlying radical gynaecological surgeries as a form of sterilisation throughout the long twentieth century. Radical gynaecological surgeries have been promoted for several different purposes throughout their history and, of course, are sometimes therapeutically necessary. However, they have often disproportionately impacted the most disadvantaged groups in several different global societies and have frequently been concentrated in populations that are already maligned on the basis of race, ethnicity, age, criminality, disability, gender deviation, lower class, caste or poverty. This heritage continues to inform current practices and contributes to ongoing global inequalities of healthcare.

          Related collections

          Most cited references201

          • Record: found
          • Abstract: not found
          • Article: not found

          The Complexity of Intersectionality

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Variation in the incidence of uterine leiomyoma among premenopausal women by age and race.

            To quantify the incidence of uterine leiomyoma confirmed by hysterectomy, ultrasound, or pelvic examination according to age and race among premenopausal women. From September 1989 through May 1993, 95,061 premenopausal nurses age 25-44 with intact uteri and no history of uterine leiomyoma were followed to determine incidence rates of uterine leiomyoma. The self-reported diagnosis was confirmed in 93% of the medical records obtained for a sample of cases. Using pooled logistic regression, we estimated relative risks (RRs) of uterine leiomyoma according to race and examined whether adjustment for other potential risk factors could explain the variation in the race-specific rates. During 327,065 woman-years, 4181 new cases of uterine leiomyoma were reported. The incidence rates increased with age, and the age-standardized rates of ultrasound- or hysterectomy-confirmed diagnoses per 1000 woman-years were 8.9 among white women and 30.6 among black women. After further adjustment for marital status, body mass index, age at first birth, years since last birth, history of infertility, age at first oral contraceptive use, and current alcohol consumption, the rates among black women were significantly greater for diagnoses confirmed by ultrasound or hysterectomy (RR 3.25; 95% confidence interval [CI] 2.71, 3.88) and by hysterectomy (RR 1.82; 95% CI 1.17, 2.82) compared with rates among white women. We observed similar RRs when the cohort was restricted to participants who reported undergoing a screening physical examination within the 2 years before baseline. A higher prevalence of known risk factors did not explain the excess rate of uterine leiomyoma among premenopausal black women.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Human resources for health in India.

              India has a severe shortage of human resources for health. It has a shortage of qualified health workers and the workforce is concentrated in urban areas. Bringing qualified health workers to rural, remote, and underserved areas is very challenging. Many Indians, especially those living in rural areas, receive care from unqualified providers. The migration of qualified allopathic doctors and nurses is substantial and further strains the system. Nurses do not have much authority or say within the health system, and the resources to train them are still inadequate. Little attention is paid during medical education to the medical and public health needs of the population, and the rapid privatisation of medical and nursing education has implications for its quality and governance. Such issues are a result of underinvestment in and poor governance of the health sector--two issues that the government urgently needs to address. A comprehensive national policy for human resources is needed to achieve universal health care in India. The public sector will need to redesign appropriate packages of monetary and non-monetary incentives to encourage qualified health workers to work in rural and remote areas. Such a policy might also encourage task-shifting and mainstreaming doctors and practitioners who practice traditional Indian medicine (ayurveda, yoga and naturopathy, unani, and siddha) and homoeopathy to work in these areas while adopting other innovative ways of augmenting human resources for health. At the same time, additional investments will be needed to improve the relevance, quantity, and quality of nursing, medical, and public health education in the country. Copyright © 2011 Elsevier Ltd. All rights reserved.
                Bookmark

                Author and article information

                Journal
                Med Humanit
                Med Humanit
                medhum
                mh
                Medical Humanities
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1468-215X
                1473-4265
                March 2023
                10 August 2022
                : 49
                : 1
                : 27-37
                Affiliations
                [1] departmentSchool of Humanities and Communication Arts , Western Sydney University , Penrith South, New South Wales, Australia
                Author notes
                [Correspondence to ] Associate Professor Alison M Downham Moore, School of Humanities and Communication Arts, Western Sydney University, Penrith South, NSW 2751, Australia; alison.moore@ 123456westernsydney.edu.au
                Author information
                http://orcid.org/0000-0002-9642-1437
                Article
                medhum-2022-012381
                10.1136/medhum-2022-012381
                9985708
                35948394
                73d4a969-77f9-4959-9df8-5e0069510744
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 15 June 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003190, Freiburg Institute for Advanced Studies, Albert-Ludwigs-Universität Freiburg;
                Award ID: Alumni Fellowship 2021
                Categories
                Original Research
                1506
                Custom metadata
                unlocked

                history,cross-cultural studies,gender studies,medical humanities,reproductive medicine

                Comments

                Comment on this article