Body of Opinion

Linda A. Rabben

The Woman in the Body:
A Cultural Analysis of Reproduction
By Emily Martin
Boston: Beacon Press, $21.95.

FEMINIST THEORISTS have a problem. One of their main a priori assumptions is that women, no matter what the differences among them, share a common experience of oppression. Since many women and men do not share this conviction, feminist scholars spend an inordinate amount of time trying to convince readers of basic feminist principles.

As women’s studies takes over from feminist polemics, daring gives way to respectability. No more SCUM manifestos; now we read and write dissertations and journal articles. A few writers try to break rules-be outrageous. Others compromise.

Emily Martin is one of the compromisers. She is trying to prove, in academic style, that women have accepted and rejected a hegemonic, male-generated ideology of the female body as a machine and reproduction as a form of industrial production. And she is trying to make a case for the possibility of change in the face of pervasive, internalized biological determinism.

Martin and a team of assistants talked to a variety of women, interviewing 165 Baltimore residents of different classes, ages and races. She presents examples of women’s own attitudes as well as abstract generalizations.

In the section on “Science as a Cultural System,” Martin reviews traditional and contemporary medical literature, showing its ideological foundations by analyzing the metaphors in textbook descriptions of menstruation, menopause and parturition. These metaphors are of machines and hierarchically organized control systems, both of which tend to break down.

For example, medical texts commonly describe menopause as “regression, decline, atrophy, shrinkage and disturbance,” rather than a normal process. Men’s reproductive processes are described positively, however. When men produce huge amounts of sperm, that is “remarkable” or “amazing;” when women Reproduction, Work, Family

From “Women’s Vantage Point,” she examines self- and body-image, menstruation, premenstrual syndrome, birth and menopause as they are affected by the dominant ideology of work, race and class. She contrasts women’s cyclical changes with the rigid organization of time under industrial capitalism.

In our society it is difficult to fit childbearing, childrearing or menstrual and menopausal problems into workaday life, because most workers are expected to be on the job for at least eight hours a day, five days a week. Martin contrasts this organization of time with the way women in traditional societies are secluded during menstrual periods or after childbirth.

“Although women chafe at the confinement, they regard this period positively specifically because it is free of work,” Martin says. In such cases, women have often managed to turn taboos to their own advantage. Martin asks if they might also be able to transform the industrial regime into one more consonant with their needs. Throughout these chapters, Martin, an anthropologist, interweaves cross-cultural comparisons and excerpts from interviews. Through them she shows the subtle and open forms of resistance that women use to cope with their marginalized and subordinate status.

“I made up my mind,” one woman says, “If I started labor I was going to keep it a secret. As much as possible because they were talking about time limits, you know, you start labor and you go fourteen hours and if you haven’t had that baby yet, you just might get a C-section… I made up my mind I’m not going to let anybody know until it’s really there and I’ve got a head start on those doctors, and I’m not telling them until it’s too late almost.” This woman and others use time as a weapon against those who would make them subject to it in the name of efficiency.

In her determinedly hopeful conclusion, Martin remarks, “Looked at as program for social reform, women’s responses to science and ideology are not trivial. They are radical, they are threatening, they would mean revolution.”

Martin bases her interpretations on interviews rather than on observation of actual behavior. “Doing a study based on interviews meant that I gave up the rich, multilayered texture of life that I would have experienced by living in a community or with a family,” she admits.

She missed more than that. Every field researcher finds out sooner or later that what people say is not always the same as what they do, and what they say is not always what they mean.

As Martin herself points out, women live out the contradictions in the hegemonic, male-generated ideology to which they are subject. It is naive to assume a one-to-one relationship between speech and behavior, especially when the speaker is responding to a survey questionnaire.

Although Martin says that interviews “could be very intense,” and some friendships with respondents ensued, she did not collect data that could confirm or confute their statements. What she presents is therefore a partial picture of women’s experience. Her account would have been more complete if she had reported her observations of a hospital birth or a routine gynecological examination.

Many of the women that Martin interviewed used the dominant ideology’s terms to characterize their own bodily processes, but working-class women seemed to avoid them. Martin tries to explain working-class women’s apparent inability to use medical terminology in terms favorable to them. As a neo­Marxist, she is determined to find greater capacity for resistance in the working class.

She is so eager to confirm her presupposition that she broad jumps to conclusions: “These women have simply been more able to resist one aspect of the hegemonic scientific view of women’s bodies because it is not meaningful to them or because it is downright offensive, phrased as it is in the negative terms we have seen working-class women, perhaps because they have less to gain from productive labor in the society, have rejected the application of models of production to their bodies.”

Just because working-class women cannot or will not use these terms to describe their bodily processes, this does not mean that they have rejected them in the deliberate way Martin implies. Many other interpretations are possible: the women may be ashamed or uninformed, for example.

Political Economy of Birth

In her discussion of hospital birth procedures, Martin points out that women who go in too early may be pressured into a cesarean if they don’t “perform” according to rigid medical criteria. Curiously, though, she doesn’t fully analyze the reasons for the medical specification of “stages” of labor. Nor does she provide an economic explanation for the relatively frequent incidence of cesareans in U.S. hospitals.

Why do doctors want labor to be quick? Why do hospitals encourage cesareans? Martin notes that “the corporation may be becoming the new manager who uses standards of performance (such as the number of patients treated per hour or the number of uses to which machines are put) to control the doctors’ own labor.”

Where do these “standards of performance” come from? Martin’s interpretation makes it seem as if doctors, nurses and hospital administrators get women to have cesareans because of their attachment to certain ideals of order and hierarchy, when the immediate reasons may be related to malpractice liability and cost efficiency. Surely a neo-Marxist could give a fuller explanation of the political economy of hospital birth.

Women’s own accounts of their hospital experiences provide rich, sometimes funny examples of resistance. To avoid cesareans, women in labor have deliberately postponed arriving at the hospital until five or ten minutes before giving birth, taken showers or wandered hospital corridors for hours. The lesson is clear: Arrive seventeen hours early, and there’s a good chance that they’ll put you on your back, strap you down, hook you to a machine and cut you open. The women Martin quotes want to go through the process of childbirth.

I wondered, though, if some women still want to avoid the pain and wake up with a baby beside them. Once upon a time, women regarded anesthesia as the great liberator. This book certainly does not represent that view. Instead, Martin compares the sense of fragmentation women feel after an epidural with severely disturbed neurotics’ detachment from their bodies. Giving birth, she says, is “the only form of truly unalienated labor now available to us.”

Martin wants to replace fragmentation with wholeness. In one chapter, she describes “alternative birth imagery” coming from women’s groups.

Unfortunately, some of these “new” prescriptions prove to be as authoritarian as the old ones: “Contractions don’t have to hurt ….It is a miracle to be able to create more life force and there is no room for complaining,” says a mother of three at the Farm, a “spiritual community” in Tennessee.

A group in Kansas devoted to home birth based on allegedly “Christian” principles condemns birth attended by a midwife as “a homosexual experience” and demands that only husbands help with delivery.

Astonishingly, Martin withholds comment or criticism-as if any alternative ideology must be better than the production model under medical control-except, that is, for Michel Odent’s natural childbirth method.

Because Odent says women act instinctively at the moment of delivery, Martin takes him to task for resembling “those 19th-century writers who relegated produce blood and tissue to be sloughed off, that is wasteful or somehow sad. These characterizations have had serious consequences for women, medically, socially and psychologically women to the ‘natural’ realm of the domestic,” Considering that Martin also quotes Odent’s careful rejoinder to such charges, her criticisms of him seem overdrawn and unfair.

A Pioneering Work

At many other points, Martin’s eagerness to defend and promote her views weakens her arguments. Nevertheless, this book, like many other recent women’s studies texts, is pioneering, pro­ vocative and adventurous.

Martin boldly explores some difficult subjects, such as the biosocial dimensions of premenstrual syndrome (PMS) and menopause, whose implications continue to challenge feminists. Are these physical events “natural” disadvantages to women, or could they affect and be affected by social institutions and arrangements?

Her careful analysis of medical rhetoric is eye-opening. For example, she points out that even texts like Our Bodies, Ourselves follow the mechanistic medical model of menstruation, PMS and menopause, describing them in negative terms as breakdowns of normal processes. Though weakly argued, her discussions of PMS and menopause point the way for other researchers to build more sophisticated, complex models of the relation between physiological phenomena and socially conditioned responses to them.

Martin’s examination of the industrial organization of time and its effects on women follows a fruitful line of feminist thought. If women’s cycles do defy the industrialized organization of time and society, then attempts to change this kind of organization (instead of the cycles) will have profound consequences for us all.

January-April 1988, ATC 12-13