Women’s accounts of their own pregnancies and births were systematically dismissed as male doctors turned childbirth into a medical specialty in the 18th and 19th centuries. This project examines how that historical shift eroded women’s credibility and autonomy in healthcare—and why its effects persist today. Using the Huntington Library’s Longo Collection of early obstetrics and gynaecology materials, the researcher will trace three linked problems: how male medical knowledge was framed as superior to women’s lived expertise; how pregnancy and birth were redefined from normal life events into medical crises requiring intervention; and how these changes created structural biases that still leave women vulnerable to having their knowledge and decisions dismissed in clinical settings. This is fundamental historical research with no immediate practical application. However, by documenting the origins of epistemic injustice in women’s healthcare, the project could inform current efforts to reform maternity services, improve patient-clinician communication, and challenge lingering assumptions that undermine women’s authority over their own bodies.
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This project will use The Huntington’s Longo Collection, specifically its 18th and 19th-century materials, to examine how women’s credibility and autonomy were shaped during the professionalisation of obstetrics and gynaecology. I will focus on three broad and interrelated themes: (1) Expertise; (2) Pathologisation; and (3) Epistemic Injustice. First, I will consider how the construction of male medical knowledge as superior to women’s lived expertise served to influence understandings of women’s credibility within medical contexts. Oakley (1980) has argued that the professionalisation of obstetrics necessitated a wrongful devaluation of women’s expertise. In turn, she argues that the field of obstetrics is underpinned by disempowering gendered stereotypes (Oakley 1980). Second, I will consider how the reframing of childbirth from an ‘attended life event’ to a ‘medically managed crisis’ served to influence women's autonomy (Cahill 2000). Cahill (2000) notes that, in order to expand the scope of medicine, pregnancy and birth were redefined as pathological. Consequently, women continue to suffer from limited autonomy about decisions relating to their pregnancy (Cahill 2000). Finally, I will discuss my findings as relevant to epistemic injustice. An epistemic injustice takes place when someone is wronged in relation to their capacity to understand or contribute knowledge (Fricker 2007). Some scholars have argued that women are vulnerable to epistemic injustices in medical contexts. I suggest that the professionalisation of obstetrics and gynaecology contributed to the development of structural biases that underpin the epistemic injustices women face in some healthcare settings.
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