Our Bodies, Ourselves, page 1
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“The best women’s health reference book I’ve ever seen.”
—Julianne Moore
“This flawlessly updated edition does justice to the legacy of Our Bodies, Ourselves, which has been synonymous with women’s empowerment for the past forty years. Incredibly detailed, empowering, and enriched by the extremely diverse opinions and positions of its collaborators, this should be on the bookshelves of women young and old worldwide!”
—Nancy Redd, author of Body Drama and Diet Drama
“The new edition of Our Bodies, Ourselves offers a relatable voice to help make the very confusing reality of health and sexuality as a girl easier to navigate. In a world that doesn’t always offer girls such honesty, the new edition of OBOS makes me optimistic about the awareness and attitude of this generation of women and girls. My brain was fist pumping the whole way through.”
—Tavi Gevinson, thestylerookie.com and editor in chief of Rookie magazine
“This revamped edition of Our Bodies, Ourselves shows just how far we’ve come in the women’s health movement. The level of inclusiveness of my community—those of us who are queer, trans, or gender nonconforming—is remarkable. If this had been the edition that my mom gave me as a preteen, my life and coming-of-age would have been so different and much less confusing. It also artfully lays out the reality of women’s health as a political issue—one that goes way beyond simply understanding how our bodies work. The fortieth-anniversary edition proves that education is a radical act and that sharing our struggles, triumphs, and stories can ultimately change the world.”
—Miriam Zoila Pérez, editor, Feministing.com; founder, Radicaldoula.com; and recipient of the Barbara Seaman Award for Activism in Women’s Health
“OBOS is the most important resource on women’s health ever written by and for women. It teaches every woman how to take charge of her own body and helps us all become well-informed health care consumers.”
—Loretta Ross, founder and the National Coordinator of the SisterSong Women of Color Reproductive Health Collective
“This is truly the bible on women’s health! It has been completely revised and updated for a new generation of women who will need its guidance more than ever as they attempt to take control of their health.”
—Susan Love, M.D., author of Dr. Susan Love’s Breast Book and Dr. Susan Love’s Menopause and Hormone Book and coauthor of Live a Little!
“If only every little girl were born with a copy of Our Bodies, Ourselves in her hands, we would raise a society filled with healthy, confident women. And if women could have only one book on their shelves, let it be this classic tome filled to the brim with practical and empowering information.”
—Toni Weschler, M.P.H., author of Taking Charge of Your Fertility
OTHER MAJOR BOOKS BY MEMBERS OF THE BOSTON WOMEN’S HEALTH BOOK COLLECTIVE
Our Bodies, Ourselves: Menopause
Our Bodies, Ourselves: Pregnancy and Birth
Changing Bodies, Changing Lives
Ourselves and Our Children
The New Ourselves, Growing Older
CLINIC DISCOUNT: OUR BODIES, OURSELVES is available to clinics and other groups providing health-counseling services at 70 percent off the cover price plus shipping. Orders must be for twelve or more copies with payment (check or major credit card) and a document verifying health service status and your IRS license number for tax exemption. The document must be a copy of a statement filed with a state or federal agency indicating health services or health education as a primary purpose of your group. To place your order and/or for details, contact Simon & Schuster Special Sales at 1-866-506-1949 or business@simonandschuster.com.
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This publication contains the opinions and ideas of its author. It is intended to provide helpful and informative material on the subjects addressed in the publication. It is sold with the understanding that the author and publisher are not engaged in rendering medical, health, or any other kind of personal professional services in the book. Readers should consult their medical, health, or other competent professional before making medical decisions.
The author and publisher specifically disclaim all responsibility for any liability, loss, or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this book.
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Library of Congress Cataloging-in-Publication Data
Our bodies, ourselves/The Boston Women’s Health Book Collective.—40th anniversary ed.
p. cm.
“A Touchstone book.”
Includes bibliographical references and index.
1. Women—Health and hygiene. 2. Women—Diseases. 3. Women—Psychology.
I. Boston Women’s Health Book Collective.
RA778.N49 2011
613'04244—dc23 2011022749
ISBN 978-1-4391-9066-1
ISBN 978-1-4391-8734-0 (ebook)
eISBN 978-1-4391-9665-6
In loving memory of our close colleagues and women’s health advocates Esther Rome, Pamela Morgan, Helen Rodriguez-Trias, Mary Howell, Jose Barzelatto, Allan Rosenfield, Rachel Fruchter, Barbara Seaman, Rita Arditti, Pat Cody, and Rosetta Reitz
ACKNOWLEDGMENTS
Producing a book of this size and scope is an enormous undertaking, one that would not be possible without the help and support of many people. We have been fortunate not only to have received input from more than three hundred contributors but also to have worked with some of the most insightful and dedicated women and men involved in the fields of women’s health, reproductive justice, and social activism. This ninth edition of Our Bodies, Ourselves reflects the great magnitude of their efforts.
Contributors include nationally recognized experts and women of all ages and backgrounds who shared their stories and reviewed, revised, and rewrote each chapter. We are enormously grateful to all of them for donating their expertise and wisdom, and for collaborating to provide the most accurate, up-to-date, and reliable information about women’s reproductive health and sexuality. The contributors are listed individually by chapter in the authorship and acknowledgments section, starting on page 869; short biographical statements begin on page 877.
Special mention is due to Susan Blank, Joan Ditzion, Marjorie Greenfield, Mara Kardas-Nelson, Heidi Moore, Lin Nelson, Marcie Richardson, Gary Richwald, Ellen Shaffer, Jocelyn Sims, Evelina Sterling, Kirsten Thompson, and Susan Yanow—each of whom took on the lion’s share of writing and revising at least one chapter and participated in many rounds of discussion and editing.
The women who served alongside us on the Our Bodies, Ourselves editorial team are an invincible group. BWHBC founder Wendy Sanford dedicated the better part of the past eighteen months to this project, shepherding multiple chapters from the earliest stages of reaching out to contributors to writing and shaping final drafts. We are most grateful for her patience and nuance with words. OBOS Executive Director Judy Norsigian and nurse-midwife Amy Romano also oversaw numerous chapters, improving each one with great insight and hands-on knowledge. Ayesha Chatterjee, assistant program manager for the OBOS Global Initiative, worked passionately to include the stories and perspectives of women’s groups around the world who have adapted Our Bodies, Ourselves into their own languages and for their own cultures. As anyone who has worked on a large project knows, success rests on the details, and so we are indebted to June Tsang, OBOS program assistant, for her careful attention to every task, including integrating edits and organizing graphics, permissions, and contributors’ bios.
The entire editorial team has been inspired by and feels deep gratitude for the extraordinary involvement of those who have contributed over the years to Our Bodies, Ourselves. Particular recognition is due the founders of the Boston Women’s Health Book Collective as well as to the organization’s staff, volunteer board members, and interns, all of whom are listed on pages 873–74. Their early and ongoing efforts and passion have made a true difference in women’s lives.
Kiki Zeldes, Senior Editor
Christine Cupaiuolo, Managing Editor
CONTENTS
Introduction
Part 1: Bodies and Identities
Chapter 1: Our Female Bodies: Sexual Anatomy, Reproduction, and the Menstrual Cycle
Chapter 2: Intro to Sexual Health
Chapter 3: Body Image
Chapter 4: Gender Identity and Sexual Orientation
Part 2: Relationships and sexualit
Chapter 5: Relationships
Chapter 6: Social Influences on Sexuality
Chapter 7: Sexual Pleasure and Enthusiastic Consent
Chapter 8: Sexual Challenges
Part 3: Sexual Health and Reproductive Choices
Chapter 9: Birth Control
Chapter 10: Safer Sex
Chapter 11: Sexually Transmitted Infections
Chapter 12: Unexpected Pregnancy
Chapter 13: Abortion
Part 4: Childbearing
Chapter 14: Considering Parenting
Chapter 15: Pregnancy and Preparing for Birth
Chapter 16: Labor and Birth
Chapter 17: The Early Months of Parenting
Chapter 18: Miscarriage, Stillbirth, and Other Losses
Chapter 19: Infertility and Assisted Reproductive Technologies
Part 5: Postreproductive Years
Chapter 20: Perimenopause and Menopause
Chapter 21: Our Later years
Part 6: Medical Problems and Navigating the Health Care System
Chapter 22: Selected Medical Problems
Chapter 23: Navigating the Health Care System
Part 7: Major Forces Affecting Women’s Sexuality and Reproductive Health 689
Chapter 24: Violence Against Women
Chapter 25: Environmental and Occupational Health
Chapter 26: The Politics of Women’s Health
Chapter 27: Activism in the Twenty-first Century
Recommended Resources
Notes
Authorship
About the Contributors
Index
INTRODUCTION
We are delighted to present Our Bodies, Ourselves—an in-depth look at women’s sexuality and reproductive health, from the first gynecological exam to sexual health in our later years.
Since its first newsprint edition published in the early 1970s, Our Bodies, Ourselves (OBOS) has enabled women to learn about their bodies, gain insight from the experiences of other women, and consider how best to achieve political and cultural changes that would improve women’s lives. This completely revised and updated ninth edition, released on OBOS’s fortieth anniversary, covers topics ranging from sexual anatomy, body image, and gender identity to pregnancy and birth, perimenopause/menopause, and navigating the health-care system.
This edition reflects the perspective and voices of a wide range of women, and their stories are told through new formats. At our invitation, more than three dozen women of all ages and identities participated in a monthlong online conversation about sexuality and relationships; we found their honesty and forthrightness so compelling that the conversation itself became the foundation of a new “Relationships” chapter.
Other new voices include women’s organizations around the world that have created their own resources adapted from Our Bodies, Ourselves. Throughout the book, you will meet members of the Our Bodies Ourselves Global Network and read about their work on issues such as abortion, infertility, HIV education and prevention, and social activism. From distributing posters via canoes in rural Nigeria to setting up interactive websites in Israel and Turkey and reshaping health policy in Nepal and Armenia, their efforts exemplify movement building and the power of voices raised in action.
This edition focuses on the core health issues—reproductive health and sexuality—that first brought the Boston Women’s Health Book Collective together. Some topics added over the years—such as nutrition, emotional health, and medical conditions that disproportionately or differently affect women—have been omitted this time, in part because information is now more readily available elsewhere. This has given us room to expand on issues such as reproductive rights, violence against women, and environmental health, which not only are centrally related to women’s sexual health and well-being but also are areas where, despite decades of advocacy and activism, women still face enormous challenges and obstacles that prevent them from leading safe and healthy lives.
Our Bodies, Ourselves is both a text dedicated to factual information grounded in the best available evidence and a resource about health-care inequities and the work of those dedicated to ending social injustices. The many contributors to this book did not always agree on how to analyze the social, economic, and political forces that affect women’s health or how to characterize a medical controversy. When a conclusion remains uncertain, we have shared their questions and concerns so readers can make their own decisions in the absence of the kind of evidence we ultimately hope will be available. Our website (ourbodiesourselves.org) contains additional content, references, and useful links on women’s health topics not covered in this book.
* * *
OUR BODIES OURSELVES GLOBAL INITIATIVE
Ever since Our Bodies, Ourselves became a best seller in the United States, it has inspired women in other countries to adapt it—in part or as a whole—to their unique cultural needs. Through the our Bodies ourselves Global Initiative, we support more than twenty-two women’s organizations as they develop materials based on Our Bodies, Ourselves and use their resources in wide-scale outreach to advance the health and human rights of women and girls in their countries. Although the earliest projects were located primarily in Europe, we have since collaborated with organizations across Africa, South and Southeast Asia, the Middle East, Latin America, and Europe to bring culturally meaningful and reliable information to communities where it is most needed. As a result of our partnerships, resources based on the book are now available in more than twenty-five languages and in print, digital, and other socially interactive formats. You will read about our partners in the “In Translation” sidebars and we invite you to visit ourbodiesourselves.org/programs/network to learn more.
* * *
As always, we recognize how the personal is often political and thus underscore when individual solutions are not possible or not lasting. Throughout the book, women who have joined with others to bring about change share their stories. The combination of practical information with political critique and women’s lived experiences has long been the hallmark of Our Bodies, Ourselves and is one of the reasons the book has remained one of the most enduring legacies of the women’s movements that grew out of the late 1960s and early 1970s.
Much has changed in the United States since the first edition, when abortion was illegal, birth control was not widely available, and the few available texts on women’s health and sexuality—almost all written by men—discounted women’s experiences and perspectives. Today, information is abundant, but it is still difficult to find reliable information that encompasses the diversity of women’s experiences and teases apart the conflicts of interest inherent in many issues that affect women’s health. Far too often, corporate and pharmaceutical interests influence medical research, information, and care, and contribute to the unnecessary medicalization of women’s bodies and lives. This not only wastes money and poses avoidable risks but also can discourage women from questioning the assumptions underlying the care they receive and from valuing and sharing their own insights and experiences. The need for a book like Our Bodies, Ourselves remains as strong as ever.
Changing the medical system, organizing for better care, and altering the larger social, political, and economic forces that limit women’s lives require creative and concerted efforts over a long period of time. We believe that enhancing reproductive health and sexual pleasure can play a significant positive role in all our lives and strengthen us as we work toward sustaining a vision of a world that will better nurture all women, men, and children. We encourage you to explore this book with curiosity and vision.
OBOS Editorial Team: Kiki Zeldes, Christine Cupaiuolo, Wendy Sanford, Judy Norsigian, Amy Romano, June Tsang, and Ayesha Chatterjee Spring 2011
Bodies and Identities
CHAPTER 1 Our Female Bodies: Sexual Anatomy, Reproduction, and the Menstrual Cycle
Learning about our sexual anatomy and observing and exploring our bodies are good ways to become more comfortable with ourselves and our sexuality. These are also good ways to learn what is normal for each of us and to become aware of changes and potential problems. Understanding the way our sexual and reproductive systems work, how they interact with other body functions, and how they are influenced by our lifestyle, environment, and general well-being can help us enhance sexual pleasure, reduce the risk of some health problems, and make informed reproductive decisions.
