There is an organ that only part of the population has, a little more than half, “that is inextricably linked to our biological, social and political destiny,” according to the writer and midwife Leah Hazard, who has already written a memoir about her years of practice. of medicine in Scotland and hosts a popular podcast, What the Midwife Said.
Despite being at the center of many political battles, for reproductive rights and gender identity, it is also one of the least studied and least understood. Throughout history, in fact, the idea that the general population and the medical establishment in particular had of the uterus served as a barometer for all kinds of ideas regarding sexual politics and social hierarchy.
In the book The Uterus (Salamandra), Hazard traces a kind of biography of this key organ, which allows him to go through embarrassing episodes of the past, such as the experiments carried out by Dr. Marion J. Sims, considered one of the fathers of gynecology, with African-American slaves in the 1840s. It also addresses very current issues, such as reproductive violence, which goes far beyond childbirth, or the prevalence of endometriosis, alarmingly underdiagnosed. Hazard makes it clear that not all women have a uterus (her starting point is radically trans-inclusive) and that some men, and not just trans men, do.
What motivated you to write a biography of the womb?
In 2019, she wrote a memoir about my years as a midwife, Hard Pushed: A Midwife’s Story (Hutchinson). I knew I wanted to write about women's health in a broader sense, but it took me a while to find a new angle. When I realized that no one had written a non-academic book about the uterus, I couldn't believe it. It is an organ that should be celebrated and understood, but it is also the lens through which we view many important issues surrounding reproductive health. The womb is the place where politics, power, science and sex converge. Everyone has an opinion about what should or shouldn't happen there, but very few people understand how it works. I hope my book helps correct that.
Her work proves time and time again that the ideas of Medicine in each historical period are dominated by the ideological trends of each moment, and that this is especially evident in everything that has to do with women's bodies.
The medical establishment has long viewed women's bodies as mysterious and dangerous, and the uterus is at the center of that danger. Until relatively recently, any type of female behavior that deviated from social norms was attributed to the uterus. Hence the idea of female hysteria, which even now continues to contaminate many cultural attitudes towards women. The uterus is a complex organ that requires the same respect as the brain or the heart. It does not control us, but it is worthy of study and care.
What are the most common misperceptions now?
There are many, and about reproductive health in general. People don't understand the basic structure of the uterus itself, nor the active role it plays in conception. Nor how it affects and is affected by sexual health, how it also works and how it fails during pregnancy, nor how it changes with age. For too long, reproductive science has focused on a penis going in and a baby coming out. There is much more to our bodies than that.
The womb is also, for better and worse, a political battleground. When legislation is passed that harms women's reproductive health, it is often heard from the feminist camp: if you don't have a uterus, don't give your opinion.
I think that is a simplistic motto and not very useful. Not all women have a uterus and not all men are evil and ignorant enemies of reproductive rights. Any conversation on this topic should be inclusive and compassionate.
At several points in the book she talks to scientists who carry out studies on women's bodies and who lament how cornered and poorly funded they are. The study of menstrual fluids, for example. It is shocking how little effort is invested in this. Were you surprised?
I would say I found that imbalance of resources shocking, but not surprising. It is inexcusable that women's health is so grossly underfunded compared to other areas of medicine. But, again, medicine is only a mirror of society and research resources are a reflection of the values and interests of the people, almost always men, who make financial decisions.
It also gives a voice to many women who have seen their gynecologists ignore or gaslight their own symptoms. One of the founders of modern gynecology, Marion J. Sims, wrote that she hated the female anatomy.
All of these practices prevail in Europe. Reproductive violence exists all over the world and always has existed. People who need reproductive care often find such experiences depressing and traumatizing. Delayed care and ineffective treatments add to the trauma.
As a reaction to that, an anti-science movement has also emerged, which is very evident on Tik Tok, for example. There, many harmful theories and advice are spread in the name of feminine care outside the medical establishment.
TikTok is a complex place. On the one hand, there are many young people talking honestly about their sexual health on social networks and there are very good online doctors who give information tailored to huge audiences. However, the Internet also allows self-proclaimed experts to spread erroneous and dangerous information to users who do not know how to distinguish. And the algorithm rewards the most striking. I hope that users know how to discern the information they consume, but sometimes it is very difficult to know the difference between authority and quackery.
She writes about synthetic wombs and other technological advances. When they are reported in the media, the reaction is often one of a certain fear, it is given a dystopian nuance that is not perceived in other areas of medicine.
It is human and normal to be cautious about big changes, and it is okay to ask questions about advances in reproductive technology. They are tools with many ethical implications, but it is important to avoid being too sensational. When assisted reproduction techniques were implemented and that technology was accessible to the general public, there was also a lot of fear and anguish. Now most people see it as an acceptable way to build a family. Values and concerns change over time. I think it's okay to look to the future with a balance of skepticism and optimism.
