Plate from Ashton’s Essentials of Obstetrics (1896). via the Medical Heritage Library.

One of the greatest pleasures of working in the library and archives world is the opportunity to engage every day with the researchers who come through the doors of our institutions. From a wide range of backgrounds, each researcher challenges we library staff to think in new ways about our collections and the scholarship those materials inform.

I had the opportunity last Thursday, one of the first warm days Boston has seen this spring, to cross the Fens and pay a visit to one of the BSS partner institutions, Countway Library, where their 2014-2015 Archives for Women in Medicine fellow Rebecca Kluchin was giving a talk on her work at Countway’s Center for the History of Medicine. Kluchin’s presentation, “Pregnancy and Personhood: The Maternal-Fetal Relationship in America, 1850-Present,” provided an overview of her research and gives us insight into the questions that lead historians into the archive in search of evidence to document change over time.

In May, our seminar participants will be preparing for their three weeks in Boston by reading, among other things, a selection from historian-activist Alice Dreger’s latest book Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science (Penguin, 2015) that challenges us to think about the importance of evidence-based activism — and the role historians can play in marshaling evidence in support of social change. Rebecca Kluchin’s work is one such example of the way in which historical research can provide clarifying context for present-day moral challenges.

Kluchin introduced her work with the story of Angela Carter, a pregnant woman diagnosed with terminal cancer in 1987. When Carter’s death was imminent the family was prepared to allow mother and fetus die together — but Carter’s doctors sought legal intervention on behalf of the fetus and performed a c-section without Carter or her family’s consent in an effort to “rescue” the fetus. Unable to survive outside the womb, the infant died within two hours and her mother died shortly after due to the cancer and the physical stress of the surgery. “The hospital saw two patients in Carter,” Kluchin observed, and acted against contemporary case law (under which Americans retain the right to refuse medical intervention even at the cost of human life) on behalf of the “fetal patient” while ignoring the rights, wishes, and well-being of their second patient, Angela Carter.

Kluchin first read of this case while pregnant with her own daughter, and was haunted by its implications. With a background in the history of obstetric care (her first book examined forced sterilization), she set out to discover the history of “maternal-fetal conflict” in law, culture, and medicine. What she learned is that public debates about “women’s responsibilities toward their pregnancy,” rather than being a product of twentieth-century abortion politics, stretch back into at least the mid-nineteenth century.

At CHoM she has (among other sources) been reading the papers of Horatio Robinson Storer (1830-1922), an early anti-abortion activist, whose papers contain correspondence on the status of legal abortion nationwide. She credits Storer’s letterbooks with “forcing [her] to look at language,” as legal, medical, and lay terminology for pregnancy shifts over time and varies by region. By exploring medical textbooks, research files, public health literature, popular magazines, private correspondence, and hate mail, Kluchin is exploring how doctors talked to doctors, doctors spoke to their patients, and how women spoke among themselves, about the relationship between pregnant individual and developing fetus.

While the first legal claim on behalf of a fetus, as distinct from the pregnant woman, was made in Northampton, Massachusetts in 1884, it was not until the 1940s that the courts began accepting such arguments. Kluchin argues that mid-twentieth century scientific study of human fetal remains, partnered with public interest in science and the increased visibility of life inside the womb (often, ironically, depicted through the imaging of preserved fetal remains), encouraged Americans to perceive the fetus as distinct from the (visually absent) pregnant person within whose body the fetus was contained.

As the twentieth century progressed pregnant women were increasingly depicted as a source of threat to fetal health. Despite a 1990 appellate court ruling that affirmed (post facto) Angela Carter’s right to refuse surgery, pregnant Americans face continued — even increasing — cultural and legal scrutiny, as the recent sentencing of Purvi Patel in Indiana vividly illustrates.

During the question and answer period following Kluchin’s presentation, audience members asked about the role of midwives in nineteenth century debates about fetal status, how the story of forced sterilization maps onto the debate over the maternal-fetal relationship, and the place of religion in pre-1970s discussions of pregnancy and abortion. As Kluchin observed, “women’s reproduction is still very much up for debate” in the public sphere in the twenty-first century, as it in the nineteenth, even if the terms of debate — scientific, moral, and political — shift over time.

The history of science and medicine is a growing field, and one in which scholars interested in questions of sexuality and gender are — as Rebecca Kluchin pointed out — often underfunded and overlooked, yet critical to a full exploration of medical politics and ethics. I encourage our research teams, 2015 and beyond, to consider how the medical and scientific history collections at our partner institutions might inform their own social justice concerns.

– Anna Clutterbuck-Cook