Date of Exhibition: Spring 2022- Present
Curators: Sritama Chatterjee, Kirsten Crowhurst, Paula Orozco Espinel, Jessica Frankeberger, Alison Mahoney, Maria Ryabove, Nelesi Rodriguez Trujillo. All of the curators were enrolled in GSWS 2240: Reproduction, Fall 2021, taught by Dr. Rachel Kranson
Location: Archives & Special Collections exhibit gallery, 3rd floor Hillman Library, University of Pittsburgh 3960 Forbes Avenue Pittsburgh, PA 15260
Description: Few areas of medicine have been as politicized and controversial as the care surrounding reproduction, contraception, abortion, and sexual health. The Archives & Special Collections at the University of Pittsburgh Library System preserve a rich array of records showing how advocates for reproductive care articulated and justified the need for these services. As a whole, these materials illustrate the many ways in which discussions of reproductive health care have intersected with issues including race, class, ability, pleasure, and national identity. By showcasing some of these documents and publications, this exhibition trace public conversations over reproductive health as they played out locally, nationally, and transnationally over the course of the twentieth century.
All materials on display come from the Planned Parenthood Center of Pittsburgh Records, 1923-1980 (bulk 1930-1949, 1974-1980) AIS.1987.05.
Curators have written essays (published here in the following tabs) providing further analysis of the questions presented by this exhibit’s curators.
Decades before the 1960s sexual liberations movements, women’s erotic pleasure had already become a valid topic for discussion in medical settings. In the 1930s, Lena Levine, M.D., wrote and published this booklet offering premarital sexual advice to brides, highlighting the importance of sexual pleasure for a happy marital life. This was one of several similar publications prepared by doctors and organizations across the country. Dr. Levine recognized that “procreation can and often does occur without orgasm in the female,” but at the same time, she asserted that “marital happiness cannot under such circumstances exist.” (p. 7)
This pamphlet drew on the language of rights when discussing married women’s orgasms. It encouraged women to insist on sexual satisfaction early in the marriage so as to establish positive habits right from the start. Dr. Levine enjoined wives take responsibility for guiding their husbands as to the kind of caresses and stimulus they required to reach climax. Thus, she invited women to overcome their shyness and be communicative with their partners.
This booklet’s emphasis on female pleasure and women’s active role in guiding their husbands should not be mistaken as a feminist assertion. Dr. Levine continued to stress the importance of conservative gender roles. For instance, she portrayed the husband as “the aggressor, the initiator, the hunter,” while the wife is understood as the one to be wooed.
Moreover, she portrayed female pleasure as something that should occur mostly, if not exclusively, vaginally and always on the traditional marriage bed:
In the beginning it is likely that the young husband’s control will be imperfect and that he will have his orgasm without being able to wait for his wife, who, as has been shown, is slower. When this is the case he can and should bring her to orgasm by further manual stimulation of the clitoris. This method is desirable in the earliest stages of marriage [...]. It is definitely not to be accepted as a permanent procedure.” (p. 11)
However, a striking irony is that by legitimizing the erotic expression and physical pleasure of women, publications like the one presented here laid the groundwork and began to articulate the vocabulary of the sexual revolutions of the 1960s and 1970s.
After the passage of Roe v. Wade in January of 1973, reproductive health centers across the United States began to offer early abortion services. The ratification of abortion as a reproductive right led many organizations to expand their mission and programs. In that process, they often felt uncertain about how clients and the wider public would receive their changes. The 1974 Department Heads Meeting Minutes from Pittsburgh Planned Parenthood included in this exhibit captures some of these reservations and anxieties: Will there be a market for this service? Can we continue to employ staff if the demand is not there? How will we fund this service? This document gives us a glimpse into the questions, concerns, and even biases that reproductive health providers grappled with as they embraced abortion as a logical extension of contraceptive services and a part of reproductive rights.
Notably, the word “abortion” is nowhere to be found in the minutes. They use the phrase “menstrual induction” to refer to this aspect of reproductive care. The alternative term shifted the focus away from the fetus and instead emphasized the end goal of this method––to resume menstruation. They believed that the term “menstrual induction” would help ease the anxieties of people who did not want a pregnancy but felt conflicted about abortion. Providers used other terms for early abortions during the 1970s, including “menstrual regulation,” “menstrual extraction,” and “endometrial aspiration” (Goldsmith 121). In time, all of these phased out as reproductive health providers and activists upheld “abortion” for clarity and pride.
Recent challenges to Roe v. Wade have renewed attention to the potential of ambiguous language to help protect reproductive rights in the United States. Similar to how providers used the term “menstrual induction” in the 1970s, the “missed period pill,” also known as “medical menstrual regulation method,” refers to “medications such as mifepristone and misoprostol that are widely used for elective abortion but can also be used to induce a period, thereby ensuring the person is not pregnant” (Seldon and Winikoff). The “missed period pill” has been a popular and safe abortion method in countries where abortion is criminalized. Increasingly, people in the United States have sought access to these pills from providers in and outside the country. Aid Access and Plan C are two organizations that have made news headlines as more people in the United States has opted for tele-abortion or ordering abortion pills by mail.
Although an imperfect solution, just like “menstrual induction” was at its time, referring to a medical abortion as a “missed period pill” – and focusing on menstruation rather than the fetus – could prove strategic in the present. Reproductive health advocates explain that centering the alternative uses of mifepristone and misoprostol (the elements of the “missed period pill”) could help the cause of making them more widely available in the United States and therefore guaranteeing access to safe abortions. This rhetoric might also help mitigate abortion stigma and its sustained influence on people’s reproductive choices.
Broad public support for family planning and reproductive health services, juxtaposed with a decline in federal funding, necessitated a new approach to fundraising. While public support for family planning was at an all-time high (84%) in 1980, the political landscape saw the emergence of an organized anti-abortion movement and fiscal conservatism under President Ronald Reagan. Federal policy changes to Title X (the Public Health Service Act), the main contributor for family planning funding, resulted in an 18% reduction of funding for maternal and child health within the first two years of the implementation of a new type of granting system. Instead of ear-marking federal dollars for family planning funding and providing incentives to fund family planning programs, the Reagan administration shifted to block grants, providing large sums for public health to the states, allowing states to determine how to distribute the funds for public health. The block grants decentralized funding, leading some states to spend zero dollars on family planning.
In Western Pennsylvania and across the U.S., these changes prompted a shift in the Planned Parenthood business model. In the past, a majority of funding came from federal dollars to support family planning and women’s health while donations came from a membership model and relied on contributions from their Board Members. Planned Parenthood now relied on individual donors, corporations, and foundations to meet the ever-growing need for family planning and reproductive health services and to survive in an increasingly hostile landscape for social services.
Public-facing events became a way to not only raise money, but also increase awareness of the services that Planned Parenthood of Western Pennsylvania provided. Drawing in signature guests like Jacques Pepin, increased the reach and audience of the events. While the $15,000 they raised may seem like a drop in the bucket, that amount is equivalent to almost $51,000 in today’s dollars.
Beginning in the early 1970s, the national deinstitutionalization movement advocated for the closure of public institutions that housed intellectually, psychiatrically, and developmentally disabled adults, often in horrifically abusive conditions. Journalistic exposés of bleak conditions in public institutions like Willowbrook in Staten Island, New York and, locally, the Polk State School and Pennsylvania Training School for for Feeble-Minded Children (later called the Elwyn Institute), eventually led to mass public outcry for closure and reform with regard to how the United States provided for its disabled citizens. With the closure of public institutions came a new wave of community-based care, often in the form of group homes for those with intellectual and/or developmental disabilities.
The opening of group homes in established communities often drew criticism from community members concerned that formerly institutionalized adults would be a social menace. Because this part of the population had been segregated from mainstream society for nearly a century, advocates for community care had to dispel stereotypes that disabled adults were likely to engage in criminal behavior. These stereotypes often framed formerly institutionalized people as uncontrollably and dangerously sexual. This document from the East Liberty Family Planning Center notes their rationale for providing sex education classes to disabled adults, reflecting attitudes common at the time: “The incidences of community unrest and apprehension…, relative to the influx of atypical individuals in supervised living arrangements, are well known. Evidence points to a particular fear as a major factor in this unrest: that these individuals were unable to deal in a socially acceptable way with their sexual feelings.”
“Normalization” (later called Social Role Valorization, or SRV) programs worked to allay these community fears. The sexual education programs offered in Pittsburgh by Planned Parenthood and the East Liberty Family Planning Center likely used SRV techniques in their curriculum. These practices worked to teach formerly institutionalized adults and children the skills they would need to participate in mainstream society, including job skills, social skills, and sex education. Although widespread SRV enabled the closure of abusive institutions, many participants and scholars of the technique have critiqued it for reinforcing normative heterosexuality and treating those with disabilities as innocent or childlike.
While SRV was an important element in convincing federal and local governments of deinstitutionalization’s social viability, its harmful legacy still heavily influences special education practices, including in the realm of sex education, today.
The meeting of Gandhi and Sanger took place within a broader conversation around ‘over population’ in ‘third-world countries’ that the US and other imperialist powers had long crafted and perpetuated in order to maintain domination. A 1941 report published by the Milbank Memorial Fund articulated this line of reasoning plainly:
such a situation [poverty and overpopulation] would adversely affect the immediate economic interests of this country and of other western powers that are heavily dependent on the specialized products of these regions, and that the resulting catastrophes would grossly offend the humanitarian sensibilities of our people and the world. (155-158)
Population control became a way to influence the reproductive politics of the global south through the promise of greater economic stability, though the goal was explicitly guided by imperialist ambitions.
In December 1935, when Sanger visited India, her main mission was to convince Mahatma Gandhi to implement birth control for women – especially women living in poverty – to secure the future of the Indian nation. Sanger made this argument when the anti-colonial movement to secure India’s freedom was at its peak. Gandhi’s response was that instead of birth control, people should be able to control their desires to have sex and procreate, thereby assigning a moral value to having sex rather than as something that can be enjoyed for pleasure. However, a number of leaders within the Indian National Movement, including Jawaharlal Nehru, the first prime minister of India, Sarojini Naidu, and Vijaylakshmi Pandit, who also visited Pittsburgh in 1945 to deliver a lecture on “Public Health in India,” supported Sanger’s proposal. They were trying to carve a model of feminist nationalism within the freedom movement through the image of “Mother India”. Controlling the reproductive bodies of cis-women was at the heart of constructing a nationalist imaginary of progress, modernization, and development.
The legacies of Sanger’s visit to India continued to live on in the population control measures adopted in the 1970s when parliament-member Sanjay Gandhi introduced forced sterilization (Nakshbandhi) as public policy. This practice, which targeted those who lived in the slums and the disabled community, had enormous political repercussions for the Indian nation-state. Considering these transnational linkages becomes important at a time when the reproductive labor and bodies of women in ‘third-world nations’ such as India continue to be racialized and used for transnational surrogacy, thereby feeding into the forces of racial capitalism.
The 1977 annual report of the “The Caring Place,” a Pittsburgh-based Teen Clinic, provides insight into the public debate and growing attention to adolescent sexual and reproductive health concerns of the 1960’s-1980’s. The 1960s saw widespread public support for sex education in schools, but this education promoted abstinence until marriage. By the sexual revolution of the 1970s, access to reproductive care and family planning had increased for adults along with the legalization of abortion and access to oral contraception (the pill). Nevertheless, schools offered limited comprehensive sexual and reproductive education and, as reflected in this 1977 report, adolescents and young adults often lacked a basic understanding of such topics.
Above all, the report emphasized the importance of providing age-appropriate and comfortable spaces for adolescents to receive sexual and reproductive health services and education. Unlike annual reports of medical or public health programs often found today, this 1977 report focused little on specific activities or improvements needed by the Teen Clinic, but rather spent significant space calling attention to the need for such programs for adolescents and young adults in the first place. Highlighting public concern over increasing teenage pregnancy rates and the proportion of abortions sought by minors, the report aimed to garner support for adolescent sexual and reproductive health programming and expand healthcare services for this population.
The Teen Clinic’s annual report highlighted the rampant misconceptions regarding sexual and reproductive health that were widely accepted as fact by adolescents of the era. With limited formal sex education, adolescents often relied on “street talk – uniformed peers or other questionable sources” for information on sex, reproduction, and sexuality. The Teen Clinic and similar programs attempted to provide formal, accurate, and comprehensive outreach and services for the population to allow teens to “make a responsible decision about their sexual activities; for they will then have the necessary knowledge regarding attendant commitments, emotional involvements, and fertility management alternatives.” These programs were precursors to growing public debate in the 1980’s and continuing today regarding abstinence-only sex education versus comprehensive education for adolescents, and reflect today’s continuing concerns regarding health misinformation and its consequences.
“The people of this nation must be physically tough, mentally sound,
and morally strong. If we are not, we can leave our planes unbuild
and our battleships on paper. We shall not be able to use them.”
MD. Surgeon General of the United States.
The opening quotation of this pamphlet, published in 1941, immerses the reader in the military discourse of the World War II era, which in itself was deeply embedded in the American eugenics movement. Considering the shameful history of American eugenics, it is unfortunately not surprising that in 1941, reproductive health care services were often perceived as a tool to aid in the reproduction of able-bodied workers and soldiers. The goal of the population program promoted in this pamphlet aimed to persuade future parents "to have every child a well-born child." The pamphlet defined these “well-born” children as being physically tough, mentally sound, and morally strong. Writing from a nationalist perspective, the writers imagined that these children would build "our" planes, and fight in "our" battles.
Along with describing the traits of so-called “desirable” babies, the pamphlet also depicted “undesirable” babies as those with mental disabilities, criminal tendencies, and ill health. Steeped in eugenic thought, this pamphlet understood these babies to be the opposite of "well-born" children. Unlike the supposedly “well-born” children, the writers of this pamphlet presented the “undesirable” babies as an economic loss for the nation.
This pamphlet connected the reproduction of future citizens to the economy of the country, and the major persuasive point of the pamphlet was supported by a cost-benefit analysis: the cost of the population program they promoted vs "state expenditures for relief, medical and institutional care, and social inadequacies."