Healing Hands: A History of Women’s Work in Medicine

From early on in the history of women in medicine, women were relegated to the world of caregiving of their families as well as their communities. Women have played a significant role in their communities as doctors, nurses, midwives, patient advocates, and public health experts. However, only in the nineteenth century did women become licensed medical practitioners. It’s important to note that most healthcare, until recently, took place in the home, and was left to family, friends, and neighbors with some knowledge of healing practices. Family-centered sick care remained a widespread practice until the nineteenth century. For women, falling into the role of the medical practitioner at home was only natural, given stereotypical gender roles that tend to play out even today. It would be approximately one hundred years from the opening of the first hospital in America in 1751 that these institutions would gain public confidence and trust.

Concerning female criminality, psychologists point to many myths perpetrated around women serial killers in history, such as the reluctant sidekick or manipulated victim of a domineering male who is coerced into criminal acts out of the need for survival. There are appearance-based theories tied to the murderous vixen or the unappealing, revengeful outcast, the copycat criminal following in male footsteps, or a scorned man-hater out for revenge. None of this explains the mystique around these femmes fatales. What motivates them? How are they different than their male counterparts?


Caregiving Becomes a Steppingstone for Nursing

The history of women in nursing in the United States began by invitation during the Revolutionary War in 1775. Although tradition dictated that nurses in the military be male, General Horatio Gates requested that women be called upon to care for wounded soldiers. George Washington honored this request, asking Congress for female nurses and matrons to supervise them. Washington’s purpose was two-fold—he supported Gates’s idea, and he also wanted to relegate work to daughters and mothers of soldiers who, out of a lack of support at home, were forced to follow the army. Emerging from these ideas was the first military nursing system and the formation of hospitals. There were advantages to the arrangement. Women proved to be better at caring for the sick, and each nurse that was hired freed up a soldier to fight on the battlefield. The work was hard. To attract and keep talent, Congress raised their compensation several times, from $2 to $4 and eventually to $8 per month (in contrast, surgeons and apothecaries were paid $40 per month).

Most were likely inspired by the work of Florence Nightingale, often referred to as “the Lady with the Lamp,” who after extensive studies abroad, practiced nursing before returning to England to work at a hospital for “gentlewomen” in London. At the beginning of the Crimean War in 1854, Nightingale was asked to manage a group of nurses to treat wounded soldiers. She would continue to spread her medical practices through the establishment of an Army Medical College, her publications, and the Nightingale Training School. Inspired by her work, the International Committee of the Red Cross created the Florence Nightingale Medal, awarded every two years to excellent nurses. Since 1965, International Nurse Day has also been officially celebrated on her birthday.

Another one of the most famous nurses in the history of American medicine was Clara Barton, who was employed by the federal patent office in Washington D.C. when the Civil War broke out in 1861. During the war, she provided nursing care and supplies to soldiers, which earned her the nickname “Angel of the Battlefield.” When the war ended, President Lincoln supported her in opening the Office of Missing Soldiers to help connect more than 20,000 men with their families. But her work as a pioneer within the Red Cross movement is how she earned her fame. After a trip abroad, she founded the American Red Cross to protect war-wounded civilians in conflict zones. Her work and the work of other nurses also culminated in the Army Nurse Corps in 1901.

Black Nurses Clear High Professional Hurdles

Women of African descent were challenged to enter the world of medicine on two fronts: gender and race. Mary Eliza Mahoney, daughter of freed slaves, would receive her education at Phillips School in Boston, which became one of the first integrated schools in the country. She then spent time as a nurse’s aide and went on to apply her knowledge of medicine to graduate from the New England Hospital for Women and Children’s professional graduate school for nursing. In 1908, she became America’s first Black nurse. Later, Martha Minerva Franklin founded the National Association of Colored Graduate Nurses (NACGN) to support the welfare of Black nurses and break down racial discrimination.

Others have followed in breaking down barriers to the medical profession. Most notably, Hazel Winifred Johnson-Brown’s dreams of becoming a nurse culminated in an impressive career as a nurse and educator in the United States Army from 1955 to 1983. In 1979, she became the first Black female general in the United

States Army and the first Black female general of the United States Army Nurse Corps. She also served as Director of Walter Reed Army Institute of Nursing.

Medical School Acceptance Leads to Bigger Achievements

It wasn’t until 1849 that Elizabeth Blackwell, the first female doctor in American history, would earn her medical degree. Blackwell’s desire to practice medicine was borne from a series of life events. After her father’s death, she worked as a schoolteacher (one of the few occupations open to white, middle-class women). While caring for a sick friend, Blackwell was inspired to do more. Before her friend died, she shared her belief with Blackwell that she would have suffered less as a patient under the care of a female physician and encouraged Blackwell to use her talent and education to become a doctor. Upon careful consideration and advice from other physicians within her social circles, Blackwell applied to more than a dozen medical schools before being accepted by Geneva Medical College in upstate New York and is known as the first woman to become a doctor in the United States, followed by Mary Putnam Jacobi, Ann Preston, and two female contemporaries.

In the 1850s, Blackwell partnered with contemporaries Dr. Marie Zakrzewska, and Dr. Emily Blackwell, her younger sister, to establish the New York Infirmary for Indigent Women and Children, which is now New York-Presbyterian Lower Manhattan Hospital. Around the same time, the Women’s Medical College of Pennsylvania opened in 1850, the first of its kind, devoted to the medical education of women. The close of the nineteenth century saw the establishment of nineteen women’s medical colleges and nine women’s hospitals.

The history of women in healthcare, particularly as physicians, was initially clouded by skepticism. Harvard professor Edward H. Clarke, in 1874, presented some backlash to these efforts, declaring that somehow this educational activity was hazardous to women’s health, and by extension, the profession. It was reflective of prevailing attitudes at the time. Given the state of gender equality in the late nineteenth century, these early female doctors graduated after years of study to disapproval and discrimination, sometimes from their own families. Despite this backlash, by the end of the nineteenth century, more than 7,000 female physicians constituted 19% of American physicians.

Female Doctors: Advocates for Change

English physicians like Sophia Louisa Jex-Blake, who pushed for legislation permitting women to access the MD degree and licensing needed to practice medicine and surgery, encouraged more women to pursue medicine. American women like Kate Campbell Hurd-Mead, who, on the advice of Mary Putnam Jacobi, decided to follow in the footsteps of her father and pursue a career in medicine. She is credited for establishing the Evening Dispensary for Working Women and Girls in 1891 in Maryland, the first medical facility to hire female doctors in Baltimore. Hurd-Mead is well-known for her promotion of maternal hygiene and infant welfare and is an early historian of women’s contributions to medicine.

The gains of women doctors during the nineteenth century, though seemingly small by today’s standards, cannot be underestimated. In 1860, Rebecca Lee Crumpler, challenged prevailing attitudes toward “women’s work” and systemic prejudice against African Americans as a whole, as the first African American woman to earn a medical degree in the United States. Before she was admitted to the New England Female Medical College in 1860, Crumpler had worked as a nurse for eight years. After her graduation in 1864, she practiced medicine in Boston, then moved on to Richmond when the Civil war ended to work alongside other Black physicians caring for freed slaves, who would otherwise have no access to medical care.

The Future of Women in Medicine

Today, women continue to serve as trailblazers, advocates, and leaders in medicine like those who have gone before them, including Dr. Virginia Apgar, whose simple, rapid assessment for assessing the viability of newborns, called the Apgar Score, is standard practice in maternity wards today. Despite the accomplishments of Apgar and others, female physicians continue to struggle with gender discrimination in the form of glass ceilings, sexual harassment, and lack of maternity support. Still, things are looking up. According to the American Medical Association (AMA), women now make up 34.7% of physicians in America; however, half of the medical school admissions, and graduates, are women.

  • Malthusian, 1879-1921 (formerly Women and the Social Control of Their Bodies)

    Two turn-of-the-century periodicals are the focus of this collection: The Malthusian and Eugenics Review. The former was published by the Malthusian League, the world's first group promoting family planning, which operated from 1877 to 1927. Championing the ideas of Thomas Robert Malthus, members believed that overpopulation was the biggest cause of poverty. Per its statement of purpose, the league's objectives were “to agitate for the abolition of all penalties on the public discussion of the Population Question” and to spread “knowledge of the laws of population, of its consequences, and of its bearing upon human conduct and morals.” The league battled public disapproval but succeeded in affecting both public policy and the thinking of Sigmund Freud and Margaret Sanger, among others.

    This collection consists of the group's monthly journal, The Malthusian, from its first issue in 1879 through its last issue under that name, in 1921. Articles focused on poverty, overpopulation, demographics, laws, race, and birth control, often in relation to issues of the time. The publication offered detailed minutes of league meetings and meetings of doctors and policymakers where family planning was discussed. Serious in tone, The Malthusian was not written for the poor and working-class families for whom it advocated family planning. It offered no practical advice regarding birth control, nor did it discuss political or economic changes that might diminish poverty, such as socialism or trade union participation.

    Eugenics Review was a quarterly publication of the Eugenics Education Society. Eugenics is the belief that positive human traits are hereditary. Therefore, the genetic quality of the population could be improved by encouraging people with positive traits to reproduce and by discouraging those with negative traits from reproducing. Francis Galton, who coined the term “eugenics,” wrote the foreword to the Eugenics Review's first issue. The goals of the periodical were to acquaint members with each other, spread information about eugenics, and place eugenics on a scientific foundation. Topics included abortion, birth control, morality, divorce, crime, poverty, parenthood, legislation, and many other concepts relating to families. This collection contains all issues of Eugenics Review from its beginning in 1909 through 1921.

    The Malthusian and Eugenics Review will interest researchers studying the theoretical underpinnings of early groups promoting family planning and the day-to-day activities of such groups.


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  • Planned Parenthood Federation of America Records, 1918-1974

    This collection includes documents from the Planned Parenthood Federation of America, dating from its founding in the early part of the twentieth century to 1974. Today, Planned Parenthood is the nation's largest provider of reproductive health-care services.

    Meeting minutes, articles, speeches, and other media reflect the early history of the birth-control movement in the United States with files from the archives of several of Planned Parenthood's forerunners, including the American Birth Control League and the Birth Control Clinical Research Bureau. These two organizations merged in 1939 to form the Birth Control Federation of America, which in 1942 was renamed the Planned Parenthood Federation of America (PPFA). This organizational history is traced in detail in this collection. Legal materials—briefs, decisions, correspondence, memoranda, and reports—document the organization's efforts from 1931 to 1941 to educate the public and to legalize birth control. Meeting minutes, conference notes, and administrative files from 1943 to 1947 shed light on how the PPFA reorganized and adjusted its mission to meet the changing needs of Americans following the Second World War.

    Also included here are the PPFA's correspondence, mailings and subject files. These files depict the workings of the birth control movement in the 1930s and 1940s as the organization sought out the assistance of other agencies, many of which were reluctant to publicly collaborate. Materials include abstracted articles on maternal health from 1937 to 1947, as well as subject files on the organization's pursuit of more effective and affordable means of birth control. The correspondence files offer insight into the people behind the policies and how programs were established. Administrative records from the archives of a variety of related organizations, such as the National Committee on Material Health and the National Committee on Federal Legislation for Birth Control, reveal the inner workings of PPFA's collaborators and forerunners.

    The records in this collection provide unique insight into the founding of PPFA and how it competed and cooperated with other family-planning organizations, government agencies, corporate enterprises, and individuals throughout the twentieth century.


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  • Women and Health/Mental Health

    For the purposes of documenting women's history, or “herstory,” the Women's History Library was launched in 1968 with content submitted by women from across the United States. Primary sources such as press clips, journals, alternative newspapers, fliers, research papers, graphics, and poetry represent an array of perspectives. The library blossomed as interest in women's history gained traction, and it became a valuable chronicler of the key years from 1965 to 1974 in the U.S. women's liberation movement. Women and Health/Mental Health is one important collection from that library.

    The Women and Health/Mental Health collection features pamphlets, speeches, newsletters, reports, memos, conference papers, mainstream and alternative newspaper stories, and academic journal articles. A subset of the collection comprises special issues of mass periodicals that focus on topics relevant to women's health, including People (women's medicine, sterilization, Planned Parenthood, sex education), Harper's Bazaar (sexuality), and Psychology Today (sexuality, sex education).

    Together, these sources provide a comprehensive account of the liberation movement era's perspectives on women's health and illnesses. Topics include nutrition and dieting, sleep and insomnia, addiction, hygiene, and depression. Women's biology and life-cycle concerns are treated extensively, including puberty, menstruation, childbirth, breastfeeding, menopause, and aging and death. Some of the collection's resources are specific to black women and women from other parts of the world, including statistical and health information concerning sterilization, family planning, and health care.

    The largest focus of the Women and Health/Mental Health collection relates to abortion and birth control. Legal, financial, medical, and political aspects of the topics are taken into account in materials that address the establishment of abortion clinics and centers for women's health, and related protests. Information on birth control covers IUDs, male contraceptives, condoms, chastity, celibacy, and in particular the pill, which, because of its impact on the functions and risks of sex, was surrounded by fierce debates and protests.

    This collection offers unique insight into the evolution of thought and public discourse regarding women's bodies and health during a pivotal moment of social change in America.


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  • Australian and New Zealand Women's Organisations, 1835-2002

    Items have been selected from across the holdings of the State Library of New South Wales concerning women's organisation across Australia and New Zealand. The collection documents promoting the emigration of females to the Australian colonies; business and professional women's clubs; women's missionary work; religious councils; the Young Women's Christian Association; societies for women's and children's health; political groups and women's rights organizations.


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  • Hidden Treasures of the Mitchell Library: Sydney Periodicals, 1886-2016

    A selection of women's magazines from the Mitchell Library's large and unique collection of magazines published in Sydney since 1895. These publications provided a commentary on the many activities of domestic, social, cultural, and political life experienced by women.


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  • Historical Nursing Journals

    The Royal College of Nursing's collection of historical nursing journals is a fantastic resource for researchers, family historians and students from a huge range of disciplines. The historical nursing journals contain a wide range of information about hospitals, wards, staff, patients, illness and diseases, medicine and treatments, hospital equipment and events. As well as articles, letters and obituaries, the journals contain many photographs relating to all aspects of nursing and a wide variety of advertisements. The advertisements provide a rich source for the history of patent medicines, childcare products, uniforms and social and medical history.


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  • National Association of Colored Graduate Nurses Records, 1908-1951

    The National Association of Coloured Graduate Nurses (NACGN) was organized in 1908 by a group of fifty-two graduate nurses. Martha Franklin in Connecticut, a graduate of the school of nursing of the Woman's Hospital of Philadelphia, spearheaded the development of the organization. The goals of the new organization were to achieve higher professional standards, to break down discriminatory practices facing black nurses, and to develop leadership.

    The records of the NACGN document the organization and development of the Association and its eventual dissolution. The materials have been divided into the following eight sections: 1) Minutes, 2) Bylaws and Articles of Incorporation, 3) Correspondence, 4) Memoranda, 5) Speeches and Testimony, 6) Studies and Reports, 7) Publications of the NACGN, and 8) Printed Material.


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