Fellowship Report: Maria Daxenbichler


Maria shares how she developed her dissertation during her time at the Countway.

In my dissertation entitled “Gynecology, Abortion, and the Professionalization of  Medicine” I argue that gynecological knowledge, including knowledge about how to induce and treat abortions, became a cornerstone of medical professionalization at the end of the nineteenth century. Since the middle of the century, “regular” physicians had started distancing themselves from their “irregular” counterparts such as homeopaths and midwives and sought to monopolize medical services. In the 1880s, the tools and techniques physicians developed to use in gynecological treatments became central to their claims of being the sole providers of professional medicine. 

Abortion played a central role in the process of professionalization for two reasons:  first, starting in the mid nineteenth century, physicians had led a crusade against abortion to bolster their reputation as a moral bulwark against an amoral practice. By 1900, most states criminalized abortion and granted registered physicians the sole authority to decide when the procedure was medically necessary and thus legal. Second, starting in the 1880s, physicians developed the operation dilation and curettage, which quickly became an important technique for gynecological treatments, including abortion. Using medical tools for abortion and related procedures further distinguished physicians from those physicians whose medical training did not cover this technique. 

Through the generous help from the Women in Medicine Legacy Foundation Fellowship , I was able to review papers from students at Harvard Medical School and patient records from the New England Hospital at the Countway Library of Medicine. Both sets of documents demonstrate that despite physician’s moral rejection of abortion, the operation was part of medical education and everyday medical practice. The lecture notes of Edward Peirson Richardson and George Richard Minot, who were medical students at Harvard Medical School in the 1900s, contain notes taken during classes on gynecology. Their notes demonstrate that medical students – regardless of their specialization – learned about the latest gynecological tools and techniques, including dilation and curettage and abortion. 

The patient records from the New England Hospital contain papers from the maternal, surgical, and medical wards. They illustrate that women were the majority of patients at the hospital and that their gynecological care was central to the daily operations of all three wards. The papers of the medical ward specifically show that dilation and curettage was a common operation. Students and interns from the Harvard Medical School witnessed these operations and practiced them like any other medical intervention. 

Despite physicians’ professional ethos that condemned elective abortion and the women seeking them, physicians frequently encountered incomplete abortions that needed to be treated with dilation and curettage or complications in pregnancy that made abortion necessary. The papers I studied at the Countway Library of Medicine demonstrate that leading medical schools such as Harvard Medical School prepared students for the operation, and that physicians in medical wards had to offer the operation to serve their patients. Physicians reconciled this dilemma by claiming professional authority over the decision whether abortion was medically necessary and authority over how to administer the operation safely.

This report was provided by Maria Daxenbichler who was a Women in Medicine Legacy Foundation Fellow at the Countway Library between 2017-2018.

Alicia Lazzaro