Feminist appropriation of pregnancy testing in 1970s Britain

[EmbarrassingAdmissions]

This is an interesting paper that told me a lot about the origins of OTC and greater availability of pregnancy testing: The feminist appropriation of pregnancy testing in 1970s Britain

Women have long relied on bodily signs such as a missed menstrual period or morning sickness to self-diagnose pregnancy.14 By the early twentieth century, some working-class women continued to offer their urine for visual inspection to the ‘water doctor’, but the medical encounter was increasingly mediated by the laboratory, including for pregnancy testing.15 Between the late 1920s and the mid 1960s, laboratory workers injected women’s urine into living animals—first mice and rabbits, then frogs and toads—to ‘diagnose’ pregnancy. If present in sufficiently high concentration in the patient’s urine sample, the ‘pregnancy hormone’ today known as hCG (human chorionic gonadotrophin, the same molecule later detected by home tests) triggered physiological changes in the animals, which reliably constituted a ‘positive’ result. Crucially, pregnancy testing was, in this period, a diagnostic service for medical professionals only; the only way a woman could obtain the result of a laboratory test was from her doctor. A few specialised centres and most hospitals, but not doctors’ surgeries, were equipped for pregnancy testing. G.P.s would post a patient’s urine sample to a lab and it could take a week or more for the result to come back.16

From the late 1940s, pregnancy testing was made freely available on the N.H.S., but only for medical reasons; doctors rejected demand from so-called curiosity cases: healthy married women likely to have an uneventful pregnancy.

www.tandfonline.com/doi/full/10.1080/09612025.2017.1346869

I thought this was a fascinating insight into a topic that I didn't realise I knew so little about and a reflection on woman-centred healthcare.

There is a depiction of this in an episode of MASH where Margaret thinks she is pregnant.

Sadly, the female rabbits used for the test had to be euthanised (killed) in order for their ovaries to be examined (Spoiler: Radar's isn't).

Wow, interesting! Have saved to read later.

doctors rejected demand from so-called curiosity cases: healthy married women likely to have an uneventful pregnancy

soooo paternalistic!

I want to assure people that the full paper is available to read for free because the whole area is fascinating.

The meticulously kept records of a rural G.P. interviewed by feminist sociologist Ann Oakley in the early 1980s show that he ordered pregnancy tests for only 1.3% of his female patients in the late 1940s and 38.8% in the late 1970s, a thirty-fold increase in three decades.20 Many G.P.s, however, disapproved of ‘social’ pregnancy testing as an abuse of the already overstretched service. From the mid 1960s, by which time mass-produced immunological test kits had supplanted living animals, commercial labs served women directly, not as ‘patients’, but as ‘clients’. So too did pharmacists as well as branches of the F.P.A., Brook, B.P.A.S. and P.A.S. The thriving non-medical market for pregnancy testing paved the way for Britain’s first do-it-yourself test kit, Predictor, in 1971.21 By then, some two-thirds of all women had heard of the once taboo subject of pregnancy testing.22

The idea of PT being a 'social' rather than necessary use of healthcare resources is by contemporary standards but - even then - I'd have thought it necessary to know if you were pregnant for a mass of reasons.

And the paper details that it was women's groups in some areas that ran weekly testing drop-in sessions - I had no idea that women's groups had funded and staffed these.

Thank you for sharing the paper. That was really interesting- I had no idea that pregnancy testing was such a controversial issue in the past and that wo many women worked so hard to make it available.

I had no idea that pregnancy testing was such a controversial issue in the past

No - nor that GPs considered it a 'luxury' and superfluous item. I'm trying to think when the knowledge about prenatal vitamins and folic acid came in - and when was it that women would have consulted their GPs/whomever for prenatal care. Or when SMP came in.

It's provoking so many social history questions for me alongside the medical ones.

Although it seems to strange to us, before the latter part of the 29th century testing was much more expensive and complicated, especially the animal testing. We also didn’t understand so much about things like prenatal nutrition and folic acid. Bluntly, there were not many interventions for early pregnancy so having a positive test wouldn’t have been super useful in a medical context. Pre-ultrasound there wasn’t much in the way of feral medicine either.

I do think though that we have maybe gone the other way with an abundance of early testing, I wonder about the numbers of chemical pregnancies and early miscarriages now; fifty years ago those probably wouldn’t have been considered pregnancies in the same way, especially pre 6-8 weeks pregnant.

We live in a different world now, back then it would have been much more about watching and waiting.

*20th century obviously. We haven’t magically time travelled.

And *feral medicine. Argh

Fetal- damn autocorrect.

Interesting commentary about the clinical trials involved for appraising folic acid as a prenatal supplement:

In the 1960s, Richard Smithells and Elizabeth Hibbard1 noticed that women who had given birth to children with serious birth defects, notably neural tube defects, were likely to have an abnormal formiminoglutamic acid (FIGLU) excretion test indicative of impaired folate status than women with unaffected children…[There was a study to assess this.]…In 1980, the results suggested that folic acid, or another vitamin supplement, might reduce the risk of a recurrence.
…
With the collaboration of many colleagues I led ‘MRC Vitamin Study’ trial which was launched in July 1983, with the aim of recruiting women known to be at high risk through having had a previous affected pregnancy. It was the intention to obtain information on the outcome of at least 2000 pregnancies unless a sufficiently clear result emerged sooner. By April 1991, sufficiently conclusive results had emerged to warrant ending the trial early.

academic.oup.com/ije/article/40/5/1154/660590

Fascinating. Older female relatives have told me that there was no ante-natal care (1970s). You got a pg test, and then a 'booking in' date and that was it. See you when you go into labour.

@MeltsAway

doctors rejected demand from so-called curiosity cases: healthy married women likely to have an uneventful pregnancy

soooo paternalistic!

I don't really think so. It's just that it's now taken for granted - we assume it's necessary. At the time, it wasn't.

It's similar in a way to having the sex of the baby read on a scan. It's common in many medical systems now, but it's not been without controversy even apart from the problems around sex selective abortion.

The argument is that for most people, it's not medically relevant, and why is the health system spending time and money on something that is not medically relevant? It also becomes a problem if there is an error and people hold the practitioner responsible. Similarly, for a woman with no reason to need early intervention in a pregnancy there wasn't seen to be a medical argument for an expensive test to know a bit sooner if you were pregnant.

I'd have thought it necessary to know if you were pregnant for a mass of reasons.

It’s still not essential to be certain of pregnancy in the very early stages. There’s lots of testing and people avoid certain foods, but the reality is the vast majority of pregnancies would progress healthily and without problems if we still couldn’t test. I had lots of tests and no interventions and I assume that’s true of many people who had babies when I did in the 90s.

If I was a doctor back then and had to choose between injecting human urine into rabbits and then killing them, or choosing not to test, I would probably only choose to test in selected cases where it was important to know. Presumably the cost of the test was high too as the process would be labour intensive.

And as before that, nobody had ever been tested and the human race was largely alive and well, not testing would have been considered the norm and testing an extreme luxury. I think context is everything.

That said, medicine was much more paternalistic back then. I think it was in the 80s my grandmother developed bowel cancer and the doctor told her husband and they decided between them that my grandmother would be better off not knowing. She survived a long time afterwards not knowing as well. That seems utterly bizarre to me, but was presumably considered relatively normal until quite recently.

The argument is that for most people, it's not medically relevant, and why is the health system spending time and money on something that is not medically relevant?

Why on earth would a woman not want to know if she's pregnant? Even ffs, a married woman?

The assumption underlying these arguments is that a married woman is obviously looking to become pregnant. What if she didn't want to be? Early testing for pregnancy enables termination if the pregnancy is not wanted.

The whole thing removes an essential aspect of a woman's control over her fertility.

@MeltsAway I completely agree when you’re discussing the modern world in which testing is cheap and easily accessible.

But fact is, that we’ve only had easy access to testing for 30 years or so. Before that the cost/benefit analysis was just so much harder. I personally would not want to find out I’m pregnant by sacrificing a rabbit. And I’m not even particularly an animal lover.

“Why on earth would a woman not want to know if she's pregnant? Even ffs, a married woman?“

By my forth pregnancy I knew before a test did. Even one of those early indicator ones. Pregnancy changes my taste buds and makes coffee undrinkable.
I suspect a great many women back then also new without a pregnancy test too so it would have been superfluous particularly if there was nothing to be gained by having that information.

I was wondering how vagueness about conception data would affect women's career planning and work. I freely admit that I'd no idea SMP didn't happen until 1975 nor that it was effectively unavailable for 50% of women because of the length of service requirements. (And this is despite the fact that I know women in the 90s who didn't qualify when they'd worked in one place for 10years+ because they were always employed on joined up short-term contracts which were consecutive with no pags but zeroed any accrual of rights every time.)

www.striking-women.org/module/workplace-issues-past-and-present/maternity-and-paternity-leave-and-pay

My siblings and I were all born in the 70s, my mum had no scans. I think they were available privately but my parents didn't have income for that. For me they think my mum miscarried my fraternal twin or had an early miscarriage and got pregnant straight away so my due date was anywhere between May and July! I came on June. Obviously that wouldn't happen today with scans. I get a little cross at people calling the 20 scan a 'gender' scan when it is actually an anatomy scan and has a medical purpose. My first anatomy scan picked up my daughter's birth defect. Sadly, despite surgery when she was 6 months old she died. But because of that anatomy scan I got extra scans and monitoring with my subsequent children to check all was okay. I never found out the sex for any of my pregnancies as it was not important (if other people do this that is their choice and I don't have a problem with that).

A long way of saying I do think we take these tests and scans for granted.

@MeltsAway

The argument is that for most people, it's not medically relevant, and why is the health system spending time and money on something that is not medically relevant?

Why on earth would a woman not want to know if she's pregnant? Even ffs, a married woman?

The assumption underlying these arguments is that a married woman is obviously looking to become pregnant. What if she didn't want to be? Early testing for pregnancy enables termination if the pregnancy is not wanted.

The whole thing removes an essential aspect of a woman's control over her fertility.

I'm really not following your logic here. What does it have to do with a woman's job being pregnancy?

It's not like a woman is generally going to get very far without realising she's pregnant, there are lots of signs and it becomes obvious quite soon. If she is asking the doctor for a test she already suspects.

The whole ability to test for this was new, people were quite used to not being sure in the time it takes to pee on a stick, or even the time to do the old tests, which were not quick, btw.

The medical system is not there just to do what people might prefer, if there is no medical reason to do it. The early interventions we talk about now - quitting smoking, diabetes tests, scans - were not around.

[quote EmbarrassingAdmissions]I was wondering how vagueness about conception data would affect women's career planning and work. I freely admit that I'd no idea SMP didn't happen until 1975 nor that it was effectively unavailable for 50% of women because of the length of service requirements. (And this is despite the fact that I know women in the 90s who didn't qualify when they'd worked in one place for 10years+ because they were always employed on joined up short-term contracts which were consecutive with no pags but zeroed any accrual of rights every time.)

www.striking-women.org/module/workplace-issues-past-and-present/maternity-and-paternity-leave-and-pay[/quote]
People didn't have the same expectations about accurate dates, and recovery was a whole different thing.

Inductions for women who went over date were not done in anything like the way they are now, and exact time of conception was often not known, so due dates were seen as much more general - which really thy ought to be now, we tend to try to plan to much which is not particularly good for maternal or infant health. C-sections were rare and were not an option for making planning easier as they are now in much of the USA.

Mums often stopped working a good month before (or even earlier) and spent a whole week in hospital.

I remember this happening in the late 70s/early 80s. At that time you could have a pregnancy test at a chemist, you would have to take a sample of urine in. I'm not sure but I think they would have charged for this. You could also have it done at a family planning clinic, for free.
What I remember is that a local women's group offered pregnancy testing, they were based in a little room in the basement of a labour/TU centre. I remember being shown how to do it. You had to mix the woman's urine with another fluid- I don't know what it was- and if she was pregnant then you got a kind of white precipitate. When we learnt to do it a HCP - either a MW or a HV brought us some 'pregnant urine' so we could see how it should look.
Around the same time (and probably the same group) we learnt to examine our own cervices, with a mirror and torch. Quite tricky.
By the time I was pregnant myself (late 80s) I think home testing kits were available, but actually I can't be sure!

I'll go against the grain here wrt
“Why on earth would a woman not want to know if she's pregnant? Even ffs, a married woman?“

There is certainly an element of the pregnancy testing industry that's basically capitalising on women's vulnerabilities - in this case the desire to know immediately after possible conception if you're definitely pregnant, even in it means killing rabbits to get that information.

Because basically, you know when you're pregnant. There may be rare cases when your "period" carries on for the first month or two, but after your periods stop and you feel a tiny thing wriggling inside you which can be as early as 10 weeks in, tests are a little bit superfluous.

Really interesting article.

One reason is because if you want a termination, its important to know the gestation.
Or the dating of the pregnancy might indicate who the father is.
But I agree, these devices aren't invented and sold with women's best interests in mind on the whole, they are there to make a profit.

It's not true there was no antenatal care in the 70s. It was different but my dm was certainly regularly being checked in her last pg. At one appointment the doctor decided she needed to be induced early.