Podcast Diaries: The Period Podcast S02E16

In this episode of The Period Podcast, Dr Clancy speaks to historian Dr. Lara Freidenfelds. They discuss periods throughout history. It was so interesting hearing about experiences women have had over the years. In many ways, we found the culture around periods hasn’t necessarily shifted but we could definitely see some change. As we know change can take generations but conversations like this really highlight things we take for granted.

Anyway, you’re guaranteed to have questions for your mum / grandmother after this episode so have a listen (or read if you prefer). As always, be sure to go and add this podcast to your favourite podcast app.

Listen & Learn:

Transcript:

Many women talk to me about feeling that they were not quite sophisticated enough to use tampons and that they were concerned that their mothers thought using tampons meant that you were fast, that you were sexually active. And it was very interesting how women framed it to me in terms of, "Well, where I'm from mothers are not really okay with that."

This Period Podcast episode 16. My name is Kate Clancy. And I'm a professor researching periods, how they affect our lives and how our lives affect them.

This week, I'm excited to talk to Dr. Lara Freidenfelds, a historian of women's health. She blogs on reproduction, women's health and parenting as a regular contributor to nursingclio.org and at larafreidenfelds.com/blog. I loved her most recent post entitled, Let's Question All Versions of the Myth of Perfect Motherhood, a response to the recent Time magazine essay entitled, The Goddess Myth, How a Vision of Perfect Motherhood Hurts Moms.

In this response, Dr. Freidenfelds points out that the ideal of perfect motherhood is one that gets pushed on women from many different places. All natural mommy blogs, yes, but also doctors' offices and hospitals. She uses historical evidence to show problems from both the rock and the hard place women find themselves between when it comes to navigating motherhood.

As an anthropologist, I love when I have the chance to interview humanists and social scientists. Dr. Freidenfelds has put together a truly fascinating account of what it means to get your period in the United States. It is deeply researched, drawn from dozens of interviews. This book, the topic of which will comprise most of our interview, is called The Modern Period, Menstruation in Twentieth-Century America. Her next book, Perfecting Pregnancy and Mourning Miscarriage, The History That Shaped Modern Childbearing is coming out from Oxford University Press in 2019. Let's hear what Dr. Freidenfelds has to say.

Thank you so much Dr. Lara Freidenfelds for agreeing to talk to me today for Period Podcast. I just wanted to dive right in and ask you about this book of yours, Modern Period, Menstruation in 20th Century America. What was the motivation for writing your book?

So, this book came out of my dissertation research for a degree in the history of science. But I would say that my interest actually came a lot earlier than that. I have an undergraduate degree in social anthropology. And since I began doing that kind of work, I've just been fascinated by bodies and by thinking about how bodies have culture and history embedded in them and how we experience our bodies. It's not simply a biological phenomenon, but is actually socially shaped in many, many ways.

As an undergraduate, I read Emily Martin's wonderful book, The Woman in the Body. And she wrote in such a fascinating way about how women thought about menstruation. And I think that was in the back of my head as I learned more and more about research about the body. I'm in fact also a modern dancer, in addition to being a historian, and I think that's always informed how I've thought about my research.

And when I came to graduate school in history of science, I came thinking about the history of medicine and health. And when it came time to do my dissertation, I was very interested in doing a project that would be about women and their bodies and their experiences of their bodies. And I thought hard about what kind of project would let me do the work I wanted to do.

And the reason I was interested in menstruation was because it actually is kind of ordinary for most people and not something that we actually talk about all that much. And because of that, unlike say, childbirth, we probably don't have a rehearsed narrative about it, some story about it that we've already told a lot of times, and that maybe is shaped by talking to a lot of other people about their experiences with that bodily phenomenon.

And I was really curious if I approach something like menstruation, which we don't talk about so routinely, if I could get at something about the interaction between how women experience their bodies in more private settings and how we handle them socially and how that has changed over time.

I'm glad I'm not the only one with a real fondness for Emily Martin's book. That was also a really instrumental book for me when I was in undergrad.

Very inspiring work.

Mm-hmm (affirmative). So, why did you call your book The Modern Period?

I call it The Modern Period besides being a fun pun, because it was how women talked about the choices that they made about menstruation in their own lives. And it was really striking to me that many women born all the way from the early years of the 20th century through the 1980s told me that they changed something about how they handled menstruation compared to what their mothers had done, because they want it to be modern, because they thought that it would be more comfortable and easier if they did things in a modern way.

And that word "modern", when I looked more carefully into what they were telling me about what it meant, was so interesting, because in the American context, I found that it meant people were talking about entering the middle class and being able to participate in middle class social life. And in America, we don't talk much about class. It's not comfortable. It's not something we like to reflect on very much most of the time. But we do have some idea about what it means to participate in the mainstream of American life. And that means this very broad sense of being middle class and for Americans talking about their bodies, being modern meant being middle class.

And so, can you tell me a little bit more about based on the work that you did and the folks that you interviewed, what you think the modern period, the middle class dominant cultural paradigm period is supposed to be like?

Yeah. So, I interviewed women ... Actually, I went in not assuming that people would be telling me the same story over and over again. I was very surprised to hear women repeating the story about becoming modern. I went into the project wanting to interview women from a variety of backgrounds to understand how things were different depending on where you came from.

So, I interviewed African American women and some men from the rural south. I interviewed white women and men from New England. And I interviewed Chinese Americans from California. And I interviewed people who were born all the way from the very beginning of the 20th century up through the 1980s and found that the kind of modernity that they were telling me about was the modernity that I saw as a historian as describing the Progressive Era.

And this Progressive Era modernity was about telling everyone that they could join the American mainstream. And what they meant by this was the middle class mainstream, if they acted in certain ways, if they handled their bodies and their lives efficiently the way that people were starting to think about handling factories, if they had a very consistent self-presentation, so when it came to menstruation, this meant being able to have a body that was not out of control or unpredictable, but rather a body that you could use to work and play and go to school all month, in a way that made it never seem like anything was different.

So, a body that didn't ever unexpectedly leak, or smell, or make you look ill at ease that that you never felt uncomfortable enough to have it show on your face.

That this was a way for women to enter work and school life that expected this kind of routine and consistency and daily participation and to be able to do it in the same ways that men did. And if anything even more consistently and with an even more consistent self-presentation than men because women were the ones who were usually the first representing their families in what we sometimes called pink collar occupations so, being clerical workers or working behind the desk at a department store, where they were the ones moving their family into the middle class.

And I found that these ideals of having this body that didn't leak or smell or distract you from the things that you intended to do all month was consistent all the way from the oldest women I interviewed to those born in the 1980s.

What's interesting hearing you talk is what a tall order it is when menstruating to do what you're talking about to show no discomfort, to not leak, to not smell, to show no outward sign that you're going through a pretty major physiological process. And yet, we often do this as modern American women without thinking, why do you think that is?

Well, I think that right now, in our current political moment, it's pretty clear what the cost of showing some aspect of potential female debility might be. And I think that that has been true all along. So, I think there's both that threat that if you don't perform up to certain standards that someone will accuse you of being a woman who can't get up to the standards and therefore doesn't deserve equal pay or doesn't deserve a job.

But at the same time, this promise of if you can just get it right, if you can just find the right tampons, or the right pads, or the right version of Motrin or Advil that you really would feel just like you do the other times of the month. And a lot of people find that very appealing and wish that were the case. So, I think would prefer to believe the promise of the modern period.

So, you are saying so many interesting things and I want to ask you a million different questions about them. But for our listeners sake, I'm going to back up and just ask you a little bit more of the process of researching your book. And then maybe from there, I can ask you all of these other questions that I want to ask you.

Sure, yeah. Oh, it was very interesting. So, I found myself interviewees by having a personal contact, at least one personal contact in each of the groups that I was approaching. And then once I had interviewed someone asking who they would be willing to refer me to. So, it was what you call a snowball method where I ask people for referrals.

And I was very moved by the process of interviewing people. I sat with people for anywhere between ... For some of the men's interviews, it was more like 45 minutes and some of the women up to three hours. And I had about six pages worth of detailed questions that I ask them. And by the time I had done maybe 20 of these interviews, I had them memorized and could jump between them in a very natural way.

But it was really humbling to have people tell me such personal stories that were moving and funny and poignant and many times stories they had not been told anyone before. And I really appreciated it. And I found that to engage with people that way, I had to be really open and aware of how sensitive this topic could be and aware of potential embarrassment, but on the other hand, not feel embarrassed myself to be with them and sympathetic and open.

And I just found that such a really nice thing to ask myself to do. It's a lot of work. And it took a little bit of sort of emotional investment in each interview to get up the social courage to ask all of these questions, but I found that people were so kind to me and willing to answer questions that it was a fun process.

What were some of the most moving interviews that you conducted or the stories that ended up meaning the most to you?

Oh, can I read you one story?

Please, yeah, one that I marked in my book. That when I interviewed a woman, I use pseudonyms in the book for everybody. And her my pseudonym for her is Ida Smithson. And when I interviewed Ida, so she was born in the rural south. She came from an African American family that grew tobacco and then later, she had a general store with her husband. She was born in the 1910s.

And the way that she described learning about menstruation, she said, "When I learned I was 13, I had no knowledge of what was happening to my body at all. And it was frightening. My mother hadn't told me anything, not anything, because I don't know why. And my sisters didn't ever tell me anything. It was like a hush-hush thing.

And so, I remember being in school and I had this accident and I came home crying, telling my mother. She didn't put her arms around me. She didn't do anything. She just said, 'Well, go find a cloth and pin it inside your pants.' And that's all she told me. And she didn't tell me to change it. She didn't tell me anything. She did not tell me it was going to be from now on. She did not say anything whatsoever. So, quite naturally, there's always some wise children in school, I would ask them."

And she went on from there to tell me about changing the way she did it with her own children and how proud she was of gathering the right information and the pamphlets and the medical books and leaving them where her children could see them, of telling her children that they should tell her when this happened and to expect it and that they should let her know when they had their periods. And she wanted to be the one to give them menstrual pads because she liked to be sure they were getting regular periods.

But it was really touching to hear her describe her own really challenging experience with this and the ways that she decided to do differently for her daughters and the way that she drew on all the different kinds of materials that she could find to do it. And I thought, wow. So, this is the reason to do interviews to me. There's been a lot of really, I think, cogent feminist critique about, for example, Kotex pamphlets and how they perhaps overdo the message that menstruation is all about products and not about growing up or and they avoid being very coy terms talking about sexuality.

Well, yes, those critiques I think, are legitimate. On the other hand, when I talk to someone who said those pamphlets made the difference in being able to talk to her own daughters in a way that her mother didn't know how to talk to her, I thought, "Well, there's more of a story here."

Yeah, that's lovely. And If I remember correctly, Ida wasn't the only participant that you spoke to that had that kind of a lived experience of her own period, where she had little to no information from her mother when it first happened to her, is that right?

That is right. She was not the only one by a longshot. In fact, that was typical for people I interviewed who were born before about 1940 and common still for women born in the '40s and '50s. So, I heard stories like this from women who were from Taiwan and China. I heard stories like this from women who were born in New England in the Boston area.

So, this is what I mean about being surprised that I was hearing the same story repeated from women who I assumed would be much more different from each other than they turned out to be. And the story to me really was interesting. It told me that these pamphlets while they did have a company producing them and the company did have an agenda, that part of the reason they were so dominant and so successful was that women were pushing them to have a certain kind of thing available. And women were finding that it filled a need that they really felt at that time. And that was across an amazing range of ethnic groups and incomes.

Yeah. I was born in 1979. And the way my mother told me about periods was by giving me a pamphlet. So, though I wonder, I'll have to ask her. She was born in '47 and I wonder what her experience with her mother was whether she got much of a talk or whether it was a total surprise for her. But I did at least get some advance notice in the form of a pamphlet.

You should ask her, will be a very interesting story I'm sure to learn about. How did you feel about being handed a pamphlet?

I think and I wonder about this as the mother of a daughter too, my experience of it was that I was grateful to be given something so I didn't have to talk to anybody about it. And I imagine and at least my sort of reading between the lines of some of the experiences of your participants too that rings familiar, it can be a mortifying time. And at least by my age, I had some awareness, there was something that was going to happen to me as I was growing up.

So, having some information about ... I mean, what I remember about it actually most strongly was that there was a menstrual cycle calendar at the end, and that there was this whole section about hygiene and cleanliness and the importance of taking baths. So, I wonder what brand ... I don't know, I wonder if it was Kotex or Always or someone making it. But they were saying that exercise and warm baths were the best way to ease menstrual cramps. And that's really all I remember from the pamphlet.

Well, that's quite a bit. I found when I interviewed people that I rarely got even that much detail, although people remembered what it had meant to them. And I think you're right, that your experience very much represents your generation. Though there are some women of a similar age who did say in retrospect, they would have wanted more. They wished their mothers had used it as an opening to talk about these things, rather than the end of the story. But it's hard to tell also in retrospect, we can wish that things had been the case, but it's hard to tell whether they would have been comfortable if they had happened.

And I think because of the research that I do now, I mean, I study periods and it's a big part of my life. So, my daughter has known about it. She's eight years old now and she's known what periods are for several years already. And we've already had this conversation many, many, many times. And I've made sure that she's been with me in the bathroom when I've had my period. And so she's been exposed to it sort of repetitively so that it's just a norm for her. So, when the time comes, I may give her additional written materials, but I hope that we already have that conversation.

And what was interesting too is in an earlier episode of the podcast, I actually interviewed a number of parents of kids my daughter's age, because of course, that's my easiest access to parents. And a lot of them had a similar experience to me where they were already starting to talk to their children about it or already inviting their children to the bathroom, so that they could see what it looked like. And again, this is among a very particular subset of educated middle class women. But I still found it interesting that we were taking it one step further and sort of making sure years in advance of possible menarche, we were already having that conversation.

Yes. And I think part of what you're pointing out and I saw the same pattern, at least some of the people I interviewed who had children around that age when I was doing these interviews, which was between 1999 and 2001, that there were a few people who talked about that sort of matter of fact treatment and wondered how it would be for their daughters as they grew up.

And I would love to interview the next generation. I think you would see as you're saying, this pattern of more openness. And I think it is the kind of thing where if you don't have to sit down and have a specific talk about it, but you address it as it comes up naturally, it must be a little bit of a different experience then for the daughter when she reaches menarche.

And I think that that would be to me a really heartening extension of what I see as the modern period, which is that it's not about somehow making it disappear entirely. It's about having the ability to talk about and experience and manage menstruation in a way that's on our own terms, as opposed to something which pops up out of control and public when we don't want it to be there.

So, I want to return again to what I feel like we keep returning to which is this idea that despite this vast diversity of women to whom you spoke, there were some real commonalities, certainly generational commonalities and shifts over time in terms of how women were experiencing and talking about their periods. So, in your book, The Modern Period, you argue that it wasn't new technology or new scientific knowledge that triggered our modern way of dealing with menstruation. So, what do you think did trigger this shift?

I think it really was hitting the Progressive Era. So, a really important shift in the Progressive Era was that previously in the 19th century, there had become a very distinct middle class. But the things that distinguished you as middle class, including bodily things like being cleaner and having a certain kind of self-presentation that we would identify as middle class like bathing regularly and cleaning your teeth and that kind of thing. Being middle class in that definition was doing those things because it distinguished you from people who were not of that class.

In the Progressive Era, there was a much wider embrace, an idea that that was not something that was supposed to set you apart from other people, but instead that was supposed to be the American baseline. And in fact, by 1939, which was the first year the Gallup poll asked a question about social class. They asked people what class do you believe you belong to, the lower class, the middle class or the upper class. Eighty six percent of Americans said they were middle class. If you think about that, by 1939 and possibly before, Americans believed that they were basically all middle class.

And Americans coming to think that that was the way society ought to work and that there were certain ways that you could be middle class even if you were not among the higher income people and 1939 people, they asked the question, are you socially middle class? Eighty six percent said yes. They asked people if they were financially middle class, and I forget what the number is, but it's like 40% say that they're lower class.

So, people felt that they were a particular things socially, which unified America, that was about kinds of things that were about manners and personal self-presentation, and perhaps work ethic and that kind of thing that were social and cultural and not financial. And I think the Progressive Era marks this time of great optimism that we could incorporate immigrants, we could incorporate people immigrating from the rural areas to the cities, that we could all be kind of the same.

And that, in fact, when what we meant by the same was that we were going to be modern and middle class. And it's that social transition that marks the beginning of this dramatic transition you see and how people were thinking about their bodies when they were menstruating.

And this continued, I mean, this continues to be true today. Yes, that the majority of Americans socially identify as middle class, even if you know a lot of the rhetoric around labour is that there's a disappearing middle class.

Yes. It's interesting. I've seen recent polls where people are more willing to call themselves lower class even which surprisingly and polls always that have distinguished working class as a separate category have attracted some people who are sort of equally willing to call themselves either working class or middle class or lower middle class, who recognize that there are differences in how people earn their money. I'm not sure quite what to make of those, but it's still true that the majority of Americans call themselves middle class.

I mean, it's just again, that distinction between social and financial I find really interesting because of the fact that there's this dominant idea that it sounds like we all should be trying to aspire to have certain norms of behaviour in the United States and that we're identifying as middle class. There's also a social scientist in me that saying, I wonder when you give people only three categories, most people choose the middle one, like a Likert scale. If you give people a one to three or a one to five Likert scale, if you give them an option where they can choose the middle, it makes it really hard for you to see variation and see enough spread in the scale because so many people will just choose the middle.

Yeah. No, I can believe that there's some bias in that direction. Although when they give people five options that also includes lower middle class and upper middle class, you still get a very strong concentration in the middle. But the other thing is that I'm not only going by the Gallup polls. So, there have been people writing social history, noting that Americans all think that they are a middle class. And in the post-World War II era, there was a lot of celebration of that idea that we could all be unified in our wealth and our middle class standards.

So, one of the other things I wanted to ask you about is that many of the women in your book found comfort in scientific explanations of periods. Were there ever times that this worked against them? And do you feel like there are other ways of knowing that are lost when we medicalize periods?

Yes. So, it's interesting that we have a feminist narrative that's about an alternative way of knowing that's lost, which I think is interesting because as a historian, what I see is that women I interviewed said, "Well, what came before was confusion and shame." And so, that does not sound like a lost underground female narrative, at least that they were able to tell me about.

And the historical record that we have is scarce. But going back to the Middle Ages, I do not see evidence of this sort of this fantasy picture of women gathered around the wash, older women telling younger women about their flowers, which was a medieval term that was sometimes used to talk about menstruation. That it's hard to see if it was ever treated as a special thing among women. There's no evidence really for that. So, I'm reluctant to say that looking backward, there was something that was lost.

On the other hand, I am inclined to encourage people to imagine a different future. I don't think there's any reason that we have to think that the science is the be all and end all of ways to think about this. The scientific language has worked very well around sex education around reproduction and menstruation as part of that. Because we think of science as a neutral language, and therefore something which can be discussed, even though it's a sensitive topic. And I think it's had a very important role that way. But it's not necessarily the most meaningful way that people experience their periods.

And certainly, the youngest women I interviewed who were born in the 1980s talked about some amount of scepticism. "Well, when I got my period, I didn't really want to look at a diagram. I wanted to know, like, why it hurts and that it's going to be okay." Or one woman said, "I was really surprised that it was brown and not red because they talked about blood and I thought blood was red. And so, I was all confused whether this really was the thing I was expecting."

So, in some ways, in not developing a more experiential way of thinking about and communicating about menstruation, we're giving our daughters some kind of narrative, but maybe not always the one that would actually be the most helpful at the time of menarche, for example. I also interviewed some younger women who found the way that we told the medical story to be problematic.

So, this isn't the only way you could narrate it, but it's often narrated as menstruation is there. It's really important because it's going to be what allows you to have babies. The menstrual cycle is really important for having babies later. So, you should think of it as a blessing. And they said to me, "I don't want babies for at least 15 years. So, this seems totally useless to me. And this narrative doesn't mean anything."

So, I think it's well worth thinking about whether our narrative that we use, the scientific narrative really is the most salient for young women now and how much we want to put it at the center and how much we should just think of it as part of how we talk to our daughters and our sons about what menstruation is.

Right. And this sort of makes me think about two different things. And since you're the historian of science, you can probably speak about this far better than I can. But one of the main critiques that I often have about medical views of menstruation and I'm saying this as a scientist who studies periods, is that the history of medicine is intensely problematic, particularly around women's bodies.

I think you and I've probably read a lot of same stuff in terms of Secrets of Women and The Woman in the Body and other works like that. And I guess I'm wondering two things. One, even though I do agree, I think you make a lovely point about how science and scientific explanations give us a neutral way with which to start these conversations.

I wonder, in addition to that, what baggage we may be acquiring from the historical and cultural context of medicine and the study of women's bodies. And then the one other thing I was thinking about is you do have a portion of the book where some of the folks that you interview discuss having trouble getting good medical care and actually being believed and trusted when they describe certain symptoms. So, it seems like there are maybe a couple ways in which this is not to say we should be completely throwing out scientific explanations, but ways in which science might be failing women.

Yeah. Well, I mean, I think there's many ways. It was interesting to me learning about the feminist health movement, that examining one's own cervix was supposed to be the means to enlightenment when I thought, well-

That sounds painful.

Yeah, and I don't necessarily need your ultrasound to know what the baby's doing, thank you very much or we're so excited about the scientific narrative that we don't always recognize there might be some other way to perceive what's going on, and to narrate it in useful way and think about it.

I think the scientific narrative for menstruation is interesting and helpful insofar as if what we want to do is to say to our children, this thing happens, and there's a reason for it, and let me tell you about the reason why it happens and why it happens as you grow up into womanhood and why it's different for women's bodies and men's bodies, that if you didn't have some of the scientific narrative there, we don't have in our culture really an alternative way of thinking about what it's for. But we probably should be careful about our science.

And I don't think I can find the quote quickly, but there's a one wonderful pamphlet that popped up in 1975. And this narrative never popped up again, but someone who wrote the 1975 pamphlet decided to describe it as the miraculous renewal of this nice pink uterine lining.

And so, you can create a scientific narrative about what menstruation does that you isn't about it being for making babies, that can be about the renewal of a woman's body and a woman's body having the ability to be potentially receptive to sustaining babies, but actually, at the same time, quite efficient in it's not having constant availability of materials for reproduction, when that's not in fact what's happening in a woman's body that month.

So, we can think about alternate kinds of explanations. But it's hard to imagine 21st century explanations of bodily phenomena that don't acknowledge to me a scientific description in some way of what's going on. But it doesn't have to be the baseline. It doesn't have to be the most important or the primary way of describing it.

Yeah. I think what I'm trying to get at is I'm just unsatisfied with the way scientists because of their own biases and one of the big problems in sciences unfortunately, that most scientists think that they're unbiased. And so, therefore they never consider their lived experience and how that might influence problem formation, questions, hypothesis testing, results, interpretation, things like that.

And so, they don't necessarily think about the ways in which their own culture might influence the words that they choose when describing something. So, a lot of descriptions of menstruation are very violent. Again, I'm referring to ... I mean, Emily Martin is one of the main people who spoken about this but this horrible ragged tearing of the midst of the epithelium as it makes its way out of the body. And it's amazing. I think Havelock Ellis is quoted as saying like he doesn't understand how a woman can survive it because it's such a terrible violent process.

If you look even at more recent medical textbooks, there's some move towards neutrality of language but it still is described as this, I don't know, one, as something that happens to women and two, as something that is negative and not that I would ever presume to push back on women who have negative experiences with periods because I think all of us do at some point or another who menstruate. But it would just be nice for there to be a little more variation or this lovely language that you used, I'd love to see more pamphlets that talk about the miraculous renewal of the uterine lining, you know?

Absolutely. And I think there's room in the market for producing more feminist's sensitive accounts of how women's bodies work and there are some. Now, it's making me want to go look a former student of mine, wrote a wonderful book called Body Drama, which is for educating teens about their bodies. And I'll have to look and see how she describes menstruation. But I know that she's quite aware of the possible downfalls of going with the standard scientific narrative.

And actually, I'd say even more problematic, as far as I'm concerned, is the very basic narrative that menstruation is what happens when you don't have a baby. Because how many times do we really intend to have babies? Thirty five percent of us intend to do it twice. That's the number for America, 35% of American women have exactly two children. And then most of the rest have either one or three.

So, thinking of menstruation as something that happens because you don't have a baby, it's a little bit of a funny formulation given that really, it's more like menstruation is what happens except for the couple of times that you have a baby.

Yeah. I like how that's norming the menstrual experience as opposed to norming the childbearing experience. So, I want to return to another really lovely earlier point you made that again, I think links up with this move to the Progressive Era. And that's this idea that women could and should behave during menstruation as though it's any other day. So, what are the strengths of situating menstruation as something that can be made invisible, efficient and well managed? And what might be some potential problems?

Well, the strengths so that when it works for you, it can be quite glorious. And I had women really of all ages tell me about being very athletic as girls. We can forget that there were women in the 1950s who thought of themselves as athletic. But they did and then my interviewees did. And they found it very frustrating to have cramps or to find themselves with terrible chafe marks on the inside of their legs from running around the way that they liked to when they had their periods.

And for women who found that using tampons and a little ibuprofen got them to where they were very happy and comfortable to be doing things like playing intense sports, that I think that that vision that women could do that is really great.

And that comes out of actually, women, physical educators at women's colleges in the 1920s and 30s started to say, "Now, women can handle this and it's okay and we shouldn't be telling women to be all frail and that they have to stay home and stay in bed at that time of the month. Let's see what they can do if we give them some support. Like we give them some exercises to do and we tell them that it's okay to have some exercise every day and we tell them to get rid of their courses and to wear proper shoes and to eat well, will they then feel good? And can we support them in feeling good all month?"

I think the downfall is that our solutions are not entirely solutions. They don't work for everybody. And for women who find that all the Advil in the world is not going to make it okay, they're really let down by something that is promised to them as something that could make their lives work and could make them be able to be modern like everyone else. And it's very, very frustrating.

And also, since 1960, we've had the birth control pill on the market. And actually, it was prescribed even earlier than that for menstrual dysfunction that started in 1957. That can work very well as a menstrual regulator for a lot of women and some of the women I interviewed said, these doctors who seem to blow them off and be completely clueless about menstrual pain, inadvertently solved it by prescribing them the birth control pill and it was like a miracle. Suddenly, they were comfortable and happy.

But on the other hand, we know that the birth control pill has side effects, and certainly as it was in the 1960s, you didn't want to take it for more than a few years. There were concerns about various side effects. So, asking women to accept a potentially dangerous medication because it will make them menstruate in ways that are socially approved, that seems problematic.

One of the other things that I'm struck by as I'm getting older, I'm actually 15 weeks pregnant, so I'm not actually menstruating right now. I'm in my late 30s. I have a lot of friends who are in their 30s and 40s. And one of the conversations that has started coming up among me and my older friends has been, all of a sudden we're leaking again. That adolescent period where you're still learning to manage things and wear pads appropriately and understand the start and stop of your flow.

Suddenly now, we get these gushing periods that come out of nowhere. And so, at this point, I don't think I know a woman around my age who hasn't had a workplace experience of actually having a public leak of some sort. I've had this happen in an important work meeting. I have a colleague who just had it happen to her at a work meeting, another friend with a story of leaking all over her work chair, which is in a cubicle where everyone else can see. And it's just interesting to me that as periods change as you get older, they present these new challenges that make it very difficult to have an invisible and well-managed period.

Yeah. I'm curious whether when you heard these stories, you got the sense that people felt the same kind of humiliation or out of control sense that they felt as adolescence or was there any difference to the experience as someone who's more midlife?

Well, I'm thinking about two of the stories in particular, I think it was more anger and frustration. Like, are you kidding that I'm dealing with this again, after hitting this point in my life where I thought I kind of had it all under control and I've been doing this for several decades. So, I do agree that there's probably less humiliation when this happens when you get older.

But I don't know, when I think about my own experience of it happening, it was in front of a woman and a man, both of whom were senior to me at my job. So, I was pretty darn embarrassed. I mean, I found a way to more or less hide the experience and wrap a sweater around my waist and everything, but it's interesting to think about the ways in which, looking back on it, I wonder why I freaked out so much, considering the fact that the man was married to a woman, probably very comfortable with periods and the woman herself had probably been through a number of them.

Yeah. No, I mean, and I think the fact that in some sense, we have it mostly under control, it's then shocking when it isn't. And I think you probably also have a lot of peers who use birth control that suppresses menstruation.

So, you've definitely had experiences with women who must not be using hormonal birth control or the marina IUD, but on the other hand, a lot of people are, which then mean some of the women I interviewed found that they hadn't had what they would call a natural period, kind of since they were 18. From when they were 18 through they were probably going to go all the way to menopause on some kind of hormonal birth control, and it does end up separating out some of our experiences.

So, I do have one more question I'd love to ask you about your book and that's on the latter section of it about tampons. So, this is one of the places in your book where there was quite a bit of controversy and disagreement. So, what were some of the worries around sexuality that tampons seem to trigger among some of the older women in your sample? And in what ways did tampons increase in acceptance over time?

Yeah. So, tampons were introduced on the market in 1936. And actually, it's that brand you know, it's Tampax, who introduced tampons on the national market, and it had copycats pretty much right away. And the first concern that I saw registered about it was actually in the medical literature, that doctors said, "Whoa, is this safe?" And you can see why they would be concerned. I would have hesitations about trusting manufacturers at quality control that they were wondering what women might be introducing into their vaginas.

But they also had this concern that somehow the tampon was not okay for virgins. And it was doctors were not entirely willing to get behind that perspective. I think they knew that that probably didn't really make sense. Also they're worried that somehow handling one's vagina would make one sexually aware. And it's interesting and if you think about that's a very masculine idea about what is somehow sexually arousing or awareness creating for women.

And Robert Latou Dickinson, who's a fascinating character from the 1930s and '40s. He was a physician and a sex researcher wrote these really interesting papers about how actually pads rubbed on the clitoris. So, if you wanted something which avoided stimulating women sexually, you are better off with a tampon. And he drew this picture of the width of a tampon and a phallus and a married woman's hymenal opening and someone who had had children, how big her hymen opening was, and demonstrated that the tampon was actually smaller than any of those and therefore ought to be safe.

Now, Consumer Reports finally published a version of this without all the pictures in it and said actually, tampons are probably fine. But the women that I interviewed, it was very interesting. This was the one place where women talked a little more about feeling hesitant, about their mothers. One woman I interviewed who was born in the 1930s and was from an Orthodox Jewish family in New York, talked about fighting with her mother. It was in the 1940s. She was a teenager and she said, "I'm going to the beach," and her mother said, "You are on your period, you can't." And she said, "Oh, yes, I can. I'm going to use a tampon."

And she knew that that was going to cause a fight. And her mother said, "What are you doing?" And her mother assumed that she must be sexually active if she was using tampons. And this was a common theme among my interviewees all the way from women talking to me about what happened to them in the 1940s through the 1980s. That women, not everyone, of course, but many women talked to me about feeling that they were not quite sophisticated enough to use tampons, and that they were concerned that their mothers thought using tampons meant that you were fast, that you were sexually active.

And it was very interesting how women framed it to me in terms of, "Well, where I'm from, mothers are not really okay with that." So, the Orthodox Jewish woman talked about it as being from an Orthodox Jewish community and having an immigrant mother.

Another woman told me about having this experience in the 50s. And that this was her mother's feeling about it. But then when she went to college, she realized that educated people thought about it differently. Another younger woman, who was growing up and who's an African American woman growing up in the rural south in the 1980s, told me about learning about tampons from a friend, a friend at school who was kind of exciting. She was a city girl and she thought she was fast and fascinating and she was the one who told her about tampons. But in her rural community that was considered a little out of the box.

So, across the board, just these very interesting stories where women were telling me that tampons was pushing the envelope, that that was a little too much in the ways of the sophisticated urbanites and the people who had gone to college. And they did talk about being more comfortable about it a little bit later often in their lives once they felt that they were legitimately sexually active that using tampons was okay.

I also found that in particular, Chinese American women had health concerns about tampons. And this was because traditional Chinese ideas about inserting things and about needing the blood to flow freely are more salient to many Chinese Americans than those actually very similar traditional western ideas about bodily health are at this point to most Americans.

So, there were a number of women who said, "I don't know if it's safe to stick something in there to hold the blood in to keep this blood that's supposed to come out inside your body." And particularly Chinese American women had that hesitation, and some of them still didn't use tampons even after there was no question about sexual legitimacy.

There still also seems to be quite a fear of toxic shock syndrome. I mean, certainly when I first was introduced to the possibility of using tampons in my teens. I thankfully did not have a mom who sexualized tampons at all and it was available to me though, I have to admit I actually didn't like them at all. And so, I think a number of doctors at this point have pretty unequivocally said, "Unless you're wearing these for much longer than recommended, it's not an issue."

And in fact, TSS is an issue with any kind of menstrual product if you wear it for too long. It's not necessarily so much about the insertion. It's about having blood sit on something, on a substrate for a long enough period of time that bacteria can get in. So, I'm wondering, did that come up at all in any of your conversations?

Absolutely. So, for Chinese Americans, especially the mothers who weren't so sure about tampons in the first place, toxic shock syndrome, just proof that they were right. They looked at it and they said, "Well, see, we told you." And some young women told me that their mothers pulled out those inserts and sort of waved it in their faces and said, "Look, this says, it's not safe. You cannot use these."

And I found that young women, well at the time that I was doing the interviews around 2000, I think the inserts were still pretty much saying that. I guess I haven't read them in recent years. I don't know if they've been adjusted at all, but as far as they understood that it was probably safe as long as they were sensible about it. But it was interesting to me that actually, they saw tampons as slightly risky and yet they were willing to use them anyway, for what they saw were the benefits.

So, being able to do your regular things and not worry about a pad and be more comfortable, women saw that as a manageable risk even when they saw a risk. And I thought that was really interesting. That women, they do sort of size up the risks and make decisions in many ways about bodily technologies that are not perfect. And we do the same thing about birth control, deciding what kinds of birth control we want to use and how perfect they need to be versus the risk to our bodies that they carry.

And I found that that for a lot of women using tampons was important enough in their lives that they were willing to take a small risk, perceived risk anyway, of having toxic shock syndrome.

And speaking of bodily technologies that are not perfect, you have a new project that you're working on. And I know, at least what you briefly mentioned to me is that home pregnancy tests factor into your more current project. Can you tell me a little bit about what you're doing now?

Sure. I'm writing a book called Counting Chickens Before They Hatch, Miscarriage and the Quest for the Perfect Pregnancy. So, I'm looking at early pregnancy loss, miscarriages that happened in the first couple months of pregnancy and asking how they went from being something that women took for granted as part of childbearing and reproductive like generally, to something that many Americans experience as a real tragedy, for some couples almost like losing a child.

And that's a pretty dramatic shift and we can see it happening over the past century. And it's also really important to understand what is going on and that it's happening because so many pregnancies miscarry and mostly in those first couple of months. And the reason that the home pregnancy test is so important to the story is because, and relevant to my work on menstruation, is that it's the home pregnancy test that turned many late periods into early miscarriages.

And of course, not literally, but the experience. Many people have an experience, a physical experience that would have been perceived as a late period or frankly and on time period.

Now, that our pregnancy tests can measure the pregnancy hormones as early as five days before your expected period, people who are eager to get pregnant and are measuring carefully are experiencing many more miscarriages in terms of their understanding of what's happening in their bodies, even though they may or may not physically be experiencing something that their mothers or grandmothers would have called miscarriage. And given how emotionally difficult miscarriages are for many people, the fact that we're creating many more of these experiences, I think is very troubling.

I have to do IVF in order to get pregnant and I had two failed embryo transfers last year. And even the experience of knowing there was an embryo put inside of me and then having a negative pregnancy test, that already caused me an unbelievable amount of grief, even though based on the test, it probably never even implanted.

It probably wasn't even really viable. In both cases, they were very old frozen embryos from my first pregnancy. And it was something that really got me thinking quite a bit about exactly what you're talking about because I didn't even technically experience a miscarriage and yet I grieved for months, and my husband grieved and my daughter grieved. I mean, we were all so broken up by that experience.

And it still doesn't hold a candle to the women who actually know that they've had some implantation, some growth, some number of weeks of there being some kind of embryo alive in there or existing in there. And then to have the cramping and bleeding and actually having a miscarriage.

Yeah. Well, I mean, I'd say a couple things about that. I'm sorry, you went through that. That's really hard. So, one thing is, I guess part of what I want to suggest with this book is that it used to matter how hard it had been to get pregnant and whether you could get pregnant again. And we assumed that women who were struggling with infertility were facing a real difficult situation. And that we saw different miscarriages differently.

And I guess I think that was actually emotionally appropriate. And I think it's sort of too bad that we've created a situation where we're defining it as if it's a miscarriage, then we should mourn. Because I think in fact, different miscarriages, potentially justifiably have different kinds of impacts on us, depending on what they mean for our future fertility.

And second, I do have a chapter on IVF as well and something that really struck me in talking to people and reading about IVF experiences with the degree to which a larger narrative about how pregnancy unfolds, winds up informing how people go through IVF. So, in addition to it being this really high stakes pregnancy, were you given some black and white printouts, photographs of the embryos?

Oh, yeah, I have. Well, not of the two frozen embryos. That's a longer story that has to do with it. I also had a pretty incompetent infertility doctor during that period. But with my daughter that is now eight, we have the picture of her as an embryo. With the foetus gestating in me right now, I also have a picture of the embryo. And it's amazing how the second I saw that picture, I fell in love with it, despite again, being a scientist, being aware of the chances of it actually being successful and knowing I was just looking at a multicelled embryo as opposed to anything that had any kind of equivalency to life, you know?

Yeah. And part of what's happening there is that we have a really robust cultural narrative about ultrasounds and ultrasound images, that that picture is part of, that we know how to read an ultrasound. In fact, you can give someone an ultrasound of kind of anything and the first assumption is that it's a picture of a baby. And so, when we go through a process like IVF and then the rituals of childbearing are integrated into it, I think it makes it even harder on this kind of high stakes pregnancy and puts that pressure even earlier, as you're saying in an IVF pregnancy you know about conception even before you know anything about implantation. You know it the very first possible moment you could possibly know.

So, I think it's these larger cultural narratives and rituals around the pregnancy process inform IVF in a way that we're not always aware of and I think the clinics are not always careful about. The other thing clinics do is call you and say, "Congratulations, you're pregnant." And we all know what a pregnancy test means or what it's supposed to mean.

I think that's even harder on people, that there actually is some power to saying, "Here's your HCG levels, we're going to measure again in a week," as opposed to, "Congratulations, you're pregnant." Because we think we know what a positive home pregnancy test means or a positive clinical pregnancy test. We think it means you're going to have a baby in nine months. We should know that in fact, it means that there's a 70% chance you'll have a baby in nine months.

Exactly.

But that's not part of our cultural narrative. And I think it really needs to be, so that's part of my project with this book.

Yeah. I mean, my understanding is a lot of places, well if your HCG is below a certain threshold, they'll say it's at this threshold, we want to see it double in two days. If we don't see a double in two days, this is not what you think it is. That there are under maybe, is it 50 micrograms or I don't remember what the actual units are. But there's like an under 50 or an under five, if I remember correctly around which they sort of give you a more, not so sure about this kind of notion.

But yeah, my experience with this one was that the doctor and his nurses all got on the phone together and sort of like, woohoo, celebrated with me, which was lovely. But then I also immediately being a science nerd, I said, "Can you tell me what the actual HCG was?" So, my first thing is I wanted to know what it was. And then two days later, when I had my doubling test, I wanted to know what that one was, because I wanted the data.

And I wonder, too, this is making me think a little bit about what you were saying about how the pamphlets for women learning about periods sort of filled a void that women were looking for and were comforting and useful to them in some way. I do agree that there are unfortunately a lot of IVF clinics who are very irresponsible. But I also wonder to what extent what they're doing is responding to what women are at least saying that they want.

Because I know personally, I'm always like, "I want as much data as possible. You can take more blood tests of me. I want more ultrasounds, I want to see what's going on," partly because of my intellectual curiosity and partly because these things do comfort me and they provide me with additional information when I'm not sure if things are going well or not. And so, I wonder, I don't want to universalize my experience, but I wonder to what extent there is a push on the side of women seeking to get pregnant, who are also themselves saying, "No, I want this," you know?

Oh, absolutely. And it's a tricky situation. I think people want it to work out and they want it to work out in a way that causes them the least anxiety and pain. And almost every IVF experience contains at least some of that and some of them are devastating. So, there's no perfect right answer. When clinics are too dour and realistic, their patients find them too unreassuring sometimes or feel like they've been a real downer on their pregnancy experience. On the other hand, when they're too reassuring and optimistic, sometimes patients feel misled. I mean, and this is true, I think of any confirmation of pregnancy but it's much more magnified in IVF.

And IVF is this miracle, that we can do it at all. And it is the instantiation of this idea that we can control reproduction and that if we can just get enough control of it, that we have the ability to make beautiful families and have the life that we all wish that we could have, again, I think as middle class Americans. But we have to face that we don't always have perfect control. And what do we do as a society when we are in many ways rightly striving for as much control as we can possibly have in order to make lives as good as they can possibly be, but then also have some way to accept it when we don't have perfect control.

And I don't have the answer to that. But I think it's a dilemma that we face more and more, almost because of all of the wonderful things we've been able to come up with in the last century. But I think it's important for us to contemplate ahead of time and have some ideas about what we are willing to accept ultimately, because as I found researching miscarriage, sometimes things don't work out and inevitably, there will be some things that don't work out which ones can we accept? And how do we accept when it doesn't work? And how much are we willing to strive to control knowing that some of the time will fail?

Right. I was recently recruited by a mainstream media parenting magazine to write a piece on miscarriage. And they asked me, "Would you make sure to talk about the latest therapies and how to prevent miscarriage?" And the very first thing I wrote back was, "There really isn't such a thing as preventing miscarriage. There's really not a lot out there that's effective. The majority of miscarriages happen because of chromosomal abnormalities and there isn't really a lot you can do about it." And the response was, "Yes, but we want something hopeful for our reader. So, can you please look into that and make sure you cover at least what little there is."

And there is a little I'm sure you know, too, because I'm sure you've had to do extensive research on this. There is some around progesterone therapies and a few things like that. But for the most part when a miscarriage happens, it's when it needs to happen. And there are certainly some structural issues sometimes in the maternal environment that can be adjusted. But a lot of the time what's going on is, is that that embryo maybe shouldn't be sticking around.

And that is a very hard thing to come up against because we'd love to have solutions. We'd love to know, if you take this pill or you do this thing while you're while you're trying to get pregnant, this is how you will ensure that it'll all work. But yeah, I agree with you that there's a lot more uncertainty that I would like us to embrace around this process. Especially as a pregnant person right now, I hate the uncertainty. But there's also a part of me that knows that has to kind of be the reality.

Right. I totally agree. So, where I stand with this is that I'm hoping to make some cultural change in our expectations and in the things that we do that make it hurt more, when we have a loss that we can say realistically, there's a 20% chance. So, if there's a 20% chance, maybe babycenter.com has to be more careful about who they send the emails to saying, "Here's the list of baby names." Maybe it's not time yet at six weeks, that we could be a little more careful with ourselves in ways that I think really would be comforting and helpful.

And to me, the way to be hopeful is not to say to people, there might be some medical thing we can do to you if you've had a miscarriage. But can I give you some perspective. If you've had a miscarriage or two, we don't anticipate that you'll have trouble having children. And ultimately, that's your goal. And that I hope we can make it okay if in the end, what happens is that you have a child, as opposed to what happens is that you don't have any reproductive mishaps.

Yeah, exactly. So, when is this book coming out? Do you know when it might be released?

I don't have a date. I have most of the manuscripts so I'm hoping it won't be-

That's wonderful.

... too, too long. Thanks. Yeah.

Okay. Well, thank you so much, Dr. Freidenfelds. This was a really lovely conversation. So, thank you so much.

Absolutely. Thank you. I really enjoyed it.

My field spends a lot of time looking for difference. What was so interesting about what Dr. Freidenfelds found was that in the quest for obtaining middle class status, Americans from all over the country changed their behaviour and became considerably more like when it came to how they experienced and manage their periods. My thanks to this awesome feminist historian for her thorough and thought-provoking work.

If you liked this interview, you can check out more at larafreidenfelds.com or pick up a copy of her book, The Modern Period, Menstruation in Twentieth-Century America.

Shownotes:

Excerpt: We learn about periods through history, and those moments when corporate interests, scientific knowledge, and women’s lives align. 

Summary: This week I’m excited to talk to Dr. Lara Freidenfelds, an historian of women’s health. She blogs on reproduction, women’s health, and parenting as a regular contributor to nursingclio.org and at larafreidenfelds.com/blog. As an anthropologist, I love when I have the chance to interview humanists and social scientists. Dr. Freidenfelds has put together a truly fascinating account of what it means to get your period in the United States – it is deeply researched, drawn from dozens of interviews. This book, the topic of which will comprise most of our interview, is called The Modern Period: Menstruation in Twentieth-Century America. Her next book, Perfecting Pregnancy and Mourning Miscarriage: The History That Shaped Modern Childbearing, is coming out from Oxford University Press in 2019.

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