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Milestones in women's health

In observance of Women's History Month, we review some of the events and people whose work has affected women's well-being

1000s Trotula of Salerno, Italy, is one of the most famous physicians of her time. She publishes a manuscript, De Passionibus Mulierum -- "On the Diseases of Women." She was an early advocate of gaining health through a balanced diet, exercise and sanitation.

1550s In France, Catherine de Medici's court developed strict regulations that governed a woman's waist size and her position in the court; it has been said she required a 13-inch waist for her ladies and their maids. Out of necessity, women began wearing new steel corsets.

1648 Margaret Jones, a midwife and a healer, is deemed a witch in early Massachusetts. She's accused of having a "malignant touch," and it is said that her medicines have "extraordinary violent effects." Jones' execution is the first for witchcraft in New England.

1880 The diaphragm is invented as a method of birth control.

1911 Foot-binding is made illegal in China, ending a 1,000-year-old practice that purposely disabled millions of Chinese women by keeping their feet from growing more than 3 or 4 inches long. Some women's feet, however, were still bound illegally. The last manufacturer of "lotus shoes," the tiny slippers made for bound feet, doesn't shut down until the late 1990s.

Also, after a deadly fire at the Triangle Shirtwaist Co. in New York City, the women who worked in the factory organized -- with the help of the International Ladies' Garment Workers' Union and the Women's Trade Union League -- to demand better working conditions, and safer and more sanitary facilities.

1917 America enters World War I. Women, in response to a call from the War Industries Board, stop buying steel-boned corsets. The effort saves 28,000 tons of metal -- enough to build two battleships.

1936 Tampax makes the first "internal sanitary napkins" with applicators and strings.

1938 The federal Food, Drug and Cosmetic Act requires manufacturers to prove that a product is safe for its intended use, provide a full list of ingredients and show sound manufacturing. The act also allows, for the first time, regulation of cosmetics and medical devices. Lash Lure, an eyelash dye that blinded one woman and killed another, is the first product seized under the new act.

1941 Penicillin is first used to treat infections.

1942 Premarin, the nation's first hormone replacement therapy, becomes available. The drug is marketed for treatment of menopausal symptoms.

1943 The Pap test is introduced. It was developed by George Papanicolaou in 1928 as a diagnostic method for uterine cancer. In 1943, along with a gynecological pathologist, he published a monograph on the diagnosis of uterine cancer, and a new diagnostic procedure called the Pap test was introduced.

1953 The drug levothyroxine is introduced to treat hypothyroidism (underactive thyroid), which affects eight times as many women as men. (As many as 1 in 10 older women may have this condition.) The drug is marketed as Synthroid, Levoxyl and others.

1956 Seven women establish an organization called La Leche League because they believe breast-feeding is important for mothers and babies.

1960 The pill arrives: The FDA approves the first oral contraceptive, and it is made available to the public as Enovid-10.

1968 To prevent complications during childbirth with Rh-negative mothers, the FDA licenses Rh immunoglobins.

1970 Package inserts are required in all oral contraceptives, explaining to women the benefits and the risks of each drug. Also, the Boston Women's Health Book Collective publishes the first edition of Our Bodies, Ourselves. It informed women about their bodies, their identities as women and the politics of health care, and has been translated into 19 languages; an updated book, Our Bodies, Ourselves for the New Century was published in 1998.

1971 A vaccine is introduced for rubella, also known as German measles, a disease that can cause miscarriages and birth defects.

Also, cigarette advertisements are officially banned from television. But women remained a lucrative target for advertising: A year after the ban, the company that makes Virginia Slims began to sponsor women's tennis tournaments.

Also, the FDA begins to require drug labels warning when a product is unsafe for pregnant women, because of diethylstilbestrol (DES), a hormone prescribed to pregnant women since 1948 to increase their estrogen levels. The FDA stepped in when it was discovered that daughters exposed to DES in the womb developed a rare form of vaginal cancer.

1972 The Special Supplemental Nutrition Program for Women, Infants and Children -- better known as WIC -- begins as a pilot program to improve the health of pregnant women, new mothers and their children. It became permanent in 1974 and offers vouchers for nutritious food, nutrition education and counseling; it also provides health screenings to new mothers who have low incomes and are determined to be at "nutritional risk."

1973 A landmark Supreme Court decision makes abortion legal in the United States. In Roe vs. Wade, the justices determined that a woman's access to legal abortion is a basic privacy right and not to be determined by state law.

1976 The Nurses Health Study begins. It is a huge long-term epidemiological investigation of the effects of oral contraceptives, diet and lifestyle factors in the development of major chronic diseases. The Nurses Health Study II, looking at a second group of women, begins in 1989.

1977 The Women's Haven of Tarrant County opens, offering a shelter for battered women. It was the second women's shelter to open in Texas.

1978 The FDA approves the first over-the-counter pregnancy test kit.

Also, Louise Brown, the world's first "test-tube baby," arrives, in England on July 25. Today, hundreds of thousands of pregnancies have been achieved through in vitro fertilization.

1979 An English psychiatrist from London, Dr. Gerald Russell, is the first to declare bulimia nervosa a disease.

Also, FDA approves an X-ray machine that measures bone-mineral density. The breakthrough was especially valuable to women who lose bone density as a symptom of osteoporosis.

Also, a World Health Organization meeting in Khartoum, Sudan, raises worldwide awareness of female genital mutilation. The tradition is still practiced, mostly in African countries, though it is also found in Asia, the Middle East and elsewhere. An estimated 2 million women and girls are being "circumcised" each year.

1980 After 814 confirmed cases of toxic shock syndrome in 1980 alone (including 38 deaths), the FDA requires all tampon packages to include inserts explaining the risk of TSS and how to prevent it. The effort is successful: In 1997, the United States has only five confirmed cases of TSS and no deaths.

1992 Congress passes the Mammography Quality Standards Act, which sets standards for mammography personnel, equipment, record-keeping and facility inspections. The act was passed after women and their doctors testified before Congress about problems.

1992 Two major books on menopause are published: The Silent Passage by Gail Sheehy and The Change by Germaine Greer. Menopause becomes, to some degree, a topic that gets public discussion and consideration.

1993 Marital rape becomes a crime in all 50 states. The milestone marks significant progress -- in 1978, it was a crime in only four states. (Today, more than 30 states give husbands some exemptions from rape prosecution.)

1994 A Violence Against Women Act is passed, establishing federal penalties for spouse abusers and protecting the rights of women who are victims in gender-based assaults. The act also provides federal money for rape crisis centers and women's shelters.

1995 FDA approves the drug alendronate, marketed by Merck as Fosamax, the first non-hormone treatment for osteoporosis. The disorder osteoporosis results in loss of bone density leading to potentially crippling brittleness, chiefly in women past menopause.

1997 In Mexico, Congress approves a bill that makes rape by a spouse a crime, outlining prison sentences for offenders. The bill counteracted a Mexican Supreme Court ruling that forcing sex on a spouse was not rape.

1998 The FDA requires folic acid, needed by pregnant women to prevent birth defects such as spina bifida, to be added to many foods.

2001 The U.S. Institute of Medicine determines that, because sex differences exist even at the cellular level, gender should be an important category for consideration in all medical research.

2003 A "National Public Health Initiative on Diabetes and Women's Health" is announced on March 25.

Sources: Food and Drug Administration; Centers for Disease Control; U.S. Census Bureau; Handbook of Texas; a History of the Fort Worth Medical Community by Ann Arnold, the Medical History of Fort Worth and Tarrant County: One Hundred Years, 1853-1953, by L.H. Reeves; Dr. Margie Peschel, Fort Worth; Women's Haven of Tarrant County; Afghanistan Online (Www.Afghan-Web.Com); National Electronic Network on Violence Against Women; National Clearinghouse on Marital and Date Rape; State Library of Massachusetts; "Defining Women's Health" Colloquium at Harvard University (Www.Fas.Harvard.Edu/Womenstudy/Events/Proposal--Timeline.Htm); Mothering the Race: Women's Narratives of Reproduction, 1890-1930 by Allison Berg; the Macmillan Dictionary of Women's Biography; the Penguin Atlas of Women in the World; Www.Distinguishedwomen.Com; American Women's Medical Association; Kheel Center for Labor-Management Documentation and Archives, Cornell University; CDC National Immunization Program

— Compiled by Alyson Ward
Staff writers Cathy Frisinger and Carolyn Poirot contributed to this report.
Edited by Betsy Friauf

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