Emma Day is a Leverhulme Trust Early Career Fellow at the Institute of the Americas, University College London, and a 2025-2026 Consortium Research Fellow.
I am incredibly grateful for the support I received from the Consortium which enabled me to conduct research for my second book project, tentatively titled Beyond Procreation: A New History of Reproductive Justice in the United States.
Beyond Procreation examines the creation and maintenance of the concept of reproductive health and its role in shaping the politics of the gendered body in the United States since the mid-nineteenth century. The research asks how gendered norms and expectations – in particular, the cultural expectation for women to become pregnant – has informed the production of scientific knowledge and shaped the medical treatment of a wide range of health topics that may have been related to, but were not primarily about, a person’s desire or not to become pregnant. These include the management of fibroids, cysts, and other benign tumors, as well as cancer, ageing, and anatomical variation.
Historians of reproduction have shown how efforts to promote and uphold traditional sex and gender roles have shaped restrictive policies around birth control, abortion, and immigration throughout US history. My project seeks to add to this literature by exploring how pronatalist values impacted lived experiences of illness and hampered efforts to conceptualize and address health concerns beyond their relation to procreation within modern medicine.
As a 2025-2026 Consortium Fellow, I visited five archives critical to the success of the project: the Huntington Library, Johns Hopkins University Chesney Medical Archives, Duke University’s Medical Center Library and Archives and Rubenstein Library, Drexel University Legacy Center, and the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania.
Huntington Library
At the Huntington Library in Los Angeles, I consulted the Lawrence D. Longo and Betty Jeanne Longo Collection in Reproductive Biology. Spanning the sixteenth to the twentieth century, this extensive collection of medical writings helped me to reconstruct the medical worldview and evolving practices of physicians who transformed gynecological surgery from a disreputable field into a respectable profession in the late nineteenth century. In this moment of profound scientific change, I consulted medical publications which revealed how surgeons developed theories about how the body functioned, the purpose of sexual and reproductive organs, and the ways in which their perceived misuse undermined health. The large volume of materials illuminated the wide range of conditions which animated medical debate during the period of professionalisation and specialisation, which ranged from cancer of the uterus to menstrual pain and menopause. These sources revealed why surgeons considered certain conditions particularly significant and which they regarded as most urgently requiring intervention.
Johns Hopkins University Library
I then visited the Johns Hopkins Chesney Medical Archives in Baltimore where I consulted the papers of medical professionals who helped to further institutionalise reproductive medicine in the United States: gynecologists Howard A. Kelly and Thomas S. Cullen and urologist Hugh Hampton Young. The collections at the Chesney Medical Archives illuminated how the history of gynaecology intersected with the history of urology and how the medical management of men – and of people with anatomical or hormonal variation typically codified as intersex – compared to the treatment of people codified as women. These records underscore how gender shaped the ways in which medics understood what it meant to have reproductive and sexual health over time.
In addition to consulting medical publications, newspaper articles, and medical correspondence, the case histories of people treated at the Brady Urological Institute shed critical light on the clinical encounters between health professionals and patients. These records illuminated not only the conditions for which people sought treatment, but how health professionals developed their clinical practice and shaped a school of thought on the care of patients.
The collections I consulted at the next three archives centered the voices and perspectives of women. These included physicians who applied what they learned at male-dominated medical schools like Johns Hopkins to their own practice in the twentieth century.
Duke University
At Duke Medical Center Library and Archives, I consulted the papers of obstetrician and gynecologist Dr. Eleanor Easley who in 1934 became the first woman to graduate from Duke University School of Medicine’s first four-year class. In 1941, Easley co-founded the Durham Women’s Clinic in North Carolina. Comprised mostly of lectures Easley delivered to other health care practitioners in North Carolina in the mid-to-late twentieth century, the collection revealed how Easley conceptualised health and illness, including how she understood the cause of gynaecological illness and the appropriate cure. Easley’s arguments spoke to broader social and cultural changes including the growing availability of birth control and related debates around the purported social and economic costs of global ‘overpopulation.’ Her collection reveals how physicians conceived of reproductive health in light of social and technological developments.
The Reproductive Health Ephemera collection at Duke’s Rubenstein Library also detailed the creation and circulation of knowledge on sex and reproduction beyond formal medical channels across the nineteenth and twentieth centuries. These sources – which ranged from handbooks to pharmaceutical adverts and self-help newsletters – highlighted changing social attitudes on sex, reproduction, and gender across modern US history and provided critical context to the professional papers and case histories of individual physicians.
Drexel University
The collections at the Drexel University Legacy Centre in Philadelphia provided further evidence of how women physicians addressed sexual and reproductive health topics between the late nineteenth and late twentieth century.
Highlights included the papers of Catherine MacFarlane, an obstetrician and gynaecologist who earned her medical degree from the Women’s Medical College of Pennsylvania in 1895 and completed postgraduate training in urology at Johns Hopkins. MacFarlane opened a private practice in 1900 before taking up positions at the Women’s Hospital in Philadelphia and Women’s Medical College of Pennsylvania. MacFarlane dedicated much of her career to addressing cancer and was particularly influential in advocating new methods of cancer prevention through routine pelvic and breast exams. MacFarlane’s papers illuminated the strategies physicians used to persuade people to engage in public health in ways that perpetuated normative ideas about what women’s bodies are for.
The papers of Florence Haseltine also spoke to how different areas of reproductive science and medicine informed the meaning of normal/abnormal and healthy/pathological in the late twentieth century, including how reproductive scientists drew on the science of chromosomes to address perceived abnormalities and sex differentiation. Training first as a physicist and biophysicist, Haseltine earned her MD in 1972 and dedicated much of her career to genetics and reproductive endocrinology. In 1985, Haseltine joined the National Institutes of Health where she petitioned for the inclusion of women in clinical research. Haseltine’s role in helping to create the Office of Research on Women’s Health in 1990 revealed efforted to expand the meaning of women’s health beyond pregnancy.
The papers of Catherine MacFarlane, Florence Haseltine, and Eleanor Easley illuminate changing attitudes towards women working in diverse fields of reproductive science and medicine across the twentieth century, including how women accepted, navigated, or challenged established ideas and practice.
University of Pennsylvania
Shifting the focus away from physicians, my visit to the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania in Philadelphia revealed the role of nurse-midwives in the development of reproductive health care in the twentieth century.
Since the colonial era, women relied on networks of other women for information on techniques to prevent, end, or aid a pregnancy. In the nineteenth century, women’s ability to provide care for one another came under attack from trained physicians who sought to monopolize medical practice.
Despite these obstacles, the practice of midwifery persisted. The American College of Nurse-Midwives was founded in 1955. The papers of nurse-midwives including Joyce Roberts and Ruth Watson Lubic revealed the ongoing role of midwives in assisting women with fertility management, including abortion, in addition to supporting birthing and pre-and-postnatal care. These records, analyzed alongside the Nursing History Small Collections, which contained evidence of nursing education and training, illuminated how different professions competed for the management of sex and reproduction and the power to conceptualize reproductive health.
This research has deepened and expanded my project in several ways. Most notably, while the sources revealed the medical community’s persistent concern with the impact of urological and gynecological conditions on procreation, they also illuminated the other social and medical factors that motivated practice with long-term implications for sexual and reproductive health.
