Pashigian, Melissa

English

Scholarship, Research, and Creative Work at Bryn Mawr College | Bryn Mawr College Research

Bryn Mawr CollegeScholarship, Research, and Creative Work at Bryn MawrCollegeAnthropology Faculty Research and Scholarship Anthropology2003Review of Regulating Menstruation: Beliefs, Practices,Interpretations, edited by Etienne van de Walle andElisha P. RenneMelissa PashigianBryn Mawr College, mpashigi@brynmawr.eduLet us know how access to this document benefits you.Follow this and additional works at: http://repository.brynmawr.edu/anth_pubsPart of the Anthropology CommonsThis paper is posted at Scholarship, Research, and Creative Work at Bryn Mawr College. http://repository.brynmawr.edu/anth_pubs/4For more information, please contact repository@brynmawr.edu.CitationPashigian, Melissa J. "Constructing Menstrual Regulation," review of Regulating Menstruation: Beliefs, Practices, Interpretations, edited byEtienne van de Walle and Elisha P. Renne. Current Anthropology 44, no. 2 (2003): 313-314.Volume 44, Number 2, April 2003 F 313technological change and institutional change and theimplications for an equilibrium theory of markets.In a concluding chapter of the book, he illustrates histheory with reference to problems of economic devel-opment. Once again, he chooses to critique theories ofdevelopment that ignore individual decision making,subsequent institutional emergence, and the constrain-ing nature of institutions and individual learning. Henotes, as have other new institutionalists, that suchtheories fail to explain why development has proceededso unevenly in countries with very similar formal in-stitutions and, at the same time, observes that coun-tries with similar informal institutions but differentformal institutions have also had very different eco-nomic trajectories. Thus, any theory of development inlarge-scale societies must take account of both types ofinstitutions and consider why some sets of informal andformal institutions are complementary rather than op-positional. In the final pages he begins an explorationof this problem, asking what institutional mix providesthe conditions for growth. In the end, however, it is notclear to what extent he believes that deliberate designof institutions is possible. He dismisses Elinor Ostrom’s(e.g., 1990) work on institutional design by arguing thatit is relevant solely to small-scale societies governedby informal institutions whereas large-scale societiesrequire formal institutions that can only evolve by anunintentional process of the invisible-hand type. Hecomes to the disheartening conclusion that it must berare for complementary institutions to arise in bothinformal and formal sectors. In the case of post-SovietRussia, the adoption of formal institutions guarantee-ing property rights and open markets has not been suf-ficient to create growth, since existing informal insti-tutions (e.g., expectations about the stability of reforms)are not complementary to the formal ones and can beexpected to change at a much slower rate. It must benoted, however, that while making this “Hayekian” ar-gument that the growth of knowledge and of institu-tions cannot be deliberate, he differs sharply withHayek in arguing against a unilineal process leading toeconomic growth and greater social welfare. Rather,with North, he argues that many paths are possible inan evolutionary process driven by this view of individ-ual learning.References Citedb o y d , r . , a n d p . j . r i c h e r s o n . 1985. Culture and theevolutionary process. Chicago: University of Chicago Press.n o r t h , d . 1990. Institutions, institutional change, and eco-nomic performance. New York: Cambridge University Press.o s t ro m , e . 1990. Governing the commons: The evolution ofinstitutions for collective action. New York: Cambridge Uni-versity Press.Constructing MenstrualRegulationmelissa j . pashigianDepartment of Anthropology, Bryn Mawr College,Bryn Mawr, Pa. 19010, U.S.A. (mpashigi@brynmawr.edu). 18 iv 02Regulating Menstruation: Beliefs, Practices,Interpretations. Edited by Etienne van de Walle andElisha P. Renne. Chicago: University of ChicagoPress, 2001. 292 pp.Regulating Menstruation brings together articles byhistorians, anthropologists, demographers, and healthspecialists to examine perceptions of menstruation andwomen’s intentions to affect their menses. Part 1 con-cerns menstrual regulation in the West both histori-cally and in the present; part 2 is a compilation of so-ciocultural perspectives on menstrual regulation inAfrica, Latin America, and South and Southeast Asia.Menstruation has been described as polluting and/orpurifying and as an indication of illness or health. Thesesymbolic ambiguities are reflected in women’s actionsto regulate it. The contributors to this volume suggestthat the behavior of a woman who fails to menstruateand seeks to regulate her menstruation through the useof emmenagogues (agents promoting menstrual dis-charge) can be interpreted in multiple ways; she maybe seeking an early-term abortion or simply protectingher health, and the resumption of menstruation attrib-uted to their use may signal that she was not pregnant.Contributors point out that the ambiguity surroundingwomen’s intentions reflects the nature of menstrua-tion. Amenorrhea can indicate pregnancy, the inabilityto conceive, or underlying disease. Return of mensescan indicate failure to conceive or, alternatively, thepossibility of a future pregnancy. The case examples inthis volume reveal the ways in which menstrual reg-ulation is a culturally embedded practice and show thatwomen’s intentions in using it are not always clearlydefined.In the course of the past 300 years, irregular men-struation has been varyingly interpreted to indicatepregnancy, underlying disease, or normal variation ina woman’s cycle. Part 1 of this volume traces some ofthese changes historically. Van de Walle’s essay tracesthe topic of menstrual stimulation in the West to thehumoral theories of Hippocrates and Galen and themateria medica assembled by Dioscorides, exploringthe contexts in which Greek physicians recommendedmenstrual stimulants and the substances used. Em-menagogue use took on the meaning of producingmenstrual regularity in the 18th, 19th, and 20th cen-314 F current anthropologyturies in Anglo-American and European contexts. Dis-tinguishing the use of emmenagogues to restore awoman’s health from their use as abortifacients couldconfer social respectability on a woman in 18th-cen-tury America (Klepp). Similarly, the ambiguity of em-menagogues was further manifested in the 19th-cen-tury United States as women, their physicians, andcommercial trade in fertility-intervening drugs pro-moted regularized reproduction (Brodie). During the20th century, Western interpretations of emmena-gogues reflected shifts in the ways in which both themedical community and laypersons viewed irregularmenses, from causing ill health to resulting from illhealth to reflecting ill health and a growing desire forcontrol over childbearing (Santow).Siedlecky explores the properties of a number of com-mon emmenagogues and abortifacients used at the turnof the century and suggests that while women havehistorically sought to control their fertility for bothmedical and social reasons, the effectiveness of herbalemmenagogues was dubious and any success likelyfortuitous.Currently, the contraceptive pill is a menstrual reg-ulator that can prevent pregnancy, regularize menstrualcycles, and serve as a postcoital emergency contracep-tive. Some women experience breakthrough bleedingusing the pill, and uninterrupted pill taking for con-secutive cycles can prevent menstruation altogether.Potter finds that the desire for menstruation outweighsthe desire for convenience and pregnancy protection,leading users and prescribers to feel ambivalent aboutthe pill.Focusing on demography, Warriner reviews the lit-erature on secondary amenorrhea—the pathological ab-sence of menstruation in women who have previouslymenstruated regularly—and considers its causes andimpact on fertility, suggesting that it has been largelyneglected in demographic studies, particularly of de-velping countries in which its prevalence is high.Part 2 of the volume addresses menstrual regulationoutside the West but touches on many of the samethemes. These chapters make abundantly clear thatmenstrual regulation is embedded in the social contextsin which it is practiced. In the high-fertility context ofGuinea, inducing menses is a way of ensuring futurechildbearing by maintaining good reproductive health.Menstrual problems signal compromised fertility, theimpetus for using plant medicinals to induce menstru-ation when it is late. Levin argues that menstrual reg-ulation in this cultural context is understood both tohelp women avoid pregnancy and to maintain theirhealth and that trying to separate women’s intentionsmisses the point.Bamana women in Mali are expected to bear largenumbers of children and can experience great psycho-logical distress when trying to reconcile high-fertilitydesires with irregular menses. They also link regularmenstruation with reproductive health, using emmen-agogues to induce menses. Madhaven and Diarra shedlight on the ambiguity that surrounds this use when itmay signify to others a possible abortion in a contextin which high fertility is demanded.Renne suggests that menstruation and its regulationcannot be understood outside of their larger sociocul-tural and historical context. Shifts over the past 100years in the social lives of the Ekiti Yoruba in south-western Nigeria have contributed to changes in wo-men’s reasons for menstrual regulation and the meth-ods they use. Renne describes the ambiguous use ofherbal and chemical emmenagogues and dilation andcurettage among these women to cleanse the womb inorder to enhance fertility or to cleanse the womb ofpregnancy.Hull and Hull suggest that Indonesian women takeherbal emmenagogues for individual reasons that mayvary with their circumstances. The meaning of this usemay alternate between a means to regulate menses asa sign of health and a way to prevent pregnancy. Theycall for further research on the actual impact of herbson menstruation and for recognition of menstrual reg-ulation as a central issue in reproductive health re-search and policy agendas.In Matlab, Bangladesh, menstrual blood at once sym-bolizes pollution and cleansing of the female body andsignifies that a woman is fertile. Johnson shows howmodern contraception, including injectable contracep-tion that can induce amenorrhea, has influenced theways in which rural Bangladeshi women experience andrespond to irregular menstruation, which now includethe use of other modern contraceptive methods suchas oral contraceptives and dilation and curettage.In the Andes, Quechua-speaking women privilege in-digenous female knowledge about menstruation and fe-male-related syndromes. Hammer reports that thisknowledge is often hidden and passed among femalekin. These women apply ideas of bodily humoral con-cepts in the regulation of menstrual flow, with theamount and duration of flow being indicators of fertilitypotential.Cosminsky addresses the issue of midwives and au-thoritative knowledge in treating delayed menstruationin rural Guatemala. She argues that midwives, withtheir ability to negotiate the ambiguity of delayed men-struation, serve as agents of social control, reinforcinglocal values as well as perpetuating ethnomedicalknowledge and principles. She suggests that becausetheir knowledge is denigrated by biomedical authoritiesand midwifery training courses, this knowledge may bedying out.The articles in this volume eloquently show thatwomen attempt to regulate their menstruation for amultitude of reasons the nuances of which have oftenbeen neglected. Revealing new ways of looking at men-struation and new aspects of the contexts in whichmenstrual practices are embedded, it significantly fur-thers our understanding of the issues that shapewomen’s reproductive experiences and practices.

Review of \u3ci\u3eRegulating Menstruation: Beliefs, Practices, Interpretations\u3c/i\u3e, edited by Etienne van de Walle and Elisha P. Renne

Scholarship;  Research;  and Creative Work at Bryn Mawr College

Bryn Mawr College
Scholarship, Research, and Creative Work at Bryn Mawr
College
Anthropology Faculty Research and Scholarship Anthropology
2003
Review of Regulating Menstruation: Beliefs, Practices,
Interpretations, edited by Etienne van de Walle and
Elisha P. Renne
Melissa Pashigian
Bryn Mawr College, mpashigi@brynmawr.edu
Let us know how access to this document benefits you.
Follow this and additional works at: http://repository.brynmawr.edu/anth_pubs
Part of the Anthropology Commons
This paper is posted at Scholarship, Research, and Creative Work at Bryn Mawr College. http://repository.brynmawr.edu/anth_pubs/4
For more information, please contact repository@brynmawr.edu.
Citation
Pashigian, Melissa J. "Constructing Menstrual Regulation," review of Regulating Menstruation: Beliefs, Practices, Interpretations, edited by
Etienne van de Walle and Elisha P. Renne. Current Anthropology 44, no. 2 (2003): 313-314.
Volume 44, Number 2, April 2003 F 313
technological change and institutional change and the
implications for an equilibrium theory of markets.
In a concluding chapter of the book, he illustrates his
theory with reference to problems of economic devel-
opment. Once again, he chooses to critique theories of
development that ignore individual decision making,
subsequent institutional emergence, and the constrain-
ing nature of institutions and individual learning. He
notes, as have other new institutionalists, that such
theories fail to explain why development has proceeded
so unevenly in countries with very similar formal in-
stitutions and, at the same time, observes that coun-
tries with similar informal institutions but different
formal institutions have also had very different eco-
nomic trajectories. Thus, any theory of development in
large-scale societies must take account of both types of
institutions and consider why some sets of informal and
formal institutions are complementary rather than op-
positional. In the final pages he begins an exploration
of this problem, asking what institutional mix provides
the conditions for growth. In the end, however, it is not
clear to what extent he believes that deliberate design
of institutions is possible. He dismisses Elinor Ostrom’s
(e.g., 1990) work on institutional design by arguing that
it is relevant solely to small-scale societies governed
by informal institutions whereas large-scale societies
require formal institutions that can only evolve by an
unintentional process of the invisible-hand type. He
comes to the disheartening conclusion that it must be
rare for complementary institutions to arise in both
informal and formal sectors. In the case of post-Soviet
Russia, the adoption of formal institutions guarantee-
ing property rights and open markets has not been suf-
ficient to create growth, since existing informal insti-
tutions (e.g., expectations about the stability of reforms)
are not complementary to the formal ones and can be
expected to change at a much slower rate. It must be
noted, however, that while making this “Hayekian” ar-
gument that the growth of knowledge and of institu-
tions cannot be deliberate, he differs sharply with
Hayek in arguing against a unilineal process leading to
economic growth and greater social welfare. Rather,
with North, he argues that many paths are possible in
an evolutionary process driven by this view of individ-
ual learning.
References Cited
b o y d , r . , a n d p . j . r i c h e r s o n . 1985. Culture and the
evolutionary process. Chicago: University of Chicago Press.
n o r t h , d . 1990. Institutions, institutional change, and eco-
nomic performance. New York: Cambridge University Press.
o s t ro m , e . 1990. Governing the commons: The evolution of
institutions for collective action. New York: Cambridge Uni-
versity Press.
Constructing Menstrual
Regulation
melissa j . pashigian
Department of Anthropology, Bryn Mawr College,
Bryn Mawr, Pa. 19010, U.S.A. (mpashigi@brynmawr.
edu). 18 iv 02
Regulating Menstruation: Beliefs, Practices,
Interpretations. Edited by Etienne van de Walle and
Elisha P. Renne. Chicago: University of Chicago
Press, 2001. 292 pp.
Regulating Menstruation brings together articles by
historians, anthropologists, demographers, and health
specialists to examine perceptions of menstruation and
women’s intentions to affect their menses. Part 1 con-
cerns menstrual regulation in the West both histori-
cally and in the present; part 2 is a compilation of so-
ciocultural perspectives on menstrual regulation in
Africa, Latin America, and South and Southeast Asia.
Menstruation has been described as polluting and/or
purifying and as an indication of illness or health. These
symbolic ambiguities are reflected in women’s actions
to regulate it. The contributors to this volume suggest
that the behavior of a woman who fails to menstruate
and seeks to regulate her menstruation through the use
of emmenagogues (agents promoting menstrual dis-
charge) can be interpreted in multiple ways; she may
be seeking an early-term abortion or simply protecting
her health, and the resumption of menstruation attrib-
uted to their use may signal that she was not pregnant.
Contributors point out that the ambiguity surrounding
women’s intentions reflects the nature of menstrua-
tion. Amenorrhea can indicate pregnancy, the inability
to conceive, or underlying disease. Return of menses
can indicate failure to conceive or, alternatively, the
possibility of a future pregnancy. The case examples in
this volume reveal the ways in which menstrual reg-
ulation is a culturally embedded practice and show that
women’s intentions in using it are not always clearly
defined.
In the course of the past 300 years, irregular men-
struation has been varyingly interpreted to indicate
pregnancy, underlying disease, or normal variation in
a woman’s cycle. Part 1 of this volume traces some of
these changes historically. Van de Walle’s essay traces
the topic of menstrual stimulation in the West to the
humoral theories of Hippocrates and Galen and the
materia medica assembled by Dioscorides, exploring
the contexts in which Greek physicians recommended
menstrual stimulants and the substances used. Em-
menagogue use took on the meaning of producing
menstrual regularity in the 18th, 19th, and 20th cen-
314 F current anthropology
turies in Anglo-American and European contexts. Dis-
tinguishing the use of emmenagogues to restore a
woman’s health from their use as abortifacients could
confer social respectability on a woman in 18th-cen-
tury America (Klepp). Similarly, the ambiguity of em-
menagogues was further manifested in the 19th-cen-
tury United States as women, their physicians, and
commercial trade in fertility-intervening drugs pro-
moted regularized reproduction (Brodie). During the
20th century, Western interpretations of emmena-
gogues reflected shifts in the ways in which both the
medical community and laypersons viewed irregular
menses, from causing ill health to resulting from ill
health to reflecting ill health and a growing desire for
control over childbearing (Santow).
Siedlecky explores the properties of a number of com-
mon emmenagogues and abortifacients used at the turn
of the century and suggests that while women have
historically sought to control their fertility for both
medical and social reasons, the effectiveness of herbal
emmenagogues was dubious and any success likely
fortuitous.
Currently, the contraceptive pill is a menstrual reg-
ulator that can prevent pregnancy, regularize menstrual
cycles, and serve as a postcoital emergency contracep-
tive. Some women experience breakthrough bleeding
using the pill, and uninterrupted pill taking for con-
secutive cycles can prevent menstruation altogether.
Potter finds that the desire for menstruation outweighs
the desire for convenience and pregnancy protection,
leading users and prescribers to feel ambivalent about
the pill.
Focusing on demography, Warriner reviews the lit-
erature on secondary amenorrhea—the pathological ab-
sence of menstruation in women who have previously
menstruated regularly—and considers its causes and
impact on fertility, suggesting that it has been largely
neglected in demographic studies, particularly of de-
velping countries in which its prevalence is high.
Part 2 of the volume addresses menstrual regulation
outside the West but touches on many of the same
themes. These chapters make abundantly clear that
menstrual regulation is embedded in the social contexts
in which it is practiced. In the high-fertility context of
Guinea, inducing menses is a way of ensuring future
childbearing by maintaining good reproductive health.
Menstrual problems signal compromised fertility, the
impetus for using plant medicinals to induce menstru-
ation when it is late. Levin argues that menstrual reg-
ulation in this cultural context is understood both to
help women avoid pregnancy and to maintain their
health and that trying to separate women’s intentions
misses the point.
Bamana women in Mali are expected to bear large
numbers of children and can experience great psycho-
logical distress when trying to reconcile high-fertility
desires with irregular menses. They also link regular
menstruation with reproductive health, using emmen-
agogues to induce menses. Madhaven and Diarra shed
light on the ambiguity that surrounds this use when it
may signify to others a possible abortion in a context
in which high fertility is demanded.
Renne suggests that menstruation and its regulation
cannot be understood outside of their larger sociocul-
tural and historical context. Shifts over the past 100
years in the social lives of the Ekiti Yoruba in south-
western Nigeria have contributed to changes in wo-
men’s reasons for menstrual regulation and the meth-
ods they use. Renne describes the ambiguous use of
herbal and chemical emmenagogues and dilation and
curettage among these women to cleanse the womb in
order to enhance fertility or to cleanse the womb of
pregnancy.
Hull and Hull suggest that Indonesian women take
herbal emmenagogues for individual reasons that may
vary with their circumstances. The meaning of this use
may alternate between a means to regulate menses as
a sign of health and a way to prevent pregnancy. They
call for further research on the actual impact of herbs
on menstruation and for recognition of menstrual reg-
ulation as a central issue in reproductive health re-
search and policy agendas.
In Matlab, Bangladesh, menstrual blood at once sym-
bolizes pollution and cleansing of the female body and
signifies that a woman is fertile. Johnson shows how
modern contraception, including injectable contracep-
tion that can induce amenorrhea, has influenced the
ways in which rural Bangladeshi women experience and
respond to irregular menstruation, which now include
the use of other modern contraceptive methods such
as oral contraceptives and dilation and curettage.
In the Andes, Quechua-speaking women privilege in-
digenous female knowledge about menstruation and fe-
male-related syndromes. Hammer reports that this
knowledge is often hidden and passed among female
kin. These women apply ideas of bodily humoral con-
cepts in the regulation of menstrual flow, with the
amount and duration of flow being indicators of fertility
potential.
Cosminsky addresses the issue of midwives and au-
thoritative knowledge in treating delayed menstruation
in rural Guatemala. She argues that midwives, with
their ability to negotiate the ambiguity of delayed men-
struation, serve as agents of social control, reinforcing
local values as well as perpetuating ethnomedical
knowledge and principles. She suggests that because
their knowledge is denigrated by biomedical authorities
and midwifery training courses, this knowledge may be
dying out.
The articles in this volume eloquently show that
women attempt to regulate their menstruation for a
multitude of reasons the nuances of which have often
been neglected. Revealing new ways of looking at men-
struation and new aspects of the contexts in which
menstrual practices are embedded, it significantly fur-
thers our understanding of the issues that shape
women’s reproductive experiences and practices.


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Scholarship; Research; and Creative Work at Bryn Mawr College