This is 42 Sidenotes. The place for the incurably curious and endlessly fascinated. Where you’ll find multifaceted, opinionated observations, answers, and questions on life, the universe, and everything. Articles drop every other Sunday.
This is a long one. Read it online (click the title) or click the “read more” (or similar) link when you when you get to it.
Over on Deliberately Difficult & Laughing, I published an article about a pattern that’s played out throughout patriarchal history. It’s still playing out today, despite all the progress we’ve made towards gender equality and equity.
It also talks about how to use it in your favor. Not the pattern, but what it tells you about what gets men interested in butting in and taking over.
Researching that article I dug up 14 conspicuous examples of men butting in and taking over what women started. The details are mindboggling illustrations of patriarchy, patriarchal thinking, and the patriarchal machinery at full throttle.
The first 5 are in this article. The other 9 will follow in future issues.
#1: Labeling changes perceptions
Men weren’t interested until it became sexy.
Computer programmers were women.
It was considered clerical work, similar to typing.1 So women were allowed to do it because men weren’t interested.
When companies realized what computers and the software written for them could do, things changed. The work gained status. Salaries rose. Employers decided it was a technical job. Men arrived. Recruiters built male hiring tests.
When I joined the industry in the mid 1980s, I had to take one of those.
Passed with flying colors. Got hired. At least the company was smart enough not to discount the test results because I was (and am 😁) a woman. Was one of the few “girl programmers”2 throughout my ~35 years in the software industry.
Tasty stats:
In the US women held around 37% of computer science degrees in 1984 (a year before I joined the software ranks, without a CS degree). Their share steadily dropped after that.
Britain is a particularly sharp case. The UK government replaced trained women technologist with men. Its computing industry declined afterwards.
Sources:
Nathan Ensmenger, The Computer Boys Take Over (MIT Press, 2010)
Marie Hicks, Programmed Inequality (MIT Press, 2017)
Janet Abbate, Recoding Gender (MIT Press, 2012)
NPR Planet Money, “When Women Stopped Coding”
#2: A 300 year track record torpedoed
Women brewed beer for ~300 years. Then beer started to make money…
In the 13th and 14th centuries, people drank beer, not water.
About a gallon (~4.5 liters) a day.
This was a large trade. Dominated by women for ~300 years.
Men only entered when the women started making money off of it.
Two things drove beer brewing from women to men: access to capital, and… a smear campaign. The women, called brewsters, were described as filthy and sellers of polluted ale. Male brewers did not get written about this way. Wouldn’t surprise me if that was, at least in part, because the writers were… male.
Sources:
Judith M. Bennett, Ale, Beer, and Brewsters in England, 1300-1600 (Oxford University Press, 1996)
UNC Endeavors, “When Brewing Was Women’s Work”
#3: Hubris despite reasons for humility
In 19th century Vienna, going into childbirth you’d better not be able to pay a doctor.
Women’s medicine had been a women’s issue. Male physicians took over between the 12th and 15th centuries. Licensing and male-controlled guilds played a part. Literacy another as medical knowledge moved into university texts and most women couldn’t (weren’t allowed to learn to?) read.
In Vienna, the general hospital ran 2 maternity clinics. One were midwives ruled. One staffed by doctors and medical students. The hospital sent you to one or the other depending on the day of the week.
As if they intentionally created a randomized trial…
Women desperately tried not to be sent to the doctor’s ward.
They may not have had any data, but they knew. They knew what was at risk. Observing, noticing, and sharing stories was all that was needed. Because the difference was so stark.
In the doctors’ ward, you were almost 3x more likely to die.
Alexander Gordon (1795) and Oliver Wendell Holmes (1843) said doctors carried the disease killing the women to them.
They and their findings were rejected by the profession. Loudon attributed the deaths to interventions: forceps, ether, episiotomy, surgery. Which weren’t performed by midwives. And, fascinatingly, doctors did to justify their fees…
But Gordon and Holmes were spot on.
Doctors conducted post-mortems in the morning, then examined women in labor. Midwives didn’t go near dead bodies.
In 1847, Semmelweis ordered doctors and students to wash their hands with chlorinated lime after post-mortem examinations and (or?) before entering the maternity ward.
After that, deaths on the doctor’s ward dropped to the level in the midwives one…
The stats:
From 1840 to 1846 on the doctors’ clinic 98.4 women out of 1000 died. Almost 1 in 10! On the midwives’ ward: 36.2.
After Semmelweis’ order: 12.7 per 1000 on the doctors’ ward versus 13.3 in the midwives’ clinic.3
Sources:
Irvine Loudon, “Ignaz Philipp Semmelweis’ studies of death in childbirth,” Journal of the Royal Society of Medicine (2013)
“Semmelweis and the aetiology of puerperal sepsis 160 years on,” Epidemiology & Infection (2007)
Collected Works of Florence Nightingale, “Maternal Mortality and Gender Politics”
Embryo Project Encyclopedia, “The Contagiousness of Puerperal Fever (1843)”
Monica H. Green, Making Women’s Medicine Masculine (Oxford University Press, 2008)
Adrian Wilson, The Making of Man-Midwifery (1995)
Irvine Loudon, Death in Childbirth (Clarendon Press, 1992)
#4 Safety as a cloak for greed and bias
US maternal deaths did not fall during the 15 years when births moved into hospitals.
Before the Civil War, 50% of reproductive health care in the US was in the hands of Black women.
In 1921 the Sheppard-Towner Act pushed states to require midwife certification.
Certification is a good thing, right? And moving births to hospitals, too, right? After all, that’s what we’re doing in most “civilized” countries, nowadays…
Why then did mortality not decline between 1915 and 1930 — the transition years?
And was the story in Newark (New Jersey) even grimmer?
While births moved into hospitals and midwife-attended births in Newark (New Jersey) dropped from 48% in 1917 to 38% in 1921; maternal deaths rose from 4.1 to 6.5 per 1000 births.
Ironic to say the least considering safety was cited as the reason for removing midwives and moving births to hospitals.
The real motives?
Greed, with doctors (males mostly at the time) complaining midwives’ lowered fees; and fueled further by gender and race biases which inspired a smear campaign.
One stated Black midwives were “not far removed from the jungles of Africa”. An official called them “filthy and ignorant”. A newspaper claimed midwives “should be eliminated and their work taken over by physicians and nurses”.
Not until sulfa drugs (antibiotics) hit the scene in 1937 did maternal mortality start to drop, causing a 73%-95% decline from 800 deaths per 100,000 births in 1920 and ~641 from 1925 to 1936.
TL;DR: Doctors removed practitioners with better outcomes, said it was for safety, but safety did not improve for another 20 years until antibiotics arrived.
The tragic consequence of removing midwives?
Black maternal mortality in the US is among the worst in rich countries.
Sources:
TIME, “The History that Explains Today’s Shortage of Black Midwives” (2024)
Historical Perspectives (Santa Clara University), “The Decline of Southern Black Midwifery in the 20th Century”
New York Academy of Medicine, “Maternal Mortality in New York City” (1933)
Jayachandran, Lleras-Muney and Smith, “Modern Medicine and the 20th Century Decline in Mortality,” AEJ: Applied Economics (2010)
Mississippi Encyclopedia, “Midwives”
#5: Sued to stop doing what you invented
Nurses invented anesthesia. Doctors sued one ~60 years later to stop them.
Doctors were more interested in performing surgery than in making their patients comfortable during it, when Sister Mary Bernard established anesthesia training for nurses in 1877 and Alice Magaw was called the Mother of Anesthesia.
While the Mayo brothers adopted the practice in 1889, nurses did this work for some 40 years before doctors wanted it for themselves. They turned it into a “respectable medical specialty” during the 1920s. And then turned on the nurses, attacking them for informal training and a lack of standards.
It didn’t stop there.
Physician anesthesiologists sued Dagmar Nelson, a nurse anesthetist in California. In 1936 the Supreme Court of that State ruled in Dagmar Nelson’s favor. It classed her work as “not medical work”.
Nurses founded the American Association of Nurse Anesthetist in 1931 to defend the field. It’s still going strong today.
Sources:
Nursing Clio, “The Handmaids of Surgery: The Role of Nurse Anesthetists” (2021)
Chalmers-Francis v. Nelson, Supreme Court of California, 1936
But wait… there’s more
This is the first of three (probably) articles. Illustrations of the pattern still to come:
Filmmaking in early Hollywood
Dairy farming in Canada
Seamstresses and the guilds
Rice farming in Gambia
Restaurant kitchens in Lyon (France)
Botany in England
Advertising copywriting
Early electronic music
The cannabis industry
Live long and prosper.
Not that this view has changed much.
Many managers in the industry still think that programming is mostly typing. True in one way: developers spend their time staring at screens and hacking on keyboards.
A phrase I counterintuitively still like. Because my favorite marketer at one of my software employers used it when she came specifically to say hello to me because she’d never (or rarely) met any “girl programmer”.
That both dropped, makes me wonder whether doctors “helped” in the midwives’ clinic for emergencies.