Everything Below the Waist: Why Health Care Needs a Feminist Revolution by Jennifer Block

Everything Below the Waist: Why Health Care Needs a Feminist Revolution Reviews

• 
  Caroline

  ***NO SPOILERS***
  
  It's been reported that doctors dismiss female patients while taking seriously male patients. For instance, doctors are more likely to miss symptoms of heart disease or heart attack in women than in men. Jennifer Block’s argument is that a feminist revolution in medicine is very needed, but that’ll only happen when the medical establishment genuinely values women; when women are more empowered; and when they're allowed to have a larger say in their care. Doctors need to check their egos at the door and not just allow women to be proactive in their care but welcome and respect it. As this title suggests, Block focused specifically on care of the female reproductive system, a focus that allowed her to illustrate her point--that the medical field is sexist--most effectively.
  
  The female reproductive system covers a range of sub-topics, and Block laid out the facts thoroughly and specifically, with generous citing of studies from numerous reputable medical journals. Covered here is routine gynecologic care, hormonal birth control, infertility treatment, abortion, pregnancy, and childbirth. Her presentation is especially good. This topic has the potential to be complex and dry, but Block wrote engagingly, smoothly transitioning from one related topic to the next. I was gripped from the first page. It’s hard to believe medical care for women is really that dysfunctional until seeing the problems articulated in stark black and white--and this is only pertaining to the reproductive system. The reality is grim, and the real-life profiles illustrate that well.
  
  Errors in female reproductive care can be catastrophic. The trans-vaginal mesh (used to treat incontinence) and permanent birth control Essure have destroyed the quality of life of countless women and should never have been released. The more serious side effects of hormonal contraception are shamefully downplayed. A surgical instrument called a
  morcellator is convenient for surgeons but can be lethal if the tissue mass it's used on is cancerous. Far too many unneeded cesarian sections are performed each year. In some hospitals, 50% of babies are born via C-section. C-section is a major surgery with serious risks, but it’s fast for busy and impatient obstetricians. The phenomenon of unneeded C-section has made it into news media, but Block deftly broke this down to get to the heart of why.
  
  Also overdone are complete hysterectomies as a cure for painful endometriosis, Polycystic Ovary Syndrome, and fibroids. Hysterectomy is the second most common surgery in the U.S. after C-section when it should be a last resort. Right after the loss of a uterus and ovaries, women are sent into full-blown menopause, and often their sexual function is forever damaged. Relating to this, Block pointed out that a female equivalent to Viagra doesn’t exist. Women’s sexual enjoyment isn’t prioritized the way men’s is.
  
  On the topic of abortion, Block advocates for something radical: self-administering abortion. She detailed how the abortion procedure is fairly simple, and women can actually do it safely themselves if they’re taught. Additionally, midwives traditionally provided a full range of gynecologic care, not just pregnancy monitoring and delivering of babies. They’re qualified to perform abortions, just not licensed. Block believes that midwives, with their concern for the emotional well-being of their patients, are a more attractive option than the usually stoic and impersonal abortion clinic.
  
  I would have liked to hear more about racism in medicine. Block addressed the issue, but it looks like it warrants a chapter of its own. Black women and women in the southeast of America are more likely to get hysterectomies--and not because they have more risk factors. They also are more likely to get C-sections. In every aspect they’re especially poorly served or under-served; however, most interesting, and disturbing, are gynecology’s roots. Pioneering gynecologists in the South experimented, without anesthesia, on slave women, giving the field roots in the institution of slavery. Physicians in the North were reliant on poor immigrant women, mostly Irish, for their unanesthetized experimental surgeries.
  
  I’d improve this book in one small way: adding illustrations. I was particularly curious about the morcellator. I really wanted to see this device while reading about the disasters it can cause. I needed a visual of the device for self-administering abortion even more. Block explained that in detail, but I didn’t trust the image in my head. The same is true of Essure and the trans-vaginal mesh--what they look like and how they malfunction to cause irreparable damage.
  
  What I’ve reviewed here is but a tiny fraction of what’s in these pages. With Everything Below the Waist, Block has made a significant, and especially well-timed, contribution to the subject. While right now much-needed attention is directed at sexual harassment and sexual assault, sexism in medical care doesn’t get all the attention it deserves.
  
  Because Everything Below the Waist includes statistics, reading it now, while those are up-to-date, is ideal. Additionally, women are the obvious audience, but I urge men not to dismiss this book assuming it’s information they don’t need; on the contrary, there’s no reason men shouldn’t be just as informed and fight for equality in medical care. It goes without saying that medical professionals must read this.
  
  Complementary documentaries: "At Your Cervix," "The Bleeding Edge," “Orgasm Inc.,” “In Our Control,” and "Eggsploitation."
  
  Complementary articles: “Women Tend to Receive Disease Diagnoses Years Later Than Men Do, New Study Says”
  https://people.com/health/women-recei...
  
  “Inside the Quietly Lucrative Business of Donating Human Eggs”
  https://www.wired.com/story/inside-lu...
  
  NOTE: I received this as an Advanced Reader Copy from Goodreads in March 2019.
• 
  TL

  *dates reflect when my hold ran out on Overdrive app and had to wait my long wait for my turn again.*
  
  
  Audiobook narrator: 5 stars
  
  This is such an an important book, everyone needs to read it. I will be recommending this to all my friends and family (and my niece when she is old enough to understand ).
  
  So much in this I didn't know (and some things that made me see red and want to HulkSmash). It definitely shows you how screwed up our healthcare system is.
  
  
  Definitely buying a copy for my shelves if no one gets this for me for xmas.
• 
  Sarah

  This book wasn't exactly what I expected it to be, but it is a solid introduction into the issue of women's health care. I expected this book to cover more general topics of health and look into how women may have a more difficult time being heard within the medical community, but instead it focused on women-specific health concerns, such as the Pill, female organs, pregnancy, and related topics. While this book was well-written and straight-forward, so that the average person like me could understand all of the medical jargon, I was not a fan of the first-person perspective that the narrator decided to take throughout the book, inserting herself into her narrative, creating a sense of bias throughout. Additionally, the author definitely seems to prefer holistic approaches to medicine, and while I welcome an opening for discussion into such practices, I also wish she talked about Western and holistic medicine in a more equal way, instead of heavily favoring the holistic approach.
• 
  Ian Rose

  Such a hard book for me to review. It wasn't written for me, and I'm not qualified to criticize it, many of the ideas, terminology and situations in it being new to me. I think it's important for men, particularly men in politics and public policy, to be at least basically literate on women's health. I'd prefer that my opinion was never asked on this topic, but it is, every time I vote, and so I should be minimally educated. I learned a lot from this book, but I will say I can't go as far as the author's skepticism of modern medicine. I get the reasons for it - there are horror stories in this book that are more than enough reason to be worried about doctors and hospitals - but I can't help feeling like this skepticism is on the edge of falling into anti-science and anti-vaccine traps, and could be used by people in those movements to justify their harmful beliefs and policies. I'm glad I read it, and if anything, my disagreements with it will get me to read more, from equally well meaning authors from slightly different perspectives than this one. Maternal mortality in this country is a shameful unnecessary disaster, on that and the need to do better by mothers and children we should all be able to agree.
• 
  Shannon

  When I read the synopsis of this book, I knew I wanted to read it immediately. As someone who has both chronic physical and mental illnesses, I have experienced the way our medical community often treats women. Everything Below the Waist contains not only a great deal of information on the state of women's healthcare, but also includes a lot of real life stories from women. I very much agree with the statement in the synopsis, that women are often over-diagnosed and over-treated. And I have witnessed first hand how male doctors often brush off female patients, as the author will talk about in the book. I am going to try not to make this a long review, but it is a topic I am fairly passionate about and I am so glad an author finally brought it to attention.
  
  The author talks about a variety of women's health topics in the book and in one chapter, she talks about how women are frequently over-diagnosed and over-treated. I am going to tell a quick personal story about why I was so happy to see this finally addressed in a book. I have always had gynecological issues, ranging from reoccurring cervical cancer to ovarian cysts to a great deal of pain. Several years ago, my OB transferred me to another doctor within in the practice who dealt more with these issues. He has a great bedside manner and I really liked him. After looking over all my test results and asking me a great deal of questions, he did a pelvic exam. When he got to my right ovary and he could see I was in obvious pain, he made his diagnosis. He told me that I had endometriosis and that he could feel that my right ovary was adhered to my pelvic wall. I was surprised to hear this but grateful for a diagnosis until he sat there explaining to me that there was a good chance he would have to remove that ovary. I went home crying to my then boyfriend, now husband, and was incredibly anxious for 3 weeks until I had surgery. I had to write out all these medical instructions for the doctor depending on what he found, where he would have to come talk about anything with my mom & boyfriend before removing any organs. I remember walking into the hospital crying and shaking because I was scared of losing my ovary. Fast forward to me waking up from surgery, groggy and disoriented. The surgeon comes into speak with us and says, "Well, I didn't find much, there is a small spot of endometriosis on one of the right ligaments that is too deep to remove and pelvic congestion syndrome, otherwise we flushed the tubes and uterus and everything looks good. I literally said, "What the f*ck?" to my mother & boyfriends horror because this surgeon had drilled into my head his "diagnosis" when really, he couldn't make a diagnosis until I had surgery.
  
  Around this time, I started bringing my now fiance to all of my doctor's appointments, as I found my doctors seemed to listen to me and take me seriously with a man present. I continue to bring him to almost all of my appointments today. I imagine I am not alone in this and it is a tragedy that in our society, women can't always trust their doctors. I could write 100 personal stories that relate to everything the author talks about in this book, but I will spare you.
  
  I have read quite a bit about the labor & delivery culture in America, which is far behind every other country in anything related to pregnancy, birth & infants. However, the personal stories in the section about this topic were horrifying to me. Doctors doing procedures even when a patient says no; doctor's calling CPS when a woman won't sign a consent form; unnecessary c-sections and stories of nurses holding patients down to do things against their will. I am currently pregnant, so some of these things I have read about but others were a total shock to read. That fact that this occurs in our country is disturbing and I am so glad that the author has addressed all of these issues in her book.
  
  There was a chapter on abortion, which I tried to read, but because of my personal beliefs, I ended up having to skim that chapter. I understand that it is part of the medical system that effects women, it was just too difficult for me to read.
  
  Beyond that, this book was fantastic and I highly recommend that every woman read this book. I can't tell you how many times I stopped to tell my husband about what I had just read because it directed related to experiences I had with previous doctors. It was also nice to know that this happens to a lot of women and not just me. I could go on and on about how great this book was and I definitely recommend adding it to your TBR for July. It covers SO many important topics and I have to imagine that most women can easily relate to it.
  
  Thank you to the publisher, St. Martin's Press, for sending me an ARC of this book.
• 
  Oksana

  This is the worst and most tonedeaf white feminism content I've ever read. Can't believe I actually made it through this (did it at 2x audio to make it more bearable) but I can't not finish books. Where to start with this absolute shit. The author shames women (little to no mention of others who can have a uterus) and creates fear around the following:
  - birth control pills
  - ivf
  - literally anyone who doesn't want kids
  - hysterectomies
  - cervical cancer screening
  - somehow any woman who wants the same things as men?
  - abortions at clinics
  - birth at hospital
  
  The last chapter is what I actually read for class and that was relatively sane, though not so much given the whole book. I recommend skipping this and finding books on reproductive care that don't try to shame you about whatever you chose to do.
• 
  Simone

  4 stars for an engaging, informative read on a very difficult, frustrating topic. A compelling blend of both historical and modern feminist struggles, and cases seen from both physicians and patients perspectives. Attention is given equally to deeply personal anecdotes and more formulaic commentary on statistics and data.
  
  However, although mentioned, I think the treatment of black women in OB/GYN care deserved its own chapter. Additionally, I don't recall any real discussion on trans healthcare, which feels like quite the oversight for a 2019 publication.
• 
  Vovka

  Wow. Everything you think you know about women’s medicine is wrong. From IUDs to abortion to the birth business ... this book is eye opening.
• 
  Melissa

  “This is a book about feminism’s unfinished revolution in women’s health.”
  
  Fascinating, informative, and appalling, Jennifer Block has written the most revealing book on women’s healthcare to date. This one is a must read for every woman currently under the care of the US healthcare system as well as all medical providers.
  
  Offering up an extensive history of women’s healthcare, this book can at times be a bit dry. But those dry facts shed light on history many of us may not know as well as the antiquated and often counterintuitive medical practices providers and insurance companies are pushing on women.
  
  Block does an excellent job of reminding us of the feminist vision for modern day healthcare and the compromises we’ve actually accepted. After flat out scaring us with statistics on unnecessary surgeries and procedures, stories of bullying by medical staff, and the reminder that it takes 17 years for scientific evidence to change medical practice, Block paints a vivid picture of what could be with women and advocates who are standing up, fighting back and saying no.
  
  Block has furthered an important discussion that no woman should shy away from. It’s your body, it’s your right to know, defend and protect it, and Block’s book is a great step in that direction.
  
  Thank you to NetGalley and St. Martin’s Press for providing me an ARC of this book in exchange for my honest review.
• 
  Jill

  This book changed me and added to my frame of feminism. This brought up so much that I had surface understanding on but no deeper knowledge or understanding.
  
  I loved that she looked at views seen as “deeply rooted in society” as gendered views, resistance and large companies like pharmaceutical companies and lobbyists like “breast is best”(which had always bothered me), midwives/doulas, home births v hospital, abortions/policy, clinics, family dynamics, medicalization and SO MUCH MORE.
  
  I listened to in on audiobook, but immediately had hi get a hard copy to be able to find the ideas and people mentioned to continue my learning, especially as a woman-identified person who has not given birth.
• 
  Renay Russell

  Very interesting read - found it quite eye opening
• 
  Sandra

  My first DNF of 2023.
  Took about 50% of the way through for me to Google the author and find all her transphobic tweets. Automatic DNF for TERFs.
  
  Besides this, I did have problems with the book itself. The author presents information in a very biased and shame-y way (women should just track their cycles to prevent pregnancies - the pill is dangerous!, and that a cure for infertility could just be a uterine massage?). As a nurse who has worked in the sexual and reproductive health field for many years, it is clear that the author does not have a medical background, and she does not present information and contraceptive options (of which there are MANY) in a non-biased way.
  
  It’s a shame bc some of the chapters present important information (particularly the OB chapter about maternal mortality and complication rates), although she does spend a long time talking about an OB who had a very traumatic birthing experience herself, but blames the nurses every time she has to do a c-section on a patient, because they are “overreacting” to fetal heart decelerations?
  
  Through reading reviews, I see that she may be anti-HPV vaccines (the only vaccine we have that actually PREVENTS cancer?) I haven’t got to that part yet, and it’s good I haven’t, bc I would probably flip a table.
• 
  Mel

  How can a book with this much good information only get three stars!?
  
  Because the privilege of the author is palpable, visceral, and absolutely pervasive throughout the book. The economic reality of the United States (where and about the author writes) is hand waved at best and at worst outright mocked--in her cheerleading of "attachment parenting" the author concedes that someone who must prioritize being with their baby 24/7 won't be "smashing the glass ceiling" as though ambition, and not economic requirements as mundane as "paying bills" and "eating" is driving the skepticism. Her chapters about LARC and hormonal birth control never once mention the fact that a baby before the age of 25 condemns a woman to a lifetime of financial consequences-- to the tune of more than two years of lost wages. These are worries for those lesser people who do not work full time from home.
  
  The author condemns speaking to women "as if we all have unlimited time off" but then does precisely that. If you can ignore these elements and focus more on the interesting data, much of which is under reported elsewhere, this is worth a read.
• 
  Jessica

  (I received my ARC of this book in a Goodreads Giveaway).
  
  I will start off by saying this book has taken me so long to finish because it is so heavy and in your face with information that it is at times quite overwhelming. (The first chapter about birth control pills actually sent me into a panic attack).
  
  However, as I've continued reading, this book has become my very own personal Healthcare Bible. I've probably dog eared at least 50 pages for my own future reference because I kept reading and thinking "yes, that's me! That's what I'm going through!" Block's work is vital and necessary to improving women's healthcare and ensuring that we don't slip back into the dark ages.
  
  If you are a woman, identify as a woman, love a woman, and/or know a woman, then you should read this book.
• 
  Talia

  I really wanted to like this book. While the author discusses many important topics and brings up aspects of the health care system that need to be discussed, her privilege and one-sided, unnuanced arguments made this book one that I'm unlikely to recommend.
• 
  Victoria Tice

  A must-read for every woman.
• 
  Kailyn

  Scary but important stuff.
• 
  Mary

  Everything Below the Waist is a thorough investigation of women's health care. Block examines topics such as birth control, fertility/infertility, routine gynecological exams, and so much more. She dives deeply into each topic, and her research often goes back decades as she strives to give readers an understanding of how practices have evolved over the last 50-100 years. She makes a solid case that many common practices for women's health care are not based on good research and are not serving women well.
  
  This book has the potential to be controversial, and I believe Block alludes to that throughout the book. She wades into the murky debate of many different big issues, and she isn't afraid to highlight issues on both sides. Despite the book calling for a feminist movement in women's health care, Block shows how the feminist revolution may have hurt or, at the very least, hindered women's health care over the past few decades. She also doesn't stray away from highlighting poor medical practices or sharing the stories of women who have been bullied by doctors.
  
  I will admit, there were times where my perspective on things did not line up with Block's, but I really appreciated her research, as well as the way she weaves statistics and stories into a cohesive narrative. It's also worth knowing that some of the stories are heart-wrenching and shocking--there were moments where I wanted to cry for the women who have dealt with awful situations brought about by the very people who were supposed to help them.
  
  While I have never experienced a traumatic experience like some of the women in the book, I know what it's like to feel belittled by a medical care giver, and I've had situations where I have avoided unnecessary procedures by doing my own research and being my own advocate. However, the only way I've been successful is by having a primary care doctor who not only took the time to listen to me, but was also respectful of my desires and willing to consider what was truly best for me. I deeply appreciate the case that Block makes for a health care system that truly values and respects woman because I want good health care for myself and all the women in my life. If I had any criticism at all, it would be that I didn't find her chapter on abortion compelling, and it didn't seem as thoroughly researched as her other chapters. However, this is one area where my personal beliefs don't align with hers, so I freely admit that my criticism may be coming out of my own bias.
  
  Regardless, I believe that her research will be truly helpful to women, doctors, and health care professionals as they contemplate the current state of women's health care, and I hope that it will lead to future changes in the health care system.
  
  A big thanks to Jennifer Block, St. Martin's Press, and NetGalley for allowing me the opportunity to read and honestly review this book!
• 
  Aurora Dimitre

  |This book was won from a Goodreads Giveaway|
  
  Thisss was an interesting one--obviously, as a 22-year-old woman, I have heard horror stories about childbirth, beyond the whole 'the most painful thing' part of it, and this was a whole book full of not only those, but birth control horror stories as well! So that was really fun in a, 'it definitely disturbed me' kind of way.
  
  Obviously this book has an agenda, and it shouldn't be taken for your only resource on women's reproductive health. But I do think it's a good place to give you some things to think about. I don't think that their birth control chapters were super well-done; the author does really push the 'pull out/time it by your time of the month' method, which isn't really as effective as she would like you to believe, but she is entirely right on the fact that you do need to play around with different methods of birth control before you find the one that works for you and doesn't completely fuck with your emotional and physical state.
  
  But overall, it was interesting. The childbirth chapters especially--it did make a good case for midwives.
• 
  BMR, LCSW

  I got an ADC from Netgalley for review.
  
  I finished this a couple of days ago but I was not sure how to review it.
  
  I went back and forth on 4 or 5 stars, because there was a lot I disagreed with but ultimately it was so well written, and taught me so much I didn't know about previous fights for abortion rights, that I could justify the 5 stars for info and research. I loved the knowledge and history shared.
  
  I knew a little about birth trauma but some of the stories in here...it's enough to make you rip your own teeth out in anger over how women and anyone with a uterus are treated. I'm so tired of women and anyone with a uterus being treated like they exist solely as vessels to procreate, placing the supremacy of the uterus and its contents over the person with the uterus (I'm trying to explain it without being trans-exclusionary, hope that's okay).
  
  Recommended for anyone interested in human rights, healthcare policy, midwifery, doulas, childbirth, fertility issues, and anyone who cares about anyone w/a uterus.
• 
  Michelle Inman

  I mean yes. Absolutely yes. A healthcare system created by and for males cannot just be carried over to females easy peasy. Yet, that’s not historical reality of how women’s health came to be. So yes, feminist revolution for healthcare here we come (hopefully)! This book gave me insight to the history of women’s health, the issues in women’s health, and the ways that I, as a woman, can take a stand and have a voice for my health. That might sound silly, but I grew up in a world of doing what you’re told and following doctor’s orders no matter what.
  
  I do think that for my interest level, I would’ve been more satisfied with a condensed version of this book. This book also highlights the extreme failures of the medical industry which became annoying and caused the book to lose some credibility in my eyes. So 3/5 for me but still recommend for women wanting to learn more on the topic!
• 
  Emma Refvem

  This book was very interesting and enraging. I listened to it on audiobook and had to stop halfway through bc it was making me dread my commute. I think the author did a good job of being inclusive though I think trans issues could’ve been centered more fully. Some issues were presented in what felt like a more biased way, but in general this was a deep dive into all the terrible ways people with uteruses or vaginas or ovaries/etc. are treated by the healthcare community. Some parts were sensational and included only anecdotes, but maybe that is important to hear in a culture that pushes those stories aside as the exception to the rule. Anyway- very interesting and impactful.
• 
  Brittany

  "There are reasons to nurse and reasons for policy and culture to support it. Where we get tripped up is mistaking reason for duty." Very interesting point in decoupling reasons for something and a duty to do it.
  
  "How can we step outside this culture enough to see a path forward, where demanding social support for our biology is a feminist act? How can we get to a place where women can be fully in the world and fully in their bodies?"
• 
  Cari

  Block's PUSHED was an influential work in the fight against medicalized birth. I found it to be the most well-researched book I read while preparing for the deliveries of my children in 2012 and 2015. While there are never any easy answers when it comes to birth, Block covered the story from a well-rounded and evidence-based point of view. I appreciated this same perspective in this book, which expands the scope to include birth control, IVF, hysterectomy, and abortion. I generally consider myself well-informed when it comes to health, but there were some topics covered here that I'd never encountered, and I will be thinking about them for some time as I consider how to navigate my post-childbearing years.
• 
  Aneri Shah

  While this book has its merits, like bringing in new perspectives besides those of liberal feminism, it often relied on anecdotal evidence to refute the positions of organizations (ACOG, AAP, Planned Parenthood) that seem to base their positions off of more quantitative data. While one reviewer called this book a 'sequel' to Invisible Women, the latter felt a lot more unassailable.
• 
  Diana

  An eye-opening, important book about inequality in medical care for women. Provides hard to come by statistics.
• 
  Tabea

  God. I have so many thoughts on this book.
  It was informative, BUT....it was also very, very subjectively written.
  Chapter 1 basically condemds the pill and puts a huge emphasis on natural methods, but it also only tells a one-sided story. You can't only describe disadvantages without also pointing out advantages. And no... girls don't only use it for beauty but maybe also for...anitconeption?!
  Also after she gives information about IVF and other options. But again, it feels one-sided. It doesn't point out how for some women it's maybe a way to get the child they wish for. While I appreciate the description of risks and how healthcare doesn't look at the full picture I think she could have also informed more about other possibly positive things so that everybody can make their own informed decision.
  Then, in a later chapter, she very harshly criticises vaccines for hvp vaccines, and it feels like she's against it? While I find it good that she doesn't just accept all and looks how influenced campaigns are, I think that it's also important to point out that there are other risks when not getting vaccinated? It's so much more individual. Medicine needs to simply take a better look at the individual and, based on that, make recommendations. It's neither black nor white. It's a grey area where several things need to be contemplated.
  Obviously, this is my personal experience and opinion, and I will still need to learn much more. But for now I just think this book was a picture of privilege and a subjective way of conveying information.