COURTESY OF OUR BODIES, OURSELVES

The progressive social movements of the last half-century produced millions of pages of print, from manifestos to journalism to novels, but nothing as influential as Our Bodies, Ourselves. The feminist women’s health manual is the American left’s most valuable written contribution to the world. This claim is meant to be provocative, of course, but it’s true. The publication of an excellent book about the book, Kathy Davis’s The Making of Our Bodies, Ourselves: How Feminism Travels Across Borders, makes this a good time to examine its impact.

Our Bodies, Ourselves spoke for a women’s health movement that transformed American medicine and popular health-and-sexuality culture. In the 1960s, physicians commonly addressed female patients as if they could not understand medical diagnoses and sometimes withheld information about their illnesses; unmarried women could not legally get birth control; women who sought sterilization had to qualify under an arbitrary formula (number of children x patient’s age = >120), while poor and minority women were sometimes sterilized without their knowledge, let alone consent; women were routinely excluded from clinical trials of important drugs; women discussed breast cancer in whispers with a sense of shame. A nationwide hypocrisy pretended that sex fit only in marriage; most gays and lesbians had to dissemble when seeking healthcare; Americans mostly believed that whole milk, red meat and cheese were fundamental to a healthy diet.

Starting from this landscape, the achievements of the American women’s health movement are impressive: prohibiting coercive sterilizations, opening public discussion of breast cancer, regaining women’s control over childbirth, requiring physicians’ honesty toward patients, radically increasing the number of female doctors and women’s health centers, impelling sex manuals to discuss women’s sexual pleasure as well as men’s and maintaining–barely, against unremitting attack–the right to reproductive choice. But few understand these victories as the hard-fought products of a social movement.

The original book, published in 1970 on newsprint for 75 cents, sold 250,000 copies without a commercial distributor. The radical content of the book would have been inconceivable without the civil rights/new left/feminist context. It included a left-wing critique of medicine in a corporate economy; detailed line drawings of genitalia, complete with pubic hair and the variety of hymens different women might have; a discussion of sex that presented heterosexuality, lesbianism, masturbation and celibacy as equally healthy; a section on abortion that told the reader where to go to get one, illegally in Massachusetts or legally abroad, and estimated the costs of these options–this was not your standard left-wing political pamphlet.

Even less well-known is that for more than thirty years Our Bodies, Ourselves supported and energized women activists throughout Africa, Asia, Latin America and Europe. These women’s movements–antiwar, anti-fundamentalist, anti-neoliberalism, pro-human rights–are often the most progressive forces in the field. Worldwide, the book has sold well over 4 million copies (its various versions, some of them unauthorized, and its multiple distributing channels make it impossible to get an exact count) in more than twenty languages from Swedish to Albanian to Korean, not counting Braille and audio versions, with several more translations in progress. The profits, along with much other fundraising, support education, advocacy and new translations. (Nation editor Katrina vanden Heuvel helped support the Russian translation.) In other words, the book has had marathon legs. Its global impact comes not mainly from the information it offers but, as feminist scholar Kathy Davis argues, from its radical method: a democratic politics of knowledge and expertise.

The Boston Women’s Health Book Collective, which produced the first Our Bodies, Ourselves (titled Women and Their Bodies), emerged from consciousness raising, the potent organizational tool invented by the women’s liberation movement. CR groups, when they worked well, did not aim at therapy or support (although support was an important byproduct) but examined how gender and women’s subordination were reproduced and maintained. These small groups created a free space in which women gained the confidence to challenge dictates on the nature of woman by religious leaders, lawmakers and physicians. Consciousness-raising operated on the premise that women could challenge even their own assumptions, exploring alternative explanations of, say, why women cleaned and cared for children, and men so often merely “helped.” Through the analysis of shared experience, CR groups developed oppositional interpretations of women’s and men’s “nature,” today called gender. Our Bodies, Ourselves continued that process with a focus on health.

If Our Bodies, Ourselves had retained its original authorship, the homogeneity of the original Boston-based CR group–in class, race and nationality–would have limited its appeal. The group’s concern with women’s concrete experience led them to gather many personal reports, so the book’s sources grew increasingly varied. As activists in other countries discovered the book, they asked for versions in their own languages. As Davis recounts in her history of the book’s global expansion, the original authors soon came to understand how saturated their book was with the perspective of educated, middle-class, white American women. In fact, the group’s initial chutzpah in challenging medical authority was partly a product of these women’s privilege. As their global sophistication increased, the Boston group came to a new understanding of what “translation” requires: Words, sentences, images and anecdotes have different meanings in different contexts. What was oppositional and radical for the Boston authors, such as challenging mainstream medicine, made no sense to women who lacked access to medical care.

The authors realized that you could not just hire a translator, or allow publishers in other countries to hire translators. The non-English versions of Our Bodies, Ourselves were adaptations, and they could emerge only from protracted discussion. The authors work closely with “translators,” discussing how to present controversial material and providing help with publishing arrangements, information resources, graphics, fundraising and connections with activists worldwide.

We should not imagine that in these global discussions US feminists were necessarily more “advanced.” In some cultures–and not just European ones–women were accustomed to speaking of sex more frankly than Americans. (Bawdy jokes among women are common, for example, in many conservative Muslim cultures.) Germans thought the book was too focused on motherhood; several Third World women’s groups thought Americans did not grasp the global economy of health.

Kathy Davis watched closely as a group of health activists from throughout Latin America created a 2000 translation, Nuestros Cuerpos, Nuestras Vidas. New experiential accounts and illustrations to reflect Latinas’ lives were just the beginning. The “translators” wanted more poetic language, not only for literary reasons but because of the oral traditions of many who would hear but not read the book. One of the most sex-radical images in the book, a woman alone on a bed looking at her vagina and cervix in a mirror, would have made no sense to them, because it assumed the book would be read by an individual in private. The Latinas wanted to reach women who could never buy the book and never had a private room; they oriented their book for group educational meetings. Furthermore, they disliked the self-help emphasis of Our Bodies, Ourselves, which they associated with the individualist, private solutions emphasized by Americans. They banished the words auto ayuda and used ayuda mutual.

The American book began with a discussion of body image and the yearning for a perfect, sexualized body–pressures the Latinas blamed on a commercialized, wealthy and individualistic culture. Distress about body image was not a major concern in Latin America. Their first chapter, instead, was “Perspectiva Internacional,” which discussed issues the Americans had put at the end of the book: the problems of poor women deprived of resources yet responsible for family maintenance, problems created by neocolonialism and global corporate power. A chart reports educational levels, contraceptive use, maternal mortality (8 per 100,000 in the United States, 650 per 100,000 in Bolivia) and other social indicators across the Americas. Yet, the first sentence in this chapter reads, “Como feministas, sentimos un vínculo entrañable con todas las mujeres” (“As feminists, we feel a close bond with all women”)–a strong assertion of common interests.

They also added material. Before their critique of modern scientific medicine they discussed traditional healing practices, distinguishing them from an “Anglo, New Age approach.” They used Mexican religious retablos, for example, to honor healers of the past and the foremothers of the “translators.” They discussed women’s activism on issues other than health, such as that of the Madres de Plaza de Mayo in Argentina. The American book mentioned religion only in its discussion of antiabortion activism; the Latinas wrote a fuller and more complex discussion of Catholicism. They believed its sanctity-of-life values could be transformed from a screen for forcing motherhood and subordination on women into the imperative to protect the lives of children already born, of women, of communities.

Our Bodies, Ourselves is no longer a bestseller, and many young American women have not heard of it. Many think they no longer need it because much of its information has become mainstream. But health messages these days typically come from corporations, selling goods and services as commodities, often with reckless claims. Though it faces different challenges, an oppositional health movement is no less needed today than in 1970.

Meanwhile, the terrain has shifted, and much of the leadership of the women’s health movement–and of progressive women’s activism generally–comes from the global South, where Our Bodies, Ourselves has become part of a transnational women’s health movement. Active in the anticolonial movements of the mid-twentieth century, women soon saw that national independence by no means guaranteed democracy or public welfare, let alone their emancipation. Some women’s health activism developed from the need to resist negative developments: in a vivid illustration of the diversity of local conditions, Indian women opposed a coercive population-control policy, while Filipinas opposed suppression of abortion and contraception. A 1977 International Conference on Women and Health jump-started an international women’s health movement. Ten international women-and-health meetings have convened at regular intervals, mainly in global South countries. At these, along with the meetings of NGOs accompanying the UN-sponsored gatherings at Nairobi (1985), Cairo (1994) and Beijing (1995), activists shared problems, created ever denser global connections and spread the movement. Regional coalitions supplement national groups in most parts of the world.

For too long, many of the big foundations and aid agencies–and many feminists in the global North–assumed that reproduction control was the highest health priority for poor countries. The international women’s health movement works to educate them otherwise, communicating not only grassroots needs but also a global structural analysis of the problems women face. Throughout Africa and parts of Asia, clean water is a top priority, and achieving it means resisting the rapidly encroaching privatization of water. Women want action against pollution, environmental destruction and exposure to toxics in manufacturing and agriculture. Agencies have begun to learn from women’s health movements that violence against women and women’s poverty are major contributors to HIV/AIDS.

Unfortunately, this activism is largely defensive, in the face of fundamentalist repression and IMF/World Bank “structural adjustment” policies requiring cuts in social, education and health spending. Health indicators are worsening in many parts of the global South and in former communist countries. Women face pharmaceutical companies’ attempts to block generic drugs, privatization and “user fees” for healthcare and education, US bans on foreign aid to effective reproductive and sexual health programs, high levels of violence against women and attempts to impose reactionary religious family law.

Still, world health would be worse without the activism of the international women’s health movement. By the mid-1990s, that movement was largely responsible for forcing the World Bank to backtrack somewhat, urging governments to provide at least rudimentary healthcare and treatment for infectious diseases. The new People’s Health Movement (phmovement.org) has put women’s health issues at the forefront of its campaigns. But compared with the size of the problem–to use a single example, one in 7,300 women in developed countries die during pregnancy or childbirth; in Africa, one in twenty-six–progress has been poor.

As the feminist slogan goes, “Women deliver.” In other words, when women control resources, the social gain is greater than when men control resources. Improving health for the poor is as likely to produce progressive change as any other strategy, because health activism these days requires challenging the world’s most powerful and destructive forces. Matters of the body are politically fundamental. If Our Bodies, Ourselves contributed even in a small way to activating women globally, American feminists can feel proud.