Contributor: Marsha Fowler, Ph.D., MDiv, MS, RN, FAAN

The skirmishes and battles have changed, but the war has not. First wave feminists battled the constellation of the regulation of prostitutes, the control of venereal disease, and the toxic sexual double standard.  Our battle today is the callous and obdurate slaughter of Roe v Wade, a battle that second wave feminists thought we had won.  The larger war remains the intractable inequality of women in all social spheres despite some legal advances, including battles over the control of women’s bodies. Our early nursing leaders made a bold frontal attack in their battle and gave nurses and women a victory –and perhaps a way forward for us in our own struggle.

Nursing’s core Social Ethics gave rise to ethico-political activism at the turn of the last century that is absent from today’s nursing ethics. Confronted with the eradication of abortion rights (and possibly contraception), the work of nurse colleagues Albinia Broderick (Ireland), Lavinia Dock (US &UK), and Mary Burr (UK) provides a guiding example for nurses today; their historical battle is important for us to examine.

In 1864, 1866, and 1869 the UK Parliament passed The Contagious Disease Acts (CD Acts), laws that sought to eradicate “venereal diseases” (then identified as syphilis, gonorrhea, and soft chancre) through the regulation of prostitution, initially around 18 army and navy bases. Similar laws were operative in the US. The Acts were repealed in 1886 but several points are important before getting to their repeal.

The CD Acts required any woman suspected or reported to be a prostitute to be detained by the local police, to be submitted to an external and internal gynecological exam, and if found to have a venereal disease to be incarcerated in a “lock hospital” until determined to be disease free (“clean”) – for up to nine months incarceration.  The local police were dressed in plainclothes and had the unsupervised and uncorroborated authority to designate a woman a prostitute. They were referred to as “morality police.” And Josephine Butler, a non-nurse, suffragist, and activist, referred to the gynecological exam with a telescoping speculum as “steel rape.”

The CD Acts galvanized an unexpected storm of middle-class, white, women feminists (including nurse leaders—and Nightingale) to protest. Victorian society of the mid 1800s in the US and UK were unprepared both for the women’s fury, and for women explicitly to raise issues of sex, sexual behaviour, reproductive anatomy, and the sexual double standard in public. Nurses Broderick, Dock and Burr were in the forefront of the protest and presented coordinated, successive, papers on this complex issue at the 1909 ICN Congress.  Dock subsequently (1910) wrote a textbook for nurses on the social structures that created, authorized, and perpetuated prostitution; abused the prostitutes; and created sex trafficking to restock brothels with young women (as life expectancy of a prostitute was 10 years but usually 3-5years). The Acts also legitimated a sexual double standard. Broderick, Dock and Burr activistically sought the repeal of the CD Acts.

In part, with a ring of familiarity, their arguments were these:

• Any disgruntled male could falsely report any woman as a prostitute, who would then be arrested and subject to a humiliating gynecological examination
• There was no due process as the local morality police could arrest any woman without evidence
• The age of consent (for intercourse) was 13 and it was only a misdemeanor to kidnap girls over the age of consent “for immoral purposes” (rape, trafficking)
• There was a presumption of the woman’s guilt; innocence had to be proved
• The Acts created a structure that established prostitution as a commercial business
• The Acts perpetuated a sexual double standard that restrained female sexual behavior only
• The Acts implicitly blamed female prostitutes, not the men, as the cause and perpetuator of the venereal diseases
• Men were not examined because “they would object”
• The constitutional rights of the women were violated

The CD Acts and their social context were more complex than indicated here.  However a number of features those 157 year old Acts resemble the same injustices women encounter today in reproductive rights.

The overturn of Roe v Wade, and the triggering of a range of abortion bans, including the re-enactment of zombie laws from the 1800s, initiate many of the same issues for which Broderick, Dock, Burr and other nursing leaders took up placards, linked arms and marched in protest – note that it would be another decade before they would have the vote. The groundswell of middle class, feminist women, and the working-class men that they successfully recruited to the cause, brought about the repeal of the CD Acts.

Rumors are swirling and it is hard to know what the state laws will come to include, but Texas and Oklahoma have effectively created a vigilante force of morality police.  These are persons who can make accusations, even deliberately false accusations, against any woman—another form of revenge porn. The women would be presumed guilty. Would the woman then be subject forcibly to “steel rape”? If a woman of child-bearing age leaves the state, must she prove she did not leave for an abortion? These laws intrinsically perpetuate a sexual double standard, failing to limit men’s reproductive health, failing to hold men accountable.  Rape and incest are tragically silenced or under-reported: the laws that make no exception for rape or incest effectively declare open season on young girls and women.  In some states the penalty for having an abortion following rape is more stringent than the sentence for rape, again the double standard. Women, perhaps in some forthcoming states’ laws, can be incarcerated for a felony for having had an abortion.  When the fetus is made a person under the law, perhaps the woman can be arrested for failing to take prenatal vitamins.

Broderick, Dock and Burr and their companion feminists and nurses presented incisive, critical arguments for the overturn of the CD Acts.  Their arguments were effective.

We nurses, we feminists, must make our voices heard and demand in a groundswell–with Albinia, Lavinia, Mary—that Congress overturn the unjust laws that deny women control over their own bodies, deny reproductive rights, and wreck harm upon women and the nation.

About Marsha Fowler

I am a nurse-educator with a PhD in Social Ethics. I have a long term research interest in the history and development of nursing ethics from the 1800s to the movement of nursing into colleges and universities in the mid-1960s. My work differentiates between nursing ethics and the subsequent, medicocentric bioethics, and calls for recovering and reclaiming our nursing ethics and its ardent social and civic engagement.