Contraception in women over 40 years of age

Rebecca H. Allen; Carrie A. Cwiak; Andrew M. Kaunitz

doi:10.1503/cmaj.121280

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Contraception in Women over 40 years of age
Ronald Bayne

Posted on: 19 April 2013

Posted on: (19 April 2013)

Contraception in Women over 40 years of age
Ronald Bayne, Emeritus Professor of Medicine
This Review reminded me of conversations I overheard as a boy growing up in the 1930's in Sherbrooke QC.
My father was a general practitioner and surgeon (MDCM '14 McGill) and in his practice he not only delivered babies but also carried out abdominal and gynaecological surgical procedures. In those days the advertising or sale of any form of contraception was strictly forbidden, although in the newspaper one r...
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This Review reminded me of conversations I overheard as a boy growing up in the 1930's in Sherbrooke QC.
My father was a general practitioner and surgeon (MDCM '14 McGill) and in his practice he not only delivered babies but also carried out abdominal and gynaecological surgical procedures. In those days the advertising or sale of any form of contraception was strictly forbidden, although in the newspaper one read that a health product could be ordered and would be sent by mail in a "plain brown paper package". Abortion was a criminal offence except if the woman's life was seriously endangered.
My father would deliver young unmarried women at a discreet nursing home where the baby was usually then put up for adoption. For older married women he offered a surgical procedure then called "re-suspention of the uterus" which was to relieve low back pain. This treatment was based on the idea that in a mature woman the uterus became tipped back and pressed on the spine causing severe pain. Although there was little evidence of its effectiveness for back pain, it allowed the surgeon to tie off the fallopian tubes. Many Protestant anglophone women requested this treatment and some Roman Catholic women as well. In those days the career options for women were limited and after marriage an RC woman could expect to have a life dedicated to pregnancy and childbirth for the next 20 years. Some were desperate to escape.
The procedure could only be carried out at the Sherbrooke Protestant hospital, not at the St Vincent de Paul or the Hotel Dieu although a hysterectomy could be done in these hospitals if absolutely necessary for health reasons. Of course the removed specimen was carefully examined for real pathology. But after re-suspention of the uterus there was no specimen to examine.
Conflict of Interest:
None declared
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Competing Interests: None declared.