By Michelle Murphy . Published by Duke University Press , Durham and London , 2012 . ISBN 978-0-8223-5336-2 ; 259 pages .

Reviewed by Karen Willis

Faculty of Health Sciences, University of Sydney

This is a book about the women's health movement. While the practices and philosophies of the 1970s feminists may often be consigned to history, books such as the Seizing the Means of Reproduction provide a timely reminder that health, technologies and power remain integrally connected, and that reproductive health practices remain contentious today. Drawing on the Californian radical self-help women's health movement, Murphy explores how feminists engaged with emerging technoscience to ‘do’ reproductive health. Focusing on three technologies – the plastic speculum, the Pap smear and manual suction abortion – she examines how the women's health movement both changed the relations of, but was implicated within, the ‘biopolitics’ surrounding reproduction.

In Chapter One, Murphy discusses feminist encapsulation of their self help through the notion of protocol. Rather than locating their practice as a ‘space’– this form of self help was a set of practices and procedures that were ‘saturated with politics’ (p. 29). Murphy takes a Foucauldian approach, particularly in referring to the exercise of power that occurs through the governing of individuals. She makes the point that ‘biopolitics’ also is implicated in ‘necropolitics’, with discussions of race and the valuing and devaluing of particular lives woven through the book. After introducing the notion of protocols and the interweaving of women with the ‘technoscience’ of the time, Murphy unpacks the feminist self-help movement with reference to four other analytical dimensions: ‘Biopolitics’ and its connection to science and technology; the racial dimensions that meant that much of the radical self movement was shaped by whiteness; the emergence of biomedicine and links with the industrial-pharmaceutical complex; and the politicisation of small group practices. This theoretical introduction is challenging to read, but does an excellent job of setting the scene for the case examples.

In Chapter Two, Murphy analyses the vaginal self exam and the use of the speculum. She uses the analytical concept of ‘immodest witnessing’ to draw out the ways that women studied their own sexed bodies. Vaginal self exam was a challenge to the authority of medicine, and to the scientific knowledge by which assessments of normality and abnormality were made. In feminist self groups, different knowledge was privileged, for example, knowledge was gained through the ongoing comparison of the self, rather than comparisons across populations. The group setting for examination of cervixes, along with narration of the experience, provided basis for comparison with other women.

The case example of the Pap smear (Chapter Three) shows the complexity of the women's health movement. Recognised as a lifesaving technology and as thus less controversial than some other practices, the women's health movement controls this technology, following their model of self-help protocols. However, the contradictions of doing so are illustrated by Murphy when she says, “in feminist self-help, the well woman, not only made herself available to medical scrutiny; she enacted it” (p. 116) – thus the practices were the same, but the conditions under which they were practised differed. For example, in normalising ongoing surveillance of the cervix through knowing your own body, “feminist self help called for more intensive surveillance of the cervix than recommended by gynecology” (p. 119).

The final case example illustrates the techniques of ‘manual extraction’ and ‘menstrual regulation’, both enabling evacuation of uterine contents for women at risk of being pregnant. This is a fascinating account of the protocols surrounding abortion, the rise of individuals who were able to promote ‘abortion kits’ both within the self-help movement and overseas. It is in this chapter that the links between such ‘technoscience’ and the United States (US) Aid program are made explicit, and Murphy analyses the way that feminist self help was inextricably linked with the population control agenda of the government. Technologies such as manual extraction, composed of household constituent parts, and widely distributed, were utilised by Non-Government Organisations (NGOs) and enabled policies of population control to be enacted.

The visual images throughout the book are fascinating. Photographs of women in groups engaging in self-help practices are particularly powerful in showing how women both narrated their experience and maintained visual connection with the procedures in which they were engaged, even when they were unable to perform that procedure themselves. This has an interesting resonance with many contemporary health procedures that privilege consumer connection through the use of visual screens, i.e. ultrasound, some testing and surgical procedures.

It is difficult to do justice to this book in a short review. Reading of the book occurs at multiple levels – it is a fascinating account of the women's self-help movement of the time; it is also a thought-provoking analysis of ‘necropolitics’ with particular reference to the issues of race in the US. Finally, it situates the women's health movement within the broader global context –where the practices, if not the protocols, were implicated globally in the policies around reproduction that were inserted into other countries in the form of US Aid. This is a challenging but extremely worthwhile read.