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How is medical knowledge produced and what are the implications of that knowledge production for medical practice? Using theoretical ideas on evidence-based medicine, standardization in medical research and practice, and biopower, I examine the relationship between medical knowledge and medical practice through the case of pelvic pain care in the US.

Data from ethnographic observations at two medical conferences as well as interviews with healthcare providers inform a critical analysis of the medical discourse.

The analysis reveals how evidence-based medicine is practiced in the context of medical conditions that lack objective evidence, as well as the unintended consequences of such practices. I provide an alternative approach to medical practice for conditions lacking traditional evidence through presenting outlier cases in the data.

In doing so, I make the broad theoretical argument that biomedical paradigms must emerge through the critical process of negative dialectics in order to reach past the limits of standardized medical care.

In sociologically analyzing the case of pelvic pain care, I reveal dire limits in the evidence-based approach to medical care for conditions and symptoms that may be deemed medical anomalies, demanding an alternative approach to care for such conditions.

Consumer health literacy is a necessary skill in all facets of library work, from reference desk to programming to website development. In this chapter, the authors present key terms in the domain of health literacy; challenges and controversies in research and public library practice; and findings from a recent study of public library workers meeting consumer health information needs. Finally, the authors present examples of National Library of Medicine (NLM) initiatives for public libraries and public librarians focusing on bridging health literacy gaps. Socially disadvantaged groups who are the most affected by health disparities tend to be those who are lower-income, have less education, and are not White. The combined effects of environment and socioeconomic status mean that these communities have particular, highly local challenges in addressing their health issues, as individuals and as a population. Health literacy can serve as the enabling factor in obtaining quality health information, navigating healthcare, and seeking better health. To support the public, NLM and its National Network of Libraries of Medicine have placed a strategic emphasis on public libraries in order to develop long-term partnerships. The goals of these partnerships are to support staff development and programming, and to promote resource-sharing about programs and activities focusing on health information. Public libraries are everywhere and open to all. This makes them the ideal community agency to reach out to the public and implement national information initiatives.

The medical suppression of female sexuality in Victorian society has long been the subject of historical and cultural scholarship, with documentation not only of textual threats by religious and medical “experts,” but also of surgical assaults on female reproductive systems (Longo, 1979, 1986; Scull & Favreau, 1986; Sheehan, 1997). Less well known is the apparent obverse: the use of medical techniques to stimulate the female genitalia as a means of treating hysteria and other mental disorders (Maines, 1999; Schleiner, 1995). In this paper, I trace the cultural history (mainly Anglo-American) of the psychiatric enhancement, as well as repression, of female sexual pleasure, through various genital treatments, including the surgical and the electrical.¹ I then make the case that these “opposite” treatments are, in the context of Victorian society, two sides of the same coin of the patriarchal, medical control of female sexuality.²

This chapter examines symphysiotomy in twentieth-century Ireland as one example of a systematized obstetric violence that has characterized Ireland’s modern history. Expanding scholarly interpretations of state- and Church-inflicted abuse of women in the twentieth century, this analysis establishes the medical profession as a central actor alongside the twentieth-century state-Church coalition that regulated women’s reproductive lives and engaged in systematic repression. This chapter recognizes that Ireland’s history of reproductive abuse and coercion did not just involve contraception or abortion but also labor and birth experiences. In addition, it offers a more complete and complex interpretation of obstetric violence by highlighting the experiences of married women with wanted pregnancies; almost all research to date focuses on the experiences of unmarried pregnant women or unwanted pregnancies. This examination of symphysiotomy and obstetric violence in Ireland illuminates the ways in which religious, national, and medical power has been mapped on women’s reproductive bodies, particularly in the decades after independence in 1922. It also makes essential links between Ireland’s past and present, demonstrating that a careful analysis of the history of obstetric violence and the religious underpinnings of it are essential in understanding Ireland today. With this research, we also place symphysiotomy within the context of the global reproductive justice movement, asking how a reproductive justice framework – one that links reproductive rights with social justice – can help us interpret obstetric violence and address the wounds of Ireland’s past.