For over a century, researchers have argued that suicide in the United States fluctuates with business cycles, rising during downturns, when “deaths of despair” skyrocket, and falling during flush periods. Using case-level data from autopsy reports and suicide notes, this essay analyzes suicide trends in New Orleans between 1920 and 1940, an era that included immense prosperity and the Great Depression. Thus, the essay draws from quantitative and qualitative evidence to revisit the leading explanation for suicide patterns. It concludes that only a small segment of the population experienced surges and contractions in response to economic forces. For other New Orleanians, different stressors, relating to class-, race-, and gender-based expectations, shaped suicidal behavior. Firearm availability and public health conditions also influenced suicide patterns. Counterintuitively, suicide rates soared in good times and plummeted in bad times.
This article traces the historical processes by which Brazil became a world leader in cesarean sections. It demonstrates that physicians changed their position toward and use of different obstetric surgeries, in particular embryotomies and cesarean sections, over the course of the nineteenth and twentieth centuries. The authors demonstrate that Catholic obstetricians, building upon both advancements in cesarean section techniques and new civil legislation that gave some personhood to fetuses, began arguing that fetal life was on par with its maternal counterpart in the early twentieth century, a shift that had a lasting impact on obstetric practice for decades to come. In the second half of the twentieth century, cesarean sections proliferated in clinical practice, but abortions remained illegal. Most importantly, women remained patients to be worked on rather than active participants in their reproductive lives.
This article analyzes expert debates relating to abortion in Poland between 1956 and 1993, a period when the procedure was legal and accessible. Through the pages of the primary Polish journal for gynecology and obstetrics, Ginekologia Polska, the author traces continuities and ruptures around three major intersecting themes: the procedure’s indications, its (dis)connection to health, and the patient-doctor relationship. The journal became a forum showcasing interpretative tensions over indications for abortion and the malleability of the categories “therapeutic” and “social.” In addition to these tensions, abortion was represented throughout this period as a potentially risky surgery, although this was initially nuanced with parallel representations of legal abortion combating maternal mortality. During the 1970s, abortion began to be linked to infertility, often in simplistic cause-and-effect terms. Simultaneously, opposition to abortion based on the idea of defense of the nation and fetal “life,” surfaced in expert discourse.
The transformation of the Merck Manual of Diagnosis and Therapy from a “doctors-only” reference into a consumer health bible illuminates a critical era in the history of the twentieth-century medical book. Merck and Company restricted sales of its Merck Manual, first published in 1899 to offer up-to-date information for the busy practitioner, to physicians and other health care professionals until the 1970s. As more laypeople sought to get involved in their own health care decision making, the Merck Manual developed a devoted following. In the late 1980s, with almost a quarter of its sales going to nonphysicians, Merck and Company decided to put out a home edition of its famous manual. This evolution provides important insights into both the history of the medical book and the doctor-patient relationship in the United States.