Description of: A Public Health Journey My quest to provide voluntary contraception. The struggle for reproductive health, and the right of individuals to make permanent decisions about their own bodies, has been a long one. This book chronicles many aspects of this shift in societal attitudes, from the post-war era of puritanical repression, through the sexual revolution, to what we believe now to be a more enlightened age. The author of the book, a registered nurse who fought her own battles before there was any public support, was on the forefront of these changes. The first part of the book is a broad history of the organization now called EngenderHealth, Inc. It covers the period from the mid 60's through the mid 90's, reporting from the view of an insider what the organization was doing to broaden reproductive choices for both men and women. The book begins at the time when hospital policies refused tubal ligations for mothers with fewer than five or six children, when there was no public funding or insurance coverage for the surgery, when there were no out-patient facilities, and when female surgical contraception required a long abdominal incision. Gonzales describes how the organization, in their attempts to achieve sexual and gender equality, fought to permit young, single, or child-free persons to choose surgical contraception, if they were fully aware of the permanency of the method. It also fought to allow women to obtain a contraceptive sterilization in the absence of spousal consent, ensuring that women and their reproductive organs were no longer a man's possession. The book demonstrates the organization's efforts to develop counseling and informed consent procedures, to establish vasectomy clinics, to encourage surgeons to perform simpler, out-patient procedures for women and to teach the "no-scalpel" vasectomy technique to urologists, medical schools and medical students. The second part of the book follows the author as she represented the Medical Division of the association overseas once the battles in the United States had been won. Experiences of her many trips to less-developed areas of Asia, Central and South America, the Indian subcontinent, and sub-Saharan Africa are colorfully related.
About the Author: Betty Gonzales has spent most of her life working to expand reproductive choices as an activist for voluntary sterilization. Together with an organization now called EngenderHealth, she helped make social and surgical changes in the United States, and overseas. A registered nurse and working in public health, Gonzales became a spokesperson for the association, speaking at community meetings and professional conferences. She was also the guest on over one hundred radio and television programs, to discuss the choice of permanent birth control (vasectomy and tubal ligation). After ten years of volunteer work for the association, Gonzales was prepared to join the staff and assume a leadership position in the national office. During those years, voluntary sterilization became, and remains today, the most widely used method of contraception in developing regions of the world as well as many developed countries. Once a high level of national public information had been achieved, the next step was to foster professional education. She edited The Bio-Medical Bulletin, to help educate professionals about new techniques and surgical standards. She introduced the need for counseling clients requesting permanent contraception and fought against any form of coercion. She was instrumental in the development of the Federal Regulations for Voluntary Sterilization that were introduced in 1978. When the new technique of laparoscopy was introduced, Gonzales took instructions along with gynecologists and surgeons. When the technique of performing vasectomy without the use of a scalpel was first brought to the United States, she suggested a training manual. No-Scalpel Vasectomy: An Illustrated Guide for Surgeons was published with Gonzales as the primary author. It has since helped teach the surgical technique to thousands of doctors around the world, and has resulted in the no-scalpel vasectomy becoming the "gold standard" for vasectomy. The organization she worked with was reorganized in 1981. A Medical Division was formed and Gonzales was named the Deputy Director. Efforts from that time until her retirement focused on assuring safe medical and surgical practices across the globe. She worked in over fifty countries, assuring high medical standards, and developing curricula for training doctors, nurses, and counselors. Her book, A Public Health Journey: My quest to provide permanent contraception covers thirty years of her work and travels.