Women`S Health Network: Country Report Germany
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EWHNET European Women's Health Network Women`s Health Network: State of Affairs, Concepts, Approaches, Organizations in the Health Movement Country report Germany August 2000 EWHNET is a project in the fourth Medium-Term Community Action Programme on Equal Opportunities for Women and Men (1996 -2001) and is financially supported by the Federal Ministry for Family Affairs, Seniors, Women and Youth (BMFSFJ). Authors: Vera Lasch, Brigitte Hantsche, Eva Schindele, Catrin Halves, Cornelia Burgert, Christina Sachse, Regina Stolzenberg, Ute Wülfing, Christiane Niehues, Birgit Babitsch, Judith Fuchs, Daphne Hahn, Karin Wieners, Hildegard Hellbernd Where to order: Ute Sonntag Landesvereinigung für Gesundheit Niedersachsen e.V. Fenskeweg 2 30165 Hannover Germany phone: 0049 511 3500052 fax: 0049 511 3505595 e-mail: [email protected] Copyright: No portion of the contents may be reproduced in any form without written permission of the contributors of this issue. All rights reserved. The following texts reflect the authors‘ views. The commission is not liable for any use that may be made of the information contained in that publication. 1st edition Hanover 1998 (by ifg; Institute Women in Society) 2nd edition Hanover 2000 (Landesvereinigung für Gesundheit Niedersachsen e.V.; association for health promotion in Lower Saxony) Contents: Part I 1. Introduction......................................................................................................................5 2. Aspects of the women´s health movement .......................................................................6 3. In-depth contributions......................................................................................................8 3.1 The rise of gynaecology and the pathologisation of womanhood under special consideration of female transition stages: puberty, pregnancy and menopause ............8 3.1.1 The rise of a profession........................................................................................8 3.1.2 The boom of hormones........................................................................................8 3.1.3 Risk factor: being female.....................................................................................8 3.1.4 Women's expectations of gynaecology............................................................... 10 3.1.5 On the agenda - placing the women's health movement...................................... 10 3.2 Pregnancy care and obstetrics between standardisation and reform............................ 11 3.2.1 Introduction....................................................................................................... 11 3.2.2 Critique of hospital births .................................................................................. 12 3.2.3 Objections to prenatal diagnostics...................................................................... 12 3.2.4 The heuristic model of pregnant women at risk.................................................. 12 3.2.5 Clinical routine and marketing strategies ........................................................... 13 3.2.6 Alternatives to delivery in hospital..................................................................... 14 3.2.7 Breast-feeding ................................................................................................... 14 3.2.8 Midwives' research ............................................................................................ 15 3.3 Menopause................................................................................................................ 16 3.3.1 How menopause is seen in our society ............................................................... 16 3.3.2 Social background ............................................................................................. 16 3.3.3 The medical approach to menopause.................................................................. 17 3.3.4 The problematic nature of osteoporosis prophylaxis........................................... 18 3.3.5 Alternatives and other methods of treatment ...................................................... 18 3.3.6 Organizations dealing with the subject of menopause ........................................ 19 3.4 Breast Cancer............................................................................................................ 21 3.4.1 The problem ...................................................................................................... 21 3.4.2 Historical development...................................................................................... 23 3.4.3 What must be changed? ..................................................................................... 24 3.4.4 Which organizations take this subject up?.......................................................... 24 3.4.5 Structural characteristics.................................................................................... 25 3.5 Critical points in operative gynaecology.................................................................... 26 3.5.1 Gynaecology as a "surgical" subject .................................................................. 26 3.5.2 Quality assurance in operative gynaecology....................................................... 26 3.5.3 The problem area of operative technique............................................................ 27 3.5.4 System-related conflicts of interests................................................................... 27 3.5.5 The value put on female organs and psychosomatic connections........................ 27 3.5.6 Rehabilitation and aftercare ............................................................................... 28 3.6 Violence Can Make You Ill - The Connections Between Violence and Health .......... 28 3.6.1 Violence against women and girls...................................................................... 29 3.6.2 The effects of violence on the health of women and girls................................... 32 3.6.3 Violence as an issue of medical care .................................................................. 35 3.6.4 Assistance available to women and girls affected by violence............................ 36 3 3.6.5 Prospects and requirements................................................................................37 3.7 Women's Health Research in Germany Ulrike Maschewsky-Schneider, Birgit Babitsch, Judith Fuchs, Daphne Hahn; translated by Luita D. Spangler............................................42 3.7.1 The Development of Women's Health Research in Germany: From the women's health movement to public health.......................................................................42 3.7.2 Women's health reporting ..................................................................................44 3.7.3 Social situations and the health of women..........................................................46 3.7.4 Methods of gender-sensitive health research ......................................................48 4. Brief Description of the Structure of the Health Care System in the Federal Republic of Germany .............................................................................................................................53 4.1 General Facts ............................................................................................................53 4.2 Organisation of the Health Service ............................................................................53 4.3 The German Health Reform Act................................................................................55 4.4 Discussions about the Health System.........................................................................56 5. Organizations within the Women`s Health Movement .................................................57 5.1 Associations, networks, registered societies, foundations ..........................................57 5.1.1 coordination and information centres .................................................................57 5.1.2 Nature healing ...................................................................................................60 5.1.3 Professional associations and comparable organizations.....................................62 5.1.4 Networks, registered associations, foundations in the field of health promotion .83 5.2 Special health problems...........................................................................................101 5.2.1 AIDS ...............................................................................................................101 5.2.2 Eating disorders ...............................................................................................105 5.2.3 CANCER.........................................................................................................112 5.2.4 PSYCHIATRY ................................................................................................114 5.2.5 Addiction.........................................................................................................117 5.3 reproductive health..................................................................................................122 5.3.1 Sexuality..........................................................................................................122 5.3.2 mother convalescence centre............................................................................130 5.3.3 PREGNANCY AND BIRTH...........................................................................132