Book Review

The Medical Care of Women

N Engl J Med 1996; 334:60January 4, 1996

Article

The Medical Care of Women
Edited by Phyllis L. Carr, Karen M. Freund, and Sujata Somani. 846 pp. Philadelphia, W.B. Saunders, 1995. $95. ISBN: 0-7216-3779-5

To be honest, as I began reading this large book, I had a bias as a male gynecologist. The preface, foreword, and contributions, most of which have been written by women, suggested a feminist critique of my current practice — that I do not address the care of women from a woman's perspective and that we men have deliberately fragmented health care, to the detriment of women. As I delved further, however, I found that the majority of the chapters present information as it would appear in most books in my specialty. I was relieved. The topics related to women's health outside my area of expertise were the most interesting. They meet the need to educate physicians about diseases in women that affect both men and women, since the aspects of those diseases in men have received more emphasis.

In the 78 chapters of this book, the editors bring together the issues in women's health care. As usual in such a multiauthored work, the depth of coverage, clarity, and usefulness of each contribution vary (e.g., 15 pages are devoted to lung disease in pregnancy, which is a more comprehensive presentation than that found in most obstetrical textbooks, whereas the common condition of miscarriage is covered in only 7 pages).

The editors and the authors of the foreword propose a unique place for this book on the basis that it is a multidisciplinary compilation of information on women's health care. Seventy percent of the chapters, however, can be found in most standard obstetrical and gynecological textbooks. The remaining chapters provide useful (and in places novel) perspectives on general medical and psychosocial issues affecting women. As an academic gynecologist, I hope that a number of these issues find their way into formal textbooks in my specialty, since they broaden our view of our patients.

The intended audience for this book is primary care physicians. However, I believe there are better options for reference to specific medical problems in obstetrics and gynecology and in general medicine. As a work that will encourage physicians — both primary care and specialist — to adopt a more focused women's perspective on health care, however, this book breaks new ground.

In a world where half the new medical graduates are women, I suspect this book may find a niche — although not always for the correct reasons.

Michael G. Chapman, M.D.
St. George Hospital, Kogarah, NSW 2217, Australia