A book with heart: ‘In the Hands of Women’ by Jane Loeb Rubin

This novel opens in Baltimore, USA, in 1900. Hannah Isaacson is one of a small group of women admitted to Johns Hopkins Medical School, in the face of doubt and opposition from the men who dominate and control everything about healthcare and medical education, including for women. She is determined to achieve her goal of working as a qualified doctor in obstetrics.

To do so, she has to study and work hard and find a way around the demands and questionable practices from some doctors who don’t put the interests of patients first.

She becomes increasingly concerned about the rising number of women she has to deal with who are the victims of botched abortions. The stark reality of women’s lives at this time led some to choose this way of dealing with an unwanted pregnancy: middle-class and ‘society’ women to avoid shame for themselves and their families; poor women because they cannot afford another mouth to feed.

Contraceptive devices were illegal under Federal US laws at the time – women left with very few choices regarding family planning and their own health needs.

Hannah wants to work to change all this.

After she is qualified, she moves back to her home town of New York City to work in a major Jewish hospital there, and meets other women with similar aims, including the real-life Margaret Sanger, a pioneer in areas of women’s birth control and suffrage.

When Hannah tries to save the life of a woman dying after a botched abortion, she is arrested and incarcerated at the notorious Blackwell’s Workhouse, where she is horrified at appalling neglect and abuse of inmates. Her experiences here add to her determination to address the devastating effects of poverty on women, especially among the communities of immigrants pouring into New York from Europe and Ireland.

When she is finally released, she has to claw back her reputation and career, and while doing so, develops a plan to create women’s health services in the poorest parts of the city.

This is a carefully researched novel, with a mix of real-life and imagined characters. I love that part of the inspiration for one of its central women, was the author’s great-grandmother. And I enjoyed learning about the beginnings of modern hospital care and obstetric services in an important US centre and its immigrant populations, especially Jewish people from Europe escaping anti-semitism in the nineteenth and early twentieth centuries.

Hannah is a believable character. She is determined, but not without anxieties and insecurities. Her experiences with men add complications and leave her questioning her own instincts. Many readers will relate to that side of Hannah. However, despite all the challenges confronting her, she does not lose sight of her goals to better the lives of others. She is smart, sensitive and empathic. Her dealings with the men in charge of institutional funds and regulations allow her to develop some wily negotiation skills!

I enjoyed In the Hands of Women: an engrossing novel with themes and characters I could care about. There is a prequel on the way by Jane Loeb Rubin which I look forward to reading on its release.

In the Hands of Women was published by Level Best Books in May 2023.
My thanks to the publishers and NetGalley for a review copy.