1. Taking care of ourselves
(1) Body Image
Our constant preoccupation with our body and its image accompanies us from childhood in different contexts and to varying extents, depending on internal and external factors. The feminine body comes in an amazing array of shapes and sizes: we are tall, short, thin, fat, strong or fragile. Our eyes come in a range of shapes and colours, our skin in a large rainbow of hues and our hair in many shades and textures. All the same, we are all judged (by ourselves and by others) by irrational standards which create an ideal image of beauty, not achievable by most.
This chapter deals with how our body image affects our lives, how it shapes it and how we cope. Areas of Israeli culture also shape our body image, i.e. army service or local ethnic attitudes regarding the beauty ideal. The chapter ends with cosmetic surgeries that are available to women today and about choosing to change your external appearance in this way. This section includes a critical discussion of all angles, the chances and the risks, as well as information on surgical procedures and much more.
(2) Eating Well
Eating is not just a physical need which influences our health, but also a product of culturally defining elements. All over the world many more women than men cook, feed, are concerned with food as eaters (or perhaps as ones who do not eat enough – Israel is rated highest in teenagers who are forever dieting). The chapter deals in femininity & eating, the representation of women in food ads, eating & sexual abuse and more. This chapter was compiled by a nutritionist, a specialist in eating disorders, women who suffered eating disorders at various levels, a vegetarian, a vegan etc. The correlation between femininity, love and food is especially strong in the Middle East.
(3)Addictive Substances – Alcohol, Drugs and more
Most of us have used addictive substances at some point throughout our lives, as adult women or as teenagers. Some drink a glass of wine or beer in the pub, others drink daily. Some try cannabis once and some smoke regularly, while others are addicted to pain killers. Even if we ourselves do not use any addictive substance, we often share our homes or our communities with those who do. The chapter deals with addictive substances and their physical and mental effect on us, how to reduce the risk and damage, ways of fighting addiction, support groups and centers available in Israel, preventative measures and ways to help.
(4) Our Bodies in Motion
The human body was created to move. Motion does not necessarily mean exercise or sports. Working in or out of the home has become, over the years, much more mechanical, so that women, nowadays, are less mobile. Physical exercise includes an array of activities which can be done alone, in groups, or as competitive or achievement-orientated activities. Physical activities need to fit personal inclination and the health of each of us. The chapter discusses fully the influence of movement and exercise on physical and mental wellbeing. It deals with general Israeli issues such as access to sport facilities and financial support (or lack of) of women’s sports by the government and local municipalities.
The health system in Israel meets, confronts and sometimes even cooperates with holistic practices such as acupuncture, homeopathy, chiropractics and many other methods. The holistic approach does not only tackle the physical ailment, but aims to strengthen both the body and mind as one. Most of the Israeli public does not yet have access to a large pool of information on holistic practices. This chapter surveys the various holistic approaches while offering the reader basic tools to take care of herself and how to weigh up the advantages and disadvantages of different types of holistic medicine. It also reviews the accessibility (or lack of) of such health services to the weaker sectors of society.
(6) Emotional Well-Being
The well known Greek saying “a healthy spirit in a health body” is just as true today as it was three thousand years ago. During our lives we deal with emotions, situations and events which require mental support from family members, friends and relatives. It is often their support which provides us with a sense of security and stability. Yet there are situations and events in life in which this support does not provide adequate assistance, and the guidance of a professional is essential.
The chapter on Emotional Wellbeing provides an in-depth description of the array of therapy options available in Israel today, from publicly funded services, options available through the different Kupot Holim (HMOs) and private services. This rich overview, combined with personal narratives collected from women of varying ages, ethnicities and socio-economic backgrounds, enables the readers to make educated and informed choices regarding which professionals would be most suitable for them.
Chapter sections include: Therapy as an option – Finding a competent, caring therapist – Is it all in our brain chemistry? – Concerns about medication – Challenges for consumers – Social or political action: an often overlooked source of help. The chapter answers such questions as: Which therapeutic methods are available in Israel today? How to I select the type of therapist which would best suit my needs and values? When should therapy include psychiatric aspects?
(7) Environmental and Occupational Health
The quality of the environment has an impact on our lives and shapes our health in various ways. Our environment has, over the years, become less and less safe. The air is polluted by poisonous gasses omitted by cars, factories and more. The waters are polluted by chemicals and from the over use of pest control in agriculture and more. Our food is sprayed, sterile and full of hormones and chemicals. Even inside our homes we are not safe. We breathe poison from detergents, from the paint on the walls or the infected water and food. These substances affect our health and we need to be aware of their danger. Even our work place, were we spend a large portion of our day, does not always take enough care of our health and safety. This chapter reviews the various hazards and how we can combat them. For instance, the workers in factories are exposed to poisonous gasses; a growing number of women are working in commerce and are standing for long hours, without rest or available chairs; continuous work in front of the computer can distress joints and sight.
(8) Violence and Abuse
The phenomenon of violence against women is typified by the close relationship with the attacker, who usually comes from within the circle of the woman’s close relatives. The private nature of the violence against women sometimes renders it ‘transparent’, so that it is almost not seen because it takes place within the home or because society views it as legitimate. Violence puts the women victim at risk of death, disability and affects their emotional state and health. A long string of laws and regulations define violence at different levels as punishable criminal offences. Nowadays, women in Israel are regularly battered, raped, sexually harassed, are trafficked and even murdered.
The chapter strives to support women who experience violence and sexual harassment by undermining the common myths relating to rape, highlighting the indicators of violent men and surveying the available legal, mental and medical support systems.
2. Relationships and Sexuality
(9) Gender identification and Sexual Orientation
Our personal gender identification and our sexual orientations do not always correlate to the accepted social norms which identify two categories – man and woman. This chapter delves into the complexities and fluidity of gender identification. Such an outlook is challenging or unacceptable for some and an intimate personal story for others. The chapter deals with topics that might influence the relationship we have with ourselves, with others and with the world.
(10) Relationships with Men
Those of us who find men as partners for friendship, love, support, sex, or any other relationship, face many issues and reflections concerning satisfaction, happiness, love and comfort. There are many challenges in the day to day life between women and men, for instance, how to demand safe sex and to avoid a violent and harmful relationship or queries relating to the communication between the sexes and self protection. In Israeli society, where partnership and family are the accepted norm, single, divorced or widowed women or sometimes women in unsanctioned partnerships, are confronted by constant pressure to find the accepted partnership. Many researches look at the tendency of the Jewish society to see the family and its continuation as a form of contribution towards the Zionist project.
The chapter encourages women to find the inner strength to cope. It tackles the array of relationship systems between women and men outside the external constructs, and the challenges posed by the media. It also surveys the legal situation regarding partnership and singlehood.
(11) Relationships with Women
The choice to live in the open as a lesbian in 21st century Israel is not a simple or an easy choice. Those of us who classify ourselves as lesbians struggle almost daily with homophobia, prejudice and institutional discrimination. The process of outing oneself is a long process which never comes to an end. Again and again we have to do it in front of family, friends, colleagues, children’s friends and other social groups. We carry on our relationships, bring up our children and belong to other sub communities (such as religious Jewish lesbians, Palestinian lesbians etc) surrounded by discrimination.
This chapter deals with various problems which could interest lesbians. Those of us, who have changed gender identification at a later stage, are faced with special challenges such as keeping in touch with previous partners. The medical system for a lesbian is hostile and many lesbians tend not to visit gynaecologists. This chapter also offers support to lesbian mothers who are struggling to find out what assistance and services are available in Israel.
Sexuality is a pivotal force which can be a powerful source of many sensations such as pleasure, empowerment and liberation. The chapter deals with and discusses sex and sexuality in various settings. Its main aim is to contribute towards the realization of our positive sexual potential and allowing other positive influences into our lives. The way we experience sexuality stems from the social setting in which we live, but can also form it. The chapter examines social behaviours and codes which push many of us to quell, diminish or limit our desire, our sexual experience, our pleasure and the varied ways we identify ourselves as sexual female beings.
(13) Sexual Anatomy, Reproduction and the Menstrual Cycle
Where are the ovaries? What is the function of the fallopian tubes? This chapter gives a guided and thorough tour of the internal aspect of the sexual and reproductive organs and helps to introduce us to the organ terminology, their function and their place in our body. After the tour, we deal with the menstrual cycle – including ovulation and bleeding. The chapter also touches upon the cultural aspects of menstruation and its influence on women’s moods and mood swings which may occur at various stages of the cycle, as well as the range of ways to combat the pain which can accompany the monthly bleeding, and more. The last part of the chapter is dedicated to religious women writing about Nida and Jewish/Muslim religious requirements relating to menstruation.
(14) Safe Sex
The chapter deals with our ability to have sexual encounters which are sensual and passionate whilst protecting our sexual health. Safe sex is not necessarily the opposite of pleasurable sex. The use of buffer birth control can prevent sexually transmitted infections, yet will not lessen our pleasure. One of the most common causes of unsafe sex is ignorance, resulting from the fear of discussing the subject. The avoidance of momentary embarrassment and discomfort could lead to being infected by incurable venereal diseases. Therefore, an open and honest discussion with a partner about sex may get rid of concerns and contribute towards cooperation and the safeguarding of our health.
(15) Sexually Transmitted Infections
The chapter looks at the infectious venereal diseases, ways of being infected, diagnosing the illness, the treatments and whether complete healing is possible. The chapter informs you of the health services being offered in Israel to infected women.
(16) Aids and HIV
The Aids/HIV epidemic is a global crisis. This chapter is for all of us who are interested in learning more about HIV and Aids for those of us who are living with the disease and wish to understand more and consult someone about it. The chapter includes general information on the disease and ways of transmission, details about check ups and advice centers, availability of support networks and state assistance and existing conventional and complimentary means of treatments, as well as information about HIV/Aids pregnancies.
3. Reproductive Choices
(17) Considering Parenting
During the second half of the 20th Century, many changes have occurred which relate to a woman’s reproductive choices. Until fifty years ago, fertile women became pregnant and gave birth out of choice or because there were no adequate contraceptives. The decisions were defined by rigid social expectations and medical realities. The chapter deals with the variety of reproductive choices that exist today in regards to parenting, the accessibility of birth control, terminations and new reproductive technologies. The chapter also deals with women who decide not to bear children, and the varying types of “family units”, such as single motherhood or same sex partnership wishing to either give birth or adopt. The chapter handles questions relating to public and legal aspects of parenting as well as to the social norms accepted within this area.
(18) Birth Control
The right to make decisions regarding our bodies is in our hands and includes, amongst other things, the right to reproduce. We can decide whether we wish to bring children into this world, when and with whom. The various contraceptives at our disposal allow us to engage in safe sex with men. Today we have many more choices than our mothers and grandmothers had. The improvement and advancement of birth control technology provide us with more options and methods, allowing us to suit our form of birth control to our way of life and our health. Yet, those choices are still limited and have an impact on our health. This chapter deals with the personal and health implications of each of the birth control options available today. The chapter touches on questions and difficulties which many women experience when considering contraceptives – questions such as which contraceptive to choose? How effective is each method? What impact will it have on my health? How useful it is in preventing pregnancy? And, what is the role of my partner in all this?
(19) Unexpected Pregnancy
About half the women discover, at some stage in their life, that they are unexpectedly pregnant. If we suspect we have such pregnancy, it is important to identify the last day of the menstrual cycle and, of course, take a pregnancy test. Early discovery could allow us more choices of action. This chapter provides stepping stones. Whether we experience confusion, anxiety, happiness or curiosity, we will need help in the form of practical information and emotional support which can assist us in deciding whether to carry on with the pregnancy or to terminate it. The chapter directs us to many sources of information for each stage of the pregnancy, including the decision whether to choose abortion or adoption.
The decision to terminate a pregnancy is a hard and important decision. Some women are sure of their decision; others live with the guilt for years. This chapter assists women at this important juncture, and tries to provide as much information as possible in order to help you make the right decision. The chapter reviews the current law on abortion, its history and women’s rights within it. The chapter provides explanations about the medical implications of abortion, the various medical options and centers in Israel where abortions could be carried out as well as the dangers relating to illegal abortions and the medical problems which can accompany it. Also described in the chapter are alternative ways of dealing with abortions, the ceremonies and the emotional healing available. Israeli society is made up of many religious and social streams. The chapter reviews the various streams and sites relevant literature, points of view and practical information available in different languages. One more aspect covered in the chapter, unique to Israel, touches on the concept of the ‘perfect baby’. This concept drives a relatively larger percentage of women to late terminations, resulting from their fear of having an imperfect fetus.
The chapter focuses on creating a safe environment for pregnant women. We touch, throughout the chapter, on the range of emotions which pregnancy can cause in women and their partners; we give advice on how to choose a practitioner and a companion for the duration of the pregnancy relating to health, medical and nutritional aspects of the pregnancy. The chapter provides information about medical tests and various symptoms occurring during pregnancy, pregnant women’s rights, special cases such as high risk pregnancy and pregnancy at a young/old age, as well as pregnancy & addictive substances and pregnancy & the disabled, handicapped and the chronically ill. Towards the end of the chapter there are thoughts and considerations in order to help you choose the best place and way for you to give birth in Israel.
When giving birth, our history, our ceremonies, our values, needs, strengths and anxieties play a part. Childbirth is one of the most fundamental events in our life and we can experience it in a variety of forms. This chapter offers detailed information about childbirth, starting from conception through to the different stages of pregnancy, culminating in the birth and the different emotions and rewards we experience throughout. We also give information about interventions and other medical procedures, Caesarean birth, unique forms of birthing and the first hours and days after the baby is born.
(23) The First Years of Parenting
Becoming a mother changes our point of view, leaving us to face a new range of emotions, which can sway from one extreme to another. The chapter deals with the health and wellbeing of the new mothers during the initial period after the arrival of the baby. This is a time filled with strong emotions and physical changes and it requires a lot of adjustment. The changes to a woman’s physical and emotional wellbeing that occur during pregnancy, childbirth, and the months following are most important for women who give birth. The chapter will also deals with women who adopt children and with the unique aspects of becoming a mother in this way. The chapter delves into a range of views regarding breastfeeding, sexuality during this time, the change in the way of life, questions relating to returning to work, social, physical and psychological issues, including detailed viewpoints relating to post-natal depression.
(24) Childbearing Loss
A childbearing loss, no matter how it happens (miscarriage, stillbirth, SIDS etc) is an extremely distressing loss. Even a woman who decides to terminate her pregnancy, for whatever reason, can undergo a profound and agonizing experience of bereavement. The loss can affect the way we see ourselves and may have a physical and mental impact on us. The chapter deals, in details, with the various reasons of childbearing loss, the wide implications and relates other women’s experiences, stories and ways of easing the loss and coping with it.
(25) Infertility and Assisted Reproduction
Dealing with infertility is not easy, especially in Israel where giving birth is seen as a natural part of being a woman. The chapter focuses on infertility, the possible reasons for it, the physical, emotional and social implications, the possible treatments and their consequences. The chapter opens by defining fertility and how our way of life effects fertility of women and men. It also looks at the cultural standpoint of fertility in Israel. The chapter delves into definitions of infertility, the prevalence of the phenomena and the different explanations for infertility in men, women, the combination of reasons for infertility as well as cases which appear to have no medical explanation. The main aim of the chapter is to raise awareness of the treatments available in Israel. It begins with the diagnostic attributes and provides detailed explanations of the various treatments available, the medical implications and the possible complications, the ethical aspects of assisted reproduction and the possible emotional, partnership related and sexual aspect of it. The chapter also presents the social and legal aspects of assisted reproduction, such as: the law in Israel, the rights of women and men during the treatment, Halachic viewpoints, as well as assisted reproduction for different kinds of families – single parents and same sex partners and the Arab population. It provides up to date information of service centers – Kupot Cholim (HMOs), IVF units, sperm banks, charities and other sources of information, as well as discussing issues such as holistic medicine, surrogacy and adoption.
5. Growing Older
(26) Midlife and Menopause
As women, we go through a phase in our lives – midlife – which is often referred to in negative terms such as ‘old age’, ‘period of transition’ or ‘midlife crisis’. During this time, women experience a vast array of symptoms such as heavy bleeding and/or irregular periods, and/or hot flashes. Menopause starts later – about 12 months after the menstrual cycle has stopped – and continues to the end of our lives. The chapter deals with the emotional and physical ways we handle midlife. The chapter reviews various studies dealing with hormones and their influence as well as with natural remedies. It supports the idea of coming to terms with and being at peace during this time in our lives and accepting it and ourselves.
(27) Our Later Years
Our ‘later years’ are becoming longer. Old age is starting later and later and we live longer. There is a close link between our health and our quality of life in later years. Yet, there are other things which influence our quality of life, our body and our independence, such as retirement and/or loss of a partner. The health system in Israel provides health services to older people and, unlike other western countries, the medication and some of the medical treatments are subsidized. Women who did not work outside the home when they were younger, or did not receive the employer’s contribution to their pension fund, can find themselves, in later years, dependent on national insurance for medication and their basic needs. The chapter focuses on chronic conditions, the available help for people with physical impairment, how to cope with loss of skills and abilities as well as with family loss or the loss of a lifelong partner. The chapter tries to paint a general picture of aging women in Israel while pointing out the beauty of this period and the difficult struggles we face.
6. Medical Problems and Procedures
(28) Unique to Women: Breast Health
In this chapter we discuss healthy and unhealthy breasts. We examine the shape of breasts, their development during adolescence and the changes which take place during menstruation and pregnancy, the various symptoms which can appear and their meanings, such as benign breast conditions and breast cancer. The chapter aims to allow us to understand the various symptoms and types of breast cancer, the risks including genetics as a diagnostic and preventative tool. The chapter discusses the various ways of diagnosing cancer, whether by self examination, medical tests or other methods. If breast cancer is found, we explain how to choose the medical team to treat you as well as sorting through the many possible treatments available nowadays. We also deal with the physical and mental aspects of the illness and its effect on us and the people around us. Finally, we discuss life after cancer: fertility treatments, pregnancy, cosmetic reconstructions, menopause and more.
(29) Unique to Women: Sex and Reproduction [The Vaginal Area]
The chapter examines our body and focuses on medical conditions unique to women and medical issues related to these conditions. It aims to widen our knowledge and understanding of our sexual and reproductive organs. The chapter opens with how to perform self-examinations and how to identify changes in our normal condition. It describes signs of common problems in the vaginal area and when we should go for medical checks. The chapter deals with gynecological checkups and whether only doctors can see what’s between our legs, and what we should expect during these checkups? What kinds of tests exist? The chapter examines in details common infections, amongst them irregular uterine bleeding, uterine and vaginal infections and pre-cancerous changes in the cervix. It talks about some benign conditions, such as melanoma and cystic fibrosis, but also about cancerous growth inside the vulva and the vagina, the cervix, the uterus and the ovaries. The chapter describes ways of diagnosing the problems and the many medical treatments and surgeries available, so that we can be informed participants and make informed choices.
(30) Special Concerns for Women
The chapter discusses conditions that affect women more severely than men. For example: anaemia is more common in women. Anaemia can occur as a result of inherited conditions or as a result of iron or folic acid deficiency. Anaemia can be treated by changing ones diet or by taking supplements. Another common condition in women is arthritis which occurs three times more often in women than in men. For other conditions (such as inflammation of the cartilage, rheumatism – an auto immune disease) there are treatments which aim at easing the symptoms as well as medical treatments. There are auto-immune diseases more common in women, such as thyroid, lupus, and scleroderma.
Chronic problems, such as fibromyalgia and cardiovascular problems, even though no less common in women, receive much less attention when diagnosed in women. Other illnesses that fall into this category include atherosclerosis, high blood pressure, coronaries, heart attacks and strokes, cancer of the colon and the rectum, diabetes I & II and urinary infections. The chapter describes the symptoms, the risks and the available preventative measures and treatments.
7. Knowledge is Power
(31) Navigating the Health Care System
One of the obvious advantages of the Israeli health care system is that health insurance is given to all its citizens. Even though the idea is meant to be equal healthcare for all, health and wellbeing is still, in part, a derivative of one’s social and economic status. Navigating the health system effectively requires much knowledge, not only of the system, but also of our body. The chapter examines the holistic aspect of women’s health, bringing together two main components – the biological differences between the sexes and the social, economic, operational and cultural differences which cause women, more so than men, to use the health systems more often. The chapter includes, apart from data about the health conditions of women in Israel (which is a testimony to the present situation), problem areas which require a greater allocation of resources and treatments etc. It also includes a breakdown of the healthcare package by gender, what kind of treatment is available within the package [at the time of writing], our rights as patients, alternative sources of information, as well as the barriers to receiving quality care which stem from various types of discrimination.
(32) The Politics of Women’s Health – Organising for Change
Health is a combination of physical, emotional, social and economic aspects, which are derivatives of basic human rights. Israeli society is multi-cultural, including a wide variety of cultural, ethnic and religious groups. Analysing women’s health statistical data in Israel reveals an inequality and a clear link between the woman’s state of health and her economic and social status, uncovering unique health needs. The Israeli-Palestinian conflict is another reason for the increase of inequality, fear, stress and violence. The chapter points out these issues and other problems which relate to politics and women’s health such as, how technology, bio-technology and genetics evolve and infiltrate women’s bodies without giving them a second thought; what is the link between the Knesset’s short term politics and women’s health today and tomorrow? How is the health package decided? How is the subsidised packet decided? Why isn’t there any subsidy for healthy products – do people who live in poverty have to eat only white bread? What are the long term implications of these decisions? What is the link between education and women’s health? These and other issues are dealt with, not only academically, but also in practical terms of how to organise ourselves towards change, highlighting ideas we have come across, giving advice and opinions and ways to raise money and lobby for change.