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As a physician in Russia, one thing always surprises me – the contrast between the high intellectual and spiritual level of Russian women, their familiarity with the world of literature and art, and at the same time – complete absence of knowledge about their own bodies, physiology and psychology. It is this ignorance that causes a lot of health problems, including very high rate of abortions in Russia, many sexually transmitted infections and withholding of love to newborns because of unwanted pregnancies. There are still unreasonably high rates of maternal mortality, deaths caused by breast cancer, as compared with those rates in developed countries. Publishing the book “Our Bodies, Ourselves” in Russian provides a unique opportunity to fill the gap that exists in the Russian literature market and to help women learn a rational approach to their bodies, emotions and capabilities. This book consists of 32 chapters organized into 8 parts. The first part, “Caring About Yourself” includes the information necessary, first of all, to question a self-consciousness which causes much needless suffering when women reject their natural external looks such as body weight, shape of the nose and other bodily characteristics. This chapter pays a lot of attention to the importance of a good diet and adequate physical activity. It reviews the effects of psychotropic substances like cigarettes, alcohol and drugs, the environment, adverse emotional conditions, as well as gender-based violence on women’s health. All these problems are universal for all women on Earth and can be solved only through knowledge and by working together in order to change conditions.

Professor, Doctor of Medical Sciences, L.P. Simbirtseva We Want to Walk Side by Side Preamble to the Russian Edition of “Our Bodies, Ourselves”

The second part of the book, “Interpersonal Relationships and Sexuality”, mostly innovative to the Russian society, which still remains patriarchical, is often difficult to discuss even in modern and quite conservative America. It sounds strange, but it is in the USA itself where efforts are made to ban abortions, where physicians and clinics are being under pressure. This section criticizes sexism and homophobia. Its goals are protection of every person’s right to freely choose her sexual orientation and gender identification. In the Russian society the word “gender” is interpreted in a somewhat different context related to the social specificities of sexual roles. Nevertheless, the American perspective can be interesting to readers, and can offer a different interpretation of the word as not yet well-defined, which can be helpful for its future life in the Russian language. This section certainly will be important and interesting for human rights organizations and simply for people who are different because of their sexual orientation and identification.
The section of the book entitled “Sexual Health” includes four exceptionally important chapters. It presents in an understandable and practical way the anatomy and physiology of women’s sexual system, ways to achieve safe sex and prevention of sexually transmitted infections (STIs). It addresses problems of HIV and AIDS in today’s America and in the whole world. It takes into consideration the fact that Russians usually get infected at a very young age, and that there is a high morbidity rate among teenagers. While adapting this book we also included specific information about the possibilities of receiving information and treatment in Saint-Petersburg youth clinics.
The section “Reproductive Choice” is devoted to a conscious and comprehensive assessment of a family’s decision about birth or adoption, consideration of financial, psychological and social problems related to these decisions. Unfortunately, our constant discussions and the unstable condition of the Russian adoption system did not allow us to adapt this part of the book to our realities. Yes, there is a real need to improve the situation connected with adoptions in America too. Nevertheless, this chapter can be quite useful for our legislators who work in the field of adoption, guardianship and temporary adoption of children. The same section of the book presents modern methods of contraception and practical methods for protecting women’s reproductive rights related to the birth of a wanted child. Unfortunately, in the Russian media we still hear about cases of young mothers killing their newborns, and the number of abandoned children in our country is shamefully high.
“Childbirth” is a large section. It reviews in detail, chapter by chapter, not only a description of pregnancy, delivery and the first year of motherhood, but also ways to support parents in case of loss of the newborn; it also helps women and men to deal with cases of infertility. The authors approach the modern methods of artificial fertilization quite critically, and frankly show all of its positive aspects in helping with fertilization as well as its negative aspects, related primarily to the unpredictability of short and long-term results and effects.
The next section of the book, “Growing Older,” consists of two big chapters – “Middle Age and Menopause” and “Our Older Years.” By critiquing the myth of the “miracle” of hormone replacement therapy during menopause, the authors quite fairly state that a healthy life style, reasonable diet, physical activity and getting rid of unhealthy habits such as smoking, alcohol and drugs are more important for maintaining youth and beauty than the most advanced hormone therapy. The latter can not only be useless, but risky, leading to early strokes and infarctions.
Yes, it is well worth it to read and re-read this book in order not to become victims of aggressive unethical advertisements announcing “the newest” achievements of medicine. There are many examples of this kind in the book, all of them strikingly relevant for Russian women who are pressured by such advertising and conditioned to consider every published word as the Truth.
There are many older women. Although the average length of life of Americans lags behind many developed countries like France, Japan and Scandinavian countries, American women do live for a long time. The chapter “Our Older Years” relates not only to the medical issues of old people – it advocates the social support they need. Here, we can learn from American pragmatism, although the authors are, as always, very critical about public health in the USA and want to improve it, we should admit that the system of medical and social support for the American elderly people is worth a careful study. We need to adopt it. While translating we did not want to compare it with the Russian system, which still leaves old women to die, their pensions only half the amount of men’s.
The next largest section of the book is entirely devoted to the treatment of some most typical and important diseases. It is not a guideline for health providers, but a guide for laypeople and especially women. We have many medical textbooks, but manuals for patients are unreasonably few. At the same time we have so many questions – how to choose the most effective diagnostic test among a wide variety of tests strongly advertised but often unsafe and useless? How to protect our rights as patients to participate in the choice of treatment method? – it is our bodies that they are going to cut, irradiate or expose to other aggressive therapies, often with adverse complications. What questions do we need to ask ourselves and our physicians before deciding about radical methods of treatment? What is necessary to know? How not to enter into a dangerous conflict with physicians while protecting our own interests? The book gives interestingly wise, specific and professional answers to these questions. In Russia a physician is habitually viewed as an absolute authority, almost as a God, with whom discussing or disputing any problems of diagnosis and treatment is considered not only unacceptable but impossible. At the same time, especially now that we have entered a market economy, the rights of patients for full information and informed choice is ensured not only by the “Declaration of Patients’ Rights,” which Russia signed a long time ago, but also by the fact that patients largely pay for their health services out of their own pockets. Besides, physicians may have financial interests causing them to push for a particular medical diagnosis and treatment while serving a firm or company. The book emphasizes that acquiring informed consent is a process, and not simply a token signature on a piece of paper. You need to not only listen and read, but understand what is offered and what is necessary.
The last section of the book is called “Knowledge is Power”. Here the current public health system in the USA is toughly and even cruelly criticized. The section also demonstrates that the social reforms of the last decades in the light of further globalization and the enrichment of international corporations lead to the deterioration of public health. The data from 2003 shows that 45 million Americans do not have guaranteed medical care. The newborn mortality is higher than, for example, in Cuba. Debt because of medical treatments become the leading cause of bankruptcy in the USA. In 1999 “approximately half of all bankruptcies ere related to payments for medical care, and for certain groups, especially women with many children and for the elderly, these bankruptcies are very characteristic”.
The whole book is written in the first person plural, which has a special impact on the reader. In reality the authors have a right to do that, as the book reflects the voices of many different women – women doctors, scientists, housewives, young and old, white and black, heterosexuals and lesbians, married and single, wanting partners and wanting to remain single. It is always possible to say “we”.
While working on adapting this book, we tried to maintain the wonderful style of writing and to give Russian readers the opportunity to learn the opinion of American women about their physical, mental and social health. In reality, we incorporated only some data related to Russian women, carefully trying not to change the general style of writing. Meantime, we thoroughly examined all the pharmaceutical links, and the names of medications are presented in accordance with the 1999 edition of “Medication Registry of Russia”. Some clarifications are also included for anatomical names, in accordance with international anatomical terminology. Several statements in the book are overemphasized, others are understressed, and the pictures and photos have been changed. This was done after considering our cultural and traditional specifications and after a detailed discussion within our Russian authors’ group. We hope that these inserts and changes will not alter the overall impression of the wonderful book, which has been designed, republished and improved over the period of 35 years. In most people’s opinion, the book is one of the best sources in the world for women to obtain information about their health, their sexuality and their reproductive needs.
This book is exceptionally important also for doctors if they want to learn an empathetic and highly professional attitude towards women’s health. It provides an example of a holistic, comprehensive approach to women’s health. In the preamble to the bylaws of the World Health Organization, it is written: “Health is a state of complete physical, spiritual and social well-being, and not merely absence of diseases and physical deficiencies”. Exactly these factors comprise the foundation for the health of individuals, nations and whole societies.
Although the authors always emphasize that the book is written for women and by women, and we can add that the text is translated and adapted also exceptionally by women, it does not reject or diminish the role of men in health care and in society. Yes, we are different biologically and there should be a special approach to our health and to our needs, but it doesn’t mean that we are better or worse than men. We do not want to follow, we don’t want to lead – we want to walk side by side.


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