Angelina Jolie, the beautiful film star who has been at the center of so many media stories, has reached new fame with her decision to have a double mastectomy as a way to avoid breast cancer. Her decision has sparked some controversy, but also an outpouring of informative stories describing different types of the breast cancer and different options for treatment. Ms. Jolie’s candid explanation of her choice in a N.Y. Times op-ed piece has encouraged more discussion about the risks women face. She joins a long line of prominent women who have had the courage to try new solutions to women’s enduring health issues. One of the most surprising of them was Queen Victoria, the ultra-proper ruler who presided over the stringent rules of the Victorian era, showed courage in taking the initiative in her own healthcare.

More than 150 years ago Victorian women endured an often painful and sometimes dangerous succession of childbirths. Even Queen Victoria, despite her position as monarch of the British empire and the most powerful woman in the world, went through the same pains of childbirth as she bore nine children in fairly quick order. Having many children and enduring the struggle of their births without complaining was a demonstration of her status as a virtuous wife. But eventually even Victoria felt rebellious, it seems, and her loving husband Prince Albert, agreed with her that she deserved some help in easing the pain of childbirth.

Although women had been seeking relief from the pain of childbirth for centuries, when anesthesia finally became available during Victorian times, many people condemned its use. Men of religion proclaimed that if God had wanted childbirth to be painless, He would have designed it that way, so using anesthesia was against God’s wishes. The pain of childbirth was described by at least one English minister as suffering that women owed to God. There were few women ministers at that time to argue against that. Finally women began to demand some easing of their pain. We can imagine the arguments in homes across the Western world as women began to demand relief.

When Queen Victoria led the way by having chloroform administered during the birth of Prince Leopold, she gave courage to many women across England. Just like Angelina Jolie today, her decision was reported in the news and started conversations and discussions. Nowadays some women choose to have childbirth without anesthesia while others prefer the medication. Either decision is accepted as a woman’s right. In just the same way, Angelina Jolie’s decision to choose preemptive mastectomy will broaden the choices that women in her situation feel empowered to make.

Three cheers for the powerful women who have the courage to set an example that gives other, less well-known women, more choice in their lives!