The Racist Roots of Gynecology & What Black Women Birthed
I think of trans-generational traumas, and how they shape us, and I wonder whether the pang that I sometimes feel in my gut connects me with the agony of my foremothers.
Trigger Warning: This article contains discussions of racialized reproductive and sexual violences against Black women
We have been rather preoccupied with our statues of late. As we should be. They are symbols of who and what our nation chooses to venerate and immortalize, and monuments to white supremacy have stood long enough—they should never have been erected to begin with.
At the edge of Central Park, in New York City, stands a figure in honor of J. Marion Sims, an allegiant to the Confederacy who often vocalized his loyalty to the south and southern tradition, including slavery. This nineteenth century doctor is known as the “father of modern gynecology.” While the field respectfully celebrates its patriarch, it too often neglects to remember its mothers. Among them: Lucy, Anarcha, and Betsey.
Sims became the world’s most renowned authority on reproductive health after years of experimental operations on enslaved Black women in the backyard hospital of his Montgomery, Alabama home from 1845 to 1849. Lucy, Anarcha, and Betsey were his subjects, taken on from local slavers. These young women were in horrible condition and went hoping that he would cure their ailments quickly.
This began “before the time of anesthesia,” Sims notes in his autobiography. The first successful surgery performed with anesthesia occurred in 1846, but Sims never gave any to the enslaved women in his care. It is recorded that he subscribed to the belief that Black people did not have the same capacity to feel pain as white people, a belief that many people in the medical field unfortunately still hold. Physicians continually offer less pain relief and fewer management resources to their Black patients, even to children, due to this accepted myth.
After each operation, Lucy, Anarcha, and Betsey were confined to bed for at least two weeks. They were not given much food or sustenance during their confinement, but were dosed with opium to induce constipation as they recovered. But recovery only meant preparation for their next excruciating stint on his backyard operating table under unsanitary conditions.
In his autobiography, Sim writes:
“Besides these three cases, I got three or four more to experiment on, and there was never a time that I could not, at any day, have had a subject for operation. But my operations all failed, so far as a positive cure was concerned. This went on, not for one year, but for two and three, and even four years. I kept all these negroes at my own expense all the time.”
Through these torturous operations, which were open for observation to local physicians and medical students, Sims discovered a method to cure the vesico-vaginal fistulas from which the women suffered, using an “unsterilized, slightly bent spoon.” He eventually perfected and patented the instrument, which has since become known as the Sims Speculum.
A vesico-vaginal fistula is an abnormal opening between the bladder and the vagina, resulting in urinary incontinence. This condition often presents following a long, harrowing experience with childbirth or after a brutal sexual assault, as it has been documented in the Congo where sexual violence is used as a tool of war. The uncomfortable and mortifying malady was disproportionately high among enslaved Black women during the nineteenth century, and this was directly due to the amount of sexual and reproductive violence that enslaved Black women and girls endured on the plantation. This means that the disorder itself was tangled up with the institution of slavery as part of the reproductive violence of the ugly machine.
This also means that the condition was a threat to the economy of the institution. Reproductive and sexual exploitation was status quo for enslaved Black women, but those afflicted with vesico-vaginal fistulas could not be used as factories to produce more workers nor be consumed for the sexual gratification of slave-owners. They were unable to perform any labor — reproductive, sexual, domestic, agricultural, or otherwise. The work of J. Marion Sims helped to create an entire field of medical inquiry, but at the root of his breakthrough was the need to correct this particular disorder so that enslaved Black women could resume the many forms of labor that the institution of slavery demanded of them.
The medical field is, in so many ways, built upon and upheld through the dehumanization of Blackness. Black people’s bodies have been violated in unthinkable ways to serve the advancement of white men in the field of gynecological study, and racial bias still exists within the profession. Black people suffer higher mortality rates in childbirth, nearly four times the rate of whites. The medical profession’s continued disregard for our health care needs is undoubtedly due to beliefs about our ability to withstand pain or inability to feel it at all. It leaves Black people un(der)served and un(der) protected by the health care system, as well as many other social systems.
A few years after completing his vesico-vaginal fistula trials, Sims relocated to New York City, where he helped to found the first women’s hospital in 1856. There, Sims accepted only white women as patients. They were afforded privacy during their operations, as well as sterile instruments and anesthesia. He believe that white women were too delicate to withstand the agony of an operation and maintained that it was the wealthiest white women who were the most susceptible to pain. This is where gynecology as a specialized modern medical institution began.
This history, like so many others, illuminates how white womanhood is defined against Black womanhood; how their humanity gets (re)affirmed through our dehumanization. White people’s reproductive rights, health care access, and prosperity has always come at the expense of people of color. From birth control to treatment for ovarian cancer and beyond, through eugenic abuses, reproductive violences, and stolen cells.
Our ancestors give us memories. I often feel the weight of those memories and the weight of my Blackness together at once, both of them heavier than anything else I will ever carry. I think of trans-generational traumas, and how they shape us, and I wonder whether the pang that I sometimes feel in my gut connects me with the agony of my foremothers. Black wombs are so, so bountiful. And we have given more to this world than it deserves.
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