Medical Bondage
Slavery, Gynecology, and Modern Medicine
In her book, Medical Bondage: Race, Gender, and the Origins of American Gynecology, author Deirdre Cooper Owens traces the intertwined history of American slavery and the development of gynecology.
The first dedicated women’s hospital in the United States was started by James Marion Sims on a slave farm in Alabama. Sims, considered the father of modern gynecology, invented the Sims speculum and developed a procedure to treat vesico-vaginal fistula and later served as the president of the American Medical Association from 1876 to 1877.
Sims and other early gynecologists experimented on enslaved women without anesthesia, often repeating the procedure for years until doctors could document a cure. These surgeries were also frequently performed in front of a male audience. In urban settings in the North, Sims and other gynecologists experimented on poor Irish immigrants (often domestic laborers or sex workers). Patients were legally unable to refuse consent or resist.
In practice and the journal articles documenting their experiments, doctors promulgated and relied upon the myth of the “medical superbody,” the contradictory notion that black women were physically and intellectually inferior and unable to feel pain. Yet doctors knew that techniques developed on black bodies would treat white ones. Doctors also frequently relied on enslaved women to work as their medical assistants, often recruiting the women they were experimenting on to perform as nurses for another woman’s surgery.
In the U.S., gynecology grew as the end of the trans-Atlantic slave trade required the continued birth of slaves at home. The economic value of enslaved women was directly tied to their reproductive health and ability to have children. Gynecologists could raise a woman’s dollar value by treating reproductive diseases.
What’s past is prologue, and this history of gynecology helps to put modern medicine into context.
We see the long aftereffects of these racist beliefs in the poor care that black women receive today. Medical students still prescribe black patients fewer pain meds, believing they have a heightened pain tolerance.
In the U.S., mothers die during childbirth at a rate higher than any other developed nation. This trend has only gotten worse over the past 25 years. Black mothers face especially stark disparities in maternal mortality, dying at three to four times the rate of white mothers. These deaths are often due to preventable causes that could be addressed with proper screening and monitoring.
The long-term consequences of tying women’s value to childbirth makes headlines each week. In 2019, seven states have passed bills to restrict abortion. Ohio, Mississippi, Kentucky, and Georgia have all passed “fetal heartbeat” bills that would prohibit abortions early in the first trimester of pregnancy. Louisiana and Missouri are exploring similar proposals. Alabama has gone the furthest, effectively banning abortion, including in cases of rape and incest, and introducing criminal punishment for doctors who provide the procedure. These are the results of views normalized by early gynecologists of women as hypersexualized and promiscuous, but without being granted personal agency, while the men were exonerated of their own responsibility.
