Gynecology, the study of women’s health with a focus on the female reproductive system, has long been noted as one of the most critical and valuable practices of medicine to date.
The foundations for modern gynecology were laid in the United States during the 19th century, most notably by J. Marion Sims, who invented the modern day speculum and the surgical procedure to correct vesicovaginal fistula (VVF), a break between the bladder and the vaginal wall, a common occurrence after childbirth in the 1800s.
His findings, however, were due to the lurid maltreatment of African American women.
In 1807, when Congress abolished the importation of slaves, enslaved women became breeding grounds for producing more slaves, thus keeping the industry alive. Doctors relied heavily on plantation owners as their source of income, getting paid for ensuring the (bare minimum) health for the slaveowner’s “property.”
After studying medicine in his hometown of Lancaster, South Carolina, Sims moved down to the heart of slave-owning territory in Montgomery, Alabama to start building his career. He built his reputation among wealthy, white plantation owners, doing most of his practice on the property, but taking more complicated cases to the eight-person hospital he built.
Sims soon honed his interests to gynecology in 1845, after examining a woman who had fallen off of her horse and needed an interior examination. Upon discovering she had VVF but with no idea as to how to surgically correct it, he began to experiment.
Sims only recorded three names of the estimated 12 to 14 women he operated on during his experiments: Lucy, Anarcha and Betsey. Lucy was the first woman he operated on; at the age of 18, she kneeled completely naked in front of a dozen doctors, her head in her hands in front of her, and endured an hourlong operation, screaming and crying in agony, as recorded by Sims himself.
Lucy became extremely ill with blood poisoning after her procedure due to his use of a sponge in her bladder; it took her three months to recover.
Anarcha, only 17 when she was given to Sims for his medical project, underwent 30 different experiments before Sims felt that he had “perfected” his surgery, after success with a silver wire. From slaveowners’ perspectives, success laid in reinstituting the value of any enslaved women who had contracted VVF through childbirth.
Perhaps the most traumatic part of these experiments, besides the inhumane brutality brought upon the women without any trace of consent, was Sims objection to using anesthesia on his black patients. Due to a perpetuated falsehood, Sims believed that black people did not feel as much pain as their white counterparts. And, after experimenting on black women for four years and finalizing his procedure, Sims progressed to operating on white women, utilizing anesthesia.
Sims’ mistreatment of African Americans went beyond adult women; before and after his period of gynecological experimentation, he tested surgical treatments on African American children to cure neonatal tetanus (with no results), and would operate on them with a shoemaker’s tool to pry apart the bones of the skull, acting off of yet another misconstrued belief that the skulls of black people develop too quickly around the brain, causing them to be intellectually inferior.
Beyond the man deemed as the “father of gynecology,” more recent history of the medical field is also deeply troubling.
When hormonal birth control was first pioneered, it was illegal to administer in most states; in order to test it, the inventors (Margaret Sanger, Gregory Pincus, Katherine McCormick and John Rock) went to Puerto Rico to aid their studies of the side effects. They chose Puerto Rico because of concerns about overpopulation on the island, in part due to the eugenics movement that arrived in America in the early 20th century, where both birth control and abortion were legal.
Due to the extensive and painful side effects, Puerto Rican women soon dropped out of the study; so, the four founders looked to female populations that they were able to force into taking the pills, including patients at a mental institution in Massachusetts and clinical students at a school in San Juan.
Then, Dr. Edris Rice-Wray, the medical director of the Puerto Rico Family Planning Association at the time, came up with a new strategy: telling the women on the island what the pill was supposed to be for.
Sure enough, hundreds of women then signed up to take the oral contraceptive, unaware that they were participating in a clinical trial. When the study was concluded, the pill was proven to be 100% effective. However, massive amounts of side effects were reported. In fact, three women died during the study, leading Rice-Wray to conclude that the pill was too dangerous for regular ingestion.
Nonetheless, it was put on the market in 1957 as Enovid, containing 10 times the amount of hormones needed to prevent pregnancy.
These two experiments are examples of the brutality and racism that lie behind the history of gynecology. However, the past is not just the past. Recent studies show that the echoes of racism still reverberate around the medical field today. In order to continue the fight for all women to obtain equal access to and fair treatment within healthcare, one must be aware of the history.