The story of modern gynaecology; Reclaiming Black women’s health

For too long Black women have been used as tools to progress medicine, but what progress is being made for Black women?

Writer: Ellie Jackson
Editor: Pauline Münchenberg
Artist: Sophie North

CONTENT WARNING: discusses violence and mistreatment of Black women.

In the spring of 2018, long before the Black Lives Matter movement took off in 2020, there was a quiet revolution in New York’s Central Park. The statue of Dr J. Marion Sims, a man considered as the father of modern gynaecology, was removed. For many years, Sims was revered and idolised for his work in women’s health: he developed the first consistent and successful operation for vesico-vaginal fistulas (a form of childbirth complication) and created the modern speculum, a device still used today in vaginal examinations. However, with a chequered past of experimenting on female slaves and children, he is a man best remembered for his barbaric mistreatment of Black women to benefit his own scientific career.

The horrific truth behind the father of gynaecology 

Born in 1813 and educated in medicine at Jefferson College, Sims eventually found himself in Montgomery, Alabama, treating the slaves of plantation owners for general medical ailments and building a reputation. Many slave owners were content to leave their ill slaves with Sims, paying taxes and providing clothing until the slaves were ready to work again. After successfully treating a woman with severe pelvic and back pain following a riding injury, Sims found himself plunged into the world of gynaecology due to his use of a vaginal examination during the treatment. Up until this point, gynaecology was considered uncouth and disrespectful to women; a reason why much of the related research was seen as fit to be conducted upon slaves. 

Despite his extensive experimentation in the field of gynaecology, we sadly know the names of only three of the women who were brutally mistreated under his hands; Anarcha Westcott, Lucy and Betsey, the latter two deprived of surnames in Sims’ medical journals. All of the women he treated for gynaecological issues were operated on naked on all fours, with no anaesthesia, in a room surrounded by dozens of doctors watching, as Sims believed that Black women could not feel pain. Anarcha was subjected to surgery 30 times before he successfully managed to close the holes between her bladder and rectum, some of which he likely caused himself. Lucy was only 18 years old when she found herself on Sims’ table and was described as being in extreme pain, requiring three months to recover from her surgery. These stories are only two examples from dozens and dozens of women who were put under Sims’ knife. Only once experiments were perfected were the surgeries even considered for white women, who of course underwent the procedures under anaesthesia. 

How does Sims’ work affect Black lives today? 

One of the reasons for Sims’ success was his access to Black bodies. Not only has this allowed him to maintain his legacy with statues, buildings and textbooks honouring his name and achievements, but it has left a lasting scar in medicine. Many medical textbooks still praise Sims for his discoveries and developments, refusing to acknowledge his problematic past, suggesting that systemic oppression and neglect of Black stories and Black bodies runs far deeper than Sims’ experiments in the 1800s.

Beyond the legacy of buildings and books, the history of slave experiments and general disdain for Black bodies in the medical profession has a profound impact on healthcare today. Ingrained systemic racism has led to the continued medical mistreatment of Black people and such disparities remain on the global conscience. This particularly affects the reproductive health of Black women, laid bare in statistics. Black women are 3-4 times more likely to die during childbirth, 40% more likely to die from breast cancer and 7.6 times more likely to contract gonorrhoea than their White counterparts. Additionally, 30% of Black Americans believe that their physicians have exposed them to unnecessary risks in medical practice. Even today, we see Black people continually under-represented in clinical trials; recent studies on the safety and efficacy of the Moderna SARS-CoV-2 vaccine had a 98% White trial group, despite the prevailing evidence that Black and other minority ethnic communities are more likely to die from COVID-19. 

Following the 2020 Black Lives Matter protests, we have seen demands to decolonise our museums, our histories and our curriculums. It is essential that we do the same in our medical practice, valuing Black women’s lives equally to their White counterparts. 

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