Black Subjectivity and the Origins of American Gynecology

Public health doctor giving tenant family medicine for malaria near Colombia, South Carolina, 1939 (Photo: Marion Post Wolcott, Library of Congress).

In her new award-winning book, Medical Bondage: Race, Gender, and the Origins of American Gynecology, historian Deirdre Cooper Owens describes the experimental work of early American gynecologists, including Dr. James Marion Sims, “the father of modern gynecology.” Beginning in 1844, Sims famously performed his experiments on enslaved women in Alabama, including Anarcha, Lucy, and Betsy, who he leased for the purpose of gynecological experimentation. Repeatedly performing his crude experiments without any form of anesthesia as he attempted to be the first to repair vesico-vaginal fistulae, Owens writes that, “After five years of medical experimentation, Sims performed his thirtieth surgery on Anarcha and successfully repaired her fistula” (38). “Thanks in large part to his experimentation on enslaved black women,” she adds, “Sims had established himself as one of the country’s preeminent gynecological surgeons less than a decade after he began his gynecological career” (39). Due to these experimental procedures on enslaved Black women and the subsequent rapid advancements in the field of gynecology, Sims eventually served as the president of the American Medical Association in 1875 and the American Gynecological Society in 1879.

With her concise scholarly monograph on the history of American gynecology and the exploitation of enslaved Black and Irish women’s bodies in the early to mid-nineteenth century, Owens centers medical case narratives, patient histories and procedures transcribed in medical journals, judicial cases from appellate courts, physician’s daybooks, as well as formerly enslaved women’s narratives to better encapsulate the ways that Black and Irish women experienced professional medical care and racism before the American Civil War. These primary sources, Owens writes, are “just as important as plantation records, ledgers, and interviews in what they reveal about doctors’ objectifying attitudes towards slaves and poor immigrants” (8). Of her five chapters, four revolve around enslaved Black women. She relies on “scant” archives of medical journals, textbooks, and hospital records to piece together a comparative history of Irish women’s racialized medical experiences in the mid-nineteenth century in her fourth chapter.

Medical Bondage joins a growing body of work committed to centering Black subjectivity; expanding an understanding of the social construction of gender and Black femininity beginning in enslavement; and revisiting slavery’s capitalism. With her work, Owens also offers a jarring counter-narrative about so-called great white medical men. Recently, historian Daina Ramey Berry expanded the historiography of slavery and capitalism with her groundbreaking work, The Price for Their Pound of Flesh: The Value of the Enslaved, from Womb to Grave, in the Building of a Nation, where she documents four external values attributable to the enslaved, including the “ghost value” of the Black cadaver or deceased, yet insured enslaved body. In an early chapter of Black on Both Sides: A Racial History of Trans Identity, C. Riley Snorton explores the relationship between “sex and ungendered flesh,” utilizing Sims’ archive as a “materialized scene of female flesh ungendered.”

Distinct from these aforementioned works, Owens’ book sets out to specifically expand the historiography of slavery and medicine and to also humanize the experiences of enslaved Black women who were, as she writes, both “subjects and objects” (9). To narrate her thesis she relies on the term “medical superbody,” a concept she employs throughout to characterize the multiple, often contradictory meanings of enslaved women’s medical experiences that produced invaluable, foundational knowledge for white doctors, yet continually relegated Black women to the realm of subhuman and naturalized servitude. The great contradiction of the history of American gynecology, Owens argues, is how deeply the groundbreaking knowledge of early gynecology depended on enslaved women’s bodies—bodies deemed inferior, inherently flawed, and culpable—and how this history has eclipsed the essential knowledge produced through Black women’s bodies and the expertise of Black midwives. With her argument, Owens enters the theoretical and philosophical conversations of earlier scholars such as Michel Rolph Trouillot, Charles W. Mills, and Susan Buck Morrs, whose writings over the last twenty years have raised crucial questions about history and power; “the silences within historical narratives” and the “silences within silences,” as Trouillot has written. Owens enters this conversation with a marked understanding that “history is the fruit of power;” its ultimate mark being invisibility.

Her work challenges history’s invisibility by gleaning medical archives for information on enslaved women’s gynecological procedures, studying how those procedures made the early field of gynecology, and paying careful attention to the erasures with the archival material she utilizes in her study. For example, Owens points out the presence of a one-year-old mulatto child in the 1850 census record born to an enslaved patient leased to Sims. Owens writes, “Although the census record cannot prove the paternity of a slave child born to a white father, the child’s existence gives rise to some critical questions about Dr. Sim’s treatment of his enslaved patients. Was his enslaved patient impregnated against her will so that Sims could more easily locate a cure for her obstetrical fistula” since labor would reopen it? Although speculative, as the archive cannot confirm the paternity of the mixed-race child, Owens pushes her reader to pay attention to questions that are shrouded by the normative conditions that white supremacy in the nineteenth century produced. Owens’ reliance on narratives and recorded personal accounts of slavery also lends import to the voices of the Black women central to her study. As slavery scholars such as Edward Baptist and Thavolia Glymph have recently written, the narratives of the enslaved are reliable and truly the best sources of information for understanding the interiority of enslaved life. While relying often on primary medical sources, Owens challenges the containment and boundaries of such archival materials.

Thinking with Saidiyah Hartman’s notion of consent, Owens asserts that enslaved women could not decide to receive or reject a treatment insisted upon by their owner. Black women were experimented and operated on because “their masters permitted them to be” (108). Consent, whether regarding rape or forced medical treatment, simply did not exist for enslaved women. Yet, Owens also takes care throughout her book to detail the spaces where enslaved women exercised agency over their reproductive bodies, noting patterns of enslaved women’s conceptions coinciding with months of reduced labor requirements, as well as the ways enslaved women named their rapists when treated for medical conditions related to their assaults and, less commonly, fought off their rapists.

Chapter four is a very brief chapter that leaves the reader wanting more and feels slightly misplaced. Perhaps owing to a dearth of available sources, the chapter is less than twenty pages long. Here Owens provides a short history of gynecological medicine in the lives of Irish women migrating to the U. S. from around mid-1840 to mid-1860. Irish women, she notes, were also the subjects of Sims’ brutal medical experiments, as they were looked upon initially as a racial group less deserving than the full humanity of other white Americans. She documents the case of Mary Smith, who arrived in New York City from western Ireland sometime before 1850. She, like Anarcha, was operated on at least thirty times in attempts to repair the “worst case of obstetrical fistula Sims had ever seen” (96) and other gynecological urgencies.  Sims eventually abandoned his treatment of her, failing to successfully heal any of her medical conditions before she died. Certainly, as the brevity of the chapter implies, more work is needed to further document this important subject, as well as the patterns that marked the making of staunch racial categories that have ultimately crystalized in the present.

Medical Bondage is a terse, gifted contribution to slavery studies and the origins of American gynecology. Perhaps its greatest contribution, however, is its ability to elucidate the ways that enslaved women’s bodies were never a home, but cavernous flesh—agape, infinite, and wholly voidable. Medical Bondage not only details Black women’s essential role in the history of gynecology, but also serves as a foundational text for understanding the realities of gendered violence against Black women in the present.

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Rachel Zellars

Rachel Zellars is an assistant professor in the Department of Social Justice and Community Studies at Saint Mary’s University in Halifax, Nova Scotia. Her work focuses on the history of slavery in Canada, Black migration through the Maritimes and into the Atlantic world beginning in the 18th century, as well as gender violence and disability. She is also a co-founder of the ​Third Eye Collective. Follow her on Twitter @rachelzellars.​