The atrocities of slavery in the USA in the 1800s have been well documented, but the development of gynaecological techniques using female slaves has not had the same acknowledgement. Within midwifery and medicine in the UK, this chapter of history has received little attention, and the black, slave women who were used in the inhumane gynaecological experiments (without consent or pain relief) have been forgotten.
Highlighting this truth makes for difficult reading, but the story of these women who suffered is a story that needs to be heard. The history of gynaecology, and some of the stark realities of its origins and those who played a part, should equally be recognised and honoured. Midwives and doctors in the UK who have benefited from these women's sacrifices need to acknowledge this hidden truth, and be the voice that these women never had so their sacrifices can be honoured.
‘The dead cannot cry out for justice. It is a duty of the living to do so for them.’
In the 19th century, when gynaecology techniques were in their infancy, a black 17-year-old enslaved woman named Anarcha had her first child. This was during the antebellum era in the southern US, the period between the War of 1812 and the start of the Civil War in 1861.
The US had stopped importing slaves in 1808. Slave owners believed that births were more important than ever because they thought that slavery and the southern way of life could continue only through babies born in bondage (Schwartz, 2006).
After a very traumatic delivery, young Anarcha was left with a vesico-vaginal fistula (VVF), which results in a tear from the bladder to the vagina, caused by obstructed labour (Ojanuga, 1993).
It was at this time that J Marion Sims, an American gynaecologist, was attempting to make a name for himself by attempting to cure VVF. He did this by gathering up and housing enslaved black women, including Anarcha.
For the next four years he operated (and failed) 30 times on young Anarcha alone, all without the use of anaesthesia. The young women even assisted Sims in surgery, working as nurses when no one else would (Barker-Benfield 1976). It is important to emphasise the fact that these young women were not asked if they would agree to such an operation and were in no way volunteers for Sims' research; permission was obtained from the slave masters (Ojanuga, 1993).
Sims went on to achieve the success he had worked so hard for, calling his Silver Sutures ‘the greatest surgical achievement of the 19th century’ (Barker-Benfield, 1976). The praise for Sims soared from there, with the accomplishments of the pioneering doctor creating waves around the world. He was universally regarded as ‘the father of gynaecology’. Since then, statues have been erected to highlight his incredible dedication to his work. We are also reminded of his work each time we use the self-named Sims speculum.
Most midwives and doctors would view the Sims speculum as an essential tool. However, when we use this piece of equipment, do we ever stop to consider the history behind it? More importantly, have we been taught the true history behind its origins?
Deidre Cooper Owens boldly shines a light on this subject in her 2017 book Medical Bondage: Race, Gender and the Origins of American Gynaecology. She highlights the plight of Anarcha and those women who endured atrocities at the hands of revered gynaecologists, such as Sims, and she emphasises the fact that ‘the occupational status of his [Sims'] enslaved patients as nurses has been consistently overshadowed by discussion of their illness’.
The book graphically describes how black women such as Anarcha were viewed by those who performed such horrific acts in the name of research.
Cooper Owens writes in her introduction: ‘They were seen merely as flesh-and blood-contradictions, vital to the research of the pioneering gynaecological surgeons, yet dispensable once their bodies and labour were no longer required.’
The lack of acknowledgement of Anarcha and the women who worked alongside her is what led Cooper Owens to recognise them and their ‘unheralded work’ in her book, and it is for this very same reason I have also decided to raise awareness of them.
My colleagues and I discovered this incredible fragment of gynaecological history for ourselves. We were not taught this at university. I have been a midwife for six years and this was never discussed.
When I spoke about it with some of my more experienced peers, they were also shocked by Anarcha's story and the lack of education about her role in the history of gynaecology. Why is this? Why is her story not an essential part of the curriculum in our universities?
There have been student movements globally that have been asking this question on a broader scale over the past few years. The protests have included a series of campaigns to decolonise the academy in universities here in the UK, South Africa and the US. The students maintain that: ‘The domination of a white capitalist curriculum that refuses to acknowledge other sources of knowledge outside the Western world, in the social sciences, for instance. Reading lists on world literature or world politics or world history as told by Western scholars about the other, with a token appearance of scholars from the colonised world, should be revised’ (Wamai, 2016).
‘The lack of acknowledgement of Anarcha and the women who worked alongside her is what led Cooper Owens to recognise them and their “unheralded work” in her book, and it is for this very same reason I have also decided to raise awareness of them. My colleagues and I discovered this incredible fragment of gynaecological history for ourselves. We were not taught this at university. I have been a midwife for six years and this was never discussed’
Researchers at the Institute of Educational Technology at The Open University and Norway's Centre for the Science of Learning and Technology have collaborated on a series of reports on new forms of teaching, learning and assessment for an interactive world to guide teachers and policy makers (Ferguson et al, 2019). One of these reflects the need for decolonised learning.
The report states: ‘Decolonising learning helps us to recognise, understand, and challenge the ways in which our world is shaped by colonialism.’ It highlights that, ‘this isn't simply about removing some content from the curriculum and replacing it with new content – it's about considering multiple perspectives and making space to think carefully about what we value’ (Ferguson et al, 2019).
The Nursing and Midwifery Council Code asks that those receiving care from us are treated with respect, that their rights are upheld and that any discriminatory attitudes and behaviours towards those receiving care are challenged (NMC, 2015).
I feel that, as a profession, we have let down a group of women and left them in shadows of time, never to be honoured as they deserve.
The lack of acknowledgment of the skills, bravery and abuse of these forgotten women is not only a detriment to Anarcha and the women she worked alongside, but also all the midwifery and medical students who have been taught skills which are only possible due to the incredible involvement of these enslaved women. It is for this reason I have started a petition requesting recognition of these formidable young women, in the UK via the Royal College of Obstetricians and Gynaecologists.
My hope is to gain a wider acknowledgment and appreciation of what they endured, in the form of a statue or plaque at the Royal College of Obstetricians and Gynaecologists, as well as imprinting the roots of the history of gynaecology in the curriculum of midwifery in the UK.
‘Injustice anywhere is a threat to justice everywhere.’
To sign the petition for a statue request for Anarcha, for her part in pioneering gynae techniques, please click here: http://chng.it/mnxQj2VmK