Tips & Advice

From Dr. Liz Herself

February 25, 2021
Women slaves who had GYN surgeries without anesthesia
Mothers of modern gynecology

Surgery without anesthesia

Can you imagine having a major surgery without anesthesia, and without even giving your consent?

Of course you can’t. Nowadays this is unheard of. But it did happen to enslaved women in the United States in the 1800’s.

Lately, we are learning about many people who were admired in history, then later found to be controversial. Some of these people were controversial in thoughts or actions even in their own day and age. One such doctor was Dr. James Marion Sims.

Sims is often referred to as “the father of modern gynecology.” (In my surgery days, I often used the surgical instrument known as the “Sims retractor.”) In particular, he is known for his development of surgical procedures to repair fistulas – a type of childbirth injury.

Born in South Carolina, Sims became a doctor at a time that required minimal education and training. After setting up his practice in Alabama, he started a small clinic that treated the slaves of the surrounding white plantation owners. He helped make sure their slaves could continue “producing and reproducing” for their owners. In fact, he took temporary ownership of these women while he was treating them in order to be able to operate on them at his own will; their consent was not even considered.

Betsey, Lucy and Anarcha

Although Sims himself recorded many of the surgeries he performed on these women, only three of them are named: Betsey, Lucy and Anarcha.

Lucy was 18 years old when she developed a fistula after childbirth. Doctors watched as Sims performed an hour-long surgery on her with no anesthesia while she screamed in agony. The (incorrect) idea that black people feel less pain was prevalent then, and unfortunately persists even today (studies show that black women are given less anesthesia during childbirth and that African-Americans overall are given less pain medication for several conditions, including bone fractures and cancer).

Anarcha, age 17, also had a fistula after childbirth; the *thirty* surgeries Sims performed on her over the next four years allowed him to “perfect” his fistula repair technique. He then went on to do these surgeries on white women, but with them he used anesthesia.

Even at the time, doctors who came to observe Sims’ procedures questioned his ethics, but once the surgical treatment for fistula he developed was successful, his experimentation was forgotten.

While most OB/GYN doctors have heard of J. Marion Sims, I had never heard of Lucy, Betsey and Anarcha until I read “Obstetrics and Gynecology: Collective Action Addressing Racism,” a joint statement issued by a group made up of 24 different women’s health medical organizations. You can read the whole statement here.

Racism is a system invented by people

I am proud to be part of a new day and age in which we no longer look away from the complicated legacies of people, no matter how powerful or influential they may have been. As the collective statement says, when it comes to racism, “a better future requires an honest examination of the past and the present.”

Racism is a system invented by people to justify the inhuman treatment of other people. It is now up to us to dismantle racism and racist ideas so we can honor each other as members of the one human family that we actually are.

References:

https://www.pnas.org/content/113/16/4296.full

https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slavesetrics and

Statement: https://www.acog.org/-/media/project/acog/acogorg/files/pdfs/news/commitmentendracism-historyobgyn-082720-v8.pdf

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