Antebellum physician James Marion Sims has been in the news quite a bit lately as a target of activism. After the Charlottesville white supremacist rallies, efforts to take down Confederate monuments have spread across the country, and those efforts have included statues of James Marion Sims. Sims is known for developing a successful technique for repairing vesico-vaginal fistulas, which involved painful surgical experiments on three enslaved women named Anarcha, Betsey, and Lucy. For many, Sims has become a symbol of scientific racism and medical injustice. However, Sims was not alone or unique in the world of antebellum medicine.
Deirdre Cooper Owens’ Medical Bondage: Race, Gender, and the Origins of American Gynecology excavates the world of Sims and his contemporaries, while revealing the centrality of enslaved women’s bodies to the development of American gynecology. But instead of focusing on practitioners like Sims, Cooper Owens deliberately centers the subjectivity of enslaved and poor women, and what their bodies and labor meant for the production of medical and scientific knowledge. She catalogs and examines the experiences of Anarcha, Betsey, and Lucy, as well as a host of other enslaved and poor women, using them to think deeply about the intersections of race, gender, and medicine in the nineteenth century.
The development of American gynecology was based upon a set of racial assumptions about black bodies, which, as Cooper Owens argues, fundamentally shaped female experiences of enslavement. Their bodies were marked as hypersexual, capable of withstanding incredible pain, and were mostly valued for their reproductive labor. For example, when physically punishing enslaved women, slaveowners would dig a hole in the ground to protect the woman’s belly so she could be beaten without jeopardizing their investment. These beliefs were rooted in at least a century of racial science and served as justification for the work of Sims and his contemporaries.
Yet in striking contrast to earlier work on antebellum medicine and slavery, Cooper Owens considers the work of enslaved women as part of the knowledge production of modern gynecology. In addition to their reproductive labor and their work as experimental subjects, enslaved women also performed important medical work. They were nurses and midwives, and even assisted in medical and surgical procedures. She shows us that enslaved women were vital to the function of “sick houses” and “slave hospitals” on plantations, and often were not recognized as medical practitioners by slaveowners or by historians.
By thinking of enslaved women as medical practitioners, we recognize their significance in the development of American gynecology. It also allows us to consider how their work produced and reified racial science, while they were simultaneously subjected to scientific racism and medical injustice.
Cooper Owens also provides an important comparative angle by including the experiences of poor Irish women in urban areas as part of the development of American gynecology. Like enslaved women, they experienced structural, sexual, and medical violence. They also had a complicated relationship with whiteness upon their arrival to the United States, and they were racialized as inferior to American-born white women.
Sims and his contemporaries also treated and experimented on poor Irish women in New York hospitals, almshouses, and prisons. Irish women in these institutions were vulnerable to particular forms of medical injustice similar to the experiences of enslaved women. Though the book would have been just as compelling if it only focused on enslaved women, the comparison of enslaved and Irish women’s experiences allows us to think about the ways that women’s bodies were used to produce racialized medical and scientific knowledge, and how women experience specific forms of medical violence.
Concise, but rich and insightful, Medical Bondage offers a much-needed corrective to the history of slavery and to the history of medicine. Cooper Owens does a brilliant job in using the experiences of enslaved and Irish women to rethink the history of American gynecology and highlight the ways in which this medical specialty relied upon slavery, scientific racism, and medical violence.
She concludes the book with her own experiences as a black gynecological patient, emphasizing how the racial assumptions and experiences that created gynecology still shape how women of color receive medical care. Black gynecological patients, Cooper Owens and myself included, are still forced to confront the violent assumptions of Sims and his contemporaries every time we visit a doctor. This makes the arguments in Medical Bondage timely and urgent, and pushes us to think about how this history is very much part of our present.
It is time for statues of Sims to come down, and time for statues dedicated to enslaved women, whom Cooper Owens calls the “mothers of gynecology,” to be erected instead.