You may have heard of the “father of gynecology,” J. Marion Sims, who is credited with inventing the precursor to the speculum and discovering a method for repairing fistulas in the 1840s. However, his contributions to modern gynecology were only possible due to his torturous experiments on enslaved black women. Although Sims experimented on numerous women, we know the names of only three: Lucy, Betsey, and Anarcha.1 These brave women—the mothers of gynecology—were voiceless then. But we can give voice to their experiences now and ensure their stories are front and center in the history of gynecology—as they deserve to be.
In June of 1845, seventeen-year-old, pregnant Anarcha went into labor on a plantation near Montgomery, Alabama. She labored unsuccessfully for 72 hours, at which point her enslavers called upon Dr. Sims for assistance. He reportedly delivered her child using forceps, although nothing else is known about whether the infant survived. Soon it became clear that Anarcha had suffered an obstetric fistula caused by her traumatic birth. An obstetric fistula is a tear in the birth canal that creates an opening between the bladder and the vagina, the rectum and the vagina, or both. It leads to uncontrollable leaking of urine/feces from the vaginal opening. Obstetric fistulas are caused by prolonged, obstructed labor. Along with her other birth injuries, her fistula left Anarcha unable to work. This—rather than concern for her wellbeing—motivated her enslavers to seek the help of Dr. Sims. Five days after Anarcha’s delivery, Sims was called back to examine her.
Shortly thereafter, two other enslaved black women, Lucy and Betsey, were brought to Sims with the same condition. Sims capitalized on the situation, and negotiated with their enslavers so that he could keep them captive and experiment on them in an effort to cure their condition. He ultimately performed multiple failed surgeries—all without any kind of anesthesia—on at least 10 women over the course of several years. Anarcha endured at least 30 surgeries, with no pain relief, and often before an audience of curious doctors.
Anarcha’s, Betsey’s, and Lucy’s enslavement made it impossible for them to refuse these excruciating experiments. While anesthesia was not widely available during that time, other pain-relieving agents such as opium and nitrous oxide were in use. Sims, however, chose not to provide his patients with any relief, claiming his surgeries were “not painful enough to justify the trouble, and risk.” The predominant view at the time was that black people could not feel pain the way white people do—a barbaric, racist perspective that persists today.
Anarcha would endure her final surgery in 1849.2 Sims went on to gain fame and influence in the medical community, while she and the other women who made his success possible were forgotten. Luckily, recent work by scholars and activists has unearthed their stories and brought their experiences into the limelight. Their contributions to modern gynecology and to women’s history are memorialized at the Mothers of Gynecology Monument in Montgomery, Alabama.
Obstetric Fistula—Still With Us Today
Today, obstetric fistulas are almost entirely preventable. In industrialized nations, they are exceedingly rare due to the advent and availability of Cesarean sections. However, in parts of the world where timely, high-quality medical treatment is not easily accessible, women and girls continue to suffer from this condition. It is estimated that half a million women and girls are living with fistula in sub-Saharan Africa, Asia, the Arab States region and Latin America and the Caribbean. The ongoing prevalence of this condition highlights the vast inequities in healthcare and social infrastructure. It affects the poorest, most vulnerable populations, who struggle to access even the most basic gynecological care. Tragically, prolonged, obstructed labor can also lead to additional suffering. Research indicates that up to 90 percent of women who develop an obstetric fistula deliver stillborn babies. On top of this great loss, women with fistula are often abandoned by their families and ostracized by their communities, and they endure lifelong health complications caused by the condition.
Thankfully, organizations around the world, including the United Nations, are fighting to prevent this life-altering condition and ensure women and girls in underserved communities get the care they need. You can learn more about the UN Campaign to End Fistula here.
- https://www.npr.org/sections/thetwo-way/2018/04/17/603163394/-father-of-gynecology-who-experimented-on-slaves-no-longer-on-pedestal-in-nyc ↩︎
- https://www.anarchalucybetsey.org/anarchalucyandbetsey ↩︎
Rhea Physical Therapy provides at-home pelvic health care to women and children in the St. Louis, MO area and beyond. Rhea PT is owned and operated by Dr. Savannah Carlson, PT, DPT, RYT. Dr. Carlson is a pelvic health specialist who is dedicated to helping her clients overcome pelvic floor dysfunction so they can reach their full potential at home, work, and play. She earned her doctor of physical therapy degree at Washington University in St. Louis. The information provided on But First, Pelvic Health is for educational purposes only and should not be used as personalized medical advice.
But first, Pelvic Health. 