ON A BEAUTIFUL AND UNSEASONABLY WARM DAY IN OCTOBER 2015, I learned that I could not become pregnant naturally. As a result, I had to have my cervix dilated so that my uterus would be more accessible for embryo implantation during my initial in vitro fertilization procedure. The dilation was conducted without my receiving either anesthesia or a numbing shot to ease the pain. The doctor, one of the city’s best fertility specialists, told me I would experience some cramping but not a lot of pain. Pain was an understatement; I had never gone through that kind of physical agony in my forty-three years of life. The next month, the doctor dilated my cervix again without anesthesia. All the while during the procedure, he kept apologizing for the pain he was causing me. He even mentioned that he had thought to inject me with a numbing medication but decided against it since I had taken two Motrin pills. By New Year’s Day, I had changed physicians due to insurance issues. Also, I suspected that if I brought my husband along with me to appointments, I would be perceived differently by white doctors. I had to remind my previous doctor that I was married, that, yes, my husband worked, although those questions stopped once nurses and physicians saw my husband, a tall, physically imposing deep-voiced man who is so light skinned that he looks like a white man.
My new specialist, a woman, was shocked when I informed her that I had my cervix dilated without being given an anesthetic. Yet she also expressed disbelief, after giving me a vaginal ultrasound, that my uterus was so small for my body (it is not). I have small bones and am fewer than five feet six inches tall; I assumed my uterus would not be especially large. It seemed that I could not escape James Marion Sims’s historical gaze but also the lessons he left for doctors who worked on the descendants of the original American “mothers of gynecology,” held in medical bondage.
To theorize about nineteenth-century black women’s bodies as medical superbodies impervious to pain is an exercise in analytical reasoning and historical methodology making. However, to live through a medical procedure in the twenty-first century in which the expectation was that I could tolerate acute pain seemed surreal. As I revealed to the medical staff during my dilation and hysterosalpingogram test (HSG), an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them, that I was writing a book about ideas about black women’s bodies and pain thresholds, American gynecology, and James Marion Sims, my African American nurse stated, “Girl, you’ve got to tell your story too.” My physician then shared with me how James Marion Sims pioneered fertility treatments in the United States. As I lay, contemplating their words and advice, I was struck by how time and space seemed to blur as the historical narrative of those women held in medical bondage in the 1880s was timely and important for black women who had to interact with present-day fertility specialists and gynecologists.
What my work as a historian of race, slavery, medicine, and gender has taught me is that the legacies from the nineteenth century are always present in our lives as Americans. I recognized that I was a benefactor of all the work that the country’s earliest gynecologists performed on black women almost two hundred years prior. I had also inherited the burden that black women in the nineteenth century carried with them about their gynecological illnesses and the pain they felt: silence and dissemblance. Unlike the black women who helped to birth gynecology through their sufferings, I have a platform that allows me to reveal how black women still negotiate their lives as medical superbodies. From studies on black women as chronic pain sufferers who live with more pain than other Americans and have less access to pain-relief medicines to scholarship that highlights the ways that black gynecological patients have always had to deal with efforts to colonize their medical bodies, my own gynecological experiences in fertility medicine mirrored other black women’s treatment.
I offer my medical experiences with fertility treatments for two reasons: I am a direct heir of James Marion Sims’s medical legacy, and I reject critiques that demonize black and women scholars as unobjective when we dare to make personal connections with the historical actors we study, especially if they were enslaved. One of the better-known historical cases that center on objectivity, slavery, racism, and sexuality is the nearly two-decades-old controversy about Thomas Jefferson’s sexual relationship with Sally Hemings, his slave and his wife’s younger half sister.
Not only did black scholars and the larger community believe the oral histories about Jefferson’s affair, but they also disseminated the narrative. Black scholars knew that white southern slave owners impregnated enslaved women regularly on plantations and slave farms. Because of the lived experiences that African American scholars had as members of a racialized and historically marginalized group and their professional historical training, they were much more receptive to the idea that an elite and revered white man could maintain a sexual relationship with a much younger woman and keep her as his concubine. This combination of training and cultural socialization as an African American woman influenced me to read the sources differently for my book than had authors who had written previously about the birth of American gynecology and Dr. Sims. I suspected that if young enslaved women were being publicly exposed during the surgical procedures they endured over the years and were already assumed to be lascivious because they were black women, there might have been at least one birth on James Marion Sims’s slave farm. Not only was I right, but also the baby was marked on the census record as a mulatto child.
As a twenty-first-century black gynecological patient, I was aware that my medical treatment might differ drastically from that of white women wishing to conceive. The specter of medical racism loomed because of the history of American women’s medicine. Numerous medical studies have presented convincing evidence that African American women have more reproductive challenges than white women and experience racism and classism with their doctors.1 The prospect of pregnancy seemed rooted in race as a biological construct no matter what I had been taught and accepted as a graduate student and later as a professor. All the doctors were white, and the nurses and ancillary staff were women of color. How could I not think of all things race-related when my blood work was sent to labs for genetic testing based on my “racial group”? Academics might have declared that race was a social construct, but doctors seemed to treat my blackness as biological. Although my work focuses on the antebellum era, the racial legacies of this period affect all Americans. Black women, the group that still represents the poorest Americans, the group that suffers from more reproductive ailments than other women in the country, and a demographic who mother as single women more than other American women are still being treated as superbodies in medicine. It is a sobering reality for me as I face my own battles reproductively despite my status as a married, educated, middle-class woman. Perhaps theorist Hortense Spillers was right: “I am a marked woman, but not everybody knows my name. . . . I describe a locus of confounded identities.”2 When I decided to write this book, I intended to not simply describe the racializing processes that created these clashing identities but to more accurately name and define them. So I went in search of the “mothers of gynecology”; in the process of my discoveries, I learned that I was their daughter, an already “marked woman.”