IWD: how the black womb has impacted british medical practices

Written By Chloe Johnson

In honour of International Women’s Day, this trio of essays highlight the strength and power of black women in the 18th and 19th century as they battled with the horrors of enslavement.

This is essay will focus on how the treatment of black women during this period has impacted the British medical practices.

One of the lesser discussed characteristics of the slave trade was the fact that on top the day-to-day brutality, enslaved women were also subjected to medical experiments, with the aim of advancing medical knowledge and treating diseases. These experiments were almost always conducted without the consent of the participants and were carried out under inhumane conditions. These experiments have contributed to the legacy of racism and discrimination in British medical practices.

There are many examples of the black feminine body being abused in the name of medicine and science, one example of such experimentation was the use of black women to test the efficacy of various vaccinations. In the 1720s, Lady Mary Wortley Montagu, the wife of the British ambassador to Turkey, having observed the practice of inoculation in the Ottoman Empire, brought the idea back to England. The procedure involved injecting a small amount of the smallpox virus into a healthy person, which would result in a mild case of the disease that would provide immunity against future infections. This was something new at the time, and of course needed to be tested. There was a hesitancy for this to be done to the general public as many thought it was incredibly dangerous, so doctors used enslaved women as test subjects to check how well the procedure would work, and how much smallpox would need to be injected. Many women died as a result, but success in these procedures led to vaccinations becoming the norm in modern medicine.

Women were also subjected to intense medical examination and measurement without the consent. Sarah Baartman, a Khoekhoe woman, was taken from South Africa in 1810 to London to be paraded and exhibited as an object of intrigue. This was due to Sarah physical appearance and body shape, typical of women of her tribe. In Europe, she was subjected to intense medical examination and measurement. Where she was exhibited, spectators were allowed to poke and prod her, examining every single part of her body up close. After her death, the lack of respect for her body continued. She was dissected – her brain, genitalia and skeleton were preserved as they were of scientific interest. These body parts were then put on display in museums in France, right up until 1976. Her body remained in France until 2002, when, after a long legal debate, she was returned to South Africa at the request of Nelson Mandela.

Probably the most impactful example of the impact of medical experiments on enslaved women, comes from the work of James Marion Sims, and doctors like him. Sims, who is often referred to as the ‘father of modern gynaecology’ conducted experiments on enslaved women, almost exclusively without anaesthesia. The reason for this lack of care came from the fact that the use of anaesthesia was still in it’s early days in 1840s America, and also because there was a widely held belief that black women didn’t feel pain in the same way white women did. His main area of investigation were fistulas, a condition that causes holes to form between the bladder and vagina or rectum, resulting in incontinence. He operated without the women’s consent, using them as guinea pigs to perfect his techniques.

Many in recent history have come to Sims defence, claiming that there was no way that such operations could be performed without anaesthetic and without consent. Many have also said that consent was given by the slave owners and that was good enough. Sim also wrote in his journals and memoir that had consent from all the women he operated on and that he was extremely grateful to these women, and the impact they had on his research. There’s no way to know if this is true or not, but history is not written by enslaved women, and no one ever asked for their confirmation.

What does this mean today? This idea that black women don’t feel pain is a trope that has continued through the centuries and has unfortunately continued into heart of the medical field today. There is a deep mistrust of the medical profession amongst many black people, making it difficult to recruit participants for research. Various studies have found that black people are less likely to sign up for medical research, less likely to trust medical researchers and less likely to believe that the medical research is conducted ethically. They are also less likely to visit the medical professionals with illnesses and ailments as they do not trust that they will be treated correctly. And that’s with good reason. The systematic racism and bias in the healthcare systems has raised so many issues around the care of black women, the black population and other ethnic minority groups. Studies have shown that black patients in the UK are less likely to receive appropriate pain management than white patients and are more likely to experience delays in receiving treatment. A direct link to this idea that black people don’t feel as much pain. Black patients are also more likely to receive a diagnosis of a mental health condition, rather than a physical condition, when presenting their symptoms.

The clearest examples of just how terrible these discriminatory biases can be, and the effect it has on black women, is prenatal and postnatal care. Black women in the UK are more likely to experience maternal mortality and morbidity than white women. A report by the National Childbirth Trust found that, Black women in the UK are more likely to die during childbirth or in the postnatal period than white women, with black Caribbean women being five times more likely to die and black African women being four times more likely to die. African women were four times more likely to die. They are also more likely to experience complications during childbirth and 34% less likely to receive pain relief during labour and that black women were more likely to be given drugs to speed up labour, which can increase the risk of complications. The report also highlighted that black women in the UK were more likely to be stereotyped as aggressive and difficult during childbirth, which can lead to delays in receiving care.

It’s clear that the medical system is not for the benefit and wellbeing of black women, and when systems are broken in this way, in order to fix them, they need to be dismantled completely. Whilst our current Conservative government is doing its best to bring the NHS to its knees, it’s not for our benefit, it’s for capitalist gain and what is likely to replace it will no doubt be far worse.

What can be done, and what needs to be done is for the healthcare system to acknowledge this legacy and to work towards addressing the disparities in healthcare for black women and other marginalized communities. This needs to start at the root, there needs to be reform in the way new medical professionals are taught, medical textbooks need to be rewritten to be more inclusive and remove racist tropes and ideas. Healthcare professionals need to be provided with cultural competency training, there needs to be a drive to get a more diverse healthcare workforce at all levels, and marginalised communities need to be involved in the design and implementation of healthcare policies and practices.

There also needs to be more of a focus on addressing the social determinants of health that contribute to the disparities in healthcare outcomes for black women. This includes addressing systemic racism and discrimination within wider society, providing access to affordable housing and healthy food options, and addressing disparities in education and employment opportunities. Addressing these factors can help to improve the overall health outcomes for black women and other marginalised communities.

 

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References:

Chloe Johnson
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IWD: The Womb as a site of Resistance