Reproductive Justice & The Exploitation of Black Women

Fatuma Hassan 

Introduction:

This issue of Constructing Race in America History, tackles the matter of Reproductive Justice and the exploitation of Black women. Firstly by outlining the historical journey and origins of black women's relationship to the field of medicine. Including how the foundations of this exploitation was created, key events, and people. Secondly by analyzing these moments in history in the constructing of difference, in particular the construction of racial and gender structures. Lastly by looking at the present day impact of this issue and the lasting ramifications, taking a broad view on reproductive issues in America. Reproductive Justice is about reframing the traditional outlooks and narratives surrounding women and black women in particular and highlighting the right to self-determination. Black women have faced America's growth in its patriarchal authority, and have been the most harmed by these structural injustices.  

History: 

Natural Sciences & Slavery

Before the Atlantic Slave Trade, the concept of race was seen as a biological one rather than a systemic one. The English definitions of racial difference evolved into what we now think of the era of slavery through biological and legal definitions. In addition the spread of christianity was monumental in the construction of these definitions. The legal classification of enslaved women as field laborers, and including them in the category of male tithables, showed the intersection of race and gender in early America. Further it set the foundation for the exploitation and violence against black women. Racial difference and the institution of slavery were mutually reinforcing as it developed alongside each other, and also used to further define the social hierarchy and identity of the American colonies (Brown).  

19th century

Origins of Gynecology

After the banning of imported African-born slaves, at the beginning of the 19th century slave owners became more interested in increasing the number of births. Slave owners and doctors began to work together closely to protect the reproductive health of enslaved women, more importantly to protect their investments, and ensure they could give birth to more children. Before this period labor and womens health was reserved for midwives, but elite men began taking over the field. One of the most prominent men in the field was Dr. J. Marion Sims who is considered the "father of modern gynecology". Sims conducted surgical experiments on enslaved Black women without anesthesia or proper consent, which he justified for the purpose of medical advancement. These women, stripped of autonomy who endured many unwanted procedures, played a crucial role in Sims' development of the techniques and tools within gynecology that helped women all around the world. For many southern doctors like Sims these medical opportunities legitimized their careers while giving them prestige and credibility, at the cost of the physical and emotional wellbeing of black women (Owens, 19). 

Sims wrote about these experiments that he did on about a dozen women. He specifically names three Anarcha, Lucy, and Betsy. In his writings he claims that they wanted to be cured and consented to these surgeries but obviously the voices of these women were not heard. Black women were perfect for these experiments and the developments within the field of gynecology because they were seen as inferior to white women, and seen as having higher tolerance for pain or feeling no pain at all. 

Harriet A. Washington in her book Medical Apartheid, describes these experiments and procedures as non-therapeutic medicine meaning that they weren't done for the healing of the patient but to further the field of medicine. Southern doctors acknowledged that the cervixes of both black women and white women were identical, and was why surgeries were performed the same, however they still maintained the biological inferiority of black women (Owens, 28). These treatments would never be done on white women because they violated the standards of modesty, however this highlights how both black and white women were harmed, because black women were exploited but these procedures were done to make sure women could continue to give birth and uphold the system of patriarchy. 

20th century

Eugenics

Moving into the 20th century, when the Eugenics movement began gaining popularity. The Eugenics movement was founded by Francis Galton who advocated for scientists to study the reproduction of the human population and develop ways to ensure a healthy society. The Eugenics movement was used to eliminate peoples that were believed to carry defective genes, and stop those people from giving birth. For black women this was seen in the development of the birth control pill. Margaret Sanger was a prominent eugenics supporter and focused on restricting the population of black people by regulating the reproduction of black women. She believed that those who reproduced too much were those “least intelligent and fit, and least able to rear their children properly”, and the birth control pill was her solution (Washington, 197). Later on the US government began to promote the use of this new pill. Although the black community was skeptical of the government's initiative, black women saw it as an opportunity to have a say in their own reproductive autonomy, and enjoyed the freedom of choice it gave them (Washington). 

Legislation & Welfare System

The welfare programs that were created during the 20th century existed to aid black women and their children, in the aftermath of President Lyndon B. Johnson's War on Poverty. Previously these benefits were limited to white women, and as black women began getting more government assistance, public opinion on welfare altered. The stereotype of black women as a “welfare queen” came into the media and the American consciousness. This perception painted black women as a burden to the state and society who were unfit to be mothers, which was an extension of centuries long sentiments (Roberts).
These racist perceptions were seen through policies like the Interagency Policy on Cocaine Abuse in Pregnancy by the Medical University of South Carolina which allowed for non-consensual drug testing on pregnant patients. During the crack epidemic, black mothers were vilified, and the Interagency Policy punished these women by immediately arresting any women who tested positive for crack after birth. The charges against these women worsened depending on the stage of pregnancy, In addition there were no alternative treatments provided.  This “policy resulted in the arrest of 42 patients,  all but one of whom were black women” (Roberts 166). 

Role in Constructing Difference: 

 This is a topic that has many intersecting identities and differences. It is an example of how the institution of slavery has manifested itself in other systems in America, which are all rooted in racial hierarchies. It also gets at the ideas about privacy and bodily autonomy, and how black women have been especially exploited in this regard. The justification for this dehumanization was rooted in the feelings that black women are the antithesis of white women. Motherhood was directly linked to femininity, and therefore black women were seen as less than. Women are supposed to be nurturing mothers who were virtuous and relied on their husbands. However black women who were forced into labor because of slavery were seen as inferior to this ideal. This plays into the stereotype of black women being bad mothers and devient. Additionally, the rules for black women were consistently changed depending on what was needed to control the bodies and perception of black women. This is seen in how and why procedures were performed, to the welfare system and even in the use of contraceptives.   

Dorthy Roberts in  Killing the Black Body explains how for white women birth control was a reflection of reproductive liberty. However the government and medical institutions initially used birth control within the eugenics movement, to regulate the reproduction of black women. But the black community later on used birth control to give themselves more reproductive liberty. It is compelling when thinking about how in different time periods whether it's slave owners wanting to increase the birth of enslaved women or governmental and medical institutions pushing for less reproduction, the goal was always about control and regulation and being able to manage the reproductive rights of black women.

The law and government’s role in further constructing race and gender is very evident within this issue. The social hierarchy that was built by powerful white men, happened through slavery and racism and through the regulation of women's bodies and reproductive autonomy, at the greatest cost to black women. At times the government worked alongside causes and organizations, at other times it itself created the methods that allowed for the mistreatment of black women. Within reproductive rights, the government oftentimes uses the protection of the fetus as a reason to enact punitive action against women, however in actuality they are just using it as another way to regulate the reproduction of women. All of these aspects have helped to establish black women as hyper-sexual, drug-abusive, incapable mothers and built the structures that have allowed for the systemic injustices against black women. 

Present Day Relevance:

Taking a look at the American healthcare system today many issues can be traced back to slavery and the history of exploitation of black women. Black women are less likely than white women to get breast cancer, but 40 percent more likely to die if they do develop it (Mckoy). In the issue of maternal mortality black women have the highest maternal mortality rate in the US three times more than white women (Stafford). These kinds of disparities show how deeply ingrained racism is within the medical field. In addition the relationship between the black community and medical professionals is deeply destructive. The fears that so many people have toward the healthcare system underscores how prevalent this issue is, and the dangers to Black people and black women in particular. The aftermath of the Covid pandemic revealed just how intertwined our healthcare systems are with the social issues that we face, and how much they can perpetuate and exacerbate already existing inequalities. The pandemic also revealed to people all around the world what is needed to improve these conditions, which is sustainable, effective, systemic change.  

Reproductive issues are a very pressing concern in this country and the world, and reproductive justice especially shows why it's been so hard to have these rights guaranteed. Roberts explains how reproductive rights are more than just bodily autonomy and go beyond the individual. She argues that reproductive rights have helped in creating racial and social inequality. In the introduction she says “The feminist focus on gender and identification of male domination as the source of reproductive repression often overlooks the importance of racism in shaping our understanding of reproductive liberty and the degree of ‘choice’ that women really have” (Roberts, 11). Although this work was from the 90s, it can still be applied today, and it should be used to learn more about why this system is the way that it is and why lawmakers and people in general have fought so hard to uphold it.

References 

“Alabama Artist Works to Correct Historical Narrative around Beginnings of Gynecology.” PBS NewsHour, 27 Feb. 2023, www.pbs.org/newshour/show/alabama-artist-works-to-correct-historical-narrative-around-beginnings-of-gynecology.

Brown, Kathleen M. Good Wives, Nasty Wenches, and Anxious Patriarchs. UNC Press Books, 1 Dec. 2012.

Mckoy, Jillian. “Racism, Sexism, and the Crisis of Black Women’s Health.” Boston University, The Brink, 31 Oct. 2023, www.bu.edu/articles/2023/racism-sexism-and-the-crisis-of-black-womens-health/.

Owens, Deirdre Cooper . Medical Bondage : Race, Gender, and the Origins of American Gynecology. University Of Georgia Press, 2017.

Roberts, Dorothy E. Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. New York, Vintage Books, 1997, pp. 150–201.

Stafford, Kat. “Why Do so Many Black Women Die in Pregnancy? One Reason: Doctors Don’t Take Them Seriously.” AP NEWS, 23 May 2023, projects.apnews.com/features/2023/from-birth-to-death/black-women-maternal-mortality-rate.html.

Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. 2006. New York, Anchor Books, 2008.