Anarcha Westcott was 17 years old when she gave birth. Although she is listed as a “mulatto” in the census, not a great deal is known about this enslaved woman’s life in Alabama. But she should be hailed – along with two other enslaved women named Lucy and Betsey – as one of the "mothers of gynaecology". Instead, we are much more familiar with the white, slave-owning "father of gynaecology", Dr J Marion Sims.
Sims has not one, but three statues in his honour in the United States (although, in 2018, his Central Park monument was removed from view after public pressure). Largely erased from the narrative are the enslaved women he experimented on, women whose bodies provided the “resources” Sims needed for his research. It is through those experiments that his name entered the annals of the historical record. Yet he failed to record most of the enslaved women’s names, other than Anarcha, Lucy and Betsey. It was on Anarcha that his experimentation was most frequently carried out, conducting more than 30 operations, with no pain relief. These led him to “successfully” perform his surgery (Anarcha never fully recovered), making Sims’ technique the first treatment for vesicovaginal fistula. He revolutionised gynaecological surgery, cementing the legacy that so preoccupied him.
Enslaved women were bought to produce, and to reproduce. Yet, as is easy to imagine, being held in captivity and labour. Brutal conditions, inadequate diet and insufficient shelter meant that poor health was endemic among enslaved people. Many suffered from rickets, which affected bone development. It’s very likely that Anarcha had a severe case of rickets caused by abuse, neglect and malnutrition. This could result in conditions such as a deformed pelvis, making it incredibly difficult, if not impossible, to give birth. In June 1845, Anarcha went into labour and spent three days desperately trying to give birth before the local physician, Sims, was called. This was not necessarily out of concern for Anarcha. Enslaved people only had “value” in so far as they could work, dead women couldn’t work, and obstructions to having children resulted in fewer workers.
Brutal conditions, inadequate diet and insufficient shelter meant that poor health was endemic among enslaved people
After a tortuous labour (which probably ended in a stillbirth), Anarcha’s body was ravaged. Her ordeal left her with tears in her vagina and rectum, a condition known as vesicovaginal fistula and rectovaginal fistula. In addition to unimaginable pain, it causes incontinence and Anarcha suffered uncontrollable bowel movements, which in turn led to further complications, including ulcers on her vulva and thighs. Given the location of these conditions and the squeamishness of male doctors in treating women, no cures existed, but Sims saw Anarcha as a prime “specimen” for his investigations.
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Sims was a man of ambition, who (according to JC Hallman, who has done extensive research on Anarcha) “settled on surgical innovation as the best path to a lucrative practice and a permanent legacy”. He subscribed to the common racist belief that African-Americans were both less intelligent than white people and less able to feel pain. These beliefs combined with his own ego to lead him to commit truly gruesome acts. For instance, convinced that “lock jaw” was caused by a mechanical issue, Sims used shoe making tools to pry enslaved children’s bones apart to “loosen” their skulls.
Initially opposed to treating women’s reproductive health, stating that he “hated investigating the organs of the female pelvis”, Sims later had a change of heart. While treating a white seamstress who had dislocated her pelvis, he made an observation that he thought he could test on Anarcha and the other enslaved women, allowing him to make history. His experiments also facilitated the invention of the vaginal speculum, still in use today.
Sims became an internationally lauded celebrity physician, performing on European empresses the techniques he had practised on enslaved women. And what of those women? Little is known, but a book on Anarcha's life, The Anarcha Quest: The Story of a Slave and a Surgeon, based on Hallman's research, is scheduled to be published next year. Hallman has also been part of the "More Up" campaign, which plans to erect a monument to Anarcha, Lucy and Betsey – long overdue recognition of the sacrifices made by the "mothers of gynaecology".
This article was first published in the September 2021 issue of BBC History Magazine