Discrimination Within The Medical Industry

The Mothers of Gynecology monument by Michelle Browder in Montgomery (SmartHistory org.)

One of the earliest and most horrific cases of racism being used to advance medicine would be in the 1840s, where a physician, to prevent childbirth injuries, continuously performed operations on enslaved girls in Alabama. (Wicker. 2026) These operations were performed without anesthesia due to the false idea that Black individuals experience less pain than others. Three women whose names are Anarcha, Lucy, and Betsy. Due to being enslaved, they had no bodily autonomy, leading them to undergo multiple operations, almost losing their lives.  While the procedures that they had to endure did result in medical progress, their sacrifices were not credited in any way, while the lead physician of the study, J. Marion Sims, was labeled as the Father of Modern Gynecology. 

Illustration by Robert Thom of J. Marion Sims and Lucy, one of the many enslaved women operated on for his study. (University of Michigan Museum of Art)

The painting invites the viewer to join the other surgeons, who merely view Lucy as an object used to satisfy medical curiosity. Simultaneously challenging the idea of this moment being a “scientific achievement” and instead as a moment of cruelty and violence.

The development of the birth control pill involved the unjust testing of the contraceptive on patients who were less than willing. June 23, 1960, is when the first hormonal birth control drug hit the market for women. One of the individuals involved in the idea of this pill was Gregory G. Pincus. He was not in it for autonomy; however, in an interview in 1967, he stated, “I am against women having sexual freedom, but I hasten to add that I am also opposed to sexual freedom among men.” His main goal is to create the pill in the name of science instead of society. Pincus later teamed up with John C. Rock, who started an infertility clinic called the Free Hospital for Women, where he repeatedly tested these synthetic hormonal birth control on low-income patients, a method that he would repeatedly push Pincus to follow. Rock worked with artificial versions of estrogen and progesterone, issuing dangerously high doses to his infertile patients with huge results. About 13 of 80 previously infertile patients were able to become pregnant after the tests were concluded. Though these results had the desired results for some, the large number of failed pregnancies discouraged many, which led to a drop in volunteers. This did not discourage Pincus, however launched a new trial in 1954, recruiting 16 female patients at Worcester State hospital, feeding them the birth control prototypes, and then slicing into their uteruses to understand how the drug affected their ovulation. 

While the study was operating in the grey area of consent at the time, simultaneously, this contraceptive drug was being tested on a larger scale in Puerto Rico. With more lax laws and the target of racial fear from many Americans, it seemed to eugenicists to be the perfect place to test this new contraceptive. Eugenicist legislation codified forced sterilization, and by 1955, 16.5% of Puerto Rican women of childbearing age to bear children had been sterilized. 

A later study conducted in 1988 of these women who had been sterilized, 16% of them said they did not make this decision themself. Rock and Pincus continued their studies in Puerto Rico, as well, utilizing female University of Puerto Rico medical students in 1955. The students were forced to participate in the study with the threat of their grades being held over their heads if they were to drop out. The methods used in the study caused occasional pain, and the side effects of the study included blood clots, bleeding, and nausea. These medical students were required to endure a vaginal smear and receive a temperature test every day while having to receive cervical dilations and uterine tissue collections every month. Laparotomies were sometimes necessary, where a large incision was placed to open the abdominal cavity in order to observe a woman’s ovaries in real time.

The final prototype was chosen to be tested in Rio Piedras, an area of San Juan. Notes of the choices from the researchers include details on how poverty and immobility of women in the area made them excellent subjects for a controlled trial. They believed that the ‘feeble-minded’, ‘people of color’, and ‘the poor’ should be experimented on. A scientist involved in this study, Gabriela Soto Laveaga, noted that these women who were volunteering for the trial did not know what was going on when offered an IUD. After the drug was approved for public use, birth control became more available. However, for those who’d helped test the drug, it was far too expensive, leaving them denied both compensation and access to the drug that they helped create. 

Years after the release of the contraceptive, questions began to arise surrounding the safety of the drug and the methods used to test it. The debate over whether or not data obtained unethically should be published became a prominent issue. When stories came out regarding Harvard’s role in the development of the birth control pill, the Puerto Rican trials and asylum testing were left out of the article, allowing for the medical mistreatment of the trial patients to remain unknown.