The history of the OB GYN specialty is filled with an abundance of medical advances that have made the lives of patients better and healthier, but there are aspects of the history, based on historical documentation, that have been the topic of books and articles written by medical ethics experts and authors for many years. One of those topics is J. Marion Sims, MD, and his work to cure the condition of vesico-vaginal fistulae.
According to various historical accounts of Dr. Sims' work, including his own memoir, Sims experimented on enslaved Black women to find a cure for vesico-vaginal fistulae.1 This condition is defined as an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence.2
In Sims' memoir, The Story of My Life, he states these experiments were performed between 1845 – 1849. He also notes, this was before the days of anesthetics.3 Anarcha was the first case of vesico-vaginal fistulae that Sims saw. She was 17 years old at the time, and when he first arrived at her bedside, she had been in labor 72 hours. He delivered her baby with the help of forceps, but five days after the delivery, he discovered she had vesico-vaginal fistulae. Betsey and Lucy were sent to him with the same condition not long after he delivered Anarcha's child. Betsey was "17 or 18 years old", according to Sims' memoir, and Lucy was "about 18 years old".4
Initially, Sims was certain he could not cure any of the women. After a chance medical visit to treat a different ailment, he discovered a surgical position and technique that possibly would serve as the means to treat the condition. Ultimately he would go on to experiment over the next five years on Anarcha, Lucy, and Betsey, as well as other enslaved women in the small hospital he had built on his property in Montgomery, Alabama. On Anarcha alone, he performed 30 experimental surgeries before successfully curing her. 5
Historical documentation also presents evidence that Anarcha, Lucy, and Betsey and others like them were trained by Sims as surgical nurses, as they continued to work in domestic and agricultural roles.6 In Sims' memoir, he states that due to "two or three years of constant failure," his colleagues gave up assisting him, and "... at last I performed operations only with the assistance of the patients themselves."7
Sims published "On the Treatment of Vesico-Vaginal Fistula" in the American Journal of Medical Sciences in 1852.8
To learn more, visit these resources:
- History.com's "The Father of Modern Gynecology"
- The American Journal of the Medical Sciences' "On the Treatment of Vesico-Vaginal Fistula"
- Geoffrey Kaye Museum's "Anarcha, Betsey, and Lucy - The Legacy of J. Marion Sims"
- NPR Podcast "Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology"
- ACOG's "Betsey, Lucy, and Anarcha Days of Recognition"
- JAMA's "Historical Aspects of Race and Medicine" - The Case of J. Marion Sims
1. Owens, Deidre Cooper. Medical Bondage: Race, Gender, and the Origins of American Gynecology. University of Georgia Press, 2018. 36.
2. Michael Stamatakos, Constantina Sargedi, Theodora Stasinou, and Konstantinos Kontzoglou. “Vesicovaginal Fistula: Diagnosis and Management.” US National Library of Medicine National Institutes of Health. Indian J Surg. 2014 Apr; 76(2): 131–136. Published online 2012 Dec 14. doi: 10.1007/s12262-012-0787-y
3. Sims, J. Marion. The Story of My Life. D. Appleton and Company, 1885. 242.
4. Sims, J. Marion. The Story of My Life, 227-229.
5. Sims, J. Marion. The Story of My Life, 228, 230, 232-233, 245.
6. Owens, Medical Bondage: Race, Gender, and the Origins of American Gynecology, 38.
7. Sims, J. Marion. The Story of My Life, 241-242.
8. Owens, Medical Bondage: Race, Gender, and the Origins of American Gynecology, 39.