Medical Bondage: Race, Gender, and the Origins of American Gynecology by Deirdre Cooper Owens (review)

In this cleverly titled book, Deirdre Cooper Owens uses the intersection of class, gender, medicine, and authority to study enslaved black and Irish women's bodies in the evolution of gynecology as a medical specialty during the early to mid-nineteenth century. Whites knew that "black women literally carried the race and extended the existence of slavery in their wombs" (8), but studying reproductive health on slave plantations, and among Irish immigrant women, is difficult. Owens faced many problems, but detailed census records opened the way to explore the issue of babies born during medical experimentation, which in turn opened the door to the world of enslaved gynecological subjects. Owens applies a sophisticated analytical framework to a wide variety of archival sources—diaries, newspapers, publications, case histories, former slave women's narratives, and court records—as well as secondary scholarship in order to demonstrate the ways in which both southern and northern doctors used racial stereotypes to advance medical knowledge. The result is an absorbing and important contribution to the history of women, slavery, and experimental medicine in the nineteenth-century United States.

Scholars in recent years have begun exploring the ways in which medicine and slavery affected each other. Owens takes this a step further by examining reproduction (voluntary and involuntary) in shaping the system of slavery and demonstrates the central importance of enslaved women's bodies to the development of American gynecology. The increased access to enslaved bodies with gynecological problems made enslaved women "objects of study and fascination" and a leading source of knowledge for the new specialty (9). Fundamental to Owens's account is the concept of a "medical superbody," not a nineteenth-century term but one she uses to describe how physicians denied enslaved women full humanity while valuing them as ideal research subjects for medical experimentation. White physicians looked at enslaved black women in racist terms, highlighting "their fecundity, their alleged hypersexuality, and their physical strength" (109). Owens argues that the analytic category of the "black medical superbody" provides the best means of exploring the various meanings of sexual, gynecological, and reproductive conditions that women suffered (117). While recognizing that black and white bodies were anatomically the same, the so-called best science of the day—really "scientific racism"—legitimated racial differences and allowed doctors to conduct gynecological experiments on a vulnerable population, laying the foundation for gynecological medicine.

The book is divided into five core chapters. The first explores the pioneering work of such well-known doctors as John Peter Mettauer, John Archer, James Marion Sims, Ephraim McDowell, and Nathan Bozeman. As the South's economy and social order became increasingly grounded in a slave society, and new imports were practically forbidden, health problems were a "physical and economic burden" to slave-owning professionals who had a vested interest in maintaining the health of their slaves (17). Informal partnerships were formed among slave owners, medical professionals, and medical schools to treat (among other conditions) the reproductive health of enslaved women. Slaves were ideal subjects for experimentation since doctors regarded them as "biologically inferior" to white women but as having a high "tolerance for pain" (23). The troubling analogy with similar abuses later, though not mentioned, is obvious. The consequence was rapid advances in gynecological medicine. Owens notes: "Thanks in large part to his experimentation on enslaved black women, Sims had established himself as one of the country's preeminent gynecological surgeons less than a decade after he began his gynecological career" (39).

The second chapter explores the experiences of enslaved women in gynecological medicine. Owens describes the surgical experiments, the reproductive challenges, and the care the women needed. Many enslaved women had served as nurses and midwives and often assisted in medical and surgical procedures, and Owens describes the challenges they faced as white men first intruded, then came to dominate the former all-female "safe" spaces for healing. The...