- Birthing a Slave: Motherhood and Medicine in the Antebellum South
Marie Schwartz has produced a fascinating and disturbing account of slave women's experiences of fertility, childbirth, and gynecological disorders under a system of domination and exploitation. Birthing a Slave is equally a history of Southern doctors' attempts to professionalize medicine in the antebellum era.
"Regular" doctors, whose training at the time usually consisted of [End Page 701] under a year's worth of medical lectures followed by apprenticeship, struggled to wrest authority and control of women's bodies away from midwives and "quack" doctors. Schwartz argues that in the antebellum South, the process of professionalization was facilitated by white male doctors' ability to take control of the treatment of slave women. Doctors sold their services directly to slaveholders (sometimes for a yearly flat rate) with the promise that they could help regulate and control black women's bodies to ensure the regular increase of slaves—and thus profits—for the slaveholder. Particularly after 1808, when Congress forbade the importation of slaves to the United States, the natural increase of the current slave population was necessary to ensure slave owners' continued wealth. In this new economic and legal context and with the expansion of labor-intensive cotton crop farming to the lower south and west, black women were evaluated and valued on the basis of their capacity to be good "breeders" for their owners. Schwartz's evidence suggests that slave women were interested in spacing out their children by means such as breastfeeding rather than by abortifacients, which were used for family planning rather than resisting all new pregnancies. In spite of this, "[r]ather than deploring the physical punishment of pregnant women and in some cases their reduced rations, medical men joined slaveholders in criticizing a supposed tendency among enslaved women to abort their children and thus deprive them of their rightful property" (141). Any problems with pregnancy were blamed on slave women rather than on their poor treatment and health.
White southern doctors used their access to enslaved women to enhance their own reputations and their profession as a whole by experimenting on slave women's bodies to produce medical and surgical "advances." In the process of these experiments, countless slave women died and were maimed as they submitted to the doctor's knife—not usually with their own consent but instead with the consent of their owners. Whereas doctors had to be sure to try not to inflict unnecessary pain and to preserve the lives of their white female patients, they were not under the same restrictions with enslaved patients. In many cases, doctors were allowed to conduct experimental surgeries without anesthesia, even when they admitted that they were unlikely to cure the patient or save her life. Slave owners consented to these experiments because they benefitted if a slave was actually cured or if, as was more likely, the doctors assumed the costs of "caring" for (and sometimes repeatedly operating on) seemingly incurable slaves. As Schwartz explains, "[s]laveholders [End Page 702] supported the physician's claim to professional status, just as doctors upheld the idea of the slaveholder's right to claim human property" (269). Whites also stereotyped black women as less able to feel pain than white women, thereby justifying doctors' experimentation on black women's bodies as a relatively harmless way to advance medical care for all. Once surgical techniques were refined by experimenting on enslaved women, doctors then felt freer to operate on white women.
Schwartz gives us an important perspective on just how ineffective and even dangerous nineteenth-century medicine really was. Doctors insisted on dramatic, violent, and visible "heroic" treatments as they bled, cupped, blistered, leeched, purged, and even poisoned their patients by administering substances such as lead, arsenic, and mercury. Schwartz links doctors' insistence on heroic medicine to a quest for manliness, which doctors, as Southern white men, tied to their honor and professionalism.
Not surprisingly, when they could, slave women resisted white doctors and their brutal...