The Black Stork

Introducing Part 2 of Medical Apartheid. Delving into another form of racial control: Reproduction.

Fannie Lou Hamer’s name in American History seems to be something that was always meant to be. In the times we are brave enough to look back at where we have come from, we see in her an inspiring picture of a bright young woman, granddaughter of a slave, daughter of sharecroppers, and the youngest child of 19, who looked up from her place in rural Mississippi and answered the shing call to usher in an era of upheaval, Civil Rights, and liberation for us all.

Growing up, and seeing her visage frozen in photographs, fingers curled around a megaphone, mouth open in an impassioned speech, and sweat licking her temples and hair, I thought of her as uniquely called to this activist work. I thought something inside of her was different. I didn’t know that physically, what had been done to her, within her very body, not only made her like so many other women but had been the turning point for her, an uneducated, dark-skinned, woman from the South to become one of the strongest Civil Rights figures in history.

Deeply religious and devoted to her family and faith, Hamer’s first dream was of children. She wanted to be a mother. She was a great help to her family and was looking forward to the day she could grow her own. The year was 1961, but as Washington writes, it might as well have been 1861. Hamer’s family struggled to survive under harsh, White Supremacist economics on a plantation, trapped in a cycle of exploitation and low wages designed to keep them forever in debt. Hamer eventually discovered she had something internally that needed medical treatment, treatment for what we now believe was a benign uterine fibroid tumor.

When Fannie Hamer left the hospital, she came back to the plantation to recover in her family’s little shack. And then, talk began to swirl. The surgeon who had operated on her was a cousin of the plantation owner’s wife, Alicia Marlow. Marlow told her cook that Hamer had not only had her tumor removed but her entire uterus as well without her consent. Hamer had been unconscious during the surgery and at no part of her admission or time in that hospital had indicated that she wanted this hysterectomy. When the cook spread the news, it finally reached Hamer’s cousin, who told her. Washington tells us that Fannie Lou Hamer was one of the last people to learn that her own uterus had been removed.

It is fitting that Harriet Washington begins the second part of Medical Apartheid with her story. In the chapter that kicks it all off, The Black Stork, Washington focuses on the reproductive control of Black women (and consequently Hispanic women). She introduced a recent history, looking from the events of the 1920s to the 1990s, to put into perspective the ways eugenics, reproductive health, and fake medical science collided to surveil, punish, and control Black reproduction.

This chapter introduces several of “the big hits” of this mess while taking care to look at how complicated and grey the history is, as conflicting agendas, narratives, and motivations cloud the events detailed.

Was Margaret Sanger, the famous mother of birth control, and what would become Planned Parenthood working alone? Was her work contributing to Black Genocide as some say to this day? Why was W.E.B. DuBois working with her? How did the Pill and the IUD become widespread and on whose bodies? Where did concerns about the underclass begin and where did racist desires to keep a majority White population begin? And what did the women at the center of it all want?

This week and the next, as we explore some of the stories of a few women whose experiences speak to a larger culture of control, we will find through Washington’s research and the medical records not a new phenomenon of medical abuse and coercion, but an evolved one. Up until this point in history, getting Black women to reproduce quickly and often was a priority for enslavers and all who benefited from the economy of slavery. More children meant more free labor, replacement labor, and a future of enslaved labor. When enslavers could no longer legally import human beings, they decided to continue to make them. Through rape or forced marriages, enslavers continued to assert control. A century later, when their children were no longer economically profitable, Black sterility became a critical aim, with generations of latent fears of a “mongrel nation” and an “inferior people” taking over blooming.

When Hamer went to confront the doctor, to ask him why he had done this, he didn’t respond. “He didn’t have to,” Hamer said. When the idea of a lawsuit was asked to Hamer, she scoffed. “At that time? Me? Getting a White lawyer against a White doctor? I would have been taking my hands and screwing tacks in my casket.”

It’s that answer, He didn’t have to, and what’s under it, that is the bedrock of every element in this chapter. The assumption that Black women and their children were still “problems” that needed to be addressed by White men who answered to no one, that their existence could be solely judged by a made-up metric, and that a good America was one with as little Black people as possible made these “Mississippi Appendectomies” normal and standard across the country. Hamer was one of hundreds of thousands of Black, poor, or mentally ill women who were subjected to this.

The creation and context of the “welfare state”, the predatory behavior of American men, and the health disparities that affected Black women could not be solved or addressed through birth control, forced sterilization, or prison. And yet, time and time again, this was the answer because from the 1920s on - as Black women ceased to become the property of anyone- the point was not about health for Black women and their children, but about maintaining the status quo of White political, economic, and social control.

There is no separating the current landscape of Black maternal and reproductive health today from yesterday. I was born in the 90s, and most of our readers in the decades before that, exactly when some of the worst traditions regarding birth control and reproductive health were practiced widely in the medical establishment. For women, this past isn’t even past. It’s practically yesterday. Delving into this chapter, we inch ever closer to unraveling are comfort and acceptance of the questionable baseline care many women and people receive today.