[Steven Greenberg:] Good afternoon and thank you for coming.
I'm Steven Greenberg from History Medicine division here
at NLM and it is my duty today, my very pleasant duty to introduce today's speaker.
Marie Jenkins Schwartz is no stranger to Washington, DC area. She received her bachelor's and
master's degrees from George Mason University and her doctorate from the University of Maryland,
College Park. And since 1995, she is taught in the History and African American studies programs
at the University of Rhode Island, where she's now an associate professor.
And her talk today is based upon her latest book, latest book, "Birthing A Slave,
Motherhood and Medicine in the Antebellum South," published by the Harvard University
Press in 2006. And before I ask professor Schwartz to begin, I just would like to remind you
that our next history of medicine and seminar will be Wednesday, August the 1st at 2:00 o'clock
in the Lister Hill Visitor Center. The speaker will be Kristen Ehrenberger , University of
Illinois at Urbana-Champaign, who will speak on "The Telescopic Body: Visualizations of
Normal Anatomy And Social Pathology in Weimar, Germany. But today,
Professor Schwartz.
[applause]
[Professor Schwartz:] Thank you very much.
I'm delighted to be here this afternoon. I have a lot to thank the Library of Medicine,
specifically the History of Medicine Division for since I've been invited here to speak today,
but also since I logged in a month,
a whole July as I recall. Here doing research for this book.
And so it's delightful to come back and be
able to share some of my research findings. My book really focuses in on how
medicine furthered slavery and how slavery furthered medicine.
And I'm going to begin with a case involving a slave woman and the
physician who was assigned to her care. I do want to say if.
Sometimes when professors talk, they do say things that may sound
confusing or odd. And now we know that. And I'm happy to have you interrupt me for
clarification if you would like to do that. But I am planning on having plenty of
time or I hope we'll have plenty of time for some questions afterwards also. Well,
here's the case I want to share with you. In December 1841, physician William
Morgan attended the childbed of Caroline. An enslaved woman who had
been in labor about 26 hours. He had been summoned because the
infant's position was not favorable for an unassisted birth. Morgan turned the infant who
came into this world feat first. Unfortunately, the mother experienced complications,
including eighteen days of hemorrhaging. For 30 days,
Morgan treated the woman with enemas, blister plasters, cathartics,
tonics of various types, astringents, excuse me, opium and morphine.
He kept note of her progress even longer.
Her health was tolerable, he observed years later.
But she continued to experience occasional abdominal pain, irregular menstruation,
and slight diarrhea. Perhaps more important, at least to the doctor and to
his slaveholding client. She had not conceived despite,
in the doctor's words, having
frequent communications with her husband.
No small part of an antebellum slaveholder's future earnings
depended on the birth of slave children.
And owners wanted women to produce living children with regularity.
the United States ended its participation in the international
slave trade beginning in 1808. After that, everyone knew that slavery and
the southern way of life could continue only if women bore enough
babies to replace the numbers of slaves who died each year.
The nation was expanding geographically. And I have a few maps I brought with me
today that I'd like to share with you so we can get clear on where I'm we're
talking about and how things were changing. In the United States.
[overhead projector utilized]
The blue dots represent 1000 bales of cotton.
And what was happening is the nation
was expanding westward and cotton
production was increasing quite rapidly.
And this area of heavy blue down here, I probably should have used the laser pointer.
Excuse me, that was called the "Cotton Kingdom," actually
came to be known that way.
And as cotton expanded westward thank you, so too did the population of slaves.
And I have this rather dramatic map I want to show you whoops
would help to get it the right way. The this top map shows the
slave population in 1820.
And each dot there represents 2000 slaves.
Now look at it in 1860 and you can see it rather dramatic
change and again because the international slave trade had ended.
These new slaves were those that were born to women in bondage.
Everyone understood the significance of that.
[overhead projector sheet rustling]
What began to happen is as the nation expanded westward,
there was a need for more
labors to grow that cotton, and the cotton wasn't grown
much in the upper South. And so,what began to happen was
that slaveholders in the upper south sold slaves to the lower South,
and so we began to have
states becoming identified as either
exporting slaves or importing slaves,
and you can see on the top map 1790 to 1799,
you can see that Virginia and Maryland
are the slave exporting states. But that begins to change
over time, 1820 to 1829 you can see that South Carolina,
North Carolina and Kentucky have
entered this slave market as sellers of slaves and shipping them down to
places like Mississippi and Louisiana. And then finally if you come down to the bottom map,
you can see 1850 to 1859 that the areas of the South that are exporting slaves,
selling them has expanded again and we have Texas on the map
which is come into the Union. So we began to have an even larger number
of areas that are importing slaves.
So just wanted to show you that briefly
because I think that visually lets us
know that planters viewed the birth of
children as both practical and profitable.
Now increased interest in the birth of enslaved infants corresponded.
With a change in the emphasis doctors were placing on treating women's health problems.
In the early 19th century, doctors were taking an increased
interest in fertility, pregnancy, childbirth and complications of
childbirth to learn how they might better manage women's health.
So these developments, the ending
of the international slave trade,
the geographically expanding nation,
the growing importance of cotton cultivation,
and the beginning of reproductive medicine, encouraged slaveholders
to employ doctors in the hope that they might increase the number of
children who were born in bondage. Now, enslaved women who bore children
regularly and without complications were not cause for concern.
But slaveholders began in the decades before the Civil War to summon
doctors for women who had difficulty reproducing whatever the perceived
cause. Protracted or difficult labor, repeated miscarriages,
recurring stillbirths, irregular menstruation,
vaginal tearing and other complications following childbirth.
Stressed and uterine cancer and the
more general failure to conceive despite opportunity all prompted
slaveholders to seek medical attention for enslaved women.
Now we want to remember here that gynecology and obstetrics did not emerge
as medical specialties until after the Civil War.
So women's diseases fell under the purview of the general practitioner
who attended all medical problems on the plantations. We're not talking about doctors who have
a specialty in this particular field. Although an increasing number of
doctors were taking an interest in reproductive medicine. We want to remember that throughout
this period, home remedies were continued to be popular.
For most slaveholders, home care was the logical first step in treating the health needs of
their slaves as well as themselves and members of their own family.
Home care saved the expense of the doctor and in some cases was
the only type of care available, especially in remote areas where there
were was a shortage of physicians.
And even if a physician practiced nearby,
he could be tied up with another case and unavailable to come.
Many slaveholders prided themselves on
being independent and on being self reliant, and they avoided any dependence on others,
and this extended to medicine.
Some slaveholders just outright
distrusted the care that doctors offer. This wasn't an age in which
doctors acted boldly. Today, we would say they acted recklessly
to produce a drastic change in the patient. They bled, blistered, [?puked?],
purged, cut, and dosed with large quantities of drugs.
So all of these reasons encourage slaveholders to rely as much
as possible on home remedies.
Even when a doctor's services were at last deemed essential,
he was not necessarily expected to appear at the patient's bedside in person,
as letters to doctors illustrate. Planter James Douglas contacted
physician Charles Brown only after
his woman had been ill for 9 days. Douglas, in his letter,
said that he had bled her several times already.
But that her condition had deteriorated. He still didn't ask the doctor to come, however.
He merely wrote and asked the doctor to clarify which side
the woman should be bled from. Home remedies often mirrored the kinds of
remedies that physicians saw use themselves. Planter William Payne did not
even specify whom they were for.
When he wrote Doctor James Carmichael quote,
to "send me up a box of your blue pills." Many planters like Payne,
kept a variety of medicines on hand to treat whatever problems
might arise on the plantation. So even when a doctor showed up,
home remedies still did not cease an importance.
Home remedies were often used either simultaneously or sequentially,
with the care that the doctor provided.
When the enslaved Peggy was ill in Baton Rouge,
her mistress complained that she thought this woman would never
get well because she persisted in using home remedies which in
the mistresses eyes contradicted or counteracted, I should say,
the effect of medicine and careful nursing that the mistress said she was providing the woman.
Well, as this case illustrates, I hope most of the home remedies
that slaves used were those they devised themselves.
Enslaved women were distrustful of both slaveholders and their doctors,
and preferred their own healing traditions. They placed faith
in the wisdom of other women who administered teas and other preparations,
evoked spiritual cures, pleaded with slaveholders for the
amelioration of slavery's worst features,
especially overworked and harsh punishments,
and they trusted their own bodies to see them through pregnancy,
childbirth and aftercare.
Because slaves viewed childbirth as a
particularly dangerous time for women, they wanted attendance at childbed who
understood their fears and who could give them advice about how to handle the chain
of events leading to and beyond birth.
When white doctors attended black women, the women confronted men
who appeared ignorant of practices important for ensuring the
wellbeing of mother and child, and who were focused on identifying
a physiological problem, the diagnosis and it's
therapeutic correction the cure.
Only rarely did a doctor considered demanding
work regimens and other social conditions.
As possible sources of a woman's ailments. But for slaves,
birth was more than a physiological episode. Events that occurred during pregnancy
and childbirth had meaning. They required interpretation and,
in some cases, action.
The midwife, the traditional birth attendant, helped parents understand these
types of events and respond to them in an appropriate way. For example,
people thought often that special rituals needed to be report performed
at the birth of twins or when a child
was born with the embryonic membrane,
what was called the call covering its face. Mom Hagar Brown,
a midwife in South Carolina, for example,
knew how to brew a special tea from the call which it fed the infants.
Was said to prevent the infant from seeing
supernatural shapes and being
subject to supernatural forces. Now, no professionally trained Dr.
could do this because doctors simply did not understand the cultural
beliefs that guided slave behavior.
Now, doctors were reluctant to engage in the time consuming task
of attending a woman in labor, and this helped enslaved women
maintain control over childbirth, even when an owner engaged the doctor
to attend a birth in the quarter. Physicians prized fees for attending
to the health needs of slaves and many southern physicians,
such as WA Brown of Georgia, cared for more black than white patients.
But obstetric cases were not particularly desirable. Childbirth,
in particular consumed a lot of time,
and slaveholders were unwilling to
pay the same fee for enslaved women
as they would pay to physicians for attending a woman in their own families.
Many white southerners believed that black women gave birth more easily than white women,
which helped them to justify in their own mind less attention and hence a
lesser fee for attending the black woman. So to protect themselves from
the loss of time and money, doctors have called to childbed of a slave woman usually did not
remain with her for very long, certainly not the duration of labor. They left, they came,
left orders for other attendants, perhaps the midwife or maybe the woman's female friends.
And then they went about their business, or maybe even visited with the
owning family and the parlor. Florida physician Charles A. Hentz's
experience was not that unusual. He took time out from one birth to
check back at his office to see if there's been any important developments.
And by the time he returned to the bedside of the enslaved woman,
she had already had her baby. So enslaved women continued throughout
the period leading up to the Civil War to put their faith in indigenous
practices for managing women's health. Poor outcomes associated with treatment by doctors,
coupled with their lack of understanding about the cultural meeting of
customs associated with menstruation, pregnancy, childbirth, discouraged
women from wanting their services. In additions,
women's health was seen as traditionally the work of women,
particularly childbirth, and there was an expectation
that men would not be involved. So rather than subject themselves
to the invasive procedures that doctors brought to the bedside.
A lot of slaves preferred to keep their medical problems hidden from you,
including even pregnancies. Secretiveness reflected the degree
of modesty about health matters, as well as the desire to follow
the advice of black midwives, mothers and friends rather than
white doctors and slaveholders. Both of whom thought it was their duty
and right to manage reproductive health in the slave quarter. Now
the struggle over reproductive health did not occur solely between
enslaved women and doctors. Slaveholders were not always willing
to concede authority to doctors once they arrived on the scene.
They were accustomed to command. They were accustomed to being
in charge of their slaves.
And they did not give up that authority very easily.
In addition, owners paid the physician. So in a sense they were the
client and many a doctor came to the plantation and discovered
that the slaveholder had already engaged and diagnosing the patient
and maybe even come up with a plan of treatment he expected to be followed.
And this was of some concern
to doctors who thought that they should be
in charge once they arrived on the scene. And I want to use one example,
a case reported by John Young Bassett of Huntsville, AL,
to illustrate the kind of thing that could
occur when a doctor arrived on the scene.
He was called-in, in 1838 to attend a
slave who had recently given birth. She had developed a fever followed by
a chill, and that the owner had decided that a physician services were necessary.
Well, the doctor came and tried calomel, mercurous chloride, and quinine
to relieve her symptoms. But later that day she appeared, and this is a quote, "hot,
dry and restless, her pulse fluctuating,
and mine wandering." Well, the doctor spoke to both the master and mistress,
and learned that all three of them had been treating her simultaneously.
They had all been administering
quinine and didn't know it until the woman fell into a stupor,
and the three came together to consult what the others had been doing.
So time and again doctors had to contend with this kind of situation with slaveholders.
Who knew, or thought they knew what the problem was and how to treat it?
Physicians who wanted plantation business really didn't have a choice
but to try to work with the slaveholder, because that was the person who was employing him.
One Alabama planter went so far as
to convince a doctor to actually give
up the practice of regular medicine.
In favor and in favor of an alternative healthcare system
known as the Thomsonian System. The planter had wanted a
physician to tend to slaves, but had decided the socalled heroic
medicine practice by regular physicians was ineffective and he
was able to convince this doctor to completely change around his practice.
And I want to read to you what what he said to the doctor in a letter that helped convince him.
He said, "you are struggling with a big family and we want to help you."
So doctors were keenly aware of the need to please the paying
physician and try to ensure that the
expectations of slaveholders were met. A Tennessee mistress called in a position for a slave
who had been in labor for 48 hours, and she made clear her expectation
that ergot be administered to speed the labor and expel the child. This is a fungus that grows on
rye and other cereal grains, and it was used to promote contractions and labor.
Well, against his better judgment, the doctor in this case administered the drug,
but only after what he called and this is a quote.
"A little diplomatic quackery."
What he did was they diluted the drug and then when the mistress's head was turned,
he threw some out, you know, on the on the ground and then administered really to the enslaved woman,
only a small amount, much less than the mistress had wanted.
I like this example because it reminds
us of something. In the patriarchal south,
white men were accustomed to determining the behavior of white women,
and sometimes when doctors came on to the plantation, we had, as this example illustrates,
a white man answering to the directives of a white woman.
And I think that this method this diplomatic
quackery was used by the physician to
save face in effect to preserve his own
sense that his of his masculine pride. He actually recommended this to
readers of a Southern Medical journal,
and the editor of the Medical Journal recommended it as well.
He thought this was a good way of handling this problem that
periodically arose on the plantation.
Well, by the antebellum era, doctors knew more about reproductive
medicine than ever before. Physicians were beginning to use forceps and other instruments
to aid in difficult deliveries, and new techniques allow them
to verify pregnancy. But instead of benefiting enslaved women
the women often found themselves subject to invasive procedures in the
hands of inexperienced doctors who acted on behalf of slaveholders more
than the women they were called in to assist. And I want to illustrate this with
a reference to cesarean section. Cesarean sections were considered
so difficult before the Civil War and so dangerous for both mother
and child that doctors performed very few. Virtually all,
were performed on enslaved women,
and virtually all the cases,
either the woman, the child, or both, died.
And the difference in the status of the women who underwent cesareans and those who did not,
suggest that enslaved black women were more apt than free white women
to be exposed to risky treatment.
Slaves feared intrusion by physicians in their reproductive lives.
Extreme measures such as bloodletting were contrary to their accepted practices,
and some of what passed for modern medicine was a little more
than medical experimentation.
Ad hoc that is practiced with whatever was available at
hand for the doctor to use. Dr. W. L. Felder stumbled on what
he considered a new treatment for adhesion of the placenta when the
quote, "usual way" of handling a case
did not produce the desired result. Called to remove the placenta from a
hemorrhaging slave woman who had given birth three or four days previously.
The doctor thought he achieved success by applying a sponge that
had been soaked in creosote. By the time he wrote his account for
a journal in January of 1853. He had performed the procedure twice,
and the next time he was going to perform it, he said he thought he would just
inject the creosote directly into the blood vessels of the umbilical cord.
So this is the kind of things they were doing. You know,
they they wanted to improve patients health. So we have to remember that,
but we want to remember that free white women could decline these
risky procedures and enslaved women, black women were less able to decline
risky procedures than free white women.
They were also more likely to be treated by inexperienced doctors.
Free women declined procedures by inexperienced doctors, particularly if they were risky.
But a lot of young men who had just completed medical school would
get their experience in the slave quarter because enslaved women
were less able to turn them away.
And slaveholders were more willing
to let them experience their or practice their profession on slaves
in the quarter rather than family
members up in the plantation house.
So few, excuse me, few physicians encountered by enslaved
women were really that qualified to practice reproductive medicine.
Remember, we're talking about general practitioners here, and they didn't see a lot of cases,
maybe over the course of a year or even years in their practice.
Many doctors didn't even own a obstetrical instruments. When one of his neighbors, slaves,
went into labor and the child presented itself in a way that made
unassisted delivery impossible, Thomas Clark, a doctor, sent word to fellow physician
Charles Brown to come quote, "if convenient,
but if not to send his instruments along." Well, apparently Brown couldn't make
use of the instruments because a communication later in the day had Clark
admitting that he had been unable to use the instruments effectively and
asking Brown to come as soon as he could. Well, given the lack of expertise,
it should come as no surprise to learn that little of the medical experimentation carried out on
enslaved women led to improved health. A notable exception was the work of J. Marion Sims,
whose name you might recognize. By 1849,
Sims working in Alabama had successfully
repaired a vesicle vaginal fistula. A tear suffered by many women
during childbirth in that time. And it was a tear that allowed urine to flow unimpeded from
the bladder into the vagina. The condition was more loathsome than life threatening,
in the words of the doctor, but his accomplishment was hailed for
eliminating a condition that distressed the women have disgusted many people
with whom they came in contact. Sims success in treating vesicle
vaginal fistula occurred only after he performed multiple surgeries on
3 enslaved women, Anarka, Betsey, and Lucy.
He performed surgery on these women
over the course of four years, always without anesthesia.
Over 3 1/2 years. He performed operations on Anarka
30 times alone. Sims is well known, in part because he moved to the North
where he achieved fame for his surgical technique and eventually became president
of the American Medical Association. Sims later downplayed the importance
of the enslaved women in the discovery of his cure for obstetric fistula.
He wrote about his early patients in vague language,
and he shifted the blame for having experimented upon them by insisting that
the slave cases had been thrust upon him. He also attempted to justify his early
experimentation on black women by maintaining they tolerated pain better than did white women.
But other lesser known physicians were doing similar experiments.
One was Nathan Bozeman in Alabama.
Bozeman had begun as an assistant to Sims in Montgomery,
and he is publicly admitted the experimental nature of his work, which he intended
to improve upon the work of Sims. He had performed Sims' operation
twice on enslaved women when the idea of a button suture came to him.
Quoting him now, "I immediately determined to subject
the case" that is the woman "to an experimental trial", he wrote. Bozeman,
who unlike Sims remained in the South throughout his career, not only boasted of perfecting a
cure for the dreadful condition. But also of improving fertility
among his enslaved subjects. Prior to the 19th century,
most Americans attributed barrenness to providence.
It was best to pray that it would be alleviated, but there were plenty of home
remedies out there that held out hope for both black and white women.
Physicians and surgeons who treated sterility among slaves as a medical problem,
tended to focus either on physical abnormalities or irregularity
of the menstrual cycle. The first group relied on
instruments to correct the problem, while the second favored other types of heroic measures,
such as blistering and bleeding and dosing with powerful medications.
Doctors who fell into the first group thought of themselves as correcting
"disordered organs of reproduction." When Virginia physician Alban S. Payne
first encountered Clary in Fauquier County, he pronounced her suffering from an,
quote, "inadequate" vagina. Discovering he could insert his finger
no more than an inch into her vagina. He immediately decided on an
operation to remove the tumor which he thought was blocking penetration.
Clary survived the removal procedure, and in a subsequent visit,
Payne measured her vagina and pronounced it,
quote, "altogether very passable." Such efforts to manage women's
health reflected the willingness of slaveholders to intrude into the most intimate affairs
of enslaved women, including their monthly menstrual cycle.
Although menstruation was little understood,
masters and mistresses embraced the
idea that achieving regularity of the menses was crucial for improving
fertility and for general wellbeing in the slave quarter. Moreover,
enslaved women sometimes lost work. From the field or other sites
because of menstrual problems. So what happened to slaveholders
kept track of menstrual cycles
of enslaved women. Masters, mistresses and plantation managers
came to know whose period was late, scanty,
characterized by excessive bleeding, suppressed or painful.
Virginia planter William Bernard, for one, kept written records of an enslaved
woman's monthly cycle when she became ill. He was not the only one to do this.
Doctors deemed regularity and menstruation critical for successful
conception and also for wellbeing,
just as the general population did. When called in to treat a young mother
suffering from painful menstruation, A G Mabry discovered a complete occlusion of the vagina,
which would have prevented conception as well as menstruation. Determined to correct the problem,
presumably at the request of an owner, the doctor made several incisions,
which healed and had to be kept being repeated.
At last he inserted a bougie, a flexible instrument used for dilating,
and kept that in place with the bandage which he
said made eventually a perfect cure.
When it came to a regular menstruation, once again much of the medical treatment was experimental.
T. L. Oger reported treating a slave girl
of 17 for suppressed menstruation. Oger tried a variety of treatments,
which had the effect of producing diarrhea, but not the menses. At the urging of a friend.
Oger tried an experiment using the water pepper plant. It supposedly produced the desired effect,
and Oger touted the cure and an essay written for a Southern Medical
journal in which he claimed to have tried the treatment on other women,
including two white neighbors. So this serves as a reminder that from time to time,
doctors did try experimental protocols on free white women,
but they often have been tried first on enslaved black women.
The nature of southern doctoring evoked criticism outside the region,
in part because the doctors relied on slave women as experimental subjects
who did not give consent for treatment.
When it came to publicizing their findings, southern physicians found themselves on the defensive,
forced to stipulate that they had gained a the patient's consent
for treatment within a system that did not require its legal or did not
think of it as a legal necessity. Henry Frost, the Doctor of Charleston, SC,
assured readers of the Western Journal of Medicine and Surgery that
a slave mother under his care had approved his performing and embryotomy
during a long and difficult labor. The purpose of an embryotomy was to
dismember a fetus to affect its removal.
When natural delivery proved impossible. Doctor Paul Eve also maintained he
had obtained a slave woman's consent, this time for surgery.
3 doctors had consulted in his case involving a slave by the name
of Mary who had never conceived, although she had been married for years.
Mary's only other symptom besides failure to concede, was great irregularity in menstruation,
which to the doctor suggested she had a tumor. Eve examined her and decided that
she only had a few months to a year to live and proposed a
removing the entire uterus. A procedure that noted Philadelphia
physician Charles Migs said had no hope
of success, even if performed correctly. Eve performed the procedure,
and Mary reportedly lived three months in a week following the operation.
Eve later wrote about the events, emphasizing that everyone involved
knew that Mary had only had a very slim chance of surviving,
and that Mary herself knew that.
And had agreed to the procedure. Mary's uterus, by the way,
ended up in Mig's Philadelphia Museum,
a Medical Curiosity. So Frost and Eve's assurances to the contrary,
physicians who treated slaves, even those who performed surgery, carried on their work,
in the words of J Marion Sims, whether the patient was willing or not.
Everyone knew the owner's consent was necessary, not the slaves. Indeed, when WV
Brown of Georgia received criticism for administering medication
to a pregnant slave woman that brought about an abortion,
he defended himself this way, and I'll read his words. "The owners of the property were apprised
of what would probably be the result, but as we regarded it as
the least of two evils.
The owners consented to its administration."
So out of concern that they might be subject to painful and dangerous procedures,
abortions or degrading treatment, including the display of body parts as
medical curiosities and even aborted fetuses. Some slaves hid pregnancy and
even the onset of labor as long as possible from their owners.
Despite even life threatening complications,
even when an owner arranged an advance for a doctor to attend a slave woman,
the doctor really didn't know when to come unless some slave from
the quarter let someone else know
that the slave had gone into labor. One South Carolina physician
waited for hours beside the bed of a slave woman
supposedly on the verge of giving birth,
only to discover to his astonishment that there was no child.
The woman had given birth in the field hours earlier,
but she chose not to tell him, apparently not wanting him
to become involved, perhaps hoping that he would tire of the
labor coming to an end and leave, as many doctors did.
When a Tennessee woman with a swelling abdomen experienced pain
and other symptoms of miscarriage. She denied that she was in a family way.
Now we really want this woman was seven months pregnant in labor and
denying that she was in a family way. Her owner was very concerned and
called in three physicians to consult in this case because the owner
was concerned for her health and possibly the health of the child.
Although I think by then they probably knew that the infant was dead.
So that doctors attempted to preserve the woman's health by inserting
a catheter and and doing so they puncture the punctured the bladder through the wall of the abdomen.
The patient died that night.
The doctors did not get any responsibility for the unfortunate outcome.
Instead, they speculated that the woman had, and this is their words,
"had taken something to prevent conception."
Or perhaps the woman had a tumor that had prevented the baby from going,
but they had done nothing to bring about the woman's death. Now we don't really know because
records don't exist what the slave woman thought family might have thought.
But based on the reading I have done of
slave sources and physician accounts,
it seems likely they would have blamed
the doctor and probably the slaveholder. So slaveholders and the doctors
they hired viewed in slave women's childbearing capacity as a commodity.
That could be claimed for profit, a means of ensuring the continuation
of Southern society and a way of enhancing the professional and
financial standing of doctors. Owners kept careful account of the birth of babies,
listing them among their assets much as they did colts and calves.
But enslaved women look upon childbearing differently.
Like people today, they wanted children.
For a chance to love and to be loved, children reminded them of
their shared humanity. Motherhood and fatherhood help slaves
maintain an identity that went beyond that of the slave and the masters
field or the mistresses kitchen.
In addition, mothers and fathers worked long hours for owners.
And children carried out a host of jobs
of practical benefit to enslaved families. They cleaned, gardened,
gathered nuts and berries, fished, trapped animals and cared
for younger siblings, for example. So encounters between black mothers and
white doctors in the South during the decades leading up to the Civil War.
Sparked important new ways in which slavery and medicine were changing.
The reach of slavery became more intrusive
into the lives of enslaved women,
and slave owners sought to use medicine to exploit women's capacity for
childbearing for their own purpose. Simultaneously, medicine
became entwined with the cause
of slavery's continuance. Childbearing came to be seen
increasingly as a medical problem, and doctors grew more conversant with
matters of reproductive health as they gained experience in examining
and manipulating women's bodies. Enslaved women struggled against these trends.
Relying on secretiveness and the reluctance of men to invest much
time in the work of birthing babies, and in this way they attempted to
maintain control over their own bodies. I'd like to stop now and maybe take some
questions if we have some time for that. OK?
Yes. I see a question back here.
[Steven Greenberg:] Actually, before, if you push the
little button in front of you, your microphone would become live and we can hear you.
[Audience 1:] Were there any attempts at birth control from enslaved women who felt like
they didn't want to bringchildren into slavery?
[Professor Schwartz:] Is that noise OK? Oh, OK.
I thought maybe I was doing something with moving around with the microphone.
Actually, this is a subject that I have been very interested in and I do
talk about in my book quite a bit, because I think the way we tend to ask
the question sometimes comes about being rather presentminded by that means.
We tend, I think all of us do. I certainly do. It's your first impulse to project
back into time the same ideas and
concerns that you have today.
And I preface my remarks with
that comment because women did try to space their children.
They had an idea of how they
wanted to give birth to children. They didn't want the children to be
born too close together because if the children were born too closely together,
they risk put them at risk because this was an age.
When children didn't thrive unless they were breastfed and enslaved,
women worked hard for the owners and didn't have a lot of time to care for the children.
And so women did things to try to
prolong the time between births. One of the things they did was
they breastfed for a long time, which tends to repress ovulation
and suppress the birth rate. But they also had folk remedies,
including herbs that they would take. They would chew cotton root, for example,
which was said to bring on the menses. And they were doing this,
though not because they didn't want children, because the overwhelming majority
of women wanted children, but what they wanted was a healthy
birth and to maintain the health of the child and to maintain their own health.
Sometimes physicians noted the kinds of things,
and slaveholders noted the kinds of things women were doing,
such as chewing the cottonroot to space out births.
And they said that women were
aborting their their fetuses and
engaging in deliberate abortion. I really think this was a very deep
cultural misunderstanding because as I have read those accounts
that charge enslave women with carrying out abortion deliberately,
it is always from slaveholders or their
physicians and always couched in a way
to explain why the birth rate was low,
why so many babies died in infancy. They never really thought about
the hard work regimens as taking a toll on Women's Health,
taking a toll on the birth of children or infants.
And they did so, but they didn't want to accept
that responsibility on their own. And they put it off onto slave women.
They said it's all slave women's fault, that they know means of aborting their fetuses.
And they're doing this all the time, yes.
[Audience 2:] Oh, it's quite a sad and sort of unnerving commentary.
[Professor Schwartz:] It is.
It was quite upsetting for me sometimes when I would read some of these accounts.
[Audience 2:] But I noticed that you mentioned white men,
white women and black women, but you don't mention black men.
So I guess in that regard, what role did?
The father of the child play in
terms of the owner of the black
people at that time playing them,
determining to bring in the doctor as
well as if it was them mating or mixing.
Having a black male that they considered profitable to mate with,
a black female that may or may not have known each other in order to generate a
progeny that they felt would they get a lot of money for versus or along
with progeny of the slave owner, his son, and one of the slaves that one of the women,
black women that he raped. What role did that play in terms of them bringing in the medical
establishment versus a few that did try to create some semblance of family with a black man
and a black woman having their own child?
[Professor Schwartz:] Well. You've got a number of good issues there.
And basically one of the things I think you're asking me is whether
deliberate breeding took place and whether there was any deliberate
effort to think about how to "breed"
"superior," we might say physically superior slaves. [Audience 2:] But we know there was deliberate breeding.
But also, if so, I guess that's part of it, deliberate breeding as well
as in the accidental child. Childbirth taking place through
a rape of one of the slaves that in that instance where they more apt to bring in a doctor.
[Professor Schwartz:] Well I I do want to say that I did not find examples of deliberate breeding.
You know most slave women and men wanted to have children for some of
the reasons I've cited here. There is simply was no reason to try to breed
slaves because they were being born out of the natural impulses that we feel today,
for why people want children.
There were people thinking about how to
pair men and women so to "improve the stock,"
if I can be so crass as to use that term because that's the way some of them thought about.
But that was really not, I don't think, what was going on.
You asked about rape and sexual exploitation,
and I think that that is a factor that certainly we want to think about
as we think about this subject. But again, the end result is if
a white man raped a black woman, there might be a child resulting,
but most men and women wanted to pair up.
They they wanted to have mates. Preferably for life,
and they didn't need that kind of encouragement from the slaveholder.
There were some odd attempts to try to do that sort of thing, but they were not
they were more the exception rather than the rule.
Again, because people want to families.
Enslaved men did play an important role in the rearing of children.
Men constructed cabins, they constructed furnishings, they got fuel for the family,
they did all kinds of things. They worked very hard and many of their
those kinds of activities were done for the family and not just for themselves.
So men played an important role. I have focused in this book on doctors,
slaveholders and women just because of I'm looking at reproductive medicine.
But elsewhere I've written about the role men have played in the
rearing of children in my first book, called
Born in Bondage: Growing Up Enslaved in the Antebellum South.
And in that book I tried to focus not
just on what mothers were doing to rear children, but also fathers as well.
I'm not sure I've really answered your question quite the way you phrased it,
but I just don't see massive efforts to try to deliberately breed
slaves in the South.
Anything else?
[Audience 3:] I guess from as a researcher
for me it's always you look at the past, maybe understand the future. So what do you think is the
significance of your research in terms of current healthcare? Is it just a visitation of things
that happened in the past or is the knowledge that you gathered,
do you think it's going to somehow change or health healthcare,
is it just knowledge for knowledge's sake?
[Professor Schwartz:] Well, I think one of the lessons
I've learned and looking at the past is to realize that medicine is
not just about the biology or the
the physical world. Medicine is
practiced in a social environment. And I think what you can see from this book
is that southern doctors were practicing in
a social environment in which slavery was
accepted and they did not question that.
They did not go about looking at the
problems in slave women were having in bearing children and raising them
through infancy. With the idea that, Gee, what's going on here? Why is the death rate so high?
They were doing things like saying, black women are engaging in deliberate
abortion and they weren't thinking about the really harsh punishments and
the really harsh work environments that these women were engaged in.
And I so I think that's one thing that because I'm interested in them
with the social history of medicine, that that's one thing that we can see here.
Another thing that we can see is that in
some ways these doctors were practicing
in what maybe today maybe romanticized as kind of an ideal environment
for doctors to practice in and that there were no regulations.
There were no rules about gaining patient
consent or following particular protocols. And there were people in Europe and in the north,
doctors who were saying this gave southern
physicians a decided advantage because
they could do what they wanted with certain "experimental subjects."
And what we see here is not that the south southern doctors are raising the
practice of medicine to new standards. They're not. In many ways, southern physicians were seen
as lagging behind their northern and European counterparts.
And what I contend is that because they were practicing in this environment where all they had to do
was to gain the approval of the slaveholder or in some cases they
actually purchased slaves themselves. That what this did was not made for
better medicine because they can do whatever they will and not have to worry
about government regulators and so on. In fact, what it made for was reckless
medicine that really didn't advance
the practice of medicine very far.
Jay Marion Sims was a notable exception. But I emphasize him and I wanted to talk
about him today because he has an exception. We don't see right innovations coming
out of the south in the period of that I've been talking about. Yes, we have a question back here.
[Audience 4:] Did you come across any female physicians during this time period?
[Professor Schwartz:] You know, they're really,
I did not. I've used the pronoun he threw out
deliberately because I have not
encountered a female physician in the south. That's not to say that women
weren't involved in medicine. They were and certain when it came to home remedies,
there were a lot of women, white women, who read medical manuals and purchased
medicine for use on the plantation. And so they were involved in that way,
but they were not trained physicians.
Yes.
[Audience 5:] I thought that was a wonderful presentation,
although certainly a rather horrifying one. And I was interested to
hear about your sources, your process of research.
Was it, was this a difficult project
of research where the are there simply lots of sources out there
that other people have not used? If you could tell us something about that?
[Professor Schwartz:] There are sources out there that not many people have used.
I'm glad you asked me this particularly here at the seminar,
because I have something I want to say about archival research.
I used a lot of interviews that were done with former slaves in
the 1930s by government agents, and there were also many narratives
that were are memoirs that were written by slaves or former slaves after
they escaped or after slavery ended. So that was one source and I also used plantation records
that were kept by slaveholders because slaves were valuable property. They were making records of
menstrual periods. They were making records of sometimes of what they were doing with menstrual rags.
They were just to give some examples. So you can find those kinds of sources there.
It's like looking for a needle in a haystack because they don't come up often.
You have to go through a lot of material. To find these scattered references.
But the other source that was very important, and the one that I used here mostly,
was southern medical journals. And what I had to do there is I had
to page through every page because indexes that were prepared in
the 19th century or even indexes that archivists have prepared
in the 20th century up until very late in the 20th century.
Black women tended to be invisible. You can't look in the National Union Catalog.
You can't look in indexes of any of these journals and find that they were
thought of as enough of an entity to warrant a separate categorization.
So the indexing tended to be about procedures.
You know, you can look up collapsed uterus, but then you have to look at every single case to see
whether it involved in a black woman or a white woman, and often they didn't use
that kind of language. You had to be sensitive to the idea
that when you're reading these cases that the physicians wrote up,
they would refer to white women
by misses or miss and a, the initial of their last name.
With slave women though, they would refer to them as Dary or Milly,
and so you had to be aware of these kinds of distinctions or you wouldn't be able to find the
cases involving enslaved women. Now if you read through the case, often times you would see other
clues that they were enslaved, like the owner gave his consent for this procedure.
That's a pretty clear evidence that you're reading a case involving an enslaved woman.
But the way our archives were done,
the way indexing was done in the past,
really is a terrible puts a terrible
burden on people who want to do research
related to African Americans and in
my case and other people who have been invisible in the written record,
it's something that I think is changing. I think a lot of archives are going about
trying to reduce some of their finding aid. So that you can more easily know
the particular collections relate have something to say about the history of of African Americans,
but it's slow and it takes money and it takes a lot of time. And so it's very slow coming.
But I hope that as books like mine come out that people will realize that, Gee,
there are a lot of things in southern medical journals about black women.
There's also a lot of things in there about black children and about
black men and how they were treated.
In terms of their healthcare, yes.
[Audience 6:] Oh, I want to go back to that gentleman's question.
You you correct me if I'm wrong,
but you made it seem that the slaves people want to have families, but how could they want to have
families if the the men and women were being separated and they take the children away and I don't,
I don't hear or see that many families.
[Professor Schwartz:] Well, I know it is.
It is sad to think about a family separation,
but
I really, I feel the evidence is compelling.
I mean, the majority of slaves had children
and the majority of slaves wanted children.
And in terms of sales, we want to remember that.
I remember the overhead I had up here where I had slave importing and exporting states
that not everybody was subject to sell,
or there would be particular places that would be subject where slaves would be
subject more to sale than other places. And often slaveholders did keep very
young children with their parents, particularly the mother, because again,
children didn't survive. Without the attention of the mother, particularly when it when they were
infants and relied on breastfeeding. So if you were to separate those
mothers from their children,
there would have been no births and
slavery could not have continued. So there was a real financial
incentive for owners to keep families
together to the extent that they felt their finances allowed it.
Now this is not to say that after slaves got to be a certain age,
maybe 12/13/14, and certainly by the time they were
15 through 25 that they might be sold off from their families of origin. But you know,
it's a real human desire to love someone and be with someone, I think,
and we can see people behaving in this way and these circumstances. I don't.
I mean, I can't think of any particular social environment where people
stopped having children because their children were dying in large numbers.
If you go back to the Chesapeake region in the colonial era,
the death rate for children was huge,
huge, and yet white men and women had
children under those circumstances. They married, and when their spouses died, they remarried.
And that's what I see these people doing. So I don't see African Americans
under slavery acting differently from the way other Americans have
acted in situations where death rates
were high for spouses and children.
[Audience 7:] It's a little different than death rates.
I think you would have to compare to like a concentration camp where
you're in an environment where you know that the family are the child
that you're going to have is not going to have the best life that it possibly could. So I think,
I think with both of these people are talking about,
it's more of the example of Toni Morrison's "Beloved," that that wasn't
just an isolated case of a parent. Going as far as that this taking
their child's life to not have that environment and also I guess rape was also very prevalent
in the separation of families. I think that your your graphics
showed that in order to to, I don't know if you called it import expert,
but in order to import slaves from other areas of the state you
have to be separating them from some part of some other family so that that all goes to that.
I just think it that.
It really has to be careful not to to
paint a picture of this family structure, of ideally family structure
that in that environment people were making really hard decisions and it must have been
hard even in terms of abortion. It must have been hard for some of these African American women to be
pregnant with the slave owners baby. So I think that those are all issues like you said
I mean your I'm sure your book goes into more details but those are all
issues that that were true and did exist during those time periods.
[Professor Schwartz:] Well I I want to say first of all I thank you for your comment because I
didn't realize I was coming off as saying that families were these
were ideal families and not at all. What I what I was trying to say is the
ideal that they wanted was to have the family and they moved in that direction.
I love Toni Morrison's, Beloved. It's my favorite book. I do think that is an exception.
Most enslaved women did not commit infanticide.
Most enslaved women did not abort their children.
But one thing it would have been.
Difficult, as you say, to manage pregnancy anyway,
and I'm not, I don't want to suggest at all that
this was an easy thing for women. I think what my book shows and examples
that I used here today is that it to show it was difficult because, my gosh,
the procedures that they were subjected to when things went wrong, I mean that would in it alone
would have been horrifying. And to have your child separated from
you through sale or for any other reason would have been horrific.
I'm sure that there are people here in this room who have experienced
that not in this way but in some way. And it's very difficult thing.
So I don't want to discount that at all. But what I'm saying is the idea
what they wanted was the family. They wanted family integrity. They work toward that.
They know they didn't always achieve it. But one of the things that I have found,
and I have I have looked very specifically at children of
mixed race born to
enslaved women. And one thing that really
stands out for me is how the slaveholders
rejected those children and how the
enslaved community accepted them. You know, slaveholders like to talk
about their families, black and white. That's how they refer to their slaves.
But they were always careful to distinguish between the black family
members and the white family members. You don't see that so much in the slave quarter.
I really have uncovered only a
couple of instances in which enslaved children were thought our
children of mixed race were thought to be so close to the white family that
they were rejected in the slave quarter. And in both of those instances I
think it was because the two children
involved were regularly tattling back to the slave holding family about
what was going on in the quarter. And one little guy, in particularly particular,
I remember his name is Henry, would be
kept up at the owner's house during the day and was kind of treated as a pet. He was very young.
He was only three or four as I recall, but he would be sent down to the quarter
to find his own shelter at night because the white family didn't want him actually
living in the white family's home. And he would go down and try to find somebody to take him in and
people would not take him in and they would tell him if if Henry, because we know you're going
to tell when you go back. But that was unusual. The majority of children,
no matter what the circumstances of their birth were accepted in the slave
quarter and nurtured in some way. Even Henry eventually found somebody
who would help him out in the quarter. And I think this is a fundamental
difference that you see within the slaveholding and the enslaved communities
of how they're defining family. And I think their willingness to
extend the family to include people
of mixed race born of rape and
exploitation isn't indication again
of how important family was to them. I think family was an important way
that slaves learned how to endure conditions of enslavement.
They weren't learning how to endure by directives sent down from the slaveholder.
They were learning at the knee of their mother, or at their father,
or maybe an aunt, maybe an unrelated person. Some of you may have heard the term
"fictive kin," as applied to enslaved people. Fictive kin was a term that historians have
applied to certain kinds of relationships in which maybe nobody
had an actual biological kin, but was taken in and accepted
as a member of the family. And it was fictive kin, not a biological kin.
But family I think, was extremely important to
the survival of slaves. You know when.
Only 5% of slaves that were ever imported
into the Americas came to the area
that we think of as the United States.
The rest of them went to South America or the Caribbean and other places.
And yet the United States became the
largest slaveholding nation ever. And it's not something that
we in the United States take pride in, in the sense that we were
the largest slaveholding nation ever,
but received substantially fewer imports of slaves than other places.
How did that happen? It was because women gave birth to children who survived.
That's how it happened. And so we know just from the statistics,
by the time the civil war comes around, they're over 4,000,000 men,
women and children alive in the United States. And that it happened because the
women gave birth to children. That's one of the reasons why I decided to explore the subject.
Because the United States was unique in this way that there
were children being born. And even though it may be hard for
us to comprehend about why children,
maybe your people wanted to bring children. Into this environment,
the fact is the statistics are there and
we know what happened and we can only,
you know, try to understand it as maybe a
strength of the African American community.
In the decade before the Civil War.
Really in the Chesapeake region,
there were women were having more children. In bondage then, slaves were dying.
In bondage by about 1720 and 1740,
and in the lower South in the Carolinas, that happened a little bit later than that,
but but the phenomenon was there, and it was the only place in
the Americas where it happened,
because everywhere else they had to import
slaves in order to sustain the population.
Because of death rate was so high elsewhere.
So we have to always kind of remember that and put it in that kind of
framework to understand that the United States experience was somewhat unique.
Yes, you have another question.
[Audience 8:] I'm trying, I'm not trying to start trouble or anything,
but I've been listening to what you said, but I read a book by Todd Savitt,
East Carolina, about medicines in the South. And they had a special section on on the slaves.
And what I got out of that is it seems like it's completely different from what you
said because it said that back in the South, even the slave trade, they didn't get the medicine and
stuff that because it was the South and they were poor and more people
in the north were receiving it. I guess what I got from you, I'm please forgive me if I'm being rude,
but you made it sound like it was Ozzy and Harriet and from what I've learned it wasn't. I don't.
[Professor Schwartz:] Yeah, I'm not. I'm not quite sure how you got that from my remarks,
since I gave some rather horrific examples. But I know Todd L. Savitt's book
quite well and I don't think he is saying that they don't, that slaves didn't get medicine.
He wrote about slavery in Virginia and wrote about the practice of medicine,
not specifically with regard to women, though he did not really look at reproductive health.
And what I want you to remember a little bit as you think about what
the remarks I've made here today, is that the growth of the slave population
was important to the slaveholding community. They knew that slavery could not continue,
the southern way of life could not continue if women didn't have children.
And so they set out in part to
increase the number of children. Born through medicine because it was
beginning to be important within the field of medicine for doctors
to look at reproductive health. That's just one thing that they're doing.
Whether they had any real impact, I don't think so,
because the things the doctors were doing, you could hear, hear weren't really effective.
But so why are you going to explain that large growth in the slave population?
We explain it by saying. That family was important and that
women wanted children and they did
their best under very horrible
circumstances to nurture them.
[Audience 9:] Hi. Just a quick question. I don't mean to change the subject,
but you mentioned before that white slave owners.
blamed based on a misunderstanding
that African American women were
killing or aborting their children purposely. Based on that idea,
I was wondering because of the
prejudice and the ideas that white slave owners and doctors
had and in their documentation that they had in the research. I'm pretty sure that some of their
writings could have been biased based on their prejudice ideas. How did you, how were you able to
shift through your research and actually
come to hardcore conclusions with understanding,
the biases in the documentation, do you understand what I'm trying to do?
[Professor Schwartz:] Well, one thing that we have to remember, yes, that's a very good question.
All documents are biased. We all have a point of view.
Whoever's creating a document is going to be biased. That doesn't mean
that you can't use that material. I think today, sometimes we live in
a world where we say, Gee, you know, it's best if we have unbiased
documents. But if you're working in 19th century society,
there's no unbiased documents. I mean, this was an era in
which people were very racist. But the fact that slaveholders created
documents that were racist doesn't mean that you can't use those documents,
because what they do is show you how slaveholders thought you have
an obligation as an historian. In my case to come to those materials
and try to see them as the people
who created them see them and as who others in that society have seen them.
So what I've tried to do is to go back and not just read through slaveholder documents and say this
is what slaveholder said and not to read about just physician documents
and saying this is what physicians said, but also read accounts by
former slaves and slaves and say
and you can begin to see
through tapping into a variety of types
of documents created by different people,
how the viewpoints differed one to another.
In some cases I read accounts by Northerners or accounts by Europeans,
and they too had a particular take on what was happening with
regard to medicine in the South. And so to me, that's how you deal with
it is if you don't try to say, oh, I've got to get to the unvarnished truth,
maybe we'll never get to that. But what you can get to is this is what
slaveholders thought they were doing. This is what physicians thought they were doing.
This is what slaves thought slaveholders and physicians were doing, as well as what they thought
they were doing themselves. And I think that's really the only way you can go about,
this kind of research or really any other kind of research because
documents will always have somebody's point of view embedded in them.
[Steven Greenberg:] I think we have to stop now,
but I expect professor Schwartz would like hanging a few minutes later or
to speak to her after the session, in the meantime, like to thank you again for coming
and thank you all for being here and for asking your questions. Thank you.
[applause]
[Professor Schwartz:] Thank you!
And thank you for your wonderful questions. I appreciated them quite a lot.