Black Women and Contraception – Health & Medicine in American History

Hi! My name is Jherron Sutton and I am a rising third year at Grinnell College. I am a Sociology major and plan to teach after graduation before beginning a career in educational law and policy. I enjoy spending time with my family and trying new foods. This upcoming fall I will be studying abroad in Pune, India and I look forward to living with my host family and learning Hindi.

In June of 1914 Margret Sanger, the founder of Planned Parenthood, coined the term “birth control” in an issue of The Woman Rebel, where she describes birth control as actions made that that keep a woman from becoming pregnant. [1] In 1964, almost four decades after that issue was published, the FDA approved the distribution of the Intra-Uterine Device (IUD), [2] and four short years later women in the United States were able to select from seven different birth control pills. Today there are at least ten different kinds of birth control that women all over the country use despite the fact that the idea of using contraception was such a heavily debated and controversial issue in the 1960 and 1970’s in the midst of a variety of social reforms. Of course, because of the history of racism in the United States, there are racial disparities specifically between black women’s use of contraception versus their white, Hispanic and Asian peers. Only eighty-three percent of black women who are at the risk of uninvited pregnancy currently use a contraceptive method compared with ninety-one percent of white and Hispanic women and ninety percent of Asian women. [3] There are many reasons behind today’s disparity, one of which includes the negative relationship black women have had with the medical system for centuries. Despite this relationship, black women have always been active in making decisions about their bodies even though both slaveholders in the 17^th century and members of their own community during the mid 20^th century made several attempts to control their bodies and influence their perception of contraception.

Since coming to the United States during the early sixteenth century, black women’s bodies have been controlled. Many enslaved women were forced to reproduce to provide a laboring population in order to sustain the institution of slavery. [4] Many of these women were raped by their slave owners and became pregnant, producing many babies to continue the legacy of enslaved peoples. During this time there were many stereotypes of black women that developed including the label of “Jezebel.” The jezebel was a negative portrayal of black women as these hypersexual beings who constantly engaged in sexual activity. [5] Furthermore, this portrayal alluded to the idea that the black woman was so sexual that her entire being would practically seduce men into sexually engaging with her. The Jezebel stereotype was used to both explain the high reproductive rate of enslaved women and to justify the sexual abuse of enslaved black women by arguing that they could not be raped because of their presumed inherently sexual nature. The effects of this stereotype can be seen today as black women are often the targets of population control and sterilization abuse, meaning that these women were either sterilized without knowing, were coerced or deceived consenting, or were given false information like being told that the procedure was not permanent or reversible. [6] In the early 1970’s the Relf sisters were the “unwilling and unknowing recipients of tubal sterilization as well as guinea pigs for the intrauterine devices and what were then experimental Depo-Provera shots.” [7] This case was not isolated, as many black women have been disproportionally affected by this crime. In 1980, Valerie Cliett sued the Hospital of University of Pennsylvania for performing a “postpartum sterilization on her without her knowledge or informed consent.” [8] Cliett insisted that she had not ordered the procedure and “wanted them to put me [Cliett] back like they found me.” [9] Cliett had just given birth to her third child before she was sterilized, and like many other black women was taken advantage of due to the racism within the medical system.

In the 1960’s the idea of contraception was a very controversial topic, especially among black men, who like black women also have a historically negative relationship with the medical system. On one end of the spectrum you have extreme vocal resistance from some black men in the community who perceived the promotion of contraception from the government as state sanctioned genocide. [10] Influential black leaders like Marvin Davies, the president of the NAACP chapter in Florida, completely rejected the idea of black women using contraception and argued that black women should have as many babies as possible so that the black population would grow to a size that would be able to effect the power structure in place at the time. [11] On the other end of this spectrum you have other influential leaders such as Dr. Martin Luther King Jr. who thought that the connection between the reproductive rights movement and the civil rights movement was an important step for black people gaining access to medical resources and for black families to improve their livelihood in the United States. [12] Lastly, in the black community there were both women and men who did not buy the idea of the government trying commit genocide against the black population but were still skeptical of medical services provided by the government because of centuries of abuse by white people and the medical field they controlled.

Despite the direct and indirect attempts of trying to control the black woman’s body, black women have been active in trying to control their bodies even while enslaved. There is compelling evidence that enslaved women chewed cotton roots as a form of contraception. [13] Ex-slave Mary Gaffney of Texas says “I cheated Master, I never did have any slaves to grow and Master he wondered what was the matter… I kept cotton roots and chewed them all the time but I was careful not to let master know or catch me.” [14] In addition to this anecdotal evidence, there is scientific evidence to support this theory as well. There is a substance in cotton roots known as Gossypol that scientist have described as a “poisonous pigment.” [15] Gossypol has also been tested and used as a male contraceptive since 1980 and in a 1988 Brazilian experiment, the study concluded that Gossypol was a potent male oral contraception and was marketed their soon. Gossypol has been said to inhibit the development of sperm as well as interfere with the menstrual cycle. [16] Centuries later, in the 1960’s when black men were adamant about black women not using birth control, black women saw something different for themselves. Although black women realized the racism within the medical field, many of them viewed contraception as the responsible thing to do, and that taking advantages of free services would be beneficial to them in the long run. In addition, and most importantly, black women recognized that they should have the right to decide whether or not they wanted to use contraception. Dara Abubakari, the vice president of the separatist group New Republic of Africa said, “Women should be free to decide if and when they want children- Men shouldn’t tell us. Nobody should tell us.” [17] This activist mentality created a pathway for many black women to become a part of the reproductive rights movement and allowed them to add an intersectional perspective to the ongoing movement. Black women encouraged the movement to move beyond the singular focus of abortion and worked to link reproductive health rights to other societal issues like poverty and welfare reform, immigration policies and environmental justice, [18] issues that affected them and other women of color.

Many times society frames black women as constant victims of societal control and wrong doings, but it is important to acknowledge that black women have been agents of change for themselves for centuries. Despite their negative history with the medical system, and their own community, black women have resisted attempts of control both discretely and vocally. Their resistance illustrates how active they have been in making decisions regarding their bodies. With this being said, it is important to change the narrative about black women that shifts from victimization to empowerment; this would accurately reflect their resilience. Lastly, reviewing the history between the black community and the medical system highlights the extreme level of distrust black people have of medical resources provided they government. “I though it would be real easy to tell people ‘you got free healthcare,’ but many of them were suspicious,” said Dr. Dorsey, a health care reformer in Mississippi, who linked the root of this distrust as the “aftershocks of the Tuskegee experiment.” [19] The fact that the medical system has not addressed, or even acknowledged these feelings is extremely problematic because it is clear that the centuries of wrongdoings have had terrible effects that can be seen today. In a 2011 study, experimenters concluded that “mistrust of the medical system accounts for the delays in using health care, especially among older African American men” and that “compared to non-Hispanic white men…African-American men go less often for preventive health visits, and…face greater illness and premature death from conditions that usually respond well to treatments if caught in early stages.”[20] It is absurd that an entire population is so skeptical of the medical system that they would risk their lives and avoid seeking medical attention when necessary because they fear being abused by medical authority that much. It is imperative that the health care system address this mistrust to improve the overall health of the black community.

End Notes:

[1] Miriam Berg. “Timeline: 100 Years of Birth Control” Planned Parenthood. July 16, 2016. https://www.plannedparenthoodaction.org/blog/timeline-100-years-birth-control

[2] Ibid.

[3] “Contraceptive Use in the United States.” Guttmacher Institute. October 2015. https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states

[4] Thomas Volscho. “Sterilization Racism and Pan-Ethnic Disparities of the Past Decade: The Continued Encroachment of Reproductive Rights” Wicazo Sa Review, 25 No. 1 (Spring 2010): 17-31. 18.

[5] Ibid., 20.

[6] Katherine Krase, “History of Forced Sterilization and Current U.S. Abuses,” Our Bodies Our Selves. October 1, 2014. Last modified April 29, 2016.

[7] Thomas Volscho. “Sterilization Racism and Pan-Ethnic Disparities of the Past Decade: The Continued Encroachment of Reproductive Rights” Wicazo Sa Review, 25 No. 1 (Spring 2010): 17-31.

[8] Rebecca Kluchin. “Locating the Voices of the Sterilized” The Public Historian, 29 No. 3 (Summer 2007): 131

[9] Ibid., 132

[10]Simmone Caron. “Birth Control and the Black Community in the 1960’s: Genocide or Power Politics” Journal of Social History, 31 No. 2 (Spring 1998): 545-569.

[11] Ibid., 550

[12] Ibid., 550

[13] Liese Perin. “Resisting Reproduction: Reconsidering Slave Contraception in the Old South” Journal of American Studies, 35 No. 2 (August 2001): 255-274.

[14] Mary Gaffney, interviewed in Rawick, ed., Texas Narr., Supplement, series 2, Vol. 5 (part 4), 1453.

[15] Liese Perin. “Resisting Reproduction: Reconsidering Slave Contraception in the Old South” Journal of American Studies, 35 No. 2 (August 2001): 262.

[16] Ibid., 270

[17] Simmone Caron. “Birth Control and the Black Community in the 1960’s: Genocide or Power Politics” Journal of Social History, 31 No. 2 (Spring 1998): 549.

[18] Kimala Price. “What is Reproductive Justice?: How Women of Color Activist are Redefining the Pro-Choice Paradigm” Meridians, 22 No. 3 (July 2008):22-26

[19] Jennifer Nelson, “Hold your head up and stick out your chin’: Community Health and Women’s Health in Mound Bayou, Mississippi” NWSA Journal 17.1 (2005): 104.

[20] University of North Carolina At Chapel Hill. “Mistrust Keeps Black Men From Doctor” Futurity. January 12, 2011. http://www.futurity.org/mistrust-keeps-black-men-from-doctor/