Authors: Chelsea Oppong, MS; Rhea Manohar, MPH; Meghan Etsey; Teresa Lazar MD on behalf of the Gender Equity Task Force

Modern gynecology saves lives every day. It manages hemorrhage, treats cancer, supports fertility, and helps people survive pregnancy and childbirth. That truth can coexist with another: the field’s foundations are entangled with violence, cruelty against the very population that it aims to serve and care for. Before gynecology had textbooks, instruments, or operating rooms, it had Anarcha, Lucy, and Betsey (Bervell, 2024). We name them first, deliberately, because too often this history begins with a physician and ends with unnamed women. In the spirit of black history month and women’s history month, we aim to not sensationalize suffering or to indict modern clinicians for the actions of the past, but to honor the women whose bodies were used to build medical knowledge, to educate ourselves honestly, and to reckon with how that legacy still shapes trust, pain management, and maternal outcomes today. History is not inert. It shows up in exam rooms, delivery wards, and in who is believed when they say they are hurting. And it is our role as medical professionals to shape the history of tomorrow.

To understand what happened to Anarcha, Lucy, and Betsey, we have to understand the world that made it possible, without excusing the realities. In the 19th-century United States, enslaved people were legally defined as property, denied bodily autonomy, and excluded from the moral category of “patient.” Medical ethics, such as they existed, were informal, physician-defined, and explicitly limited to those considered fully human under the law. Unfortunately, this definition did not include enslaved Black women (Bervell, 2024). At the same time, this era saw the rise of experimental surgery, driven by professional ambition, scientific curiosity, and a lack of oversight. Enslavement created a captive population with no ability to consent or refuse, allowing medical experimentation to proceed under the guise of progress, while systematically stripping those experimented upon of voice, choice, and protection.

What we know about Anarcha, Lucy, and Betsey comes from records that were never meant to preserve their humanity, but naming them matters precisely because of that. They were enslaved women whose lives extended far beyond the fragments captured in medical notes, women who endured repeated violations without the ability to say no, and who survived in conditions designed to deny them agency (Bervell, 2024). By naming them, we resist the historical habit of rendering them invisible while immortalizing the men who used their bodies. We also acknowledge the many women whose names were never written down at all. This is not a story about pain as spectacle; it is a story about endurance, about knowledge extracted without consent, and about how medicine advanced while certain lives were deemed expendable. Remembering Anarcha, Lucy, and Betsey is an act of restoration. While we cannot undo the tragedies that these women endured, we can provide the dignity long denied.

The surgeries performed on Anarcha, Lucy, and Betsey were attempts to repair vesicovaginal fistulas, which are devastating injuries that cause chronic incontinence and social isolation, and which genuinely demanded better treatment in an era with few effective options. That clinical need, however, does not neutralize or rationalize the ethical violations that defined these experiments. The procedures were performed repeatedly, without anesthesia, at a time when anesthesia was emerging, but not extended to these women. They did not consent. They could not refuse. Their suffering was rationalized through racist myths that framed Black women as less sensitive to pain and more biologically suited to endure physical hardship (Kuta, 2022). This becomes even more stark when contrasted with the later use of anesthesia on white patients undergoing similar procedures. What was withheld here was not only pain relief, but personhood. Specifically, the recognition that these women were patients deserving of care, autonomy, and mercy, not to be used for surgical progress.

From these experiments, gynecology advanced, techniques were refined, and reputations were built, but credit flowed in only one direction. The physician who conducted these surgeries was celebrated as a pioneer, while the women whose bodies made that work possible were rendered footnotes. In many cases, they were not mentioned at all. Statues were erected, honors bestowed, and textbooks written that framed innovation as an individual triumph, divorced from the conditions that enabled it (Kuta, 2022). Only in recent years has there been a broader reckoning: the removal of monuments, the revision of curricula, and the insistence that medical progress be told in full, not in fragments that protect professional mythologies. This reassessment is not about erasing history, but about completing it with added context and recognition. A field that values evidence must also value truth. This includes acknowledging who bore the cost of advancement and who was systematically denied recognition, dignity, and remembrance.

The history of Anarcha, Lucy, and Betsey is not sealed in the past; it shapes lived consequences in medicine today. Persistent racial disparities in pain management, maternal morbidity and mortality, and reproductive autonomy reflect long standing beliefs about whose suffering is taken seriously. As Bervell (2024) and Cronin (2020) note, myths once used to justify experimentation without consent, particularly the idea that Black women experience or tolerate pain differently, have not fully disappeared, but instead resurface as undertreatment, dismissal, and delayed care. These patterns help explain why Black women continue to face disproportionately poor maternal outcomes, even when access and education are similar (Kuta, 2022). Medical mistrust, often framed as a patient failure, is better understood as a rational response to this history and its modern echoes. To say “this was a long time ago” ignores how institutions carry memory forward through practice, outcomes, and belief. That memory still shapes care in exam rooms and delivery wards today.

The history of gynecology makes clear that modern medical ethics did not emerge in spite of past harm, but because of it. As scholars and clinicians have noted, principles such as informed consent, patient autonomy, and ethical oversight were developed in direct response to histories of exploitation that revealed the consequences of unchecked power in medicine (Cronin, 2020). Honoring Anarcha, Lucy, and Betsey therefore requires more than remembrance; it requires responsibility. Ethical practice today depends on actively listening to patients, believing them when they report pain, and recognizing consent as an ongoing, relational process rather than a one-time formality. Bervell (2024) argues that confronting gynecology’s origins is essential to rebuilding trust and practicing with integrity, particularly in fields where historical harm continues to shape patient experiences. Acknowledgment becomes meaningful when it leads to accountability, changed behavior, and improved care. Without this, remembrance risks becoming performative symbolic gestures that name past injustice without altering how medicine is practiced in the present.

Honoring Anarcha, Lucy, and Betsey is not simply an act of remembrance but rather an act of justice. Naming them restores dignity where it was denied and challenges a medical tradition that has too often celebrated progress while obscuring its human cost (Cronin, 2020). Remembering them fully means refusing to define their worth by what was taken from them or what medicine gained. What honoring them looks like today is practical and intentional. Institutions should teach their names and include this history as a core part of medical education, not an optional sidebar. Clinicians should translate acknowledgment into practice by listening closely, respecting autonomy, and providing trauma informed equitable care. Learners carry this forward by asking not only how medicine advances, but who bears its burdens. As ACOG has emphasized, confronting inequity in reproductive care requires engaging both historical injustice and present day bias (ACOG, 2021). Ultimately, honoring Anarcha, Lucy, and Betsey means affirming a simple truth: their lives mattered. Not because of the knowledge extracted from their suffering, but because they were humans who were deserving of dignity, care, and respect.

Anarcha, Lucy, and Betsey were not symbols, case studies, or stepping stones to progress. They were women who lived, endured, and were denied the protections that medicine now claims as foundational. Remembering them is not about assigning blame to the present, nor about rehearsing shame for the past. It is about choosing honesty over comfort and responsibility over silence. When we tell the full story of gynecology’s origins, we affirm that progress achieved through coercion is incomplete unless its costs are acknowledged and its lessons carried forward.

We cannot change how gynecology began, but we can choose how faithfully we remember those who bore its burdens. Honoring Anarcha, Lucy, Betsey, and the countless unnamed women means practicing medicine with humility, attentiveness, and care for those whose voices have historically been discounted. It means listening when patients say they are in pain, respecting autonomy without exception, and recognizing trust as something medicine must earn, not expect. The legacy we inherit is not only one of innovation, but of obligation. How we practice now determines whether history remains a wound, or becomes a guide toward a more just and humane future.

References: 

  1. Bervell, J. (2024, April 19). On the need to reclaim gynecology’s troubled legacy. Commonwealth Fund. https://www.commonwealthfund.org/publications/podcast/2024/apr/reclaiming-gynecologys-troubling-legacy
  2. Kuta, S. (2022, May 11). Subjected to painful experiments and forgotten, enslaved “mothers of gynecology” are honored with new monument. Smithsonian Magazine. https://www.smithsonianmag.com/smart-news/mothers-of-gynecology-monument-honors-enslaved-women-180980064/ 
  3. Cronin M. (Anarcha, Betsey, Lucy, and the women whose names were not recorded: The legacy of J Marion Sims. Anaesthesia and Intensive Care. 2020;48(3_suppl):6-13. https://doi.org/10.1177/0310057X20966606 
  4. ACOG Committee Opinion No. 729: Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care. Obstetrics & Gynecology 131(1):p e43-e48, January 2018. | DOI: 10.1097/AOG.0000000000002459  

About the Authors

Chelsea Oppong, MS, MS3

Chelsea Oppong is a third year medical student at St. George’s University School of Medicine. She earned her Master’s degree in Medical Physiology from Case Western Reserve University and her Bachelor of Science in Biology from Georgia State University. She served as Vice President of the Program for Adolescent Mothers (PAM) under the Women in Medicine chapter at St. George’s, where she developed and led initiatives to promote the health and well-being of adolescent mothers in Grenada. She also serves on the Gender Equity Task Force and the Sex and Gender Health Collaborative Committees within the American Medical Women’s Association. Beyond medicine, Chelsea is passionate about mentoring aspiring minority students and enjoys spending her free time with family and friends, exploring new experiences, or relaxing with a favorite reality show or classic sitcom.

Rhea Manohar, MPH, MS3

Rhea Manohar is a third year medical student from St. George’s University. She has a Masters in Public Health with a concentration in Maternal and Child Health from George Washington University Milken Institute of Public Health and a Bachelors of Science in Microbiology & Immunology, and Public Health from the University of Miami. She served as Co-VP of OB/GYN Education for St. George’s University’s Women in Medicine chapter in St. George, Grenada where she developed hands-on workshops to further reproductive health issues and navigating challenging physician-patient communication scenarios. Prior to medical school, she was a Research Associate for Fors Marsh Group, where she led qualitative and quantitative public health research and campaign development for federal agencies (e.g., CDC, NIH, DHHS, CPSC). She is also a member of the Gender Equity Task Force of the American Medical Women’s Association. When she is not pursuing medicine, you can find her reading, exploring artistic passions, and spending time connecting with friends and family.

Meghan Etsey, MS4

Meghan Etsey is a fourth year medical student from St. George’s University. She has a Bachelors of Arts in Biology and a Bachelors of Arts in Nutrition and Dietetics from Bluffton University in Bluffton, Ohio. She served as the President of the St. George’s University’s Women in Medicine chapter in St. George, Grenada where she expanded relationships with the community and worked towards educating women and helping the youth. She is also a member of the Gender Equity Task Force and Sex and Gender Health Collaborative Committees within the American Medical Women’s Association. When she is not pursuing medicine, you can find her with her friends and family on different road trips and adventures exploring the world. 

Teresa Lazar, MD, MSEd

Teresa Lazar, MD MSEd is the clerkship director of the Advanced Clinical Experience in Obstetrics and Gynecology and Assistant Professor at the Donald and Barbara Zucker School of Medicine at Hofstra Northwell (ZSOM). She obtained her medical degree and completed her residency in obstetrics and gynecology from the State University of New York Health Science Center in Brooklyn and graduated with a Master of Science in Education degree in health professions from Hofstra University. Dr. Lazar was recognized with the APGO Excellence in Teaching Award and is a member of the Academy of Medical Educators and Alpha Omega Alpha Honor Medical Society at the ZSOM. Currently, a member of the American Medical Women’s Association Gender Equity Task Force and the Education Committee. Dr. Lazar is board certified by the American Board of Obstetrics and Gynecology, areas of clinical interest include general obstetrical care, gynecologic care and pelvic ultrasounds. Additionally, she is passionate about medical education, faculty development, communication, and leadership. She is fluent in both English and Spanish.  

Formatting, publication management, and editorial support for the AMWA GETF Blog by Vaishnavi J. Patel, DO