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BLACK REPRODUCTIVE HEALTH TIMELINE

Updated: May 24, 2024


1619: The First Enslaved Africans are Brought to the English Colony of Virginia

August of 1619 marks the beginning of the slave trade, an industry colonist and their descendants profited from for centuries. Slave traders used myths about physical racial differences to justify the enslavement of abuse of Black bodies.

Enslaved Black people are subjected to all forms of violence, including sexual and physical violence.


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1800s: Reproductive Violence against Enslaved Women

“Colonial laws did not protect enslaved people from sexual violence. Enslavers were free to sexually exploit, abuse and control their enslaved property.” Black people were treated as property.


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1826: Cesareans without Consent

Dr. James Barry, born Margaret Ann Bulkley, performed one of the first cesarean sections in which both the mother and baby survived. Similar to other surgical experiments of the time, Dr. Barry performed these experiments on people without their consent.


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https://hekint.org/2020/04/03/a-surgeon-and-a-gentleman-the-life-of-

james-barry/


1840s: Dr. James Marion Sims – The “Father of Gynecology” 

Dr. James Marion Sims is remembered as the “Father of Gynecology” due to his contributions to the field, including inventing the modern speculum that we know today. These contributions came at the expense of experimental surgeries and procedures on countless enslaved women, including Anarcha, Betsey, and Lucy.


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1865: 13th Amendment

The abolition of slavery with the ratification of the 13th Amendment marked the end of enslavement. However, the Jim Crow era brought continued racial segregation, lack of access to healthcare, and systematic disenfranchisement of African Americans. In this era, “Granny Midwives”, the Black women who provided lay midwifery for their communities, were invaluable. Grannies, like Mary Stepp Burnette Hayden, and trained midwives, like Midwife Mary Francis Hill Coley, ensured the survival of entire Black communities through the care they provided.


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Late 1800s - Early 1900s: Black Codes

Laws passed by states following the Civil War continue to restrict Black lives. Racial segregation in healthcare institutions and the medical field limits access to reproductive healthcare for Black women.


Following the abolition of slavery, many Black women, particularly in rural Southern communities, continued to provide birth support in communities. They were known as “Granny Midwives”.  These “Grannies" were essential in their communities, especially for women with no or limited access to medical care. They were healers, advocates, and caregivers, often being the only source of care. They provided care before, during, and after birth, ensuring women received care during their pregnancies.

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Early 1900s: Erasure of Black Midwives

Medicalization of childbirth, midwifery and systemic barriers started, and in a few decades, they resulted in the erasure of Granny Midwives. By the 1960s, most babies were born in a hospital under physician care. 


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https://www.hannahillphotography.com/blog-education/the-history-of-black-midwives


1900s - 1970s: Forced Sterilization

Marginalized Black, Indigenous, and Other People of Color (BIPOC) communities were deemed “unfit to propagate” and many people were forcefully sterilized. Black women were especially targeted under the guise that Black welfare recipients were “feeble-minded”. In 1975, the Supreme Court ruled in Relf v. Weinberger that informed consent was required before sterilization after two Black teenagers were unknowingly sterilized.


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  •  NIWRC: Past and Current United States Policies of Forced Sterilization:

https://www.niwrc.org/restoration-magazine/november-2020/past-and- current-united-states-policies-forced-sterilization

  • Autonomy Revoked: The Forced Sterilization of Women of Color in 20th Century America:

https://twu.edu/media/documents/history-government/Autonomy-Revoked--The-Forced-Sterilization-of-Women-of-Color-in-20th-Century-America.pdf

1920: 19th Amendment

The 19th Amendment is ratified, granting women the right to vote.  However, Black women continue to face obstacles and violence for decades when attempting to vote.


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1932 - 1972: Tuskegee

The Tuskegee Syphilis Study, conducted by the U.S. Public Health Service (USPHS), looked to investigate the life course of the disease. The USPHS did not obtain the study participants' informed consent. While the men participants were told they could receive free medical care, they were not told about their diagnosis and their treatment was withheld. By the end of the study, more than 100 men passed away died, at least 40 women were diagnosed with syphilis, and the disease was passed down to 19 children.


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1934: Redlining

The Federal Housing Administration was established in 1934 and introduced redlining, a practice which upholds systemic racism through refusing mortgages to individuals based on race and ethnicity. Redlining and segregation is associated with the resources available to those neighborhoods, including to quality healthcare. As a result, redlining is associated with increased risk of severe maternal morbidity among Black and Hispanic people in California. 


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1935: Title V

Title V is part of the Social Security Act. It provides funding to states to support the health and well-being of mothers and children. State maternal and child health agencies apply annually for Title V funding,


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1950 - 1960s: Civil Rights Movement

The Civil Rights Movement gains momentum, drawing attention to systemic racism and inequality in all areas of life, including healthcare.


Prominent leaders and activists including Rosa Parks, Martin Luther King Jr., and Malcolm X push for an end to racial segregation. The Civil Rights Act of 1964, Voting Rights Act of 1965, and Fair Housing Act of 1968 are examples of systemic, legislative changes as a result of the national movement. 


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1951: Henrietta Lacks

Henrietta Lacks was diagnosed with cervical cancer and underwent treatment at Johns Hopkins Hospital. Her cancer cells were taken and cultured without her consent to be used in research due to their unique ability to replicate continuously. They came to be known as HeLa cells, the first immortal cell line. HeLa cells have been mass produced, they traveled into space, they were used to help develop the polio vaccine, and they made possible many other landmark scientific discoveries in genetics and the treatment of disease. The family finally reached a compensation settlement in 2023---almost 70 years after PROFITING FROM HER CELLS WITHOUT CONSENT.


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https://apnews.com/article/henrietta-lacks-hela-cells-thermo-fisher-scientific-bfba4a6c10396efa34c9b79a544f0729


1956: Puerto Rico Pill Trials

The Puerto Rico Pill Trials was one of the first large-scale human trials for birth control pills. Puerto Rican women from low-income areas were given birth control at doses 20 times higher than what is clinically appropriate for the experiment and without full informed consent. Three women passed away while participating in the trial but researchers failed to investigate if their deaths were related to the medications they took. 


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1960s: “Mississippi Appendectomy”

The “Mississippi Appendectomy” is a phrase used to describe the practice of forced sterilization that Black women were subjected to. During a routine surgical procedure, a forced hysterectomy (surgery to remove the uterus) was performed on Black women. Black women did not know that a hysterectomy would happen during the surgery. They only consented to the original surgery. 


In 1961, a White doctor performed a “Mississippi Appendectomy” on Fannie Lue Hamer during her surgery for removal of a uterine tumor.


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1965: The Supreme Court's decision in the Griswold v. Connecticut case legalizes contraception for married couples on the basis of marital privacy.

The establishment of privacy as a constitutional right laid out the foundation for future rulings such as Roe v. Wade. However, access remains limited for many Black women due to economic disparities and racial discrimination.


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In June 1965, President Lyndon B Johnson signed the Social Security Amendments which established the Medicare and Medicaid programs. The program allowed millions of Americans to receive health insurance. 


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1966: National Organization for Women

The National Organization for Women (NOW) is founded, advocating for reproductive rights and equality for women, including Black women.


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1968: The Fair Housing Act

The passage of the Fair Housing Act prohibits redlining and discrimination in housing, which indirectly impacts access to healthcare for Black communities.


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1968 - 1974: Ongoing Forced Sterilizations in California

200 Mexican immigrant women were forcefully sterilized during this time in Los Angeles County-USC Medical Center. These women would come to the hospital for emergency C-sections. However, the hospital took advantage of their lack of English proficiency and awareness of resources to conduct tubal ligations (“tying the tubes”). The head of the OB/GYN department during that time stated he intended to use federal grant money to “cut the birth rate of the Negro and Mexican populations in Los Angeles County” as a means to contribute to President Johnson’s War on Poverty family planning initiative. 


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1968: Black Women Organized for Political Action (BWOPA)

Under the leadership of Dezie Woods-Jones, a statewide non-profit advocacy and membership organization, was established. Health and access to quality healthcare became one of their core issues.


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1973: Roe v Wade - Right to Privacy

The U.S. Supreme Court ruled in Roe v. Wade, establishing that the specific guarantee of “liberty” in the Fourteenth Amendment of the U.S. Constitution protects individual privacy. The Constitution reaffirmed Liberty as the right to make personal decisions about family, relationships, and bodily autonomy.


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1980s - 2023: Black Lives and Public Health

Epidemics and pandemics such as HIV/AIDS and COVID-19 disproportionately affect Black communities, highlighting disparities in access to healthcare, including sexual and reproductive care.


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1981: Title V was converted to a Block Grant program

As a block grant program, funding is available for more broad usage. Funding is becomes available for more causes including SIDS (Sudden Infant Death Syndrome) and adolescent health. 


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1989: Rebirth of Black Feminism or Afro-feminism

A movement that addresses the unique experiences and struggles faced by Black women. 


Kimberlé Crenshaw, a civil rights activist and scholar, coined the term “intersectionality” to help explain the oppression of Black women.


1994: The International Conference on Population and Development

The landmark International Conference on Population and Development in Cairo emphasizes reproductive rights as human rights and expands the focus of sexual and reproductive health to include issues such as family planning, maternal health, and access to contraception. 


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1997 - 2023: Ongoing Forced Sterilization

Ongoing forced sterilization in California prisons and at migrant border facilities are documented. 


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1999 - 2023: Title V Equity for CA MCAH Action

Title V Maternal and Child Health Block Grant provides funding to California to improve the health and well-being of mothers, infants, children and youth. The California Title V Program is administered by the Maternal, Child and Adolescent Health (MCAH) Division of the California Department of Public Health. Every 5 years, local health departments conduct needs assessments to better understand what the community needs. The results from the assessment informs how funding is allocated to programs.


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2000s: Rebirth of Black Birthwork

Efforts are growing to acknowledge and address the racial health disparities created and maintained by the legacy of slavery. Strategic steps are taken toward achieving Black health equity and promoting birth justice. Black-led organizations, Black women, midwives, doulas, and professionals advocate and drive research in an effort to reclaim space, build power, and improve Black maternal health, rights, and justice.

2018: Black Maternal Health Week National Campaign Launches

The Black Mamas Matter Alliance (BMMA), a Black women-led cross-sectoral alliance, develops the first Black Maternal Health Week (BMHW). BMHW is a national awareness-raising campaign held annually: April 11-17.


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2019: BLACK Wellness & Prosperity Center Launches

The first Community Based Organization, BLACK Wellness & Prosperity Center, unapologetically dedicated to address Black infant and maternal mortality in Fresno County, is established.


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2019: Black Maternal Health Caucus

Congresswomen Alma Adams (NC-12) and Lauren Underwood (IL-14) launched the Black Maternal Health Caucus on April 9th, 2019. Its goals included elevating the Black maternal health crisis within Congress and advancing policy solutions to improve maternal health outcomes and end disparities. It also introduced the Black Maternal Health Momnibus Act. 


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2019: SB 464

The California bill requires facilities with perinatal care (hospitals and primary clinics, alternative birth centers) to implement an evidence-based implicit bias program and consequent refreshers for all health care providers involved in perinatal care of patients within those facilities. 


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2021: SB 65

The California SB65, the Momnibus Act, became law in 2021, allowing doula services and extended postpartum coverage to be included as a Medi-Cal benefit.


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2022: Roe v. Wade Overturned

Roe v. Wade was overturned by the Supreme Court ending the federal constitutional "right to privacy" and bodily autonomy. This ruling disproportionately affects Black women– and ALL women and other marginalized communities who already face multiple barriers to quality reproductive healthcare. This includes access to birth control, in vitro fertilization, and assisted reproductive technology that many families have depended on to have children. The lasting devastation and consequences are unknown 


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2020: AAC Launches

BLACK Wellness & Prosperity Center, in partnership with local CBOs, leads efforts to form a rapid-response African American Coalition (AAC) to address the COVID-19 epidemic. The African American Coalition goes on to provide testing, contact tracing, isolation and quarantine support, and when vaccines became available, administered thousands of COVID-19 vaccines. AAC has evolved as a permanent addition to Fresno’s public health workforce, currently providing a range of supports, education, and vaccines to support community health and wellbeing.

AAC represents a historical moment in Fresno’s history. AAC is a testament to how community leaders came together to mobilize and convene a complex coalition structure that rapidly implemented strategies which contributed to reductions in preventable morbidities and mortalities.


Original African American Coalition Partners:


African American Clergy Caucus of Fresno CA, BLACK Wellness & Prosperity Center, Cultural Brokers, Inc. Dr. Venise Curry, Fresno Metro Black Chamber of Commerce, KNOW ONE, Take A Stand, and West Fresno Family Resource Center

2021: BLACK Doula Network (BDN) Launches

BLACK Wellness & Prosperity Center launches the framework for what would become the BLACK Doula Network (BDN). The BDN is a social enterprise designed to address the doula provider deficit, build the missing backbone infrastructure needed to support and sustain doulas, and provide birthing persons with access to healthcare services demonstrated to decrease health disparities.


BLACK Wellness & Prosperity Center and the African American Coalition is officially recognized for leadership in addressing the COVID-19 pandemic.


2023 - 2024: BDN Continued Growth- Certifying First Two Cohorts

BLACK Wellness & Prosperity Center executes a first-of-its-kind, Doula Observation Agreement with Community Health System (CHS), which includes Community Regional Medical Center and Clovis Community Medical Center! This Agreement allows our doula trainees to complete required observation hours to obtain certification through our BLACK Doula Network (BDN).


The BDN moves to certify its first two doula cohorts in spring 2024!


Future threats to accessing reproductive healthcare remains unclear, but BLACK Wellness & Prosperity Center continues to have an unwavering commitment to building sustainable healthcare infrastructure




Glossary - Reproductive Health Definitions

Afrofeminism, Black feminism

A movement within feminism that focuses on the African American women's experiences. It recognizes how classism, racism and sexism shape the experiences of the BLACK WOMAN, and how these experiences make Black women's worldviews fundamentally different from those of the Black man and White woman. It believes that racism, classism and sexism must be addressed simultaneously in order to bring equity for Black women.


National Museum of African American History and Culture: The Revolutionary Practice of Black Feminisms: 

https://nmaahc.si.edu/explore/stories/revolutionary-practice-black-feminisms 


Epidemic, Pandemic, and Endemic

An epidemic refers to an increase in the number of cases of a particular disease or health-related behavior in a geographic area above what is normally expected or when cases are spreading over a bigger area. 


A pandemic is when the number of disease cases are growing exponentially, growing larger and larger each day. This typically affects a wide geographic area meaning it is occurring in several different countries and continents. 


An endemic refers to a particular disease that has a relatively constant number of cases (or baseline) in a geographic region. For example, Valley Fever is endemic to the Central Valley and Southwest U.S. as well as Northern Mexico. 


Mayo Clinic Health System: Endemic vs. epidemic vs. pandemic: What you need to know: https://www.mayoclinichealthsystem.org/hometown-health/featured-topic/endemic-epidemic-pandemic 


Columbia University Irving Medical Center: Epidemic, Endemic, Pandemic: What are the Differences?:publichealth.columbia.edu/news/epidemic-endemic-pandemic-what-are-differences#:~:text=While%20an%20epidemic%20is%20large,international%20and%20out%20of%20control 


Informed Consent

Informed consent is the process of giving a person important relevant information about a medical procedure, treatment, or experiment, or research in order for them to give their authorization to undergo the intervention. This information includes risks and benefits, alternatives to care, voluntary participation (or terminating participation) and the nature and purpose of the intervention. Obtaining informed consent is not only an ethical consideration, but a matter of law.

Intersectionality

Intersectionality is a concept that was developed in 1989. It is a metaphor that highlights that different forms of inequities can compound causing unique barriers and disadvantages for individuals, or groups of individuals. Intersectionality shows that the  BLACK WOMAN's experience is multidimensional and can only be understood if we examine how both gender and race overlap. 


Kimberle Crenshaw: Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics: https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1052&context=uclf

IVF (In Vitro Fertilization)

During the IVF process, mature eggs are extracted and fertilized manually. Cell division begins and the fertilized egg is implanted back into the uterus 5 days later. Once in the uterus, the fertilized egg will go through the same stages to become embryo and fetus.

Liberty

Freedom from restrictions imposed by an authority that infringe on a person’s life. This includes the individual's right to make decisions about family, relationships, and bodily autonomy.


https://reproductiverights.org/roe-v-wade/#:~:text=Wade%20recognized%20that%20the%20decision,abortion%20prior%20to%20fetal%20viability.

https://reproductiverights.org/wp-content/uploads/2020/12/Liberty-Roe-Timeline-spread-for-web.pdf


Reproductive Justice or Birth Justice

It is a human-rights based analytical framework that connects sex, reproduction, and rights focusing on the rights of the birthing person. It asserts that people have the right to create a family and engage in relationships the way they see it fit, without coercion, violence, and societal stigma. It also takes the social support and systems in place into account that either support or limit, even more, put barriers against the individuals’ ability to decide about their reproductive goals and the extent to which they are given the resources to raise families safely.


Everymothercounts: “Birth justice is achieved when individuals are able to make informed decisions during pregnancy, childbirth, and postpartum, that is free from racism, discrimination of gender identity, and implicit bias. Birth justice requires that individuals fully enjoy their human rights regarding reproductive and childbirth-related health decisions, without fear of coercion, including coercion to submit to medical interventions, reprisal for refusal of care, and/or face the threat of inadequate medical care. Birth justice centers the intersectional and structural needs of individuals and communities.”


Right to Privacy

Our right to privacy refers to “our freedom to make decisions about our bodies and our private lives without interference from the government”. (ACLU)

Sterilization

Surgical procedure to make a person unable to get pregnant or produce children by removing part of a person’s reproductive anatomy. It is considered a permanent method of birth control. Female sterilization occurs through a procedure called tubal ligation or “getting the tubes tied” in which the fallopian tubes are cut, blocked, and/or removed in order to prevent sperm from fertilizing an egg. Male sterilization occurs through a vasectomy or “getting snipped”. During a vasectomy, the vas deferens (the tubes that bring sperm from the testicles) are blocked or cut in order to keep sperm from joining with semen. 


Sterilization for Women and Men | ACOG

ACOG: FAQ: Sterilization for Women and Men: https://www.acog.org/womens-health/faqs/sterilization-for-women-and-men 


Forced sterilization: It is a human rights violation. Forced sterilization is when a person’s reproductive anatomy is removed by force, or without their knowledge or the person is not given an opportunity to provide consent. 

Coerced sterilization: It is a specific form of forced sterilization when the person undergoing the procedure is not given a real choice. Financial or other means of incentives, misinformation, or intimidation tactics are often used to coerce the individual to undergo the procedure.



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