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Norplant & Medical Racism

Updated: Dec 1, 2021

By Anonymous

The fertility of Black women in the United States has been manipulated from slavery to the present by the abuse of slaveholders, physicians, and the US government. During slavery, the fertility of enslaved Black women was viewed positively as a means of production and necessary to uphold the Southern economy. When Black women were freed from slavery, this view shifted dramatically towards eugenics. In the 1990s, several states attempted to employ Norplant, a form of long-term birth control that had to be implanted and removed by physicians, with eugenic motivations. The way physicians and the government have used Norplant to control Black women’s reproductive health mirrors the economic nature of reproductive medicine that existed during slavery. Eugenics is manipulating reproduction to increase ‘desirable’ traits in a population and is a practice that is both unscientific and driven by racism. In the same way that plantation physiciansmanipulated the fertility and reproductive health of enslaved women to uphold the Southern economy, the government and Planned Parenthood attempted to use Norplant to reduce welfare costs under a eugenics agenda.


During slavery, the fertility of enslaved Black women was viewed positively as a means of production and necessary to uphold the Southern economy. Black women’s bodies were profitable in the sense that they made the system of slavery economically valuable, and because of this, bearing many children was a “constructed measure of success for enslaved women, with some slave owners going as far as to reward slave mothers of large broods with gifts and, in rare instances, manumission” [4]. This was backed by scientific racism that claimed Black women were able to ensure more pain in childbirth than white women. If enslaved women were not reproducing, this was viewed as a problem that needed to be fixed, resulting in the horrors of early gynecological experimentation [4]. Gynecological experimentation was not the only way slave owners attempted to control and manipulate the reproduction of Black women. In the mid-1800s, white physicians investigated the herbal medicines used by enslaved Black women to find that they used cotton root, tansy, rue, pennyroyal, and cedar berries to induce an abortion. They published this information in medical journals along with information about how slave owners could counteract these medicines and therefore manipulate enslaved women’s bodily autonomy. White physicians “attempted not only to appropriate but also to control the use of medicinal plants by African Americans” [3]. During this time, Black women were regarded as “human beings, chattel property, and clinical matter” simultaneously [4]. After Black women were freed, their fertility and reproduction continued to be manipulated with economic motives.


A hundred years later, women’s reproductive rights gained popularity in the United States. Margaret Sanger, the founder of Planned Parenthood who supported the development of the first birth control pill, was a strong proponent of both women’s rights and eugenics. Sanger wrote that “We do not want the word to get out that we want to exterminate the Negro population, and the minister is the man who can straighten out that idea” [8]. In 1939, Planned Parenthood started the "Negro Project" which was designed “to limit reproduction by blacks who still breed carelessly and disastrously, with the result that the increase among Negroes, even more than among whites, is from that portion of the population least intelligent and fit, and least able to rear children properly" [5]. Sanger worked with the Negro Project and created family planning centers to reduce the Black population. When the first birth control pill was developed, it was made available to poor Black women free or low-cost at Planned Parenthood clinics funded by the government. In response, the 1967 Black Power Conference equated birth control with black genocide, but men were more likely to denounce birth control while many Black women had a complex relationship with birth control because they wanted it but simultaneously distrusted those who distributed and funded it [8]. When a new form of long-term, physician controlled birth control was introduced in the 1990s, these debates and dilemmas reemerged stronger than ever.


Norplant was approved by the United States Food and Drug Administration in 1990 as a long-term contraceptive method [2]. It was developed by the Population Council, a nonprofit organization founded by John D. Rockefeller III in 1952 because of concerns of overpopulation in the Third World [10]. The organization’s first president, Frederick Osborn, “was one of America’s key eugenic strategists and a long-time officer of the American Eugenics Society,” and wrote to Rockefeller in a letter saying “The best hope of improving genetic qualities of the race lies in the universal extension of effective and easy means of birth control” [6]. It is no surprise that Norplant was first selectively marketed to poor Black women and young Black girls, with data from Planned Parenthood showing that 90% of Norplant implantations paid for through Medicaid and that more Black women than white women received Norplant [8]. Norplant was marketable because it combined features of the birth control pill and the IUD to offer more effective and long-term protection from pregnancy [9]. Like the IUD, it was controlled entirely by physicians [8]. In theory, Norplant was “designed for users who could not or would not remember to take a daily pill, who did not want to be permanently sterilized, and who were unsuitable candidates for the IUD” [9]. However, the strongest predictor of choosing Norplant over the pill was the patient's healthcare, because 95% of Norplant users were Medicaid recipients, compared to only 32% of Pill users on Medicaid. Removal costs posed a problem for many Norplant users. In many cases, the physicians who inserted Norplant did not make it clear that implantation was free but removal cost $150 to $500, a burden for low-income women. In some cases, it was difficult to find a doctor to remove the device so some attempted to remove it at home themselves resulting in injuries. Physicians and health care providers had the power to decline to remove the device they inserted for poor minority women. In this way, Norplant was “embraced as a way to reduce the birthrate of poor Black women” [6]. Norplant was quickly brought into national conversations about eugenics.


After Norplant was approved, its potential uses were contested by the public and eventually debated in state legislatures and courthouses. In 1990, following the FDA approval of Norplant, an article was published in the Philadelphia Inquirer entitled “Can Contraception Reduce the Underclass?”arguing that “the main reason more black children are living in poverty, is that the people having the most children are the ones least capable of supporting them” referencing a report claiming nearly half of American Black children were living in poverty. Ultimately, the author made the suggestion that women on welfare should be given incentives to use Norplant. The story was published by The Associated Press, and then covered across the United States [9]. This was not the first publication to link poverty and welfare to birth control. Thirty years earlier, Planned Parenthood published a study showing that a midsized city would save $75,000 over five years if women on welfare prevented pregnancies by using the pill [9]. Following the article, thirteen states in 1992 and twelve states in 1994 deliberated Norplant bills in their legislatures but not a single one passed. These bills included financial incentives for low-income women, women in prison, and women with drug addiction to use Norplant [9]. One of the bills was proposed by former Ku Klux Klan Grand Wizard, David Duke, in the Louisiana legislature to provide financial incentives for Norplant in order to, in his words, “reduce the illegitimate birthrate and break the cycle of poverty that truly enslaves and harms the black race” [6]. In a court case involving Darlene Johnson, a pregnant Black mother of four convicted of child abuse, the judge included Norplant in addition to jail time as punishment, without considering that Johnson had diabetes and high blood pressure, a very dangerous combination with Norplant [1][7]. It was clear that a combination of racism and misogyny underlined the distribution of Norplant: “Norplant proposals aimed at poor, African-American women are based on the notion that poor, Black women are "deviant" and thus less deserving of motherhood than white women” [2].


Dorothy Roberts argues that “the coercive nature of the device itself [Norplant], as well as the incentives used to promote it, treats Black women’s bodies as objects of social supervision” [6]. I argue that in addition to treating Black women’s bodies as objects of social supervision, it also treats their bodies as profitable in ways that parallel reproductive medicine during slavery. In slavery, plantation physicians used early reproductive medicine to profit off of Black womens bodies, and in the 1990s the state attempted to do the same by using Norplant to cut welfare costs. The common theme is the state and medical institutions citing economics as an excuse for medical racism. In the same way that plantation physiciansmanipulated the fertility and reproductive health of enslaved women with reproductive medicine to uphold the Southern economy, the government and Planned Parenthood attempted to use Norplant to reduce welfare costs under a eugenics agenda, all underlined by misogynoir.

 
  1. Berger, Emily K. "The Legal Rights of the Poor and Minority to Have Families: Judges as Family Planers, the Vilification of the Poor, and Destruction of the Black Family." Rutgers Race & the Law Review, vol. 8, no. 2, 2007, p. 259-290.

  2. Burrell, Darci Elaine. "The Norplant Solution: Norplant and the Control of African-American Motherhood." UCLA Women's Law Journal, vol. 5, no. 2, Spring 1995, p. 401-444.

  3. Fett, Sharla M. “Sacred Plants.” Working Cures: Healing, Health, and Power on Southern Slave Plantations. University of North Carolina Press, 2002, pp. 60-83.

  4. Owens, Deirdre Cooper. “The Birth of American Gynecology.” Medical Bondage Race, Gender, and the Origins of American Gynecology. University of Georgia Press, 2017, pp. 15-41.

  5. Randall, Vernellia R. "Slavery, Segregation and Racism: Trusting the Health Care System Ain't Always Easy--An African American Perspective on Bioethics." Saint Louis University Public Law Review, vol. 15, no. 2, 1996, p. 191-236.

  6. Roberts, Dorothy E. “Killing the Black Body: Race, Reproduction, and the Meaning of Liberty.” Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, First Vintage Books ed. New York: Vintage, 1999. Web.

  7. Srinivas, K. Ravi, and K. Kanakamala. “Introducing Norplant: Politics of Coercion.” Economic and Political Weekly, vol. 27, no. 29, 1992, pp. 1531–1533.

  8. Washington, Harriet A. “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial times to the Present.” New York: Harlem Moon, 2006. Print.

  9. Watkins, Elizabeth Siegel. "From Breakthrough to Bust: The Brief Life of Norplant, the Contraceptive Implant." Journal of Women's History, vol. 22 no. 3, 2010, p. 88-111.

  10. Watkins, Elizabeth Siegel. “The Construction of a Construction of a Contraceptive Technology: An Investigation of the Meanings of Norplant.” Science, Technology, & Human Values, vol. 36, no. 1, 2011, pp. 33–54.


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