71 pages • 2 hours read
Dolen Perkins-ValdezTake My Hand
Fiction | Novel | Adult | Published in 2022A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Background
Historical Context: Forced Sterilization in the 1970s
Take My Hand is a based on true events that happened in July 1973 in Montgomery, Alabama. Young sisters, Mary Alice and Minnie Lee Relf, were sterilized without consent after their illiterate mother, believing the girls were being taken to be given birth control shots, had marked an “X” on the consent form. Filed in federal court by Southern Poverty Law Center, the lawsuit “exposed widespread sterilization abuse funded by the federal government and practiced for decades” (“Relf v. Weinberger; Civ. A. Nos. 73-1557.” Southern Poverty Law Center).
The lawsuit exposed that 100,000 to 150,000 poor people, mostly Black women, were sterilized annually under federally funded programs. In both the fictionalized lawsuit and the historical one, the plaintiffs prevailed; however, the historical case was eventually dismissed when the US Department of Health, Education, and Welfare (HEW) withdrew its existing regulations that supported forced sterilization and agreed to issue new regulations.
The practice of forced sterilization included doctors threatening to terminate women’s welfare benefits or refusing to perform labor and delivery services while the women were in labor unless patients agreed to the procedure. Even after the case was decided and HEW revised its regulations, the practice of sterilization continued, becoming “the most rapidly growing form of birth control in the United States, rising from 200,000 cases in 1970 to over 700,000 in 1980.” (Kluger, Sara. “Day 17: Mississippi Appendectomies and Reproductive Justice.” MSNBC, 2014.)
Black women were not the sole victims of the government’s program: More than 3,000 Indigenous women were sterilized without their consent before the 1970s. Additionally, around the same time as the Relf case, another case was brought by a group of women for “rampant sterilization abuse” that occurred at a medical center in California, where Mexican American women were systematically sterilized. Most of these women were primarily Spanish-speaking and were pressured, while in labor and often heavily medicated, to sign English-language consent forms. One witness testified:
The doctor would hold a syringe in front of the mother who was in labor pain and ask her if she wanted a pain killer; while the woman was in the throes of a contraction the doctor would say, ‘Do you want the pain killer? Then sign the papers. Do you want the pain to stop? Do you want to have to go through this again? Sign the papers’ (Manian, Maya. “Immigration Detention and Coerced Sterilization: History Tragically Repeats Itself.” ACLU, 2020).
While the most widespread incidents of forced sterilization occurred prior to 1980, the practice continues well into the 21st century. MSNBC’s report found that the California Department of Corrections sterilized nearly 150 female inmates from 2006 to 2010, and the ACLU’s report reveals that in 2020, immigrant women at the Irwin County Detention Center in Georgia were subjected to coerced sterilizations among other health abuses.
Socio-Historical Context: Historical Healthcare Abuses Targeting Black Americans
Unauthorized and coerced sterilization primarily targeted poor Black women; it is just one of the ways the US healthcare system has historically harmed Black men and women. University of Minnesota researcher Rachel Hardeman notes there have been “four hundred years of active decisions to dehumanize Black people and Black bodies” (Cunningham, Aimee. “Medical Racism Didn’t Begin or End with the Syphilis Study at Tuskegee.” Science News, 2022). These historical offenses are briefly noted in Take My Hand when Civil and Ty visit Miss Pope, the librarian.
This abuse stems from the medical profession historically seeing Black people as biologically inferior, impervious to pain, and valueless in US society. This view “has existed for centuries and still permeates the US health care system, causing racial disparities in access to medical care and measures of health” (Cunningham).
Beginning with slavery, Black people were subjugated to experimental, painful, and often fatal treatments. John Brown, the well-known enslaved person who escaped to England and authored a recounting of his experiences in 1855, wrote: “A slave is not a human being in the eye of the law, and the slaveholder looks upon him just as what the law makes him; nothing more, and perhaps even something less” (Brown, John. Slave Life in Georgia. London, 1855). He was experimented on to test therapies for heat stroke, wherein Brown was forced to sit in a fire pit with only his head exposed. Gynecological surgeries were performed on enslaved Black women without anesthesia because it was believed that Black women had a high tolerance for pain.
In the early 20th century, doctors believed Black men—based on a number of theories stemming from racist beliefs about the differences between Black and white bodies—experienced syphilis differently from white men. In 1932, The US Public Health Service (USPHS) began a syphilis study at the Tuskegee Institute in Macon, Alabama. Initially, 400 Black men with syphilis were brought into the study. Although in the mid-1940s penicillin became an effective treatment for the disease, treatment was withheld until the study was stopped in 1972, when most of the men had died. They were never told they had syphilis, instead being told they were being treated for “bad blood,” and the study never obtained informed consent from the men (“The Untreated Syphilis Study at Tuskegee Timeline.” Centers for Disease Control and Prevention).
The idea that Black bodies are fundamentally different from white bodies persists today. Until recently race-based adjustments were made in clinical approaches to heart and kidney disease (Vyas, Darshali A., et al. “Hidden in Plain Sight—Reconsidering the Use of Race Correction in Clinical Algorithms.” The New England Journal of Medicine, 2020) and professional football players’ brain injuries were excluded from appropriate treatment on the basis of race (“The NFL Will Stop Assuming Racial Differences When Assessing Brain Injuries.” NPR, 2021). Meanwhile, the maternal mortality for Black women is nearly three times that of white women, and Black newborns are more likely to die than white newborns. Black people are almost twice as likely for perinatal testing without consent partially because of an underlying assumption of drug use. (“Maternal Mortality Rates in the United States, 2021.” Center for Disease Control; Cunningham).
These facts are relevant to the novel and the Relf case: In the novel, when Civil finds India and Erica in pain after the surgery, they are not given pain medication until Civil insists on their behalf. The novel chronicles numerous health abuses directed at Black bodies by the US healthcare system, a trend that still exists in some areas of healthcare today.
