After being a surgeon and family practitioner 10 years, Sims stated in his biography that he had no intent on treating diseases of women and would often refer such cases to another doctor (226). He happened upon his research through a case of a 17-year-old slave girl named Anarcha that had been in labor 72 hours. The girl’s master, on the third day, contacted Marion Sims. The death of the slave and the child would have been a major loss of profit. The child’s head was compacted in the pelvis during that time. Using forceps, he pulled the child out. Soon afterward Anarcha lost all ability to hold her urine and feces, making her not fit for work in the house or field. Sims deemed the case incurable, but soon after was contacted by another slave owner with the same problem and an 18-year-old slave named Betsy that had just given birth.

Although any woman could suffer from it, vesico-vaginal fistula problems were common amongst slave women and girls that had long, difficult births without proper medical care. So Sims read on the subject and soon after, a third slave master contacted him about an 18-year-old named Lucy with the same problem. After much convincing from her owner, Sims examined Lucy in the corner of his yard, an area for Black patients. Eventually, he believed he could cure the problem of the vesicovaginal fistula and wrote to the masters of Anarcha and Betsy, “If you will give me Anarcha and Betsy for experiment, I agree to perform no experiment or operation on either of them to endanger their lives, and will not charge a cent for keeping them, but you must pay their taxes and clothe them” (236).

It took 3 months for Sims to have his own experimental instruments made. Without anesthesia, Lucy was the first to bear the operation on her hands and knees while 12 visiting doctors watched Sims’ experimental procedure. According to Sims, her bladder had fallen, leaving an opening between the bladder and vagina approximately 2 inches in diameter. He referred to the operation as being on the “…eve of a great discovery…,” and said it was, “… tedious and difficult…” (237).

Sims made improvements on the instruments he constructed as he worked. Eventually, he inserted a piece of sponge inside the neck of Lucy’s bladder and sewed it up. Naturally, within days she developed what Sims referred to as “blood poisoning” (238), and became deathly ill. After 5 days, he cut open her sutures to remove the sponge, but it had hardened. Suffering from inflammation and infection, Sims wrote that he thought, “Lucy’s agony was extreme,” and “She was going to die.” (238). However, Lucy lived and Sims continued his experimentation. Regarding Lucy’s first experiment he wrote, “It inaugurated a series of experiments that were continued for a long time” (239).

Afterwards, Sims then moved on to the other women, Anarcha and Betsy, allowing Lucy time to heal in between surgeries. The process of experimentation continued for four years with the women solely under Sims’ care. “It would be tiresome for me to repeat in detail,” Sims wrote, “all the strategies of improvement in the operation that were necessary before it was perfect (241).