As I drive north along this stretch of I-65, the sky over Alabama is cloudless and clear, as luminous as one of Mama’s paintings. I feel protected, the whole of me, in all my broken pieces under that blue. It is a wonder to behold this land, this God-filled country. My daddy hovers in it, whispering to me that it will all be fine, his thick fingers on my brow. He has always been with me, and he is with me now.
On the horizon behind me is my community—Montgomery, Centennial Hill, my friends and loved ones—all here in this place that birthed me. This is your lineage, my dear daughter, your history. More powerful than blood. The story of those sisters and what happened in Montgomery in 1973 is a history you share with people you have never even met. They are your family as much as I am your family.
You are now the age that I was then, and I hope you will benefit from the wisdom of our mistakes. This knowledge, this triumph, can, if we let it, make all of us stronger.
If we let it.
AUTHOR’S NOTE
This novel is a work of fiction loosely inspired by the real-life case of Relf v. Weinberger. In June 1973, Minnie Lee and Mary Alice Relf, sisters aged twelve and fourteen, were sterilized without their consent in Montgomery, Alabama, by a federally funded agency. Outraged by this terrible violation, their social worker, Jessie Bly, reported it to a local attorney. Eventually, the case went to federal court in Washington, DC. The lead lawyer for the plaintiffs was Joseph Levin Jr. of the Southern Poverty Law Center. This case is considered a pivotal moment in the history of reproductive injustice, as it brought to light the thousands of poor women of color across the country who had been sterilized under federally funded programs.
What was particularly shocking to me, when I first learned of this case, was that it had happened just one year after the Associated Press had revealed the story of how the federal government left hundreds of Black men in rural Alabama untreated for syphilis in a study at Tuskegee that lasted four decades. Both cases prompted national discussions about medical ethics and racism, but how could these events have been allowed to happen in plain sight? I began to ask questions about culpability and silence that contemporaneous documents in the archive could not answer.
My inability to shake these questions resulted in three years of research and, ultimately, this novel. Eager to seek more answers, I traveled to Montgomery to speak with Joseph Levin and Jessie Bly, who were so generous with their time. I am always led by my curiosity, and I found myself wondering about the nurses who worked at the Montgomery Family Planning Clinic. How did they make sense of what happened on their watch? I was never able to find firsthand accounts of nurses who worked there, so I decided to imagine what it must have been like to work there at the time. Thus, I created the characters of Civil Townsend and the other nurses at the clinic.
It is important to note that Take My Hand is not a retelling of these events; instead, I have used the historical record as inspiration to imagine the emotional impact of this moment and others like it.
The moral and ethical questions I explore in Take My Hand remain salient today. In 2013, the Center for Investigative Reporting revealed that between 2006 and 2010, nearly 150 women in California state prisons had been sterilized without official approval. A year later, the Associated Press reported on multiple instances of prosecutors in Nashville, Tennessee, submitting permanent birth control as part of plea deals. In 2020, a whistleblower alleged that immigrant women detained by Immigration and Customs Enforcement （ICE） were being forcibly sterilized without their consent in US detainment facilities. In fact, compulsory sterilization of “unfit” inmates of public institutions is still federally protected by a 1927 US Supreme Court ruling, Buck v. Bell.
Reproductive justice, a phrase coined by Black feminists at a conference in 1994, remains elusive for African American women who struggle to access affordable health care due to social and economic inequalities. The abortion rate for Black women is nearly five times that for white women. African American women are three to four times more likely to die in childbirth than white women. Furthermore, health conditions that disproportionately affect Black women, such as uterine fibroids, receive very little government research funding. My hope is that this novel will provoke discussions about culpability in a society that still deems poor, Black, and disabled as categories unfit for motherhood. In a world inundated by information about these tragedies and more, I still passionately believe in the power of the novel （and its readers!） to raise the alarm, influence hearts, and impact lives.
ACKNOWLEDGMENTS
First, I want to thank you—my readers—for waiting so patiently for my books. I have heard from so many of you since my first novel, Wench, was published. Your words of encouragement have kept me going more times than you know. Your passion for history inspires me. Your thirst for another book club pick motivates me. I am so indebted to you, and I want you to know that you are always foremost in my mind and heart.
Not everyone is lucky enough to work with the same literary agent for fifteen years. I have been one of those fortunate authors who has found not only an agent, but a lifelong friend, sister, and creative muse in Stephanie Cabot of Susanna Lea Associates.
This book would not have been written without the kind generosity of Joseph Levin Jr. and Jessie Bly. The two of you shared with me all that you remembered, and I am grateful. I have taken liberties with the story, of course, as any good novelist would do, but your answers to my questions opened my eyes to the seriousness of this moment. You are two of the most special people I have ever met.
Thank you to the Southern Poverty Law Center for taking on this case, and so many others over the years that were instrumental in righting the injustices of our nation.
With utmost respect, I want to acknowledge the entire Relf family, especially Minnie Lee and Mary Alice Relf. May God continue to bless you.
I asked endless legal questions of lawyer friends, though I deserve the blame for any mistakes: Kathy Smith, Milton Brown, Rashida LaLande, Tasha Hutchins, Tracy Colden, Jessica Waters, David Valdez. Thanks to Nyoka Beede for the constant support over the years. Thanks to Sharony Green for sharing some of the history of Alabama and always teaching my books. Thanks to Regina Freer for being my intellectual sounding board. Terry McMillan’s generous spirit is as wide and deep as an ocean. The first readers of my earliest rough drafts were Sarah Braunstein and Sarah Trembath. It does not seem coincidental to me that two brilliant Sarahs were instrumental in helping me figure out what story I was trying to tell. This finished book probably looks very different from the manuscripts you saw, and that is largely because you helped me figure out my vision. I have turned repeatedly to these writers for inspiration and sustenance over the past few years: Tina McElroy Ansa, Naomi Jackson, Lauren Francis-Sharma, Marita Golden, Lalita Tademy.
Special shout-out to the late Randall Kenan, who, years ago, urged me to write about Black class dynamics in the South. I miss you, Randall.
Dorothy E. Roberts, author of Killing the Black Body, has been a pivotal voice in the history of scholarship on reproductive justice. I am indebted to her work and that of so many others.
I am truly grateful for my friends, allies, colleagues, and students in the Department of Literature at American University, who are the most collegial and supportive community I have ever experienced in academia. Thank you to the Rowland Writers Retreat—and Pleasant Rowland—for providing a cozy bed, a spectacular view, and unlimited tea while I worked on this manuscript.