FROM BEFORE THE BIRTH of the United States, American society faulted the woman when a couple failed to produce offspring. The very father of our country expressed such a prejudice.

George and Martha Washington never had children. The two pictured were Martha's by a previous marriage. [Library of Congress]

At George Washington's verdant Virginia plantation, Mt. Vernon, the white children who capered about his house and gardens were actually Martha Washington's children by a previous marriage. General Washington treated his stepkids like blood kin, but he and Martha never produced children of their own.

Historians at Mt. Vernon say that before marrying Martha, George Washington battled smallpox and fevers that may have left him infertile. But in a letter to his nephew, the aging president made clear he thought Martha the barren one -- even though she had conceived four previous times.

In the mid-19th Centry, J. Marion Sims performed scores of experimental surgeries on women to solve infertility. [College of Physicians of Philadelphia]

"If Mrs. Washington should survive me there is a moral certainty of my dying without issue," Washington wrote (meaning he wasn't the type to fool around). "And should I be the longest lived, the matter in my opinion is almost as certain. For whilst I retain the reasoning faculties I shall never marry a girl, and it is not probable that I should have children by a woman of an age suitable to my own." LISTEN

In believing his wife the "barren" one, Washington simply reflected the thinking of his times: If a man was not impotent, he was considered fertile. Physicians and common folk assumed that infertility was a woman's problem.

Sims used an instrument like this (top ) for artificial insemination using the husband's sperm. The experiments shocked his colleagues. Sims used the uterotome (bottom) to slice the cervix.

In the 1800s, doctors linked infertility to menstrual disorders. They prescribed elixirs and dietary schemes to balance the female constitution. By the Civil War, doctors specializing in the emerging field of gynecology began focusing on surgical treatments. J. Marion Sims, a prominent New York city doctor, operated on scores of women to enlarge their cervical openings. Sims believed that a wider passageway to the uterus would expedite the flow of sperm to egg. In 1992, historian Margaret Marsh pored over Sims' treatment records and found no evidence that any of the painful experiments produced an actual pregnancy.

Part three: The Fragile Women