Racial Science, Medical Ethics, and the Debate about James Marion Sims in Mexican Medicine, 1870–90

In the early 1880s, American gynecologist James Marion Sims became a polarizing figure in Mexican obstetrical practice. Most doctors revered his clinical interventions and cited his work with respect and admiration. Yet, in 1884, one Mexican medical student—Fernando Zarraga—lambasted Sims for erroneous diagnoses, unjustified interventions, and disregard for patient safety and survival. For Zarraga, Sims's influence was part of a broader problem in obstetrical science, which, in his view, tended to approach patients as experimental subjects instead of citizens seeking health care services. As Porfirio Díaz's self-professed "scientific dictatorship" progressed, doctors claimed that indigenous women and their descendants were losing the battle to natural selection. They argued that some Mexican women's wombs were infantile, backward-facing (retrodesviado), and lacking in both neural sensibility and muscle tonicity, and that this "inferior" biology warranted high levels of obstetrical intervention. Meanwhile, because hospitals and clinics housed tens of thousands of patients per year, doctors had many opportunities to experiment with obstetrical surgeries. Although some patients were middle and upper class, most were either indigenous migrants to the rapidly industrializing city, or prisoners of the sanitary police. This paper uses medical publications and hospital records in order to explore how elite anxieties about national progress and Mexico's racial identity led to the politicization of reproductive healthcare, and how doctors reified and constructed systems of racial classification while exerting influence over women's reproductive choices. Ultimately, this obstetrical epistemology drew inspiration from Sim's abuse of enslaved women, even though Mexican subjects were supposedly equal in the eyes of the nation's liberal government. An exploration of that epistemology—which degraded and dehumanized, instead of healing—locates coterminous and dialectical discussions of blackness and indigeneity in racial science, while also underscoring the historical and transnational interconnectedness of struggles for dignity in reproductive rights.