Pelvimetry and the persistance of racial science in obstetrics.

In the late nineteenth century, Mexican scientists became fixated on pelvic structure as an indicator of racial difference and hereditary worth. Forty years later, in his 1931 dissertation, medical student Gustavo Aldolfo Trangay proposed the implementation of a eugenic sterilization campaign in Mexico. He even reported performing clandestine sterilizations in public clinics, despite federal laws that prohibited doctors from doing so. Trangay reasoned that his patients were unfit for motherhood, and he claimed that their small pelvic cavities were a sign of biological inferiority. His focus on anatomical measurements--and especially pelvic measurements--was not novel in Mexico, but his work shows how doctors used nineteenth century racial science to rationalize eugenic sterilization.

[Giving birth to medical instruments: forceps and pelvimeters among obstetricians of the 19th century in Mexico]. / Pariendo instrumentos médicos: los fórceps y pelvímetros entre los obstetras del siglo XIX en México.

Up until the mid-19th century, Mexican obstetricians associated forceps and other surgical instruments with risky operations, considering them artefacts whose use was to be avoided at all cost. This article asks why by the century's end these same instruments had come to be seen as life-saving surgical utensils. To this end, I analyzed clinical narratives that defined the norms and practices of their use, discovering that although forceps were redefined by male-midwives' norms of prudence, they also introduced medically-based ideas of gender and race and attributed to Mexican women's pelvises a supposedly pathological nature.

Pariendo instrumentos médicos: los fórceps y pelvímetros entre los obstetras del siglo XIX en México / Comparing medical instruments: forceps and pelvimeters among obstetricians in the XIXth century Mexico

Analiza las prácticas instrumentales médicas desde una perspectiva histórica. Aborda a los instrumentos médicos como habilidades y discursos situados en un contexto local; como parte de operaciones que al mismo tiempo que producen conocimientos dan cierta identidad a los cuerpos que analizan y a los sujetos que los usan. (AU)

[Radiodiagnosis in obstetrics and gynecology]. / Radiodiagnostiek in de verloskunde en de gynaecologie.

Immediately after Röntgen's discovery, people started trying to find uses for the new rays in gynecology and obstetrics. Although the first reports date from 1896-97, even in the 1920's there were textbooks to be found without any mention of the use of radiology in both areas of medicine. The availability of reliable contrast media led to the development of new imaging techniques and to the golden age of obstetrical and gynecological radiology in the 1930-1970 period. Nowadays ultrasound has replaced most conventional techniques while MRI is becoming more and more important. A historical overview of the different radiological techniques is provided.

[Obstetrical study of the pelvis: a historical overview]. / De obstetrische bekkenleer: een historisch overzicht.

The female pelvis is fundamental to life itself, but it took ages to grasp this truism. During Antiquity, physicians had no need for the concepts of pelvic dystocia and cephalopelvic disproportion. When Aranzo (16th century), a practising physician, stated that a disproportion between the size of the fetus and that of the bony pelvis was the main culprit of difficult labor, his suggestion was overlooked, so much so that it was Hendrik van Deventer (1701) who came to be coined "father of the pelvic theory". The need for an accurate knowledge of the dimensions of the maternal pelvis and of the fetal skull became imperative in the middle of the 18th century, when forceps extraction had become popular. Levret, but above all William Smellie, made valuable contributions to the pelvic theory, which, however, were weakened by Baudelocque's fallacies concerning the intrinsic value of external pelvimetry. After the first quarter of the 19th century, the epicenter of scientific obstetrics moved to Germany and Austria, and German-speaking practitioners, e.g. Michaelis, Litzmann, and the Naegele, deepened our insight in the mechanism of labor. After the discovery of the X-rays (1895), the use of instrumental pelvimetry declined, but the clinical breakthrough of radiopelvimetry was delayed until the twenties of this century. Radiopelvimetry, a very valuable technique indeed, dispensed a large number of mothers from undergoing abdominal delivery. However, awareness of the hazards of fetal-maternal exposure to ionizing radiation pushed ante- and intrapartum radiopelvimetry from the scene. Thanks to the progress of chemistry, pharmacology and electronics, "dynamic pelvimetry" became the fad, heralded by what is called "active management of labour". The fetus now assumed the role of "dynamic pelvimeter". The historical circle was closed.