The following is an excerpt from the introduction of Surgery & Salvation: The Roots of Reproductive Injustice in Mexico, 1770–1940 by Elizabeth O’Brien, which is now available wherever books are sold.
In the early morning hours of March 12, 1884, a pregnant eighteen-year-old walked on a derelict pathway in Mexico City. Known colloquially as Devil’s Alley, the street has been featured in generations of ghost stories and urban legends. It was also infamous as a site of sexual commerce. Historians do not know what brought the girl to the backstreet, but we do know that her labor pains had not yet begun, nor was she in the midst of a medical complication. In the shadowy lane she encountered two women; they reportedly pitied the youth and persuaded her to accompany them to Mexico City’s maternity clinic, la Casa de Maternidad.
Since 1806, la Casa de Maternidad had been a clinic for secret births: a place of refuge for so-called fallen women who wished to hide their pregnancies from friends, family, or the public. By the 1880s, la Casa served women of all classes. Some paid for the comfort of a private room during their stay. Most, unable to pay, received free maternity care. Some patients were brought to the Casa by volunteers from societies like las Damas de la Caridad. The Damas organized philanthropic activities and collaborated with authorities to deliver food and medicine to the homes of people who were ill or destitute. In collaboration with the Sanitary Police, the religious women also roamed the city and detained women for imprisonment in hospitals. By the 1910s, more than half the women patients in the General Hospital were carted into the establishment by the Sanitary Police; in the 1930s, nurses and social workers performed the same kind of door-to-door medico-moralization that compelled thousands of women to assent to state care.
When the young woman walked through the doors of the clinic in 1884, she was greeted by the lead physician on duty, José Torres Anzorena. He escorted her to an ample room with a bed, a fluffy cotton pillow, and clean white sheets. As he would later write, he sought to make her comfortable. The expectant mother may have been surprised by her reception in the clinic. She likely had little institutional familiarity with hospitals, as women rarely sought hospital obstetric care in the 1880s. The vast majority birthed at home or in sweat lodges called temazcales, with the assistance of midwives who provided herbal tinctures and teas to increase the strength of their contractions. Midwives also guided women in the use of birthing stools and saw to postpartum hygiene practices. The late nineteenth-century medicalization of childbirth brought with it the criminalization of popular and unlicensed midwifery; with fewer available midwives, more women sought health care in medical clinics. Midwives resisted with every means they had: by signing petitions, holding protests, and flouting licensing regulations.
Other factors pushed people into the Mexico City’s clinics by the last decades of the nineteenth century. Rapid industrialization prompted massive waves of migration to the city. By 1900, migrants from other states made up over one-half of the federal district’s 500,000 inhabitants. Hospitals provided recent arrivals with health care, shelter, and food. Obstetric patients came from all over the nation but especially from the states of Morelos, Guerrero, Oaxaca, and Veracruz. Others hailed from communities near and far, especially Toluca, Guadalajara, Querétaro, Jalisco, and the state of Mexico.
Public clinics were staffed by medical students and physicians of the Escuela Nacional Preparatoria (ENP), established in 1868. Medical education required a large number of patients on whom students and professors could practice examinations, diagnoses, surgeries, and autopsies. In fact, until 1936 students were required to design and perform medical research in Mexico City’s clinics. Earning a medical degree required them to publish and defend their studies.
It is impossible to know whether the eighteen-year-old of Devil’s Alley was accused of sex work, but she clearly became an unwitting surgical patient.
The medical school enjoyed massive funding from the cabinet of president Porfirio Díaz, who held office between 1876 and 1911. Díaz yearned to establish one of the biggest and most prestigious centers for scientific training in Latin America, one to rival the medical training of universities in Rio de Janeiro, Lima, and Bogotá, as well as Paris, Philadelphia, Boston, and Edinburgh. Outbreaks of diseases like cholera, bubonic plague, smallpox, measles, and typhus prompted public health officials to collaborate closely with physicians to address public health problems, including sex work. On the one hand, elites frequented upscale brothels, implying their tacit approval of sex work. On the other hand, rebellious “public women” degraded Mexico City’s image, and officials increasingly sought to bring them under state control. Some of these women, pregnant and not, became obstetric and gynecologic patients for Mexico City’s physicians in training.
It is impossible to know whether the eighteen-year-old of Devil’s Alley was accused of sex work, but she clearly became an unwitting surgical patient. In the Casa de Maternidad she met the nation’s most influential obstetrician, Dr. Juan María Rodríguez, who had been the clinic director and chief professor of obstetrics for fifteen years. She did not respond when Rodríguez and Anzorena addressed her. Perhaps she spoke an Indigenous language and could not understand their Spanish. Perhaps she refused to recognize their authority, and her silence signaled resistance. Or perhaps she suffered a disability and could not hear them or could not speak. Whatever the case, she almost certainly became perplexed by what happened next.
Drs. Rodríguez and Anzorena exited the room, and then returned in the company of another, younger man, who covered her face with a mask and held it there. Inhalation brought a pleasant odor and a burning, sweet taste. Chloroform incapacitated the patient, and then she was transported to the operating room where she underwent the first caesarean operation performed in a Mexican hospital for a medical purpose. She never awoke.
Elizabeth O’Brien is assistant professor of history at the University of California, Los Angeles.