J Marion Sims and the ‘forgotten women of gynaecology’

Dr J Marion Sims (1813–1883) was one of the most prominent physicians of the mid-19th century, especially noted for his development of the first consistently (but not universally) successful operation for the closure of obstetric vesico-vaginal fistula. He developed his surgical technique through a series of operations conducted on enslaved African-American women with this condition during the 1840s.

By today's societal standards, many regard what Sims did as a medical ‘atrocity’. In an article published in the British Journal of Midwifery, volume 27, issue 10, entitled ‘The forgotten women of gynaecology’, Heidi Downes (2019) argued that the contributions to medicine made by the fistula patients of Dr J Marion Sims (1813–1883) should be more widely recognised.

Downes' article offers an opportunity to consider the difficulties of rendering judgment on the clinical practice of past times and different places. If we judge the past on the basis of present assumptions rather than attempt to understand how those who lived in the past saw, experienced and interpreted their circumstances, it is easy to become angry. Although retrospective indignation may be emotionally satisfying, it rarely illuminates what the past meant for those who actually lived it.