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Increasingly desperate as she neared the end of the thirteenth month of her pregnancy, Doña Pascuala, resident of Santa María de la Ladrillera, the fictititious rancho that Manuel Payno chooses as the setting for the opening scene in his late nineteenth-century novel, Los bandidos de Río Frío, sought the help of practitioners of the two forms of obstetrical expertise available. The first was a “wise and distinguished” doctor from the university medical faculty in Mexico City, and, the second, were two curanderas from an impoverished, Nahuatl-speaking community on the very edge of the great capital.[15] Described as herbalists in the novel (as well as “witches”) for their knowledge of the medicinal properties of plants not only from their own region but from building contacts with Indigenous healers from other parts of Mexico, especially the Tierra Caliente, the two women, along with others in their community, had preserved, according to Payno, “their poverty, their ignorance, their superstitions, their kindness, and their customs.”[16] Far from belittling such practices or using the herbalists as a foil to celebrate the triumph of the “modern,” especially as represented by the doctors, Payno pokes fun at both sets of practitioners as he writes into being by means of the productive tension between modern and traditional, the written and the oral, the lettered city and the oral countryside, not only his novel but the Mexican nation itself.[17]

It is the functioning of and the relationship between these two medical systems as they evolved from the colonial period through the nineteenth century that Nora Jaffary explores in her powerfully argued book, Reproduction and Its Discontents. Doing so allows her to make an important contribution to a growing literature on “medical pluralism” in Latin America. Finding that many aspects of pre-Columbian obstetrical practice, like those referenced by Payno, continued to be embraced through the nineteenth century, Jaffary is able to dispute narratives that either celebrate the supposed triumph of modern obstetrical methods over traditional practices or romanticize such popular practices and beliefs as naturalistic, organic, and superior. And, like Payno, she too places at the centre of her narrative the close relationship between childbirth and the project of nation building in Mexico. If, for the nineteenth-century novelist, foregrounding childbirth and the beliefs and practices within which it took place served as a symbolic shorthand for the theme of inheritance — of family name and property, of the empire of Moctezuma[18] (another subplot that runs through the novel), and of the language and traditions that comprise the country — for Jaffary, doing so is a means of highlighting the ways, even if often conflicted, that law, learning, institutions, and traditions shaped reproduction and its outcomes.

To disentangle and thus explicate the strands of the legal, cultural, and medical histories associated with childbirth and contraception, Jaffary adopts a long-term approach to studying the past that breaks with chronological divisions that privilege political processes. For reasons of both convenience and inertia, Mexican history, as it has conventionally been taught at both the undergraduate and graduate levels, has tended to separate the colonial from the national period, with unintended and perhaps, at times, even unrealized, consequences for the study of Mexico’s past. By contrast, in her book, Jaffary embraces as her time frame a period that encompasses both the late colonial and early national periods, at times going back to search out early colonial or even pre-Columbian precedents in practices and beliefs, in order to make of the divide between colony and nation a problem for study rather than an assumed end point or beginning. In doing so, she continues the agenda set by a generation of social, cultural, and gender historians, some working in Canada on the history of this “middle period” in Mexico (and I am thinking particularly here of the work of Sonya Lipsett-Rivera and Luz María Hernández Sáenz).[19] The result of this framing strategy is that Jaffary’s book is relentlessly historical; what I mean is that for each of the themes or sections that she treats in the book — virginity, conception, pregnancy, contraception, abortion, infanticide, monstrous births, obstetrics — the main task that she sets for herself is, first, to trace change and/or its absence across time, and, second, to generate hypotheses that may explain the reasons for that change (or lack thereof).

Such a conceptual strategy, one that I greatly appreciated, shaped to a large extent the way in which I interacted with her book. In the second of the three parts, entitled, “The Hidden History of Contraception, Abortion, and Infanticide,” the employment of this methodology is particularly striking. Jaffary begins with the evidence drawn from her archival research, noting a strong contrast between the paucity of denunciations and prosecutions for the crime of abortion during the colonial era and a dramatic rise in the number of women and men denounced for having procured or performed abortions in the last two decades of the nineteenth century. She provides the actual number of cases she encountered as well as a discussion of the institutional contexts within which the evidence was generated. What then follows is a working through of possible explanations to account for such change over time. The first explanation she proposes is that the creation of new state institutions, like the Tribunal Superior de Justicia del Distrito Federal, from which almost all cases in the later part of the nineteenth century are drawn, may have facilitated the increased documentation of this crime. She then considers or, better, thinks through, for readers, all the reasons she finds this explanation to be unsatisfactory: first, the Bourbon court system in the late colonial period did not document a single case of infanticide or abortion, despite the extent of its reach and its perceived competence; and second, similar stark rises in rates of denouncements were not apparent for other crimes, but, rather, rates were more similar to those found in the Bourbon courts. Looking elsewhere for an explanation, Jaffary suggests that modifications in the 1871 penal code reducing punishment for the performance of abortions in certain circumstances along with a formalization of the notion that women of all social stations needed to guard their reputations, “may have” influenced rates of denunciation and conviction. This official message, Jaffary argues, “may have fallen upon receptive ears, leading to increased denunciations,” a shift that Jaffary associates with a change in the public perception of abortion (pp. 102-3).

At every step readers are aware of, and thus have the ability to, judge the interpretive burden the sources are being asked to bear in making this argument (as well as others). As I read the book, I often found myself trying to generate alternative explanations to account for the changes being discussed. Could the reason for the increase in the number of denunciations of abortion, for example, be related to a change in popular perceptions of the judicial system and the uses it might be put to, especially in cases having to do with buenas costumbres (moral habits and good reputation)? Or, rather than a measure of changing attitudes or new public perceptions, could the use of the state’s language in courtrooms, as in the case of infanticide, represent a strategic use of official rhetoric and legal language by everyday defendants, almost like a script, in an instrumentalist fashion, in hopes of receiving a reduced sentence or a favourable verdict, as Jaffary herself suggests at points (pp. 128-9). I offer these alternatives not as a criticism of Jaffary’s explanation in this example, but as a compliment. Her means of working from sources to conclusions seems a particularly compelling manner of writing history that engages the reader in the fundamental process of evaluating evidence and generating explanations to account for it and to offer a particularly productive way of advancing discussions in the field.

The originality of her argument in the section on contraception and abortion, and in the following chapter on infanticide, is in introducing the hypothesis that it was people themselves, rather than state actors or élites or medical authorities, who played a more crucial role in denouncing crimes in cases of abortion and infanticide by the late nineteenth century than has previously been acknowledged. Such cases, Jaffary argues, would not have been pursued without the support of community members (pp. 132-3). Central to this argument, as it is to many of the themes considered in the book, is the change in understandings of and increased emphasis on female virginity and female virtue more generally that Jaffary charts over the course of the nineteenth century, the subject with which she begins her book. If, in doing so, she has returned to an explanatory variable familiar to Latin American historians, that of honour, understood as a set of cultural values and an ordering principle of society and an evaluation of the public reputation of individuals and families in it, it is in a new way, in order to stress its expanding reach down the social scale and its connection to projects of national imagining. Underpinning many of the changes she charts in the book is the increasing preoccupation of ever-greater numbers of women from more humble ranks on the socioeconomic scale with female sexual virtue; in contrast to earlier periods, however, by the late nineteenth century the purity and productivity of the entire nation were at stake rather merely than the legitimacy of the colonial élite. Such a shift, upon which were premised many of the changes that Jaffary charts, she tentatively explains as the possible result of new state imperatives and concerns with populating the country and creating a healthy and productive citizenry. Given that this shift in the social status of claimants to honour underpins many of her subsequent arguments, it is remarkable how careful she is in accounting for it, never doing more than suggesting that non-élite actors may have been responding to state initiatives that increasingly premised governing and economic modernization on the ability to cultivate a productive and healthy citizenry (see the language used on pp. 100 and 102, for example).

Implementing such a developmentalist ethos meant increased scrutiny for all women, with a prominent role for medicine, especially obstetrics, practiced in a nationalistic register. Perhaps no single text that Jaffary discusses combines heightened anxiety over or preoccupation with women’s virginity with the attempt to constitute medically a national body quite like Francisco de Asis Flores y Troncoso’s, El himen en México, published in 1885.[20] Flores y Troncoso’s was one of a number of works written during the Porfiriato — works concerned with criminality, medicine, and jurisprudence — that were premised upon the assumption that the body itself, in this case, that of the Mexican woman, bore the characteristics of national identity that it could be made to yield under the gaze of “experts.” Concluding that the forms of the hymen in Mexico were annular, labial, and semi-lunar and horseshoe-shaped, with the final form meriting a place in Mexican medical classification, Flores y Troncoso’s work was not only meant as an attempt to carry out a specifically Mexican form of science, but also to be used as a resource in legal cases, especially those concerned with rapto (abduction from parental authorities), estupro (initiation of sexual relations), and violación (rape), where the law required that the state of the woman’s hymen be determined.[21] Medical authorities like Flores y Troncoso shared with judicial officials a preoccupation with the state of the woman’s hymen.

In doing so, legal and medical authorities echoed one of the primary concerns of many of the suitors writing love letters at the time. In my own work on love letters during the late nineteenth and early twentieth century in Mexico, I found extensive collections of love letters in judicial archives that had been submitted as proof of a written promise of marriage in the legal proceedings concerned with some of the cases mentioned above. Demanding in their letters what they referred to as a “prueba de amor” or “proof of love,” male suitors asked that women agree to sexual relations with them, in order to determine the woman’s state to their satisfaction, as they put it, in exchange for a promise of marriage.[22] Such letters reveal not only a common preoccupation with virginity, but also the existence of a number of bodies in addition to or sharing space with the medicalized one. In love letters, courting couples wrote into existence an epistolary body, composed of hearts, eyes, and hymens but also of wills, souls, and passion. The legal system recognized a judicial persona, a gendered construct that reserved for those who qualified the protection of the law, and an official family, the target of much nineteenth-century legislation. It is Jaffary’s discussion of Flores y Troncoso’s book, as well as of the work of his mentor, the celebrated obstetrician, Juan María Rodríguez, and that of another of Rodríguez’s students on the supposed peculiarities and pathologies of Mexican women’s pelvises, through which she highlights the role that medical experts established for themselves over the course of the nineteenth century as arbiters not only of the health of the nation, but of the contours and characteristics of its body politic (pp. 198-9).

While women’s bodies served as one of the privileged discursive sites to articulate national characteristics, moral attributes, and normative behaviour attested by these medical texts and by the thriving literature on prostitution and criminality generated during the Porfiriato, Rodríguez and his students’ focus on women’s reproductive anatomy led not only to the identification of a new discursive site on the female body — the uterus, supposedly responsible for the genesis of monstrosity in births — but also to grave consequences for women subjected to medical procedures to address their supposedly particular national malady, their narrow pelvises (pp. 198-9). Jaffary discusses how Rodríguez pioneered what he referred to as the “national procedure,” the injection of cold water into the uterus to dilate the cervix and provoke birth, and how other practitioners took up new medical instruments to deal with Mexican women experiencing difficult labours. Rates of maternal mortality in cases of surgical intervention at Mexico City’s Casa de Maternidad were unusually high and physicians and officials, blinded by their nationalist preoccupations, failed to identify the source of infections in puerperal women, blaming the nature and bodies of Mexican women themselves, rather than their unsterilized medical instruments. The novelist Payno captures the hubris of medical doctors along with his own recognition of the potentially deadly consequences of surgical intervention in childbirth. Asked for advice concerning the case of the prolongedly-pregnant doña Pascuala in Bandidos de Río Frío, a medical doctor from the prestigious national university in the country’s capital offers the following: “I can say that certainly, to me, an operation appears indispensable, but there are two inconveniences. The first and principal is that the patient may not be able to survive it and it is probable that the baby would also perish with her …”[23] Regardless of the dangers and possible knowledge of them, by the late nineteenth century increasing numbers of Mexican women, as Jaffary shows, were choosing to give birth in institutional settings, the “products and producers of a new public discourse … that overturned the highly private nature of childbirth and conception” (p. 208). Perhaps no single sentence better captures the two poles — women as subjects of and subject to the social construction of reproductive maternity and biology — around which Jaffary structures her entire book.

Having begun this discussion in Santa María de la Ladrillera, perhaps it is only fitting to return to Payno’s fictional locale at the end of it to offer one final observation on Jaffary’s fine book. As we now know, Payno launches his novel with doña Pascuala’s pregnancy, for him a means of highlighting many of the themes around which the novel turns, including those of inheritance, family, race, and nation. Of particularly significant, however, is that he chooses to do so by means of two (fictitious) newspaper articles, one in the official and another in the oppositional press. As a result, readers are immediately immersed not only in the events themselves, but also in the ways that themes such as childbirth, inheritance, gestation, and medicine play out in the press as part of a politics adjudicated in an emerging public sphere. While the official press, in this particular fictive instance, refutes many of the claims made by the opposition, seeing its focus on a prolonged pregnancy as a metaphor for governmental inaction in other matters, perhaps even more significant is that “the public” is the avowed addressee, as well as the progeny, of such reporting. The novel itself initially appeared as monthly installments in the press between 1889 and 1891, and it incorporates within its text, in addition to newspaper articles, such writing forms as legal expedientes, letters, political pronouncements, secret notes, and recipe cards, genres within which people found themselves increasingly immersed or engaged. Located within the confines of what Angel Rama has termed the “lettered city” — that site linking power, the ability to manipulate the written word and the urban centre — Los bandidos de Río Frío has everyone reading on the same page of the novel of the nation, even if by means of incorporating the common speech, customs, and habits of everyday Mexicans into its text.[24]

Newspaper articles and various genres of writing are featured prominently in the pages of Reproduction and Its Discontents. Particularly apposite is that Jaffary begins a chapter on “Monstrous Births,” the first chapter of the third section of the book, entitled, “Populating the Patria,” with two newspaper announcements (not fictional) reporting on the birth of monstrous babies, one from the second half of the eighteenth century and the other from the late nineteenth century, bookending the period she examines to argue that the way “monstrous” births were treated by the popular press changed. Whereas they were initially viewed as natural wonders and objects of pleasure, they were seen with horror and repugnance by the end of the nineteenth century. Although I am interested in these changes in perception, my concern at this point is with the relationship Jaffary sees between the periodical press at different points in time and the emergence of a “general public” that she associates with it (p. 171). Certainly, Jaffary is sensitive to the perceived power of the written word, as when, during the colonial period, she discusses how some women, when nearing or entering labour, would consume holy wafers inscribed with the “words of the Virgin” and when she describes how others would write the words to a prayer, burn the paper upon which they were written, and then mix the ashes in a drink for pregnant women to ingest (p. 23). And, her treatment of the Gaceta de México, one of New Spain’s earliest news publications, is exemplary in its concern with the degree to which this particular periodical was responsive to the “reading tastes, expectations, and attitudes of its readership,” which was comprised of wealthy, literate residents of the capital. Editors had a fine sense of what might constitute “hechos gazetables” for its readers as it produced a public that recognized itself in the “common experiences reported in its pages …” (p. 162).[25]

For monstrous birth announcements in the nineteenth century, Jaffary consults, in addition to the Gaceta de México (which continued publication after independence), a number of different genres of periodicals, including the Mexico City daily, El Siglo Diez y Nueve, more specialized scientific journals, such as El Museo Mexicano, and others, including El Monitor Republicano, La Revista Mercantil de Chihuahua, and El Universal. An 1893 broadside by engraver José Guadalupe Posada is also highlighted in her text, depicting a baby with an extra set of eye sockets, hairy legs, and a tail; Posada’s image was accompanied by an article that stressed that this monstrous birth had caused “a horrible sensation in all classes of society” (p. 165). Given this evidence, Jaffary, by the end of the chapter, claims that “the general public” regarded monstrous births with horror and repugnance. It is the introduction of this actor, “the general public,” and the claims made on its behalf, that give me pause. I am not arguing that more or different sources needed to be utilized in order to make such claims on its behalf, but that it is the category itself, “the general public,” that may need to be pulled apart. Recent work by Rob Buffington on the “counterpublic” formed by means of the penny press during the Porfiriato, and by Pablo Piccato on the public and the public sphere in the second half of the nineteenth century, reveal that “the public” has a history, one to which Jaffary makes a contribution in her book.[26] Perhaps various genres of the press and periodicals helped bring into being publics (or counterpublics) around such sites not only of women’s social honour but also around childbirth. Perhaps, also, increased scrutiny and interest in women’s reproductive and contraceptive practices was a constitutive part of being formed into such a public, where the various genres of periodicals become part of the story as much as the sources of evidence of a story taking place somewhere else. What I am suggesting is that trends that Jaffary sees as taking place contemporaneously may in fact be related.

Having finally given birth to a male child after an emotional shock that only those readers/listeners who rush to consult Manuel Payno’s Bandidos de Río Frío will learn about, doña Pascuala commissioned a retablo (votive painting) that featured a likeness of her in one corner, pregnant and moribund, beseeching the Virgin of Guadalupe who appeared in the other. The two curanderas are praying with her. Conspicuously absent from the image is the medical doctor, to whom the text on the retablo is mostly dedicated: “She called for Doctor Cordoniú to come to her assistance, but he, like the other doctors from the University, erred in his cure.”[27] Image and the written word; curanderas and medical doctors; and the Virgin of Guadalupe as the symbol of Mexico, all occupy the same frame, all brought together around one subject — the birth of a child. Those interested in change and constancy in Mexico’s reproductive history, as well as in the ways that national imagining, the construction of medical knowledge, and understandings of maternity, virginity, contraception, abortion, and the discourses implicated in them must necessarily occupy the same frame, need look no further than Reproduction and Its Discontents. Not only does Jaffary make such a compelling case in a voice every bit as powerful and original as that of Payno, she convinces a much broader audience why this all matters.