What Is the Sims' Position?

A healthcare practitioner might have to place a patient into the Sims' position for a rectal or a vaginal examination. Lying on the left side on a bed or examination table, the patient slightly flexes the right hip and right knee. This allows for easy access to the rectal or vaginal cavity, whether for examination, vaginal treatments, colonic therapy or other more intensive surgical procedures like a colonoscopy.

The Sims' position is not the only medical device or practice named after 19th century Alabama gynecologist J. Marion Sims. The Sims' speculum, or duck-billed speculum, is still in use today to give doctors greater access to regions of the uterus most effected by a condition of childbirth called vesico-vaginal fistula, which is tearing of the tissue between the vagina and bladder, as opposed to the typical tearing that can occur between vagina and anus. After controversial surgeries performed on slave labor over a decade or more, Sims discovered a way to repair these tears. The resulting procedure and other developments earned him the title among many American OB-GYN practitioners as the "father of gynecology."

It is not difficult to help a patient assume the Sims' position. First, the patient lays on one side, placing the under arm behind the back. Then the patient flexes the upper thigh. The knee is half-flexed to slightly raise one hip and reveal the vaginal or rectal cavity.


Once the rectal or vaginal cavity is exposed, a range of procedures can be performed. In a medical setting, this could be for an examination of a patient's vaginal tear, hemorrhoids or an endoscopic procedure called a colonoscopy, which may or may not involve the removal of a tumor or cyst from the lower regions of the digestive tract. In a preventative health environment, colonics are performed with patients in the Sims' position. This is also a preferred position for women in the later stages of pregnancy.

Medical professionals have a range of patient positions in their arsenal. Some of the most basic of these is the supine position, with the patient flat on his or her back and a pillow under the head, or the prone position, with the patient flat on his or her stomach. Another position named after its creator is Fowler's position. Created by New York surgeon George Fowler in the late 19th century, this position involves the supine position and the patient's upper torso to be elevated at various levels depending on the purpose — from a low angle to ease abdominal tension to a high level for meal time.


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Post 3

@irontoenail - I guess my objection is that people call him the father of gynecological medicine. Yes, he invented procedures and positions and instruments. He should be remembered. But just because we remember him, doesn't mean we should celebrate him.

Post 2

@umbra21 - Honestly, I don't know much about this particular case, but I always wonder if these kinds of doctors would feel like this about all people and see them as means to an end. He just happened to have easy access to this particular marginalized group who suffered from this particular problem.

And, to be fair, the women would have been suffering from the condition before he tried to cure it. It's a horrible condition and one which many women still suffer in places where they can't get proper medical condition. They essentially have no control over their bladders, because they have been torn up.

He may have been experimenting, but at least he didn't inflict the condition on them in the first place, as is often the case in controversial medical trials. And he came up with a way of fixing it.

Post 1

That makes me so sad that Sims practiced that procedure on slaves in order to develop it. I'm always horrified by some of what went on in medical studies. How could doctors, who must know better than anyone that we are all human and we all bleed the same, treat one group of people differently to others?

I know this procedure is used to save women all over the world from a terrible condition now, but it's hard to reconcile that with how the treatment was developed.

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