Embryo Project Encyclopedia

James Marion Sims developed a surgical cure for ruptures of the wall separating the bladder from the vagina during labor, ruptures called vesico-vaginal fistulas, and he developed techniques and tools used to improve reproductive examinations and health care for women in the US during the nineteenth century. Sims's lateral examination position allowed doctors to better see the vaginal cavity, and his speculum, a spoon-like object used for increased view into the vagina, helped to make gynecological examinations more thorough. Sims helped ease the physical and social strains of post-birth women who suffered from vesico-vaginal fistulas, and he established the first hospital in New York City, New York, dedicated solely to treating women and improving women's health care.

An intrauterine pressure catheter (IUPC) is a device placed inside a pregnant woman’s uterus to monitor uterine contractions during labor. During labor, a woman’s uterus contracts to dilate, or open, the cervix and push the fetus into the birth canal. The catheter measures the pressure within the amniotic space during contractions and allows physicians to evaluate the strength, frequency, and duration of contractions. Those measurements enable physicians to evaluate the progression of labor and intervene when contractions are too weak to properly dilate a laboring woman’s cervix to successfully deliver a fetus. Though IUPCs are not used routinely, they are important in cases where external fetal monitoring is not sufficient to monitor a difficult labor. Intrauterine pressure catheters give physicians an extremely accurate measurement of intrauterine pressure, making it possible to determine whether intervention is needed to progress the labor.

In 2014, Big Belli, a media and social networking brand, released a documentary called 40 Weeks online. The documentary, directed by Christopher Henze, followed multiple women during their pregnancies. The film predominantly features three women, though it includes the stories of many. Throughout the film, women detail their accounts of the physical and emotional changes that occur during pregnancy. 40 Weeks provides viewers with information about different aspects of pregnancy including the importance of nutrition and hydration, knowledge about safe medications, and the possible complications that can affect a pregnant woman and her fetus.

NovaSure is a device for endometrial ablation, which is a procedure that removes the endometrium, that the US Food and Drug Administration, or FDA, approved for use on 28 September 2001. Endometrium is the tissue that lines the uterus. NovaSure destroys the endometrium by sending electric beams at the endometrium. Hologic, a medical technology company concerned with women’s health, developed NovaSure to treat menorrhagia, or heavy bleeding during menstruation. Menorrhagia is a common symptom of endometriosis. Endometriosis is the growth of the endometrium outside of the uterus. While NovaSure is not a treatment that doctors use to directly treat endometriosis, the procedure may help alleviate heavy bleeding during menstruation, which may improve a patient’s quality of life as heavy menstrual bleeding is often associated with high levels of anxiety and low levels of confidence.

The Martius flap procedure is a surgical procedure used to treat obstetric fistulas in women. Heinrich Martius developed the procedure in twentieth century Germany to treat women with urinary incontinence caused by stress, and later doctors used it to repair obstetric fistulas. Fistulas occur in pregnant women when a hole is torn between the vagina and the urinary tract (called vesicovaginal) or the vagina and the rectum (called rectovaginal). The hole, or fistula, occurs in the tissue separating two organs and therefore obstetric fistulas result in either urinary or fecal incontinence. Fistulas can occur due to surgery, injury, or chemotherapy, but they most commonly occur in pregnant women who experience prolonged labor and do not have adequate access to obstetric care. As a result of the Martius flap procedure, patients regain functional use of their vaginas without continued urinary or fecal incontinence.

In 1916 Edwin B. Cragin in the United States published Conservatism in Obstetrics in which he discussed medical practices and techniques to preserve the vitality of pregnant women and their fetuses. Cragin argued that women who give birth via cesarean section, the surgical act of making an incision through both the abdomen and uterus to remove the fetus from a pregnant woman's womb, must rely on that method for future births. That claim was later coined the Dictum of Cragin. In Conservatism in Obstetrics, Cragin described obstetric techniques to maintain healthy births for women and fetuses. Cragin's article outlined the best practices for obstetricians in the early twentieth century, and publicized the claim that if a woman delivers a newborn via cesarean section, she should deliver any future newborn via the same method, a theory that persisted throughout the century.

Starting in 1929, the Royal College of Obstetricians and Gynaecologists was a professional association of physicians in the UK that aimed to improve the care of women in childbirth through training and education and to establish obstetrics and gynecology as a medical specialty. The Royal College of Obstetricians and Gynaecologists has contributed to women’s reproductive health by fostering research, establishing standards for physicians specializing in obstetrics and gynecology, and influencing legislation.

In July 2015, Ana J. Torvie, Lisa S. Callegari, Melissa A. Schiff, and Katherine E. Debiec published “Labor and Delivery Outcomes Among Young Adolescents,” hereafter “Labor and Delivery Outcomes,” in the American Journal for Obstetrics and Gynecology. The authors conducted a study using birth certificate data and hospital records in the state of Washington to compare the frequency and outcomes of cesarean and surgically assisted vaginal births among different age groups of pregnant people. They found that adolescents aged eleven to fourteen years are less likely to require cesarean or surgically assisted births but that their neonates were more likely to have birth-related complications than those of adults aged twenty to twenty-four years. While previous studies had yielded conflicting results, “Labor and Delivery Outcomes” reports generalized trends about young adolescents in labor and delivery. The researchers’ findings support future physicians in making more informed considerations for the care of pregnant patients under the age of fifteen.

In Gonzales v. Carhart (2007), the US Supreme Court held in a five-to-four decision that the 2003 Partial-Birth Abortion Ban Act passed by the US Congress was constitutional. Although the Court previously ruled in Stenberg v. Carhart (2000) that a Nebraska law that prohibited partial-birth abortions was unconstitutional, Gonzales reversed this decision. Gonzales created the precedent that anyone who delivers and kills a living fetus could be subject to legal consequences, unless he or she performed the procedure to save the life of the mother.