Embryo Project Encyclopedia

During the mid-twentieth century, Virginia Apgar worked as an obstetrical anesthesiologist and gave drugs to women that reduced their pain during childbirth in the US. In 1953, Apgar created a scoring system, called the Apgar score, that uses five measurements, including heart rate and breathing rate. The Apgar score evaluates newborn infants and determines who needs immediate medical attention. Apgar's work helped decrease infant mortality rates. As of 2020, hospitals around the world use the Apgar score.

Isotretinoin is a molecule and a byproduct (metabolite) of vitamin A, and in greater than normal amounts in pregnant women, it can cause fetal abnormalities including cleft lips, ear and eye defects, and mental retardation. Isotretinoin is commonly called by its trade name Accutane, and it's a chemical compound derived from vitamin A, or retinoic acid. Doctors prescribe isotretinoin to treat severe acne. For pregnant women, too much vitamin A or isotretinoin can also cause greater than normal rates of stillbirths and fetal disintegrations after the ninth week of gestation. Women who use isotretinoin during the first trimester of their pregnancies, even in small amounts, risk defects to their fetuses such as external ear malformations, cleft palates, undersized jaws (micrognathia), a variety of heart defects, buildups of fluids inside the skulls that leads to brain swelling (hydrocephalus), small heads and brains (microcephaly), and mental retardation.

Josef Warkany studied the environmental causes of birth defects in the United States in the twentieth century. Warkany was one of the first researchers to show that factors in the environment could cause birth defects, and he helped to develop guidelines for the field of teratology, the study of birth defects. Prior to Warkany’s work, scientists struggled to explain if or how environmental agents could cause birth defects. Warkany demonstrated that a deficiency or excess of vitamin A in maternal nutrition could cause birth defects. He also established that mercury in teething powders increased infant mortality rates. Warkany showed how substances outside the human body could adversely affect conception, growth, and development of the human fetus in utero.

In its 1993 decision Daubert v. Merrell Dow Pharmaceuticals, Inc., the US Supreme Court established the Daubert Standard for evaluating the admissibility of scientific knowledge as evidence in US federal courts. When it began in trial court, the case addressed whether or not Bendectin, an anti-nausea medication taken during pregnancy, caused birth defects. However, after the trial court dismissed the case for lack of admissible evidence, Daubert v. Merrell Dow Pharmaceuticals, Inc. advanced through appeals courts to the US Supreme Court, where the Justices defined the criteria by which scientific knowledge, which for them included a least theories based on evidence, expert testimony from scientists, and scientific techniques, could be introduced and used in court cases as evidence. The Daubert Standard states that the judge of a case is responsible for determining what claims are admissible as scientific knowledge and as evidence in the case. The admissibility should be determined by the falsifiability of the claims, by whether or not they had passed peer reviewed, by the general scientific acceptance of the claims, and for techniques, by their error rates of the techniques. Daubert v. Merrell Dow Pharmaceuticals, Inc. set a landmark precedent in the US judicial system and influenced most subsequent legal cases that appealed to science to establish facts in trials.

Henry Morgentaler was a physician who performed abortions, acted as a reproductive rights activist, and advocated for legal access to abortions in Canada during the twentieth century. In 1969, he opened his first abortion clinic in Canada and participated in the legal/court case of R v. Morgentaler (1988), which led Canada to decriminalize abortion. Morgentaler helped establish legal access to abortions for women in Canada and advocated for the protection of women's reproductive choices under the law.

Where Are My Children? is an anti-abortion silent film released in the United States on 16 April 1916. The film was directed by Lois Weber and Phillips Smalley and produced by Universal Film Manufacturing Company/Lois Weber Productions in Universal City, California. In the film, Weber tells a story of an attorney who wants to have children and raise a family, but his wife chooses to abort her pregnancies, fearing that having children will ruin her social activities. In the early 1900s, information about contraception was not freely available or legal to obtain. Physicians were allowed to distribute contraceptives only if the woman would be put in a life-threatening circumstance were she to get pregnant. In the film, Weber encourages contraceptives as a means of family planning, but advocates against abortions. Where Are My Children? is one of the first films to discuss birth control and family planning, and it is among the first to push against motion picture censorship of contraception and family planning in cinema.

Margaret Higgins Sanger advocated for birth control in the United States and Europe during the late nineteenth and early twentieth centuries. Although people used contraceptives prior to the twentieth century, in the US the 1873 Comstock Act made the distribution of information relating to the use of contraceptives illegal, and similar state-level Comstock laws also classified discussion and dissemination of contraceptives as illegal. Sanger helped to repeal the Comstock Act and similar laws so that women could legally use contraceptives to control their fertility and the sizes of their families. In 1916, Sanger opened the first birth control clinic in the US in New York City, New York. Later in life, Sanger formed several advocacy organizations that promoted access to contraception, including the Planned Parenthood Federation of America. Sanger's advocacy increased women's access to contraception and helped change the United States' social and legal perceptions of birth control.

Margaret Goldwater advocated for birth control and reproductive rights in the United States during the twentieth century. Goldwater was a socialite and philanthropist and was married to Barry Goldwater, US Senator from Arizona. She spent much of her life working to further the women's reproductive rights movement, which sought to expand women's legal, social, and physical access to reproductive healthcare, including contraception and abortions. Goldwater, with guidance from birth control activist Margaret Sanger, helped establish the second birth control clinic in Arizona, the Mother's Health Clinic in Phoenix, Arizona. She conducted large fundraising events and authored articles in local newspapers on the need for contraceptives and family planning. Goldwater's advocacy helped launch and sustain The Mother's Health Clinic, which became the largest provider of women's reproductive healthcare in Arizona, and it later became Planned Parenthood of Central and Northern Arizona.

In March 1996, the National Academy of Sciences of the United States released 'Veterans and Agent Orange Update 1996: Summary and Research Highlights,' which summarized research on the health effects of Agent Orange and other herbicides used in the Vietnam War. In their 1996 report, the National Academy connects Agent Orange exposure with two health conditions: spina bifida, a birth defect that occurs when the spinal cord develops improperly, and peripheral neuropathy, a nervous system condition in which the peripheral nerves are damaged. Spina bifida was the first birth defect to linked to Agent Orange exposure. The resulting disability compensation for affected children, as a result of the conclusions in the 1996 report, marked the first time that the US Veterans Administration addressed the health outcomes of veterans' families, and not exclusively veterans themselves.

Sprayed extensively by the US military in Vietnam, Agent Orange contained a dioxin contaminant later found to be toxic to humans. Despite reports by Vietnamese citizens and Vietnam War veterans of increased rates of stillbirths and birth defects in their children, studies in the 1980s showed conflicting evidence for an association between the two. In 1996, the US National Academy of Sciences reported that there was evidence that suggested dioxin and Agent Orange exposure caused spina bifida, a birth defect in which the spinal cord develops improperly. The US Department of Veterans Affairs' subsequent provision of disability compensation for spina bifida-affected children marked the US government's first official acknowledgement of a link between Agent Orange and birth defects. By 2016, spina bifida and related neural tube defects were the only birth defects associated with Agent Orange.