Embryo Project Encyclopedia

Pierre Constant Budin worked in France to improve the lives of newborns and their mothers during the late nineteenth century. Budin stressed the importance of proper nutrition in infants and educated new mothers on breastfeeding and infant care. Budin established infant care facilities and created a nutritional check-up system for infants. Budin helped design early artificial nipples, breast pumps, and incubators for premature newborns. He also began the practice of consulting with new mothers after they gave birth, redefining the roles of obstetricians.

In the 1950s and 1960s, researchers Leon Chesley, John Annitto, and Robert Cosgrove investigated the possible familial factor for the conditions of preeclampsia and eclampsia in pregnant women. Preeclampsia and eclampsia, which are related to high blood pressure, have unknown causes and affect at least five percent of all pregnancies. The researchers, who worked at Margaret Hague Maternity Hospital in Jersey City, New Jersey, used hospital patient records to find and reexamine women who had eclampsia at the hospital, as well as their daughters, sisters, daughters-in-law, and granddaughters. Chesley and colleagues found that the daughters and granddaughters of eclamptic women were more likely than the female offspring of non-eclamptic women to have preeclampsia and eclampsia in their own pregnancies, and especially in their first pregnancies. The study provided evidence that the disorders are inherited, enabling physicians to better monitor pregnancies in women who have a known family history for preeclampsia and eclampsia.

In 1948, Olive Watkins Smith published 'Diethylstilbestrol in the Prevention and Treatment of Complications of Pregnancy' in the American Journal of Obstetrics and Gynecology. In 632 women treated with diethylstilbestrol, Smith demonstrated that the drug stimulated the production of progesterone, a hormone that regulates the uterine condition during pregnancy. On the basis of her article, and several follow up articles authored by Smith and her husband, George Van Siclen Smith, physicians around the world began prescribing DES to women at risk for pregnancy complications like miscarriage and premature delivery. However, in 1953, researchers at found that DES did not prevent pregnancy complications. In 1970, researchers linked fetal exposure to DES to rare and severe cancers later in life. Researchers labeled DES as an endocrine disruptor, a substance that disrupts the hormone system of the body across multiple generations.

In the 1964 article, “Pelvic Scoring for Elective Induction,” obstetrician Edward Bishop describes his method to determine whether a doctor should induce labor, or artificially start the birthing process, in a pregnant woman. Aside from medical emergencies, a woman can elect to induce labor to choose when she gives birth and have a shorter than normal labor. The 1964 publication followed an earlier article by Bishop, also about elective induction. In both articles, Bishop used data gathered from the obstetrics department of Pennsylvania Hospital in Philadelphia, Pennsylvania, where he worked. In “Pelvic Scoring for Elective Induction,” Bishop introduces a scoring system later known as the Bishop Score, used into the twenty-first century, to determine if a pregnant woman fits the criteria for a safe and successful induction.

In the early twentieth century US, Jean Paul Pratt and Edgar Allen conducted clinical experiments on women who had abnormal menstrual cycles. During the clinical tests, researchers injected the hormone estrogen into their patients to alleviate their menstrual ailments, which ranged from irregular cycles to natural menopause. The hormone estrogen plays a prominent role in the menstrual cycle by signaling the tissue lining the uterus (endometrium) to thicken in preparation for possible pregnancy. In their clinical tests, Pratt and Allen showed that injecting estrogen into female human subjects restored their normal menstrual cycle, removed symptoms such as hot flashes, and caused uterine tissue to grow. The clinical tests conducted by Pratt and Allen provided experimental evidence and justification for the injection of isolated estrogen in women to alleviate, for a short amount of time, different menstrual problems, and it contributed to later hormone therapy research.

In 1952 Virginia Apgar, a physician at the Sloane Women’s Hospital in New York City, New York, created the Apgar score as a method of evaluating newborn infants’ health to determine if they required medical intervention. The score included five separate categories, including heart rate, breathing rate, reaction to stimuli, muscle activity, and color. An infant received a score from zero to two in each category, and those scores added up to the infant’s total score out of ten. An infant with a score of ten was healthy, and those with low scores required medical attention at birth. Apgar originally used the score to determine how infants responded to the pain-relieving drugs given to pregnant women during labor. But it also served to determine when the infant required medical assistance, especially oxygen resuscitation. As of 2016, nearly every hospital in the world uses an updated Apgar score to evaluate the health of newborn infants. The Apgar score has allowed for medical personnel to evaluate an infant directly after birth on an objective scale to determine whether that infant could benefit from possibly life-saving medical intervention.

In the 2016 case Whole Woman's Health v. Hellerstedt, the US Supreme Court ruled unconstitutional the Texas requirements that abortion providers have admitting privileges at local hospitals and that abortion facilities meet ambulatory surgical center standards. Whole Woman’s Health represented abortion care providers in Texas and brought the case against the commissioner for the Texas Department of State Health Services, John Hellerstedt. In a five to three decision, the US Supreme Court ruled that the requirements of the challenged law, Texas House Bill 2, had forced the majority of abortion care facilities to close. With fewer available facilities, women faced undue burdens of travel time and cost when seeking abortions, restricting their access abortion care. In previous US Supreme Court cases Roe v. Wade (1973) and Planned Parenthood v. Casey (1992), the Court ruled that placing undue burdens on women seeking abortion care was unconstitutional. Upholding those decisions in Whole Woman's Health v. Hellerstedt, the US Supreme Court struck down Texas House Bill 2 and protected women’s access to abortion care.

In the nineteenth century, Elizabeth Blackwell was a women’s healthcare reformer and the first woman to receive her medical degree in the United States. She practiced medicine as a primary care physician in both the United States and the United Kingdom. Blackwell graduated medical school from Geneva Medical College in Geneva, New York, where she was the first woman to receive a medical degree in the US. Throughout her career, Blackwell focused on her patients’ rights to access healthcare and education pertaining to healthcare, particularly the rights of women and children, whom she treated in a hospital she cofounded. Blackwell influenced the medical care during the Civil War in the United States by training nurses to treat soldiers injured in battle. In her lifetime, Blackwell educated women on their health and careers as healthcare providers, and as the first woman to receive a medical degree, made it easier for other women to become physicians in the United States.

Ian Donald was an obstetrician who developed the technology and therapy of ultrasound diagnostics during the twentieth century in Europe. Ultrasound is a medical diagnostic technique that uses sound waves to produce images of the inside of the body. During the early 1900s, physicians had no way to see inside a woman’s uterus during pregnancy. Donald developed the first method of scanning human internal anatomy in real time, which enabled doctors to diagnose potentially fatal tumors and cysts. Donald’s development of ultrasound imaging enabled doctors and midwives to more accurately track fetal development and prevent potential health problems.

Virginia Apgar worked as an obstetrical anesthesiologist, administering drugs that reduce women’s pain during childbirth, in the US in the mid-twentieth century. In 1953, Apgar created a scoring system using five easily assessable measurements, including heart rate and breathing rate, to evaluate whether or not infants would benefit from medical attention immediately after birth. Apgar’s system showed that infants who were previously set aside as too sick to survive, despite low Apgar scores, could recover with immediate medical attention. Additionally, Apgar researched the effects of anesthesia used during childbirth and advocated for the prevention and management of birth defects. Apgar’s work led to a decrease in infant mortality rates in the mid-twentieth century, and into the twenty-first century, hospitals around the world still used the Apgar score at one and five minutes after birth.