Embryo Project Encyclopedia Articles

In 1861, William John Little published, “On The Influence of Abnormal Parturition, Difficult Labors, Premature Birth, and Asphyxia Neonatorum, on the Mental and Physical Condition of the Child, Especially in Relation to Deformities,” hereafter “Abnormal Parturition,” in the Transactions of the Obstetrical Society of London. In the article, Little discussed the causes and types of what he refers to as abnormal births, and theorized how those births affect an infant’s likelihood of exhibiting a deformity. Little defined abnormal births as those involving an atypical maternal or fetal presentation, such as a slow birthing process or a fetus exiting the birth canal feet first rather than head first. In his article, Little published one of the first definitional frameworks to describe a condition causing rigidity and stiffness in the limbs that is often associated with birth-related trauma, which was then called Little’s disease, but is modernly known as spastic Cerebral Palsy.

William John Little was one of the first orthopedic surgeons to research congenital malformations and their causes in the nineteenth century and presented preliminary research on a condition modernly known as cerebral palsy, a condition of varying severity that affects a person’s ability to move. Little worked throughout the United Kingdom for the majority of the time he practiced medicine, and eventually founded one of the first orthopedic infirmaries, the Royal Orthopedic Hospital in London, England. Throughout his career, Little studied congenital malformations, which are medical conditions inherited before birth, as well as how certain medical circumstances during delivery affect the neonate. In 1861, he described a condition with motor, behavioral, and cognitive irregularities in neonates, linked with oxygen deprivation during birth. Little’s research on that condition, originally called Little’s disease, and modernly, spastic cerebral palsy, was one of the first accounts of cerebral palsy in infants.

In 1987, the World Health Organization, or WHO, took action to improve the quality of maternal health around the world through the declaration of the Safe Motherhood Initiative, or the SMI, at an international conference concerning maternal mortality in Nairobi, Kenya. Initially, the SMI aimed to reduce the prevalence of maternal mortality around the world, as over 500,000 women died during pregnancy and childbirth annually at the time of its inception, while about 98 percent of those deaths occurred in low-income countries. While WHO led the initiative, many organizations in various countries participated in additional programs in order to implement the goals of the SMI. WHO developed the SMI in order to reduce the prevalence of maternal death, developing one of the first proposals that brought attention to maternal health on a global basis at a time when global maternal mortality was high.

Breast augmentation involves the use of implants or fat tissue to increase patient breast size. As of 2019, breast augmentation is the most popular surgical cosmetic procedure in the United States, with annual patient numbers increasing by 41 percent since the year 2000. Since the first documented breast augmentation by surgeon Vincenz Czerny in 1895, and later the invention of the silicone breast implant in 1963, surgeons have developed the procedure into its own specialized field of surgery, creating various operating techniques for different results. By having varied incisions, implant placements, and improved ways of treating surgery-related complications, advanced technology has enabled women to undergo breast augmentations for aesthetic, medical, or reconstructive reasons. Trans women may also benefit from breast augmentations. Having the option of a breast augmentation gives women more control over their physical appearance, which may improve their self-image and boost their confidence.

In the 1960s, two plastic surgeons from the United States, Thomas Dillon Cronin and Frank Judson Gerow, collaborated with the Dow Corning Corporation, which specialized in silicone products, to create the first silicone breast implant. Surgeons used the implant, named the Cronin-Gerow implant, to improve the look of a woman’s breasts, by correcting for asymmetry, augmenting the size, or creating a more uplifted profile. Surgeons began widely using the breast implant almost immediately after it reached the US market in 1964, and breast augmentation quickly became one of the most popular cosmetic surgeries in the country. The creation of a silicone breast implant not only established a new branch of cosmetic surgery, but it also enabled women with breast cancer to receive reconstructions to improve their aesthetic appearance after cancer treatment and removal of the cancerous breast tissues.

Vincenz Czerny was a surgeon in the nineteenth century who specialized in cancer and women’s surgical care. Czerny performed one of the first breast augmentations using a reconstruction method to correct asymmetry and disfigurement of a woman’s breasts. Additionally, Czerny improved the safety and efficacy of existing operations, such as the vaginal hysterectomy, which involves the surgical removal of some or all of a woman’s reproductive structures. He contributed to other surgeries involving the esophagus, kidneys, and intestines. He was also one of the first individuals to research alternative methods of cancer treatment and founded the Institut für Experimentelle Krebsforschung (Institute for Experimental Cancer Research), in Heidelberg, Germany. The institute became one of the first hospitals dedicated solely to the study of cancer. Czerny’s development of the breast augmentation and vaginal hysterectomy, as well as his cancer research, helped shape the creation of modern-day surgical procedures.

In 1992, five maternal-infant health researchers founded Doulas of North America, later renamed DONA International to train certified birth attendants called doulas to provide care to pregnant women both before and after the birthing process. Annie Kennedy, John Kennell, Marshall Klaus, Phyllis Klaus, and Penny Simkin used the term doula, derived from the Greek word for woman servant, to describe a female birthing aide who provides non-medical emotional and physical support to laboring pregnant women. Eventually renamed DONA International, the organization has certified over 12,000 doulas as of 2017. Though the organization aims to provide a doula to everyone who wants one, there have been controversies surrounding the accessibility, affordability, and necessity of pregnant women using a doula before and after birth. DONA International is the largest doula-certifying program in the world and has created global awareness of the risks and benefits associated with using a doula during the birthing process.