Embryo Project Encyclopedia Articles

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.

The Clinica Para Madres (Mother’s Clinic) opened in Tucson, Arizona, in December of 1934 as the first birth control clinic in Arizona. After moving to Tucson, birth control activist Margaret Sanger, along with a group of local philanthropic women, founded the clinic to provide Arizona women with contraception. During the early 1900s in the US, contraception was illegal under the federal Comstock Act. Additionally, many viewed contraception and sex as obscene and not to be discussed in public or outside of marriage. In 1950 the clinic affiliated with the national organization, Planned Parenthood Federation of America, and it eventually became the Planned Parenthood of Southern Arizona. Clinica Para Madres, the first birth control clinic in Arizona, provided women with contraception despite birth control being illegal and socially stigmatized.

Established in 1950, the Planned Parenthood Center of Tucson provided Arizona women with family planning resources until 1977, when it expanded to locations outside of Tucson and became Planned Parenthood of Southern Arizona. The Planned Parenthood Center of Tucson was formed after the Clinica Para Madres, the first birth control clinic in Arizona, merged with the national organization Planned Parenthood Federation of America. The clinic moved to several rented locations throughout the Tucson area before establishing a permanent location named the Margaret Sanger Clinic in Tucson, Arizona.

In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest. Although cardiac arrest during pregnancy is uncommon, it can happen when pregnant women experience trauma, blood clots, infection, or have preexisting heart conditions. In the article, the authors emphasize how the Four Minute Rule increased maternal and fetal survival rates and decreased cases of severe fetal brain damage. The article “Perimortem Cesarean Delivery” was the first article to present the Four Minute Rule, which has influenced international guidelines and become the standard for maternal resuscitation and fetal survival in emergency medicine, operating rooms, and many other aspects of medical practice.

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 and colleagues wrote “Evaluation of the Newborn Infant—Second Report” in 1958. This article explained that Apgar’s system for evaluating infants’ condition after birth accurately predicted the health of infants. Apgar had developed the scoring system in 1953 to provide a simple method for determining if an infant needed medical attention after birth. The research team, working at Columbia University College of Physicians and Surgeons in New York City, New York, studied the Apgar scores of over 15,000 infants from Sloane Hospital for Women in New York City, New York, over a period of five years. In “Evaluation of the Newborn Infant—Second Report,” Apgar and colleagues established that Apgar scores correlated with infants’ health directly after birth and indicated when medical personnel should treat the infant.

Sindell v. Abbott Laboratories was a 1980 California case that established the doctrine of market share liability for personal injury cases. For such liability, when a drug causes personal injury and the manufacturer of the drug cannot be identified, each producer is responsible for paying the settlement in proportion to the percentage of the market they supplied. Judith Sindell and Maureen Rogers brought the case against the producers of diethylstilbestrol (DES), which their mothers had taken during pregnancy to prevent miscarriage and other complications. Sindell and Rogers alleged that their mothers' ingestions of DES during pregnancy later caused Sindell and Rogers to develop cancers at the onset of puberty, but they could not identify the specific manufacturer of the drug. The market share liability ruling in Sindell allowed millions of DES-affected individuals to seek restitution for reproductive cancers caused by prenatal exposure to DES.