Embryo Project Encyclopedia Articles

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 1904, physician William Henry Walling published Sexology, a family medicine reference book. In his book, Walling proposed that his guidance would help people who were married or single and young or old, as well as anyone who wanted to conform to, what he claims are, gender expectations. Sexology discusses issues such as masturbation, abortion, pregnancy, labor, and marriage. Despite Walling’s limited scientific explanations and evidence for his medical claims, the Puritan Publishing Company printed and distributed the book, which received many positive reviews and endorsements from other physicians, college presidents, politicians, and religious leaders. However, in the twenty-first century, people may consider many of Walling’s claims to be sexist and oppressive toward women. Sexology provides readers with examples of historical medical misconceptions of male and female anatomy and provides context for the logic of reproductive medicine at the turn of the twentieth century.

In 1999, the Inter-agency Working Group on Reproductive Health in Crises, hereafter the IAWG, wrote the Minimum Initial Services Package, hereafter MISP, which is the second chapter in Reproductive Health in Refugee Situations: An Inter-agency Field Manual. The IAWG wrote MISP for governments and agencies, who respond to humanitarian crises, as a guide for the provision of reproductive health services at the beginning of a humanitarian crises. The goal of MISP was to outline the services that people in humanitarian crises are to receive to minimize injury and death from complications related to reproductive health, prevent and manage the consequences of sexual violence, and reduce the transmission of sexually transmitted infections, or STIs. MISP recognizes that reproductive health is a human right and applies to people in humanitarian crises, providing specific details for governments and agencies to follow and mitigate the adverse effects of reproductive health issues in vulnerable populations.

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.