Embryo Project Encyclopedia Articles

In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the time, the Comstock Act was the first federal anti-obscenity law that targeted contraception. However, social acceptance of birth control changed at the turn of the twentieth century. In this thesis, I analyzed legislation, advocates, and literature pertinent to that social change to report on the events leading up to the decriminalization of contraception.

In 1953, Virginia Apgar published the article "A Proposal for a New Method for Evaluation of the Newborn Infant" about her method for scoring newborn infants directly after birth to assess their health and whether medical intervention was necessary. Apgar worked at the Presbyterian Hospital in New York City, New York, as an obstetrical anesthesiologist, a physician who administers pain medication during childbirth. In that capacity, she sought to reestablish clear scoring guidelines for newborn infants so that she could compare which obstetric practices, pain relief methods, and resuscitation methods worked the best during and after childbirth. She published her article in Current Researches in Anesthesia and Analgesia in 1953, and the Apgar scoring system is still used in hospitals around the world as of 2016. In the article, Apgar establishes a scoring system for newborn infants that allows for quick assessment of their health directly after birth and therefore swift intervention by medical personnel to promote healthy development.

William Stewart Halsted was a surgeon at Johns Hopkins Hospital in Baltimore, Maryland, during the late 1800s and early 1900s. In 1894 Halsted described his procedure for treating breast cancer by removing the breast tissue, chest muscles, and lymph nodes in the armpit, a procedure he named radical mastectomy, and that became the standard of care for treating breast cancer until 1970. He also made contributions to other novel medical procedures such as gallbladder surgery, blood transfusions, antiseptic techniques, anesthesia use, and using plates and screws to hold bones in position when setting bone fractures. At Johns Hopkins Hospital, Halsted established a surgical training program in which he allowed medical students and surgical residents to shadow him and perform procedures under his guidance. In the twentieth century, similar training programs spread across the country and informed the standardization of medical training. Halsted devised a surgical treatment for breast cancer and reshaped the way physicians practiced medicine in the twentieth century, which resulted in better health outcomes through more careful surgical methods, especially in women with breast cancer.

In the 1930 US federal court case United States v. Dennett, Mary Coffin Ware Dennett was cleared of all charges of violating the anti-obscenity Comstock Act, a charge she had incurred by distributing her sex education pamphlet called The Sex Side of Life: An Explanation for Young People. The United States Postal Service charged Dennett under the Comstock Act, which prohibited the distribution of sex-related materials through the mail. The US Second Circuit Court of Appeals in New York City, New York, ruled that material needed to be considered in context and could not be considered obscene if it was not intended to sexually arouse an individual. The court's ruling in the appeals case of United States v. Dennett questioned the merits of the Hicklin test, used by courts to determine whether an item had an obscene component or intent, and contributed to the dissolution of the Comstock Act, thus legalizing access to materials about contraception and reproductive health.

A licensed obstetrician and gynecologist, Pearl Tang worked to improve the health of women and children in Maricopa County, Arizona, during the twentieth and twenty-first centuries. Her work with the Maricopa County Health Department ranged from immunizations to preventing cervical cancer. Tang obtained federal grants and community support to establish various child and maternal health clinics throughout Maricopa County as chief of the Maricopa County Bureau of Maternal and Child Health. Tang established mobile clinics, including a clinic she called the Maternity Care Bus, to address the lack of access to medical care among rural women in Arizona. She also focused on family planning through education and the distribution of contraception. Tang's efforts in Maricopa Country increased the delivery of maternal, child, and family planning care and helped lower Arizona's infant mortality rate.

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.

In 1894, William Stewart Halsted published The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894, in the medical journal Annals of Surgery. In the article, Halsted describes the results from fifty of his operations on women with breast cancer, performed at Johns Hopkins Hospital in Baltimore, Maryland. Those operations involved a surgical procedure Halsted called radical mastectomy, which consists in removing all of the patient’s breast tissue, chest muscle, and underarm lymph nodes. Halsted’s surgery effectively cured breast cancer in a time period when no other effective treatment options were available. The radical mastectomy remained the standard of care from the 1890s to the 1970s as a means of treating a type of reproductive cancer common to women.

During the twentieth century, Austin Bradford Hill researched diseases and their causes in England and developed the Bradford Hill criteria, which comprise the minimal requirements that must be met for a causal relationship to be established between a factor and a disease. Hill also suggested that researchers should randomize clinical trials to evaluate the effects of a drug or treatment by monitoring large groups of people. In addition, Hill advocated for case-control studies, in which researchers compare a group of people with a medical condition to a group without that condition to investigate the condition's possible causes. Hill's own work with clinical trials and case-control studies helped him prove that smoking caused lung cancer. The Bradford Hill criteria have also been used to establish causal links between factors and cancer, including reproductive cancers such as human papillomavirus that causes cervical cancer.

The 1973 Supreme Court case Roe v. Wade was a significant event in the story of fetal personhood—the story of whether embryos and fetuses are legal persons. Roe legalized abortion care in the United States (US). However, the story of fetal personhood began long before the 1970s. People have been talking about embryos, fetuses, and their status in science, the law, and society for centuries. I studied the history of fetal personhood in the United States, tracing its origins from Ancient Rome and Medieval England to its first appearance in a US courtroom in 1884 and then to the Supreme Court’s decision in 1973.

Mary Coffin Ware Dennett advocated for social reform in the United States in the early twentieth century, particularly regarding sex education and women's rights to access contraception. Dennett authored several publications on sex education and birth control laws. She also worked to repeal the Comstock Act, a federal law that made it illegal to distribute obscene materials through the US Postal Services. During the early 1900s, Dennett distributed a pamphlet she wrote on sex education called, The Sex Side of Life, through the post, which triggered a series of legal challenges that contributed to the dismantling of the Comstock Act. Dennett was an advocate for sex education and contraceptives, and her actions helped increase women's access to information about reproductive health.