Embryo Project Encyclopedia Articles

Fetal programming, or prenatal programming, is a concept that suggests certain events occurring during critical points of pregnancy may cause permanent effects on the fetus and the infant long after birth. The concept of fetal programming stemmed from the fetal origins hypothesis, also known as Barker’s hypothesis, that David Barker proposed in 1995 at the University of Southampton in Southampton, England. The fetal origins hypothesis states that undernutrition in the womb during middle to late pregnancy causes improper fetal growth, which in turn, causes a predisposition to certain diseases in adulthood. In addition to nutritional impacts, researchers have studied the fetal programming effects of many factors, such as maternal anxiety or violence during pregnancy. Researchers proposing the concept of fetal programming established a new area of research into the developmental causes of disease, pointing towards the in utero environment and its critical role in healthy human development.

In June 2017, the Iowa Supreme Court decided the case Plowman v. Fort Madison Community Hospital, or Plowman v. FMCH, and ruled that women who gave birth to children with severe disabilities could sue for wrongful birth in Iowa. Specifically, after Plowman v. FMCH, a woman could sue for wrongful birth if she believed that her physicians failed to disclose evidence of fetal abnormalities that may have prompted her to terminate the pregnancy. Pamela and Jeremy Plowman filed the suit against the Fort Madison Community Hospital in Fort Madison, Iowa, alleging that hospital physicians failed to inform them that a prenatal test showed fetal abnormalities. Plowman v. FMCH gave women in Iowa the legal right to sue if physicians failed to tell them about fetal defects.

Hormone releasing intrauterine devices or hormonal IUDs are contraceptive devices placed in a woman’s uterus to prevent pregnancy by continuously releasing a low dose of certain hormones. Jouri Valter Tapani Luukkainen, a medical researcher at the University of Helsinki, introduced the first hormonal IUD in 1976. Luukkainen’s IUD was a plastic device shaped like a capital T. The horizontal shafts of the IUD held a reservoir of the hormone Levonorgestrel that the IUD slowly released at a constant rate over the IUD’s lifetime, allowing the hormonal IUD to remain effective for five to seven years. Women can use hormonal IUDs for long term contraception that requires no maintenance on the part of the user. The hormonal IUD provides women an option for reliable long-term birth control that does not require maintenance to remain effective.

Much change has occurred in abortion laws over the past 50 years, this thesis tracks those changes principally through Supreme Court Cases, such as United States v. Milan Vuitch, Roe v. Wade, and Gonzales v. Planned Parenthood among others. The landscape of abortion law in the US continues to shift today, as recently as 2017 with Plowman v. FMCH cases were being heard in courts that wrought subtle yet important changes in abortion law.

The copper intrauterine device, or IUD, is a long-term, reversible contraceptive first introduced by Howard Tatum and Jamie Zipper in 1967. Health care providers place an IUD inside a woman’s uterus to prevent pregnancy. Copper IUDs are typically made of T-shaped plastic with some portion covered with exposed copper. Prior to the invention of the first IUDs, women had few long-term options for safe and reliable birth control. Those options mostly consisted of barrier methods and the oral birth control pill, which were only effective if used correctly and consistently. For women seeking to control their fertility, a copper IUD was one of the first forms of long-term birth control that was highly effective and did not require consistent and regular action on the woman’s part to remain effective.

In 2011, Sarah McMahon and colleagues published “The Impact of Emotional and Physical Violence During Pregnancy on Maternal and Child Health at One Year Post-partum,” hereafter, “The Impact,” in the journal, Child and Youth Services Review. While existing studies had indicated negative chronic effects resulting from intimate partner violence, or IPV, such as miscarriage and premature labor, there was little research specifically analyzing the separate and joint effects of psychological and physical abuse on pregnant women and fetuses. The authors reported that both physical and emotional IPV had negative impacts on the woman and child at one-year after birth, including worse overall health and increased likelihood of depression. In “The Impact,” the researchers analyzed the effects of partner abuse during pregnancy, distinguishing between the effects of emotional abuse and physical abuse on health outcomes for a pregnant woman and her offspring.

In 2001, Kevin M. Godfrey and David J.P. Barker published the article “Fetal Programming and Adult Health” in Public Health Nutrition, where they identified the significance of maternal nutrition during pregnancy to healthy offspring development. The authors describe the effects of maternal nutrition on fetal programming of cardiovascular disease. Fetal programming is when a specific event during pregnancy has effects on the fetus long after birth. The authors argue that fetuses may adapt to varying shifts in their environment in utero, such as slowed fetal growth in response to malnutrition. While those adaptations can be helpful in utero, the authors assert they may persist into adolescence and adulthood, causing conditions such as high blood pressure or diabetes. Godfrey and Barker assert that fetal adaptations to maternal malnutrition may be implicated in the development of cardiovascular disease in adulthood, and called for future research investigating additional fetal programming variables.

Gonzales v. Planned Parenthood Federation of America, Inc. (Gonzales v. Planned Parenthood) was the 2007 US Supreme Court case in which the Court declared the Partial Birth Abortion Ban Act of 2003 constitutional, making partial birth abortions illegal. In 2003, the US Congress passed the Partial-Birth Abortion Ban Act, which prohibited an abortion technique called partial birth abortion. A partial birth abortion is similar to, but not the same as, a Dilation and Extraction or D&X abortion, which is what the Ban was intended to prohibit. Gonzales v. Planned Parenthood eventually reached the Supreme Court, where the Court ruled that the Ban was constitutional. In Gonzales v. Planned Parenthood, the Court ruled for the first time that it was constitutional to ban a method of abortion without providing an exception for cases where a pregnant woman’s life was endangered.

Milan Vuitch was an abortion provider in the twentieth century, who performed thousands of abortions in Washington, DC, at a time when abortions were legal only if they preserved the life or health of the pregnant woman. Vuitch was a frequent critic of Washington DC’s anti-abortion law and was arrested multiple times for providing abortions that were not considered necessary to preserve the pregnant woman’s life. After several arrests, Vuitch challenged the law under which he had been arrested, and his case made its way to the Supreme Court in Vuitch v. United States. Although Vuitch technically lost in his Supreme Court case, the Court’s ruling expanded the meaning of health and Vuitch was able to continue providing abortions. Vuitch provided abortions to women who sought them but were not able to legally justify them, and his Supreme Court case was one of the earliest challenges to the abortion law.

Otto Rank studied how birth impacts individuals’ psychology and creates anxiety throughout their lives in Europe and the US during the nineteenth century. In his book The Trauma of Birth, Rank stated that birth was extremely traumatic and that one spent his or her whole life trying to recover from the experience of being born and harshly separated from the peaceful womb. He argued that the trauma experienced at birth is the source of all human suffering and the key to understanding anxiety later in life. He stated that the experience of birth was one’s earliest experience of anxiety, which served as the blueprint for all other anxiety related experiences in life. Through his work, Rank prompted studies in developmental embryology analyzing early mother-child relationships and problems in early psychological development.