In 1901, physician William Henry Walling published the article, Some of the Uses of Electricity in Gynecology, in the January issue of the American Gynecological and Obstetrical Journal. Walling was a practicing gynecologist who studied electro-therapeutics, or the use of electricity in medicine for the treatment of disease, which was an emerging topic during the late 1800s. Walling stated that proper administration of electrical current to a woman’s vagina, uterus, bladder, or rectum could be therapeutic for gynecological diseases. He provides scientific explanations for some of his claims, but not for all. The article provides readers of the twenty-first century with context and historical examples of electrotherapy in women’s health, of what physicians understood about female reproductive anatomy, and of the standard of care in gynecology during the turn of the twentieth century.

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.

Horatio Robinson Storer was a surgeon and anti-abortion activist in the 1800s who worked in the field of women’s reproductive health and led the Physicians’ Crusade Against Abortion in the US. Historians credit Storer as being one of the first physicians to distinguish gynecology, the study of diseases affecting women and their reproductive health, as a separate subject from obstetrics, the study of pregnancy and childbirth. Storer was one of the first physicians to successfully perform a Caesarian section, or the removal of the fetus through a surgical incision, followed by the removal of the woman’s uterus, a procedure which would later be known as Porro’s operation. Storer was also an anti-abortion activist who believed that public attitudes toward abortion were too relaxed and that the laws did not effectively punish what he deemed to be the criminal act of abortion. Historians credit Storer with leading the Physicians’ Crusade Against Abortion, which they consider largely responsible for the increase in laws criminalizing abortion in the late 1800s.

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 2004, Amanda J. Drake and Brian R. Walker published “The Intergenerational Effects of Fetal Programming: Non-genomic Mechanisms for the Inheritance of Low Birth Weight and Cardiovascular Risk,” hereafter, “The Intergenerational Effects,” in the Journal of Endocrinology. In their article, the authors assert that cardiovascular disease may develop via fetal programming, which is when a certain event occurring during a critical point of pregnancy affects the fetus long after birth. Drake and Walker were among the first to show that the programming effects of cardiovascular disease could be sustained across generations through non-genetic means. In “The Intergenerational Effects,” the authors identify how non-genetic mechanisms may perpetuate fetal programming influences over generations, highlighting the importance for further research on fetal programming.

In 2001, researchers Leonie Welberg and Jonathan Seckl published the literature review “Prenatal Stress, Glucocorticoids, and the Programming of the Brain,” in which they report on the effects of prenatal stress on the development of the fetal brain. The fetus experiences prenatal stress while in the womb, or in utero. In discussing the effects of prenatal stress, the authors describe prenatal programming, which is when early environmental experiences permanently alter biological structure and function throughout life. Throughout “Prenatal Stress, Glucocorticoids and the Programming of the Brain,” Welberg and Seckl provide a number of potential biological explanations, derived from both animal and human studies, to explain the underlying mechanisms involved in programming, which helped establish how in utero stress can affect fetal brain development.

In 2011, fetal researcher Vivette Glover published “Annual Research Review: Prenatal Stress and the Origins of Psychopathology: An Evolutionary Perspective,” hereafter, “Prenatal Stress and the Origins of Psychopathology,” in the Journal of Child Psychology and Psychiatry. In that article, Glover explained how an evolutionary perspective may be useful in understanding the effects of fetal programming. Fetal programming is a hypothesis that attempts to explain how factors during pregnancy can affect fetuses after birth. Researchers associate exposure to prenatal stress, or stress experienced before birth, with an increased likelihood of some mental disorders. Glover states that such outcomes may be traced back to a fetus’s response to stress during pregnancy, and that those outcomes may have been beneficial in the past. By taking an evolutionary approach toward understanding mental disorders, Glover provided insights for studying the lasting effects of maternal stress during pregnancy on children’s mental health.

In 2009, A. John Henderson and colleagues published “Mothers’ Anxiety During Pregnancy Is Associated with Asthma in Their Children,” hereafter, “Mothers’ Anxiety,” in The Journal of Allergy and Clinical Immunology. Previous studies had shown that maternal stress during pregnancy affects children’s health during childhood. The researchers explored the association of asthma in children with maternal anxiety during pregnancy. The cause of asthma is often unknown. Thus, the researchers tested the possibility that maternal anxiety may increase disease risk in the children, particularly the development of asthma. The authors reported a positive association between maternal anxiety during pregnancy and asthma in offspring, indicating the possibility of a causal relationship. The authors’ findings demonstrated the health effects of maternal stress during pregnancy on children’s physiological and immune development.

A vaginal speculum is a medical device that allows physicians and health providers to better view a woman’s cervix and vagina during pelvic exams. Most specula are made of metal and plastic, and physicians insert a portion of the speculum into the patient’s vagina to separate the vaginal walls. Physicians have used devices to view inside a woman’s vagina for centuries, but physicians did not begin using what is known as a speculum in the twenty-first century until the 1800s. Prior to the invention of the modern speculum, health specialists struggled to find a way to view the cervix and vaginal walls. Because of that, health specialists could not accurately diagnose medical problems that were occurring in those tissues. Therefore, the speculum has enabled healthcare professionals to provide women with better gynecological diagnoses and care.

In 1971, a group of researchers founded the Monash IVF Research Program with the mission to discover how in vitro fertilization, or IVF, techniques could become a treatment for infertility in both men and women. The program included researcher Carl Wood and colleagues John Leeton, Alex Lopata, Alan Trounson, and Ian Johnston at the Queen Victoria Medical Center and Royal Women’s Hospital in Melbourne, Australia. Since the program’s establishment in 1971, the Monash IVF Research Program has helped to develop and implement many IVF technologies still used in clinical practice as of 2020. Additionally, the program established some of the first successful IVF pregnancies and births. As of 2020, the Monash IVF Research Program is one of Australia’s leading fertility programs and has used their technologies to help provide IVF treatment to thousands of infertile men and women.