In 1996, a team of researchers associated with the International Continence Society published “The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction” in American Journal of Obstetrics and Gynecology. Pelvic organ prolapse is characterized by the descent of the pelvic organs into the lower portion of the pelvis and is often caused by a weakening of the muscles and ligaments that normally hold the organs in place. The authors concluded that physicians and researchers needed to develop a system of standardized terms to use to describe the anatomical position of pelvic organ prolapse in women. They propose using terms that emphasize the location of the prolapse rather than just the involved organ. They also suggest that the system utilizes a series of examinations and imaging to uniformly describe and quantify pelvic organ prolapse. The article by Bump and colleagues was one of the first to call for a standardized system using specific terms to communicate findings about pelvic organ prolapse systematically across clinical and academic research settings.

In 1920, Joseph Bolivar DeLee published the article, “The Prophylactic Forceps Operation,” in which he describes how physicians can manually remove a neonate from a laboring woman’s vagina with the use of sedating drugs and forceps. The procedure, according to DeLee, resulted in decreased rates of complications and mortality for both the woman and neonate. DeLee claimed the procedure could reduce damage to the woman such as prolapse, or when internal pelvic organs push down and sometimes protrude from the vagina, and fatal infant brain bleeding. He also suggested that physicians make an incision from the woman’s anus to vagina to accommodate the use of forceps, a procedure later known as an episiotomy. In “The Prophylactic Forceps Operation,” DeLee proposed the technique and use of his procedure, adding to the growing debate in the early twentieth century on the best way to medically assist women during delivery.

Joseph Bolivar DeLee was an obstetrician in the US between the nineteenth and twentieth centuries who advocated for the specialized teaching of medical students in the field of obstetrics to address problems occurring during pregnancy. He claimed obstetricians maintained a wider skillset than midwives, and founded the Chicago Lying-In Hospital to provide affordable obstetric care to women in Chicago, Illinois. According to Carolyn Herbst Lewis, critics of DeLee’s practices often cite his 1920 article, “The Prophylactic Forceps Operation,” as catalyzing a cultural shift toward overly clinical birthing practices. However, rather than solely advocating for its use, he had cautioned against the extreme use of forceps during delivery, and emphasized that obstetricians needed to know the information in the case it could ever save a woman’s life. Though some of DeLee’s philosophies were controversial, such as his disapproval of midwifery, he provided the emerging specialization of obstetrics with new technologies and interventions, cleanliness standards, and the introduction of film as a teaching method.

In the 1962 case Planned Parenthood Committee of Phoenix v. Maricopa County, the Arizona Supreme Court ruled that Arizona Revised Statute 13-213, which banned the public advertising of contraceptive or abortion medication or services, was constitutional. However, the court also ruled that that Arizona Revised Statute 13-213 did not apply to Planned Parenthood's distribution of contraceptive information, allowing Planned Parenthood to continue distributing the information. Following the case, the Arizona law was challenged several times and eventually deemed unconstitutional in the 1973 case State v. New Times INC. The case Planned Parenthood Committee of Phoenix v. Maricopa County established that Planned Parenthood's distribution of medical literature was not advertising as described in the law, and it initiated a decade long discussion about the constitutionality of the laws preventing the distribution of materials related to contraception or abortion.

In the 1972 case Planned Parenthood Center of Tucson, Inc., v. Marks, the Arizona Court of Appeals required the Arizona Superior Court to rehear the case Planned Parenthood Association v. Nelson (1971) and issue a decision on the constitutionality of Arizona's abortion laws. In 1971, the Planned Parenthood Center of Tucson filed the case Planned Parenthood Association v. Nelson asking for the US District Court to rule on the constitutionality of the Arizona Revised Statutes 13-211, 13-212, and 13-213, which made it illegal for anyone to advertise, provide, or receive an abortion. The decision in Planned Parenthood Center of Tucson, Inc., v. Marks forced the Arizona Superior Court to issue a decision on the constitutionality of the Arizona abortion laws, and is one in a series of lawsuits that culminated in the legalization of abortion in Arizona in 1973.

In the 1973 case of Roe v. Wade, the US Supreme Court ruled that laws banning abortion violated the US Constitution. The Texas abortion laws, articles 1191–1194, and 1196 of the Texas penal code, made abortion illegal and criminalized those who performed or facilitated the procedure. Prior to Roe v. Wade, most states heavily regulated or banned abortions. The US Supreme Court decision in Roe v. Wade secured women's rights to terminate pregnancies for any reasons within the first trimester of pregnancy. It also sparked legal discussions of abortion, fetus viability and personhood, and the trimester framework, setting a landmark precedent for future cases including Webster v. Reproductive Health Services (1989), Planned Parenthood v. Casey (1992), and Stenberg v. Carhart (2000).

Jesse Bennett, sometimes spelled Bennet, practiced medicine in the US during the late eighteenth century and performed one of the first successful cesarean operations, later called cesarean sections, in 1794. Following complications during his wife’s childbirth, Bennett made an incision through her lower abdomen and uterus to deliver their infant. Bennett’s biographers report that his operation was the first cesarean section where both the pregnant woman and the infant survived. Previously, physicians used cesarean sections to save the fetus from a pregnant woman who had already died during childbirth. Bennett successfully performed a cesarean section, a procedure used worldwide in the twenty-first century when a vaginal delivery is not possible or would pose a risk to the woman or fetus.

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.

“Program of Action of the International Conference on Population and Development” comprises the majority of context within the twenty-year sustainable development plan, International Conference on Population and Development Program of Action, hereafter POA, published in 1994 by the United Nations Population Fund or UNFPA. Given the rising global population, the goal of the POA was to outline the steps governments around the world were to take to achieve sustainable development by 2014. Under leadership of the United Nations Population Fund, 179 countries met in Cairo, Egypt, to debate the best way to address the growing global population and the need for sustainable development. The debates began on 5 September 1994 and ended on 13 September 1994, resulting in all 179 participating countries endorsing the Program of Action. The Program of Action encouraged participating countries to prioritize human rights, reproductive rights, and women’s empowerment during all future sustainable development plans and programs.

This thesis explores the impact of Twilight Sleep on women and physicians and their perceptions of childbirth. Twilight Sleep empowered women to take on a more active role in shaping the medical care they received rather than accepting childbirth as a natural event associated with physical and mental trauma and high risk of mortality. For doctors, the debate regarding Twilight Sleep’s safety and efficacy affirmed a ubiquitous notion that childbirth ought to be seen as a pathological rather than natural event. By considering childbirth a medical condition that necessitated treatment, physicians had to evaluate their duties to their patients. In empowering women to be involved in making medical decisions and forcing physicians to balance their medical training with their patients’ needs, Twilight Sleep helped to establish more reciprocal doctor-patient relationships.