In the 2007 paper “Traditional postpartum practices and rituals: a qualitative systematic review,” Toronto-based researchers showed that women from different cultures around the world follow similar postpartum practices after giving birth. At the University of Toronto in Toronto, Canada, Cindy-Lee Dennis, Kenneth Fung, Sophie Grigoriadis, Gail Erlick Robinson, Sarah Romans, and Lori Ross examined fifty-one studies from over twenty countries that focused on traditional postpartum practices. The authors found that across the twenty countries, each culture’s postpartum practice included a specified rest period, a prescribed diet, and organized support from family members. In the literature review, Dennis and her team concluded that healthcare providers should consider the major similarities between cultural postpartum practices to deliver culturally competent perinatal care.

In 1955, obstetrician Edward Bishop, a physician specializing in childbirth, published the article “Elective Induction of Labor,” in which he proposed the best conditions for pregnant women to elect to induce, or begin, labor. Elective induction of labor requires an obstetrician to administer a drug to help a pregnant woman to start her contractions, and to rupture the fluid-filled sac surrounding the fetus called the amniotic sac. In the early 1950s, Bishop analyzed the results of one thousand elective inductions and discovered that some pregnant women had faster and easier deliveries with induced labor than other pregnant women. In “Elective Induction of Labor,” Bishop describes the characteristics an obstetrician can look for in a pregnant woman to determine if she can safely undergo an elective induction, metrics still used into the twenty-first century to determine whether or not to pursue elective inductions.

In the 1950s and 1960s, researchers Leon Chesley, John Annitto, and Robert Cosgrove investigated the possible familial factor for the conditions of preeclampsia and eclampsia in pregnant women. Preeclampsia and eclampsia, which are related to high blood pressure, have unknown causes and affect at least five percent of all pregnancies. The researchers, who worked at Margaret Hague Maternity Hospital in Jersey City, New Jersey, used hospital patient records to find and reexamine women who had eclampsia at the hospital, as well as their daughters, sisters, daughters-in-law, and granddaughters. Chesley and colleagues found that the daughters and granddaughters of eclamptic women were more likely than the female offspring of non-eclamptic women to have preeclampsia and eclampsia in their own pregnancies, and especially in their first pregnancies. The study provided evidence that the disorders are inherited, enabling physicians to better monitor pregnancies in women who have a known family history for preeclampsia and eclampsia.

In the 1964 article, “Pelvic Scoring for Elective Induction,” obstetrician Edward Bishop describes his method to determine whether a doctor should induce labor, or artificially start the birthing process, in a pregnant woman. Aside from medical emergencies, a woman can elect to induce labor to choose when she gives birth and have a shorter than normal labor. The 1964 publication followed an earlier article by Bishop, also about elective induction. In both articles, Bishop used data gathered from the obstetrics department of Pennsylvania Hospital in Philadelphia, Pennsylvania, where he worked. In “Pelvic Scoring for Elective Induction,” Bishop introduces a scoring system later known as the Bishop Score, used into the twenty-first century, to determine if a pregnant woman fits the criteria for a safe and successful induction.

Virginia Apgar worked as an obstetrical anesthesiologist, administering drugs that reduce women’s pain during childbirth, in the US in the mid-twentieth century. In 1953, Apgar created a scoring system using five easily assessable measurements, including heart rate and breathing rate, to evaluate whether or not infants would benefit from medical attention immediately after birth. Apgar’s system showed that infants who were previously set aside as too sick to survive, despite low Apgar scores, could recover with immediate medical attention. Additionally, Apgar researched the effects of anesthesia used during childbirth and advocated for the prevention and management of birth defects. Apgar’s work led to a decrease in infant mortality rates in the mid-twentieth century, and into the twenty-first century, hospitals around the world still used the Apgar score at one and five minutes after birth.