National Geographic's documentary In the Womb: Identical Twins focuses on the prenatal development of human identical twins. Director Lorne Townend uses three-dimensional (3D) and four-dimensional (4D) ultrasound imaging and microscopy to depict twin development , genetic and epigenetic variations in the fetuses, and methods of fetal survival in the confines of the womb. Artist renditions of scientific data fill in areas of development inaccessible to the imaging tools. The 50-minute film describes the lives twins live after birth and describes new research that identical twins might not be as identical as once thought. In the womb: Identical Twins is a sequel to the 2005 National Geographic film In the Womb.
The US Supreme Court case Ferguson v. City of Charleston (2001) established that public hospitals couldn't legally drug test pregnant women without their consent when those women sought prenatal care at those hospitals. The court held that such searches violated the pregnant women's protections under the Fourth Amendment to the US Constitution. The decisions also indicated those circumstances that qualified as special needs exceptions to the Fourth Amendment, and it highlighted the extent to which pregnant women are sovereign individuals in the eyes of the Court. Ferguson v. City of Charleston brought public attention to women's reproductive rights and to fetal rights.
During the twentieth century, Thomas Raphael Verny studied the way that environment affects a developing fetus’s character and psychological development. Verny studied the concept of memory before birth and covered both the prenatal and perinatal periods, meaning the time the fetus is in the womb and the weeks immediately before or after birth, respectively. During those times, Verny claimed that patterns of maternal attitudes and experiences, such as affection and stress-related emotions, impact the development of the child. Published in 1981, Verny’s book The Secret Life of the Unborn Child presented novel ideas about how pregnant women’s emotional health impacts the psychological, emotional, and physical development of their fetuses, sparking discussion about the importance of maternal emotional health during prenatal development.
In the 1971 court case United States v. Milan Vuitch, hereafter US v. Vuitch, the US Supreme Court ruled that a Washington, DC law was constitutional by overturning a 1969 district court decision. Beginning in the early twentieth century, Washington, DC, prohibited abortions except for abortions performed to preserve the life or health of the pregnant woman. In 1969, Milan Vuitch, a physician in Washington, DC, was convicted of criminal abortion for providing an abortion when the woman’s life was not endangered. In his defense, Vuitch argued that the Washington abortion law was unconstitutionally vague, meaning it failed to define health in terms clear enough so that doctors could be sure what actions violated the law. Though a lower district court agreed with Vuitch and struck down the law as unconstitutional, the Supreme Court later disagreed and overturned the decision. US v. Vuitch was one of the first US Supreme Court cases that challenged the constitutional validity of laws regulating abortion and set a precedent that helped determine future abortion cases, like Roe v. Wade in 1973, which made abortions more accessible and gave women more control over their bodies.
Sir Graham Collingwood Liggins devoted much of his professional life to obstetric research. Liggins demonstrated that hormones created by the fetus helped initiate labor, rather than hormones originating solely from the mother. Liggins also discovered that cortisol given to pregnant mothers helped delay premature labor, and that it increased the likelihood that premature infants would breathe normally after birth. Prior to cortisol treatment, premature infants often died of respiratory distress syndrome characterized by the inability to inflate immature lungs. Before the clinical application of Liggins' discoveries in the 1980s, premature infants born before 32 weeks of gestation generally died because of respiratory distress.
In 2000, Catherine Monk, William Fifer, Michael Myers, Richard Sloan, Leslie Trien, and Alicia Hurtado published “Maternal stress responses and anxiety during pregnancy: Effects on fetal heart rate,” in which the authors conducted a study on how pregnant women’s stress and anxiety affects the health of their fetuses. Previous studies had shown that stress and anxiety during pregnancy could cause fetal abnormalities. In their article, Monk and colleagues reported that the fetuses of anxious pregnant women were more likely to have elevated heart rates and increased stress when exposed to stressors than fetuses of non-anxious women. The authors’ findings indicated that fetuses of anxious women display more biological markers of stress than fetuses of non-anxious women.
In 1999, Joseph Bruner, Susan B. Drummond, Anna L. Meenan, and Ina May Gaskin published, “All-fours Maneuver for Reducing Shoulder Dystocia During Labor,” in the medical journal, Obstetrical and Gynecological Survey. In the article, the authors described a birthing technique named the all-fours maneuver, or the Gaskin maneuver, and explained its effectiveness in treating fetal shoulder dystocia as compared to other maneuvers. Shoulder dystocia occurs when the neonate’s head has exited the vaginal canal, but the shoulders get stuck behind the woman’s pelvic bone, which prevents the birth of the neonate’s body. Healthcare practitioners’ use of previous methods to dislodge the fetal shoulders sometimes resulted in fetal and maternal injury. The all-fours maneuver differed from previous methods by positioning the laboring woman on her hands and knees rather than on her back. Through the article, the authors established the all-fours maneuver as a safe, fast, and effective technique for reducing shoulder dystocia.
James Marion Sims developed a treatment for vesico-vaginal fistulas in Montgomery, Alabama in the 1840s. Vesico-vaginal fistulas were a relatively common condition in which a woman's urine leaked into her vaginal cavity from her bladder, and many regarded the fistulas as untreatable during the early 1800s. After years of efforts to repair the fistulas with myriad tools, techniques, and procedures, Sims developed the speculum and a vaginal examination position later named for him. He also popularized the use of silver metal sutures to treat and cure women who had vesico-vaginal fistulas. Sims's surgical cure for vesico-vaginal fistulas eased both the social stigma and physical discomfort of many affected women. Though current treatments of vesico-vaginal fistulas have evolved since the nineteenth century, some of the basic principles utilized by Sims have been incorporated into present-day surgeries. In particular, Sims stressed the significance of continual bladder drainage after the operation.
In the case York v. Jones (1989), the United States District Court for the Eastern District of Virginia was one of the first US courts to address a dispute over a cryopreserved preembryo. Steven York and Risa Adler-York (the Yorks), a married couple, provided their gametes to doctors who created the preembryo, which the court referred to as a pre-zygote, as part of an in vitro fertilization (IVF) program at the Howard and Georgeanna Jones Institute for Reproductive Medicine (Jones Institute) in Norfolk, Virginia. The couple sued when the doctors at the Jones Institute refused to release the preembryo to the Yorks for use at a different IVF clinic. The Virginia district court denied the Jones Institute's attempt to have the York v. Jones case dismissed, and instead upheld the Yorks' right to move forward with their lawsuit. The York v. Jones decision had important implications for future disputes over cryopreserved preembryos because it treated the Yorks' cryopreserved preembryo as legal property over which the Yorks retained decision-making authority.
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.