In 1907, researchers Bernhardt Kronig and Carl Gauss combined the drugs morphine and scopolamine to induce twilight sleep in women during childbirth. Physicians in the early twentieth century in Germany used twilight sleep, Dammerschlaf, to cause women to enter a state of consciousness in which they felt no pain and did not remember giving birth. Twilight sleep was associated with increased use of forceps during delivery, prolonged labor, and increased risk of infant suffocation. Because of those disadvantages, physicians stopped using morphine and scopolamine to prevent pain during childbirth. Morphine and scopolamine were among the first anesthetics to be used during childbirth, and after physicians stopped using them, researchers searched for safer alternatives.
Possums is a 174-page book consisting of a series of essays written about the Virginia opossum (Didelphis virginiana), the only living marsupial in the US. The essays were written by Carl Gottfried Hartman, an embryologist at the Carnegie Institute of Washington (CIW), in Baltimore, Maryland, who also worked with another mammal, the rhesus monkey. Possums was published in 1952 by Hartman's alma mater, the University of Texas at Austin (UT). Beginning in 1913, while as a graduate student, and later as an instructor at UT, Hartman captured and raised opossums. He was one of the first zoologists to study the intricacies of opossum embryology, leading to an account of the embryology and reproductive physiology of a mammal from the wild, rather than of a mammal bred exclusively for laboratory research. Possums culminated Hartman's studies of the marsupial.
In a clinical trial from 1969 to 1972, Sir Graham Collingwood Liggins and Ross Howie showed that if doctors treat pregnant women with corticosteroids before those women deliver prematurely, then those women's infants have fewer cases of respiratory distress syndrome than do similarly premature infants of women not treated with corticosteroids. Prior to the study, premature infants born before 32 weeks of gestation often died of respiratory distress syndrome, or the inability to inflate immature lungs. Liggins and Howie, then both at the University of Auckland in Auckland, New Zealand, published their results in A Controlled Trial of Antepartum Glucorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants in 1972. The study built on experiments Liggins had earlier conducted with sheep. Liggins' corticosteroid experiments changed the way doctors treated pregnant women experiencing preterm labors, and they improved the life expectancy of prematurely born infants.
Dell Publishing in New York City, New York, published Lennart Nilsson's A Child Is Born in 1966. The book was a translation of the Swedish version called Ett barn blir till, published in 1965. It sold over a million copies in its first edition, and has translations in twelve languages. Nilsson, a photojournalist, documented a nine-month human pregnancy using pictures and accompanying text written by doctors Axel Ingelman-Sundberg, Claes Wirsen and translated by Britt and Claes Wirsen and Annabelle MacMillian. Critics lauded A Child Is Born for its photographs taken in utero of a developing fetus. Furthermore, the work received additional praise for what many described as simple and scientifically accurate explanations of complicated processes during development.
Hamlin Fistula Ethiopia is a nonprofit organization that began in 1974 as a joint endeavor by Reginald and Catherine Hamlin and the Addis Ababa Fistula Hospital in Addis Ababa, Ethiopia. Hamlin Fistula Ethiopia promotes reproductive health in Ethiopia by raising awareness and implementing treatment and preventive services for women affected by obstetric fistulas. It also aims to restore the lives of women afflicted with obstetric fistulas in Ethiopia and eventually to eradicate the condition. Obstetric fistulas occur in pregnant women during labor when pressure placed on the pelvis by the fetus causes a hole, or fistula, to form between the pregnant woman's vagina and bladder (vesicovaginal fistula) or between the vagina and the rectum (rectovaginal fistula). Hamlin Fistula Ethiopia is governed by a board of trustees which includes founding member Catherine Hamlin. By 2014, Hamlin Fistula Ethiopia supported the Addis Ababa Fistula Hospital, five treatment centers across Ethiopia, a midwife school, and a long-term rehabilitation center for women impacted by obstetric fistula.
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.
In November 1921, US Congress passed the National Maternity and Infancy Protection Act, also called the Sheppard-Towner Act. The Act provided federal funds to states to establish programs to educate people about prenatal health and infant welfare. Advocates argued that it would curb the high infant mortality rate in the US. Many states accepted funding through the Sheppard-Towner Act, leading to the establishment of nearly 3,000 prenatal care clinics, 180,000 infant care seminars, over three million home visits by traveling nurses, and a national distribution of educational literature between 1921 and 1928. The Act provided funding for five years, but was repealed in 1929 after Congress did not renew it. Historians note that infant mortality did decrease during the years the Act was in effect. The Act also influenced provisions aimed at infant and maternity welfare in later legislation, such as the Social Security Act of 1935.
Prenatal Care is an educational booklet written by Mary Mills West of the US Children’s Bureau and published by the US Government Printing Office in 1913. The Bureau distributed West’s booklets in response to their field studies on infant mortality, which found that lack of access to accurate health and hygiene information put women and infants at greater than normal risk of death or disease. In Prenatal Care, West offers advice on nutrition, exercise, and personal hygiene during pregnancy and describes the processes of labor and birth. Soon after publication, women all over the US requested copies of Prenatal Care. Millions of copies of Prenatal Care were distributed nationally between 1921 and 1928 as part of educational programs funded by the Sheppard-Towner Act, and the infant mortality rate declined during that period.
In 2013, Lois Uttley, Sheila Reynertson, Larraine Kenny, and Louise Melling published “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” in which they analyzed the growth of Catholic hospitals in the United States from 2001 to 2011 and the impact those hospitals had on reproductive health care. In the US, Catholic hospitals are required to abide by the US Catholic Church's Ethical Guidelines for Health Care Providers, also called the Directives. The authors of the article argue that the Directives threaten reproductive health because of their limitations on contraception, sterilization, some infertility treatments, and abortion. The report demonstrated an increase in Catholic hospitals and an associated impact on reproductive health care, which formed the basis for lawsuits the American Civil Liberties Union brought against various Catholic hospitals and health care networks during the early 2000s.
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.