Michael R. Harrison worked as a pediatric surgeon in the US throughout the late-twentieth century and performed many fetal surgeries, including one of the first successful surgeries on a fetus in utero, or while it is still in its gestational carrier’s body, also called open fetal surgery. A fetus is an organism developing inside of the uterus that is anywhere from eight weeks old to birth. Harrison hypothesized that open fetal surgery could correct developmental defects that may become fatal to the fetus at birth. After years of research, Harrison and his colleagues at the University of California, San Francisco, in San Francisco, California, performed surgery on the fetus of a woman in her seventh month of pregnancy to correct the fetus’s developmental defects. The surgery was successful, as the fetus developed into a healthy child. Harrison’s work led to advancements in fetal treatment techniques, such as a method to conduct open fetal surgery that will not harm the fetus or pregnant woman, as well as the establishment of one of the first fetal treatment centers in the US.
In 1996, Michael R. Harrison published “Fetal Surgery” in the American Journal of Obstetrics and Gynecology. In the article, Harrison describes the importance of fetal surgery and the techniques used to correct defects in fetuses. As a fetus develops in the uterus, it can develop abnormalities that may become debilitating or fatal. Harrison discusses cases that show how physicians can use fetal surgery to repair such abnormalities, including obstructions in the heart or urinary tract, or organs or muscles whose malformations impair function. Harrison states where knowledge is lacking within the field or where surgery would be inappropriate, such as in the modification of a cleft lip, which can be fixed after birth and as such does not merit the risks of surgery. In the article, Harrison provides a summary of what information existed about fetal surgeries in 1996, which helped physicians explore fetal surgery and make further advancements.
Rh incompatibility occurs when a pregnant woman whose blood type is Rh-negative is exposed to Rh-positive blood from her fetus, leading to the mother s development of Rh antibodies. These antibodies have the potential to cross the placenta and attach to fetal red blood cells, resulting in hemolysis, or destruction of the fetus 's red blood cells. This causes the fetus to become anemic, which can lead to hemolytic disease of the newborn. In severe cases, an intrauterine blood transfusion for the fetus may be required to correct the anemia.
In 2003, the Texas state legislature passed the Woman’s Right to Know Act, hereafter the Act, as Chapter 171 of the state’s Health and Safety Code. The Act sets requirements that physicians must follow during the informed consent process for abortion, or a medical procedure to terminate pregnancy, in Texas. Lawmakers amended the Act and added several additional regulations that restrict access to abortion in 2011, 2013, 2015, and 2017. For instance, the Act requires that physicians perform abortions after sixteen weeks of pregnancy in ambulatory surgical centers or hospitals and states that physicians must perform an ultrasound to view images, called sonograms, of a developing fetus inside a woman’s uterus before a woman may receive an abortion. The Act further requires practitioners and clinics to offer state-developed informational materials to women who seek an abortion. The Act placed several restrictions on abortion care in Texas, making it more difficult for women to access safe and legal abortion care, which opponents have challenged in courts.
Nuclear magnetic resonance imaging (MRI) is a technique to create a three-dimensional image of a fetus. Doctors often use MRIs to image a fetuses after an ultrasound has detected an, or has been inconclusive about an, abnormality. In 1983 researchers in Scotland first used MRI to visualize a fetus. MRIs showed a greater level of fetal detail than ultrasound images, and researchers recognized the relevance of this technique as a means to gather information about fetal development and growth. Researchers later used the technology to take measurements of the uterus, placenta, amniotic fluid, and fetus during the first trimester of pregnancy. MRI provided doctors with a non-invasive method to diagnose and treat fetal abnormalities and maternal conditions such as pre-eclampsia.
In 1980 the US National Institutes of Health (NIH) and the US National Institute of Child Health and Human Development (NICHD) released a report titled, “National Institutes of Health Consensus Development Conference Statement September 22–24, 1980.” The report lists recommendations for birth delivery through cesarean sections, a surgical procedure used to deliver the fetus via the pregnant woman’s abdomen. The recommendations arose from the 1980 Consensus Development Conference on Cesarean Childbirth in Bethesda, Maryland. Medical professionals, consumers, and biomedical research scientists attended the conference, and the NIH’s taskforce on the subject helped facilitate discussions regarding the safety of cesarean sections. The NIH taskforce concluded that cesarean section rates can be decreased and possibly reversed in addition to improving maternal and fetal outcomes and provided recommendations for future research on cesarean sections.
In the 2012 case Texas Medical Providers Performing Abortion Services v. David Lakey, a US appeals court ruled as constitutional a Texas law that required abortion providers in the state to show women receiving abortions the ultrasound images of their fetuses. The law also required providers to describe the sounds of the fetuses' nascent hearts. In doing so, the court set precedent that ultrasound readings are necessary medical information for pregnant women seeking abortions, increasing the wait-period for women seeking abortions. The decision fueled debates in the early twenty-first century US abouts women's rights to abortions.
In 2014, the United States Food and Drug Administration published the Pregnancy and Lactation Labeling Rule to amend previous guidelines for the prescription of drugs for pregnant and lactating women. The 2014 Pregnancy and Lactation Labeling Rule was intended to increase the safety and efficacy of prescription drugs by making drug labels easier for physicians to understand and utilize. The Pregnancy and Lactation Labeling Rule restructured drug labels and required that they include narratives describing drug-associated risks to women and fetuses, rather than using complicated letter categories. The Pregnancy and Lactation Labeling Rule changed the framework for drug labeling, making it easier for doctors to prescribe safe and effective drugs to pregnant women, lactating women, and people of reproductive capacity.
Eclipse of Reason is a 1987 anti-abortion documentary film directed, filmed, and narrated by Bernard Nathanson, an obstetrician in the US. American Portrait Films released the film in 1987 featuring Nathanson’s commentary and footage of an abortion of a four-month-old fetus. The film also featured the testimony of women who had suffered following similar procedures. In Eclipse of Reason, Nathanson equates the fetus to a person, likening abortion procedures to murder and arguing for the illegalization of abortion. This documentary was a sequel to Nathanson’s first documentary film, The Silent Scream released in 1984. Both documentaries argued for illegalizing abortion, which had been decriminalized in 1973 in the United States. Eclipse of Reason was one of the most influential films that garnered public attention to the abortion debate in the US during the 1980s.
In Jeter v. Mayo, the Court of Appeals of Arizona in 2005 held that a cryopreserved, three-day-old pre-embryo is not a person for purposes of Arizona's wrongful death statutes, and that the Arizona Legislature was best suited to decide whether to expand the law to include cryopreserved pre-embryos. The Court of Appeals affirmed a decision by the Maricopa County Superior Court to dismiss a couple's wrongful death claim after the Mayo Clinic (Mayo) allegedly lost or destroyed several of their cryopreserved pre-embryos. In reaching its decision, the Court of Appeals explored ethical and legal issues relating to cryopreserved pre-embryos, including prior case law, the principles of statutory construction, and the Arizona Legislature's role in balancing the societal interests involved.