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 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.
In 1904, physician William Henry Walling published Sexology, a family medicine reference book. In his book, Walling proposed that his guidance would help people who were married or single and young or old, as well as anyone who wanted to conform to, what he claims are, gender expectations. Sexology discusses issues such as masturbation, abortion, pregnancy, labor, and marriage. Despite Walling’s limited scientific explanations and evidence for his medical claims, the Puritan Publishing Company printed and distributed the book, which received many positive reviews and endorsements from other physicians, college presidents, politicians, and religious leaders. However, in the twenty-first century, people may consider many of Walling’s claims to be sexist and oppressive toward women. Sexology provides readers with examples of historical medical misconceptions of male and female anatomy and provides context for the logic of reproductive medicine at the turn of the twentieth century.
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.
In 2008, Barranca Productions released a documentary called The Business of Being Born, detailing the topic of childbirth. Ricki Lake and Abby Epstein produced and directed the documentary. The documentary explores pregnancy related healthcare in the US, including the history of midwives and obstetrics. The film also discusses potential consequences of medicalized childbirth common in the twenty-first century. The Business of Being Born provides viewers with information about home-births, midwives, and the positive and negative aspects of going to the hospital for childbirth.
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 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.
In 2014, Big Belli, a media and social networking brand, released a documentary called 40 Weeks online. The documentary, directed by Christopher Henze, followed multiple women during their pregnancies. The film predominantly features three women, though it includes the stories of many. Throughout the film, women detail their accounts of the physical and emotional changes that occur during pregnancy. 40 Weeks provides viewers with information about different aspects of pregnancy including the importance of nutrition and hydration, knowledge about safe medications, and the possible complications that can affect a pregnant woman and her fetus.
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.