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Two centuries of women’s health in 20 minutes

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March 24, 2016   |   In the News, The Real Deal

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Two centuries of women’s health in 20 minutes

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As we’ve discussed before, March is Women’s History Month, a time to remember women’s struggles and celebrate their accomplishments in the face of adversity. Medicine and medical technology has undoubtedly been one of the most influential factors in women’s liberation. In honor of that influence, let’s explore the last 200 years in women’s health.

1826

Naturalist Karl Ernst von Baer discovers the mammalian ovum (or egg). The search for the mammalian egg had been on for almost two centuries when von Baer finally identified it under a microscope, publishing his findings a year later in a light read called De ovi mammalium et hominis genesi epistolam ad Academiam Imperialem Scientiarum Petropolitanam. This was a huge step toward understanding mammalian reproduction and the way that the female body functions. Though scientists of the time believed that human reproduction mirrored that of other mammals, the human ovum wasn’t seen in action until 1928. Learn more.


1849

Elizabeth Blackwell becomes the first female MD in the United States after graduating from Geneva Medical College. Dr. Blackwell later went on to found the New York Infirmary for Women and Children, a hospital that not only taught other women doctors but provided medical care for the city’s poor. Learn more.

1888–1896

The disposable sanitary napkin takes over the feminine hygiene market. Johnson & Johnson introduced their disposable menstrual pads, called “Lister’s Towels,” in 1896, the first American company to do so. However, America was behind the times when it came to feminine hygiene products—a German company called Hartmann was advertising the “Mulpa Ladies’ Bandage” or “Hartmann’s Hygienic Towelettes for Ladies” as early as 1895, and Southalls’, a British manufacturer, created the “Southalls’ Sanitary Towels,” available as early as 1888. Made of wood pulp or rayon, highly absorbent materials also being used in bandages and gauze for wartime use, disposable pads were a much more convenient replacement for the reusable cotton pads, rags, or other materials that women had been making do with for centuries. Learn more.

An early advertisement for disposable sanitary napkins. Image source

1913

Dr. Albert Salomon uses radiography to visualize tumors in the breast, a technique that lead to the mammogram. Dr. Salomon, a German surgeon, compared X-ray images of women’s breasts to the actual breast tissue removed from their bodies during mastectomies, identifying tumors, microcalcifications, and cysts. Though Salomon’s study was completed in 1913, mammography didn’t become became a common screening tool until the mid-’60s, after another study revealed that the technology could reduce breast cancer deaths by one third. Learn more.

1916

Margaret Sanger opens the first birth control clinic in Brooklyn, NY—only to be jailed 9 days later. Sanger, founder of the American Birth Control League (which would later become Planned Parenthood), was arrested for violating the “Comstock” or anti-obscenity laws, and the clinic was raided by the vice squad. The clinic may have been shut down, but a movement had been sparked, and it wasn’t about to be snuffed out. Sanger was problematic in many ways—her advocacy for eugenics was well documented—but her radical dedication to the cause of birth control lead to many positive changes for women, including, decades later, the birth control pill. Learn more.

Margaret Sanger leaves the courthouse after her arrest.
Margaret Sanger leaves the courthouse after her arrest.

1928

The “Pap smear” is first identified as an effective way to screen for cervical cancer. Dr. George Papanicolaou spent his professional life examining “smears,” or swabs of cells from the cervix and vagina, to see what they could tell him about the female body. Though Dr. Pap introduced his research on identifying cancer cells in vaginal smears in 1928, there was little enthusiasm for his study at the time, and the medical world—and Dr. Pap—moved on. It wasn’t until the mid-’40s that cancer research (and especially cervical cancer research, as the disease was the number one killer of women at the time) became central in the mind of physicians and the public, and Dr. Pap happily returned to his research, publishing the classic medical text Diagnosis of Uterine Cancer by the Vaginal Smear in 1943. Learn more.

Kinsey and team at work. Image source

1953

Alfred Kinsey’s study Sexual Behavior in the Human Female blows up Victorian-era theories of women’s sexuality and orgasm. In the 1800s and early 1900s, common knowledge about female sexuality was all over the place: many believed women had no sex drive at all, others believed that women could only experience sexual pleasure from coitus, and still others thought that women could suffer from a condition known as “hysteria” (or “wandering womb”), which needed to be treated by genital massage with a vibrator. That last practice was quickly abandoned after Alfred Kinsey’s study revealed that of the 62% of women who masturbated (a surprising statistic in and of itself), 84% of them used clitoral stimulation to reach orgasm. Kinsey’s study explored a variety of previously un-spoken-of hetero and homosexual behaviors, and the results changed the entire frame with which female sexual experience was viewed. Learn more.

1960

The FDA approves the first oral contraceptive, commonly known as “the Pill.” The introduction of reliable oral contraceptives is considered a historical game-changer for women. Developed by biologist Dr. Gregory Pincus (previously known for successfully completing in vitro fertilization in rabbits way back in 1934), the first birth control pill, called Enovid, was a combined oral contraceptive made of synthetic progestin and estrogen, not completely unlike the birth control pills of today. Considered quite controversial, the Pill was (not surprisingly) one of the most extensively tested drugs in the history of the FDA, but when it was finally approved after 897 trials, it completely changed the lives of women: they finally had an effective, yet reversible form of contraceptives that they could control. The Pill is credited with allowing women to “liberate” themselves from their biology to pursue a career or further their education. (Sound familiar?) Learn more.

The first cover of Our Bodies, Ourselves. Image source

1973

The revolutionary women’s health book Our Bodies, Ourselves is first published. Conceived, researched, and written by rebel feminist group the Boston Women’s Health Book Collective, Our Bodies, Ourselves tackled subjects considered taboo at the time (and some still considered taboo), like women’s sexuality and lesbianism, reproductive health and abortion, contraceptives, childbirth, and menopause. Despite its position on commonly challenged and banned book lists, over 4 million copies of Our Bodies, Ourselves have been sold to date. Learn more.

The Supreme Court effectively legalizes abortion by declaring it part of a woman’s right to privacy. Roe v. Wade, a case between Norma McCorvey (using the pseudonym Jane Roe) and Dallas County District Attorney Henry Wade, started in Texas in 1969, when McCorvey was unable to obtain an abortion due to Texas law, which allowed the procedure only in cases of rape or incest. That law, and others like it, was ultimately deemed unconstitutional, as it violated the “rights of the people” covered in the Ninth Amendment, including the right to personal privacy. Public opinion—and political action—surrounding abortion has been volatile in the 40 years since. Learn more.

1978

The first “test tube baby” is born. Doctors and scientists were aware that in vitro fertilization, or fertilization of the egg outside the body, was possible since Dr. Gregory Pincus’ aforementioned experiments with rabbits in the 1930s, but they had yet to accomplish a healthy pregnancy in a woman. In 1976, a team of British doctors experimenting with IVF met with Lesley and John Brown, a couple experiencing infertility due to Lesley’s blocked Fallopian tubes; in 1977, the couple underwent the procedure and achieved a pregnancy. In 1978, Lesley gave birth to Louise Brown. The birth was not without controversy; Louise later revealed that her family received hate mail, threats, and condemnations as a result of their choice. Worldwide, the debate over IVF was happening in scientific, religious, and ethical arenas; here in the United States, research on the controversial treatment wasn’t approved until 1979, and America’s first IVF baby wasn’t born until 1981. Learn more.

Louise’s birth prompted plenty of press coverage.

1986

The first pregnancy from frozen eggs is achieved. Cryopreservation, or the use of deep-freezing to preserve human tissue, had been in use since the early 1900s, mostly on sperm, which are smaller and easier to freeze than oocytes (eggs). As reported in the medical journal The Lancet, Dr. Christopher Chen, an Australian OB/GYN, used the earlier “slow freezing” method to preserve, thaw, and fertilize a patient’s eggs, resulting in a twin pregnancy. However, the slow freezing method introduced the chance of damaging the egg, as ice crystals could form in the fluid within the cell. Learn more.

1990s

A flash-freezing method called “vitrification” greatly improves the results of egg freezing. Vitrification, which literally translates to “becoming glass,” describes the process of freezing something so quickly that it has no time to develop ice crystals (hence, as clear as glass)—in egg freezing, an embryologist uses liquid nitrogen to almost instantly cool eggs to -196ºC, or -320.8ºF. After vitrification was successfully applied to the egg freezing process, multiple studies demonstrated that this method was a significant improvement over slow freezing, resulting in fewer damaged eggs and more pregnancies. Learn more.

Egg freezing gives options to women interested in furthering their careers, as explored in a 2014 feature in Bloomberg Businessweek.

2012

The American Society for Reproductive Medicine lifts the “experimental” label on egg freezing, thanks to research that demonstrates its safety and effectiveness. In a statement on the decision, the ASRM Chair stated that “oocyte cryopreservation is an exciting and improving technology, and should no longer be considered experimental… Pregnancy rates and health outcomes of the resulting children are now comparable to those of IVF with fresh eggs.” Praised as a gender equality game-changer, egg freezing has become increasingly popular over the past four years as it offers women more options, more flexibility, and more control over their lives. Learn more.

What has you excited about the history—or future—of women’s health? Tell us @ExtendFertility!


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