Percivall Pott was a physician in England during the eighteenth century who identified soot as the cause of chimney sweeps' scrotal cancer, later called testicular cancer. In the 1770s, Pott observed that scrotal cancer commonly afflicted chimney sweeps, the young boys sent up into chimneys to clean away the soot left over from fires, and he hypothesized that the soot inside chimneys might cause that type of cancer. Pott was one of the first doctors to identify some environmental factor as causing cancer. Pott's research helped chimney sweeps to prevent scrotal cancer by using protective clothing, and it also allowed for future research on environmental causes of cancers.

During the twentieth century, Austin Bradford Hill researched diseases and their causes in England and developed the Bradford Hill criteria, which comprise the minimal requirements that must be met for a causal relationship to be established between a factor and a disease. Hill also suggested that researchers should randomize clinical trials to evaluate the effects of a drug or treatment by monitoring large groups of people. In addition, Hill advocated for case-control studies, in which researchers compare a group of people with a medical condition to a group without that condition to investigate the condition's possible causes. Hill's own work with clinical trials and case-control studies helped him prove that smoking caused lung cancer. The Bradford Hill criteria have also been used to establish causal links between factors and cancer, including reproductive cancers such as human papillomavirus that causes cervical cancer.

In 1894, William Stewart Halsted published The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894, in the medical journal Annals of Surgery. In the article, Halsted describes the results from fifty of his operations on women with breast cancer, performed at Johns Hopkins Hospital in Baltimore, Maryland. Those operations involved a surgical procedure Halsted called radical mastectomy, which consists in removing all of the patient’s breast tissue, chest muscle, and underarm lymph nodes. Halsted’s surgery effectively cured breast cancer in a time period when no other effective treatment options were available. The radical mastectomy remained the standard of care from the 1890s to the 1970s as a means of treating a type of reproductive cancer common to women.

The 1973 Supreme Court case Roe v. Wade was a significant event in the story of fetal personhood—the story of whether embryos and fetuses are legal persons. Roe legalized abortion care in the United States (US). However, the story of fetal personhood began long before the 1970s. People have been talking about embryos, fetuses, and their status in science, the law, and society for centuries. I studied the history of fetal personhood in the United States, tracing its origins from Ancient Rome and Medieval England to its first appearance in a US courtroom in 1884 and then to the Supreme Court’s decision in 1973.

William Stewart Halsted was a surgeon at Johns Hopkins Hospital in Baltimore, Maryland, during the late 1800s and early 1900s. In 1894 Halsted described his procedure for treating breast cancer by removing the breast tissue, chest muscles, and lymph nodes in the armpit, a procedure he named radical mastectomy, and that became the standard of care for treating breast cancer until 1970. He also made contributions to other novel medical procedures such as gallbladder surgery, blood transfusions, antiseptic techniques, anesthesia use, and using plates and screws to hold bones in position when setting bone fractures. At Johns Hopkins Hospital, Halsted established a surgical training program in which he allowed medical students and surgical residents to shadow him and perform procedures under his guidance. In the twentieth century, similar training programs spread across the country and informed the standardization of medical training. Halsted devised a surgical treatment for breast cancer and reshaped the way physicians practiced medicine in the twentieth century, which resulted in better health outcomes through more careful surgical methods, especially in women with breast cancer.

In 1953, Virginia Apgar published the article "A Proposal for a New Method for Evaluation of the Newborn Infant" about her method for scoring newborn infants directly after birth to assess their health and whether medical intervention was necessary. Apgar worked at the Presbyterian Hospital in New York City, New York, as an obstetrical anesthesiologist, a physician who administers pain medication during childbirth. In that capacity, she sought to reestablish clear scoring guidelines for newborn infants so that she could compare which obstetric practices, pain relief methods, and resuscitation methods worked the best during and after childbirth. She published her article in Current Researches in Anesthesia and Analgesia in 1953, and the Apgar scoring system is still used in hospitals around the world as of 2016. In the article, Apgar establishes a scoring system for newborn infants that allows for quick assessment of their health directly after birth and therefore swift intervention by medical personnel to promote healthy development.

In vitro fertilization, or IVF, is currently a worldwide medical procedure designed to give infertile men and women the ability to have children of their own. An IVF procedure takes place outside of a woman’s body, often in a laboratory setting. However, before scientists used the procedure on humans, they initially performed IVF on animals for selective breeding and agricultural purposes. After scientists realized that the procedure had potential to become a treatment option for infertility, they expanded their research subjects to include using the technique on humans. During the procedure’s initial development, scientists began to conduct numerous IVF trials on humans that often ended in early miscarriages. This thesis shows us the history of how some of the first attempts at IVF in humans using various options such as donated egg cells and cryopreserved embryos, often ended in early miscarriages. At that time, most members of the scientific community and general public responded to those trials by regarding them as insignificant. In 1998, the success rate of women under the age of 38 having children with the use of IVF was 22.1%. Over time, scientists began to acknowledge those published findings that detailed various “failed” human IVF experiments. Scientists learned to use them as a guide for what to do differently in future IVF experiments. Because of that, scientists have since developed more effective IVF methods which have ultimately improved the procedure’s success rate. In 2016, the success rate of IVF had increased to 39.6% for women. Therefore, what we might initially think of as a “failure” is in reality not a failure at all, but rather is a “purported failure” because we can use it as a stepping-stone towards an end goal. By looking at the history of IVF research, my thesis illustrates how some of the most important science comes from acknowledging the purported failures along with the triumphant successes.

The 1973 Supreme Court case Roe v. Wade was a significant event in the story of fetal personhood—the story of whether embryos and fetuses are legal persons. Roe legalized abortion care in the United States (US). However, the story of fetal personhood began long before the 1970s. People have been talking about embryos, fetuses, and their status in science, the law, and society for centuries. I studied the history of fetal personhood in the United States, tracing its origins from Ancient Rome and Medieval England to its first appearance in a US courtroom in 1884 and then to the Supreme Court’s decision in 1973.

But this isn’t a history of events—of names and dates and typical details. This is a history of words. In the twenty-first century, words used to discuss embryos and fetuses are split. Some people use humanizing language like “unborn children” and “human life.” Others use technical words like “embryos” and “fetuses.” I studied what words people used historically. I charted how words moved from science to the public to the law, and how they impacted court rulings on fetal personhood.

The use of certain words nudged courts to grant additional rights to embryos and fetuses. In the 1960s, writers began describing the science of development, using words like “unborn child” and humanizing descriptions to make embryos and fetuses seem like people already born. That helped build an idea of embryos and fetuses as having “life” before birth. When people began asking courts to legalize abortion care in the 1970s, attorneys on the opposite side argued that embryos and fetuses were “human life,” and that that “life” began at conception.

In those cases, “life” was biologically defined as when sperm fertilized egg, but it was on that biological definition “life” that judges improperly rested their legal rulings that embryos and fetuses were “potential human life” states had a duty to protect. It wasn’t legal personhood, but it was a legal status that let states pass laws restricting abortion care and punishing pregnant people for their behavior, trends that threaten people’s lives and autonomy in the twenty-first century.

As of 2019, 30 US states have adopted abortion-specific informed consent laws that require state health departments to develop and disseminate written informational materials to patients seeking an abortion. Abortion is the only medical procedure for which states dictate the content of informed consent counseling. State abortion counseling materials have been criticized for containing inaccurate and misleading information, but overall, informed consent laws for abortion do not often receive national attention. The objective of this project was to determine the importance of informed consent laws to achieving the larger goal of dismantling the right to abortion. I found that informed consent counseling materials in most states contain a full timeline of fetal development, along with information about the risks of abortion, the risks of childbirth, and alternatives to abortion. In addition, informed consent laws for abortion are based on model legislation called the “Women’s Right to Know Act” developed by Americans United for Life (AUL). AUL calls itself the legal architect of the pro-life movement and works to pass laws at the state level that incrementally restrict abortion access so that it gradually becomes more difficult to exercise the right to abortion established by Roe v. Wade. The “Women’s Right to Know Act” is part of a larger package of model legislation called the “Women’s Protection Project,” a cluster of laws that place restrictions on abortion providers, purportedly to protect women, but actually to decrease abortion access. “Women’s Right to Know” counseling laws do not directly deny access to abortion, but they do reinforce key ideas important to the anti-abortion movement, like the concept of fetal personhood, distrust in medical professionals, the belief that pregnant people cannot be fully autonomous individuals, and the belief that abortion is not an ordinary medical procedure and requires special government oversight. “Women’s Right to Know” laws use the language of informed consent and the purported goal of protecting women to legitimize those ideas, and in doing so, they significantly undermine the right to abortion. The threat to abortion rights posed by laws like the “Women’s Right to Know” laws indicates the need to reevaluate and strengthen our ethical defense of the right to abortion.

The United States is one of the countries with the highest rates of maternal mortality in the world, with significantly higher rates than other developed countries. Maternal mortality is defined as the death of women who are pregnant or recently gave birth. Many studies suggest that those deaths are preventable and result from a lack of quality care and unnecessary medical interventions. It is notable that there are specific populations, which I describe as “vulnerable,” that are at increased risk of maternal mortality, including women of color, women in poverty, and women with low socioeconomic statuses. The United States also has lower rates of midwife-assisted births than other developed countries, which suggests that there is an association between adverse birth outcomes, such as maternal mortality, and midwifery care. In my thesis, I investigate that association and answer the question: Do midwives lower rates of adverse birth outcomes in vulnerable populations? I describe the history of midwifery in the United States and analyze the factors that lead to lower adverse birth outcomes in midwife-attended births. I then suggest methods for integrating midwives into the United States healthcare system, which I suggest will lower rates of maternal mortality.