What can be learned from the Chinese experience in response to infertility.

OBJECTIVES: The aims of the study were to reviews the history of China's population policy since 2011, and draw lessons from the Chinese experience in response to infertility. METHODS: Data from the Chinese infertility status survey report (2009) and national statistical yearbooks (2009-2019) are used to assess the severity of infertility and reproductive centers shortage in China. Lessons from China was informed by a review of existing literature. RESULTS: The proportion of couples suffering from infertility in China increased to 12.5% (166.8 million in 2009) from just 6.89% (86.6 million in 1988) two decades earlier, while the number of reproductive centers was one for every 3.1 million citizens. The total costs per live birth for medically assisted reproduction in Chinese public fertility clinics was 30,000 yuan in 2012. Among infertile couples, unemployed patients accounted for the largest proportion (21.9% in 2014). Currently in China, health regulations permit oocyte donation only from infertility patients who have 20 or more mature oocytes, of which at least 15 must be kept for their own treatment. CONCLUSION: It is necessary to integrate the reproductive health care of infertile people into the national public health service. In addition to relieving their economic burden, national policies should guide and support enterprises to guarantee employee medical leave for infertility. Growing numbers of bereaved older women who have lost their only child make it imperative to reconsider liberalizing the regulation of oocyte donation in China.

Advancing the Health of Populations Across the Life Course: 50 Years of Discoveries in the Division of Intramural Population Health Research.

In 2017, the Division of Intramural Population Health Research (DIPHR), within the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), reached a significant milestone: 50 years in existence. DIPHR celebrated this anniversary with a scientific program that reviewed past accomplishments and reflected on future directions in support of promoting the health of populations across the life course. Extending from the scientific program, the impetus of this article is to contribute to archiving and consolidating the legacy of intramural population health research at NICHD over the past 50 years. We present a brief history of the origin and evolution of intramural population health research at NICHD. Next, we conduct an empirical assessment of the scientific impact and evolving scope of this research over the past five decades and present specific key discoveries emerging from topics spanning the life course: (1) reproductive health, (2) the health of pregnant women and fetuses, (3) the health of children, and (4) associated methodologies. We also explore the Division's service to the profession in the form of mentorship of the next generation of scientists in population health research. Finally, we conclude with thoughts about future directions of population health research and reaffirm the DIPHR's commitment to promoting the health and well-being of the many populations we serve, both locally and globally.

Birthing life and death: women's reproductive health in early twentieth-century Rio de Janeiro / Vida e morte no parto: saúde reprodutiva das mulheres no Rio de Janeiro do início do século XX

Abstract This article explores women's reproductive health in early twentieth-century Rio de Janeiro, showing that elevated and sustained stillbirth and maternal mortality rates marked women's reproductive years. Syphilis and obstetric complications during childbirth were the main causes of stillbirths, while puerperal fever led maternal death rates. Utilizing traditional sources such as medical dissertations and lesser-used sources including criminal investigations, this article argues that despite official efforts to medicalize childbirth and increase access to clinical healthcare, no real improvements were made to women's reproductive health in the first half of the twentieth century. This, of course, did not make pregnancy and childbirth any easier for the women who embodied these statistics in their reproductive lives.

Resumo O artigo aborda a saúde reprodutiva das mulheres no Rio de Janeiro do início do século XX, mostrando que taxas elevadas de mortalidade materna e de contínua natimortalidade marcavam os anos reprodutivos das mulheres. As principais causas de natimortalidade eram sífilis e complicações obstétricas, enquanto febre puerperal encabeçava as taxas de morte materna. Utilizando fontes tradicionais como teses doutorais e fontes como investigações criminais, o artigo discute que, apesar dos esforços oficiais para medicalizar o parto e aumentar o acesso aos serviços de saúde, nenhuma melhoria real foi feita na saúde reprodutiva das mulheres na primeira metade do século XX. Isso, certamente, não facilitou a gravidez e o parto das mulheres que compunham as estatísticas em suas vidas reprodutivas.

Birthing life and death: women's reproductive health in early twentieth-century Rio de Janeiro.

This article explores women's reproductive health in early twentieth-century Rio de Janeiro, showing that elevated and sustained stillbirth and maternal mortality rates marked women's reproductive years. Syphilis and obstetric complications during childbirth were the main causes of stillbirths, while puerperal fever led maternal death rates. Utilizing traditional sources such as medical dissertations and lesser-used sources including criminal investigations, this article argues that despite official efforts to medicalize childbirth and increase access to clinical healthcare, no real improvements were made to women's reproductive health in the first half of the twentieth century. This, of course, did not make pregnancy and childbirth any easier for the women who embodied these statistics in their reproductive lives.

Fifty years of obstetrics and gynaecology.

The term 'obstetrics and gynaecology' now feels like an outmoded name for women's health care. Since the 1960s the specialty has been transformed by social change, technical innovation and medical subspecialization, although the core values of good clinical practice remain unchanged.

Industry is not the dark side, but an essential partner to make progress in reproductive health.

For the last 20 years, Thomas D'Hooghe has been coordinator of the Leuven University Fertility Center at Leuven University Hospitals, Belgium, one of the largest teaching hospitals in Europe. Since 1995, he has also been Professor of Reproductive Medicine and Biology at KU Leuven (University of Leuven) and Adjunct Professor at Yale University, USA. Since 1 October 2015, he has been the Vice President and Head of Global Medical Affairs Fertility at Merck's headquarters in Darmstadt, Germany. He has published nearly 300 papers in internationally peer-reviewed journals and has contributed to reproductive health serving major international organizations such as the WHO, the European Society of Human Reproduction and Embryology, the Society of Reproductive Investigation and the World Endometriosis Research Foundation.

"A word from man to man". Interwar Venereal Disease Education Films for Military Audiences in France.

In the 1910s, in the wake of the glorious decade of syphilography (1900-1910), the early health education films lay the groundwork for a pragmatic approach to the containment of venereal diseases combining (early) diagnosis, treatment and prophylaxis. Realizing that WWI was turning into a durable military conflict, the French Army created a Cinematographic Section (SCA) in 1915 for the purposes of war propaganda and documentation. In 1916, secretary of war Justin Godard declared syphilis a "national public danger" and initiated information campaigns in military and civilian spheres. Conferences accompanied with film screenings were organized for all new military recruits, resulting in the production of a series sex hygiene films for military audiences characterized by a short, evocative and precise documentary style, contrasting with the romantic sex hygiene films aimed at the general public. This contribution examines the cinematographic origins of the instructional films for the military, as well as their evolution up to WWII and their influence on public sex hygiene films for civilians in the interwar period in France.

Representation of Dangerous Sexuality in Interwar Non-Fiction Sex Hygiene Films: A Franco-German Comparison.

In the interwar period VD prevention films accompanied the introduction of new "permanent" treatments for syphilis. While they still warned the audience about the dangers of infection, these films were primarily designed to inform about these new methods for curing syphilis. These methods could only be effective if the infected patient immediately consulted a certified doctor (as opposed to a charlatan) upon experiencing the first symptoms. The objectives of the commissioners of health education films tended to go beyond simply conveying a propaganda message. They adhere to and act on the educational potential that the film medium offers to an adult audience. In addressing subjects like sexual health, the films speak to the intimate lives of the audience members, faced with characters whose sexual behaviour is meant to echo their own or that of their friends and relatives. In order to properly raise awareness, the film must escort them, help them overcome their disarray, and persuade them that they are morally able to adopt the necessary measures to avoid contagion. This paper consists in an in-depth comparative study of three anti-venereal films produced and shown between 1928 and 1931, a short but pivotal period in the development of continental European syphilis prevention films. The three films illustrate two forms of screenplay action. In the French films, the patient is identified with a tragic hero and the medical institution embodied by a providential man. Contrary to these French films, the German film tends to display a more matter-of-fact-approach, which is not meant to downplay the risks but rather to clearly identify and address the community exposed to danger and to present how the infection is taken care of once it is diagnosed. Here I consider these films together to show how different ways of conveying the same medical discourse were adopted to adjust to national cinematographic environments.