Revisiting the evolution of the Hippocratic Oath in obstetrics and gynecology.

Hippocrates, an influential figure in ancient Greek medicine, is best known for his lasting contribution, the Hippocratic Oath, which includes a significant message about obstetrics and gynecology. Given the Oath's status as a widely regarded ethical code for medical practice, it requires critical evaluation. The message of the Oath, as it related to obstetrics and gynecology, is expressed in ancient Greek by the phrase "οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω" which translates directly to "I will not give to any woman a harming pessary." The words fetus and abortion were not present in the original Greek text of the Oath. Yet, this message of the Hippocratic Oath has been interpreted often as a prohibition against abortion. In this article, we present a critical linguistic and historical analysis and argue against the notion that the Hippocratic Oath was prohibiting abortion. We provide evidence that the words "foetum" (fetus) and "abortu" (abortion) were inserted in the Latin translations of the Oath, which then carried on in subsequent English versions. The addition of the words "fetus" and "abortion" in the Latin translations significantly altered the Oath's original meaning. Unfortunately, these alterations in the translation of the Hippocratic Oath have been accepted over the years because of cultural, religious, and social reasons. We assert that because the original Hippocratic Oath did not contain language related to abortion, it should not be construed as prohibiting it. The interpretation of the Oath should be based on precise and rigorous translation and speculative interpretations should be avoided.

From Embryotomy to Cesarean: Changes in Obstetric Operatory Techniques in Nineteenth- and Twentieth-Century Urban Brazil.

This article traces the historical processes by which Brazil became a world leader in cesarean sections. It demonstrates that physicians changed their position toward and use of different obstetric surgeries, in particular embryotomies and cesarean sections, over the course of the nineteenth and twentieth centuries. The authors demonstrate that Catholic obstetricians, building upon both advancements in cesarean section techniques and new civil legislation that gave some personhood to fetuses, began arguing that fetal life was on par with its maternal counterpart in the early twentieth century, a shift that had a lasting impact on obstetric practice for decades to come. In the second half of the twentieth century, cesarean sections proliferated in clinical practice, but abortions remained illegal. Most importantly, women remained patients to be worked on rather than active participants in their reproductive lives.

"A Revolution in Favor of Reproduction"? Gynecology and Obstetrics in the "Third Reich".

During the "Third Reich," the majority of German gynecologists and obstetricians did not hesitate to put themselves at the service of those in power. In 1933, many gynecologists initially only focused on the fact that the biopolitical objectives of the National Socialists matched their own long-standing demands for population policy measures and the early detection and prevention of cancer. In addition, cooperating with the Nazis promised the political advancement of the profession, personal advantages, and the honorary title of Volksgesundheitsführer (national health leaders). As a result, gynecologists exchanged resources with the regime and thus contributed significantly to the implementation of the criminal racial policies of the Nazis. At the congresses of the Deutsche Gesellschaft für Gynäkologie (German Society of Gynecology) "non-Aryan" members, mostly of Jewish descent, were excluded, the law on forced sterilization of 1933 (Gesetz zur Verhütung erbkranken Nachwuchses/Law for the Prevention of Offspring with Hereditary Diseases) was scientifically legitimized, its implementation was propagated, and relevant surgical techniques were discussed with regard to their "certainty of success." In the course of these forced sterilizations, existing pregnancies were also terminated and the victims were misused for illegal scientific examinations or experiments. Drawing upon racial and utilitarian considerations, gynecologists did not even shy away from carrying out late abortions on forced laborers from the East during the Second World War, which were strictly prohibited even under the laws of the time. Some gynecologists carried out cruel experiments on humans in concentration camps, which primarily served their own careers and the biopolitical goals of those in power. The few times gynecologists did protest or resist was when the very interests of their profession seemed threatened, as in the dispute over home births and the rights of midwives. Social gynecological initiatives from the Weimar Republic, which were mainly supported and carried out by gynecologists persecuted for their Jewish descent since 1933, were either converted into National Socialist "education programs" or simply came to an end due to the exclusion of their initiators. German gynecologists had hoped for a large-scale promotion of the early detection of malignant diseases of the uterus and breasts, to which they had already made important contributions since the beginning of the 20th century. But even though the fight against cancer was allegedly one of the priorities of the Nazis, no comprehensive measures were taken. Still, a few locally limited initiatives to this end proved to be successful until well into the Second World War. In addition, German gynecologists established the modern concept of prenatal care and continued to advance endocrinological research and sterility therapy. After the end of the Nazi dictatorship, the historical guilt piled up during this period was suppressed and denied for decades. Its revision and processing only began in the 1990s.

Dr. Bernard Nathanson: A story of metanoia.

Bernard A. Nathanson (1926-2011), was a professionally well-recognized and successful New York obstetrician and gynecologist. An avowed atheist as a young man through his middle age, Nathanson was a co-founder of the National Association for the Repeal of Abortion Laws, whose activities are credited with hastening the liberalization of abortion law in New York State. Intent on increasing the accessibility and promoting the acceptance of abortion on demand, Dr. Nathanson taught and published journal articles on the operative techniques and on the results from large numbers of these procures. During his tenure as director of the largest abortion clinic in the Western World, Nathanson presided over 60,000 abortions, and he performed more than 1,500 in his own practice. His studies of embryology and evidence from emerging technologies to monitor and examine intrauterine fetal development led Nathanson to question the morality of voluntarily interrupting pregnancy, thence to rejecting abortion procedures from his own clinical practice altogether, and eventually to become involved in anti-abortion, pro-life activities. An influential writer, speaker and film maker, these experiences and witnessing the love and prayer of other pro-life supporters turned Nathanson to notions of God, and finally reading and personal prayer guided him from secular atheism to Christianity.

Nursing and Hospital Abortions in the United States, 1967-1973.

Before elective abortion was legalized nationally in 1973 with the U.S. Supreme Court decision Roe v. Wade, seventeen states and the District of Columbia liberalized their abortion statutes. While scholars have examined the history of physicians who had performed abortions before and after it was legal and of feminists' work to expand the range of healthcare choices available to women, we know relatively little about nurses' work with abortion. By focusing on the history of nursing in those states that liberalized their abortion laws before Roe, this article reveals how women who sought greater control over their lives by choosing abortion encountered medical professionals who were only just beginning to question the gendered conventions that framed labor roles in American hospitals. Nurses, whose workloads increased exponentially when abortion laws were liberalized, were rarely given sufficient training to care for abortion patients. Many nurses directed their frustrations to the women patients who sought the procedure. This essay considers how the expansion of women's right to abortion prompted nurses to question the gendered conventions that had shaped their work experiences.

Legacies of 1917 in Contemporary Russian Public Health: Addiction, HIV, and Abortion.

I examine the legacies of Soviet public health policy and the socialist health care system and trace how the Soviet past figures in contemporary Russian policymaking and debates about drug use, HIV, and abortion. Drug policies and mainstream views of HIV reflect continuities with key aspects of Soviet-era policies, although political leaders do not acknowledge these continuities in justifying their policies. In abortion policy, by contrast, which is highly debated in the public realm, advocates represent themselves as differing from Soviet-era policies to justify their positions. Yet abortion activists' views of the past differ tremendously, reminding us that the Soviet past is symbolically productive for arguments about Russia's present and future. I describe key aspects of the Soviet approach to health and compare how current drug policy (and the related management of HIV/AIDS) and abortion policies are discursively shaped in relation to the Soviet historical and cultural legacy.

Screening Out Controversy: Human Genetics, Emerging Techniques of Diagnosis, and the Origins of the Social Issues Committee of the American Society of Human Genetics, 1964-1973.

In the years following World War II, and increasingly during the 1960s and 1970s, professional scientific societies developed internal sub-committees to address the social implications of their scientific expertise (Moore, Disrupting Science: Social Movements, American Scientists, and the Politics of the Military, 1945-1975. Princeton: Princeton University Press, 2008). This article explores the early years of one such committee, the American Society of Human Genetics' "Social Issues Committee," founded in 1967. Although the committee's name might suggest it was founded to increase the ASHG's public and policy engagement, exploration of the committee's early years reveals a more complicated reality. Affronted by legislators' recent unwillingness to seek the expert advice of human geneticists before adopting widespread neonatal screening programs for phenylketonuria (PKU), and feeling pressed to establish their relevance in an increasingly resource-scarce funding environment, committee members sought to increase the discipline's expert authority. Painfully aware of controversy over abortion rights and haunted by the taint of the discipline's eugenic past, however, the committee proceeded with great caution. Seeking to harness interest in and assert professional control over emerging techniques of genetic diagnosis, the committee strove to protect the society's image by relegating ethical and policy questions about their use to the individual consciences of member scientists. It was not until 1973, after the committee's modest success in organizing support for a retrospective public health study of PKU screening and following the legalization of abortion on demand, that the committee decided to take a more publicly engaged stance.

Regulating cinematic stories about reproduction: pregnancy, childbirth, abortion and movie censorship in the US, 1930-1958.

In the mid-twentieth century film studios sent their screenplays to Hollywood's official censorship body, the Production Code Administration (PCA), and to the Catholic Church's Legion of Decency for approval and recommendations for revision. This article examines the negotiations between filmmakers and censorship groups in order to show the stories that censors did, and did not, want told about pregnancy, childbirth and abortion, as well as how studios fought to tell their own stories about human reproduction. I find that censors considered pregnancy to be a state of grace and a holy obligation that was restricted to married women. For censors, human reproduction was not only a private matter, it was also an unpleasant biological process whose entertainment value was questionable. They worried that realistic portrayals of pregnancy and childbirth would scare young women away from pursuing motherhood. In addition, I demonstrate how filmmakers overcame censors' strict prohibitions against abortion by utilizing ambiguity in their storytelling. Ultimately, I argue that censors believed that pregnancy and childbirth should be celebrated but not seen. But if pregnancy and childbirth were required then censors preferred mythic versions of motherhood instead of what they believed to be the sacred but horrific biological reality of human reproduction.

[Anatomist, Anti-Abortionist, Anti-Darwinian. The three lives of Erich Blechschmidt (1904­1992)]. / Anatom, Abtreibungsgegner, Antidarwinist. Die drei Leben des Erich Blechschmidt (1904­1992).

The so called "Blechschmidt-Collection" in Goettingen is internationally presented as a masterpiece of German anatomical and embryological research after 1945. Compiled by anatomist Erich Blechschmidt (1904­1992), the collection's pieces are supposed to be ethically unobjectable. However, the embryos used for the collection have an obscure and dubious history. Blechschmidt is also well known for his infamous role in the Thalidomide/Contergan-trial, during which he claimed, Thalidomide would not have any negative effect on embryos. Later in his life, he became a vehement opponent of Evolution theory and disputed the right for abortion. His example may serve as one of many university professors in his generation who were appointed during the later years of the nazi regime, quickly regained their position after 1945 and continued their former research. Until now, this group did not receive appropriate scrutiny from critically minded historians.

Medicine and abortion law: complicating the reforming profession.

The complicated intra-professional rivalries that have contributed to the current contours of abortion law and service provision have been subject to limited academic engagement. In this article, we address this gap. We examine how the competing interests of different specialisms played out in abortion law reform from the early twentieth-century, through to the enactment of the Abortion Act 1967, and the formation of the structures of abortion provision in the early 1970s. We demonstrate how professional interests significantly shaped the landscape of abortion law in England, Scotland, and Wales. Our analysis addresses two distinct and yet related fields where professional interests were negotiated or asserted in the journey to law reform. Both debates align with earlier analysis that has linked abortion law reform with the market development of the medical profession. We argue that these two axes of debate, both dominated by professional interests, interacted to help shape law's treatment of abortion, and continue to influence the provision of abortion services today.

Towards Legitimate Nursing Work? Historical Discursive Constructions of Abortion in The Canadian Nurse, 1950-1965.

To the detriment of women's health, the abortion work of nurses in Canada has gone largely unexamined and is not well understood. This historical discourse analysis examines discursive constructions of nurses' abortion work and ongoing renegotiations of professional identity in The Canadian Nurse from 1950 to 1965. By investigating what has shaped and continues to inform nurses' understandings and enactment of abortion work over time, I hope to contribute to a foundation from which to evaluate contemporary abortion services and to foster conditions that support nurses in providing safe abortion care.

Al-Akhawayni, a contributor to medieval Persian knowledge on contraception.

Modern scientific achievements in the field of contraception are clearly indebted to past studies. Al-Akhawayni Bukhari was a Persian physician in the 10th century. He lived during the 'Golden Age of Islamic Medicine' (9th to 12th century AD). This scientist recorded his knowledge on various medical matters, including contraception, in the book 'Hidayat al-Muta`allemin Fi al-Tibb' (Learner's Guide to Medicine). These 10th century views on contraception are explored in this paper through a discussion of Al-Akhawayni Bukhari's surviving book, the 'Hidayat' (Guide).

[Pregnancy termination in Bulgaria ­ past, present and future perspectives. Drugs induced abortion ­ guidelines by WHO].

There are still too many unsafe abortions performed worldwide. Together with the efforts to reduce the abortion by choice, we note a rise in the need for mid trimester pregnancy termination for medical reasons. The article looks at the past present and future perspective of the abortion as a procedure in Bulgaria. States the fact that medical abortion is officially not widely performed. We reckon that with the existing guidelines by WHO and with Mifepriston and Misoprostol recently registered in Bulgaria, it is time for the medical abortion to become part of the clinical practice in Bulgaria. We believe that early medical abortion as well as mid trimester induced abortion is and adequate if not better alternative to the existing in Bulgaria procedures.

"He is still unwanted": women's assertions of authority over abortion in letters to the Royal Commission on the Status of Women in Canada.

Throughout the 1960s, the public abortion debate was dominated by men. While women's voices were not absent, they are harder to locate. This article highlights one forum in which women eloquently expressed their feelings about abortion. In submissions to the Royal Commission on the Status of Women in Canada, women demonstrated their "right" to speak on the issue in many ways, including by sharing their experiences as mothers or with unplanned and unwanted pregnancies; referencing their professional lives, especially in care giving fields; and drawing moral authority from or opposing religious beliefs. This article analyzes women's efforts to convey their authority to speak to the legality of abortion, highlighting a component of the 1960s abortion law reform discussion often overlooked.

Religion and attitudes toward abortion and abortion policy in Brazil.

This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil.