ABSTRACT
The mean duration of human pregnancy is 280 days but the range is wide, and "term" has been defined to range from 37 to 42 weeks. In the 18th and 19th centuries, labour induction was used mainly in cases of pelvic deformity, before the foetus grew too large to be delivered. Induction methods were unreliable until the 20th century, when pituitary extract, and then synthetic oxytocin and prostaglandins, became available. "Disproportion" was the leading indication for induction until the 1950s, when it became clear that prolonged pregnancy was associated with increased perinatal mortality. Pregnancy dating was improved by ultrasound, which also showed that foetal growth slows at term. Induction rates rose during the 1970s, causing public concern about obstetric intervention. In the 21st century, large-scale randomised trials showed that perinatal mortality is lowest at 39-40 weeks, and that induction at that time does not increase the rate of operative delivery.
Subject(s)
Oxytocics , Perinatal Death , Pregnancy, Prolonged , Female , Humans , Labor, Induced , Oxytocin , PregnancySubject(s)
Language , Periodicals as Topic , Publishing , Writing/standards , Female , Humans , Male , Periodicals as Topic/standards , Publishing/standardsSubject(s)
Birth Rate , Contraception/methods , Abortion, Induced/legislation & jurisprudence , Denmark , Female , Fertility , HumansSubject(s)
Famous Persons , Hyperemesis Gravidarum/therapy , Abortion, Criminal/history , Adult , Female , History, 19th Century , Humans , PregnancySubject(s)
Confidentiality , Maternal Mortality , Female , Humans , Pregnancy , United Kingdom/epidemiologyABSTRACT
Abortion is mentioned in ancient medical texts but the effectiveness of the methods described is doubtful. Attitudes varied from apparent disapproval by Hippocrates to open approval in Ancient Rome. In mediaeval times abortion was practised by women in secret and this continued during the 19th and early 20th centuries. Despite being illegal in England induced abortion became more common in Victorian times as the population grew. At the same time the link between criminal abortion and maternal mortality became increasingly clear, and if a woman died after a procedure the abortionist (sometimes a midwife) could be sentenced to death. The law was more tolerant of abortions performed by registered doctors. In the 20th century pressure grew for its legalisation. At the time of the 1967 Abortion Act, abortion was the leading cause of maternal death in the UK but within fifteen years death from illegal abortion had been abolished.
