Mahmoud Fathalla Explores the Relationship Among Biological Evolution, Scientific Advances and Women’s Reproductive Health Challenges

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By: Sarah Blake, MHTF consultant

In “How evolution of the human brain shaped women’s sexual  and  reproductive health,”  an article published recently in Reproductive Biology Insights, Mahmoud Fathalla explores the ways that biological dimensions of human evolution have contributed to reproductive risks – but also their responses. For example, he notes that assistance during childbirth was just one practice that emerged in response to the evolution of human biology, pointing out that:

“If the human female tries to catch the baby’s head herself, and to ease it out, she may break its neck. This is why midwifery may have been the oldest human profession. Birth attendance, how­ever, carried the risk of infection in the days before asepsis, anti-sepsis, and antibiotics.”

He continues, pointing out that while women have continually borne the brunt of many poor sexual and reproductive health outcomes, the evolution of the human brain and the scientific advances it has enabled have offered many advances for women’s health.  For example, when it comes to maternal mortality, Dr. Fathalla argues:

“If women were still experiencing “natural” maternal mortality rates today, the maternal death toll would be four times its current size. Three quarters of these deaths are currently avoided throughout the world: nearly all the “natural” maternal mortality in developed countries, but only one third to two thirds in developing country regions. The blame for avoidable maternal mortality in the world today is not on science. Science has already provided the knowledge and the tools.”

Recognizing that in spite of scientific advances that have lessened the burdens that once constrained women and their health, many challenges still remain. He concludes:

“A women-centered medical and social research agenda is needed to help the woman to finally emerge from behind the mother”