Gynecologic and Reproductive Concerns

The seven U.S. Mercury astronauts, all of whom were male, were selected by NASA in 1959 to make the first human space flights. Nevertheless, the era of human space flight started not in the United States but in the Soviet Union with the single-orbit flight of a male cosmonaut, Yuri Gagarin, on Vostok 1 in April 1961. The Soviets also inaugurated female participation in space flight. The first woman to fly in space was Valentina Tereshkova, who spent 3 days on Vostok 6 in 1963. Nineteen years later another Soviet woman, Svetlana Savitskaya, ventured into space on the flight of Soyuz-T7 in August 1982. In June 1983, the first female U.S. astronaut, Sally Ride, joined this elite group of female spacefarers.

The process by which the first astronauts were chosen for the U.S. space program was initiated in the late 1950s. The U.S. Government determined that the first groups from which astronauts were to be selected would be limited to military test pilots. Although several women were able to complete the medical selection examinations (the same ones given to the men), none of them qualified for the simple reason that all military test pilots at that time were men. This policy thus effectively delayed space flights by U.S. women for 2 decades [1]. The first U.S. astronaut class to include women was formed in 1978; of that class of 35, 6 were women. To date, more than 45 female career astronauts (pilots or mission specialists) have been selected for the U.S. space program. One female Canadian astronaut and three female payload specialists have flown on the shuttle.

Regardless of the relative assets and liabilities of using men or women in future space crews, these crews will include people of both sexes. It is therefore prudent that the reproductive and gynecologic issues associated with selecting, training, and assigning female crewmembers to space missions be examined. This chapter addresses gynecologic medical standards and female astronaut selection, reproductive and operational gynecologic considerations during training and space flight, pregnancy after space flight, and gynecologic considerations for long-duration space flights.