Trailblazer for Women’s Health

MARGUERITE SHEPARD, MD, has a perspective unlike few others on women’s health. She remembers, for instance, when oral contraceptives – aka the pill – were approved by the Food and Drug Administration in 1960. It came during her first year as a medical student at Johns Hopkins.

She remembers the years before Roe v. Wade, when poor women who had illegal, botched abortions came into the Baltimore hospital where she was an OB-GYN resident, and she had to work hard to restore their health. She also cared for women for five decades when abortion was safe, legal and accessible.

She remembers learning from Drs. Howard and Georgeanna Jones, who founded the first in vitro fertilization clinic in the United States. And she can recall her own work in the 1980s, establishing the first IVF clinic in Indiana, helping countless Hoosier women realize their dreams of growing their families.

Now 87, Shepard still coaches OB-GYN residents at IU School of Medicine on how to perform ultrasounds and shares the nuances of the menstrual cycle that she fears are being lost in modern medicine. “The real thing I’ve wanted to do is help women and teach residents how to take care of women,” Shepard said. “That’s why I’m hanging around still doing this.”

SHEPARD’S JOURNEY INTO medicine was, like many of her generation, a trailblazing one. Born at a time when women were still rare in the sciences, Shepard was one of just five women in her med school class at Johns Hopkins. Despite her initial intention to become an internist, she found herself drawn to obstetrics and gynecology.

During her third-year rotation in OB-GYN at Hopkins, Shepard delivered 35 babies in two and a half weeks. And, still drawing from the vernacular of the 60s, she recalls, “It was a gas.” Her time in the gynecology ward – taking care of women from East Baltimore undergoing hysterectomies without a full understanding of their procedures – was more sobering, giving her a deeper sense of the health inequities women faced. "Those patients were often unaware of why they were having their surgeries,” she said, “and I made it my mission to educate them.”

Following medical school, she completed a fellowship in biochemical genetics, where she focused on fetal hemoglobin, a protein that transports oxygen from the mother to the growing fetus.

Early in her career, at the University of Texas Health Science Center at San Antonio, Shepard began seeing infertility patients, a niche she eventually specialized in. She taught herself reproductive endocrinology, a subspecialty of the hormonal aspects of reproduction and fertility, and soon passed the board exams.

Despite her growing bank of knowledge and experience, Shepard felt she’d hit a glass ceiling in Texas and would never gain an appointment as a full professor. That led her to IU.

HERE, SHEPARD’S WORK in reproductive medicine flourished. She was the architect of the first IVF program in Indiana, and in 1983, performed the state’s first egg retrieval – removing eggs from the ovaries. But Shepard found it difficult to perform IVF in an academic environment when the procedure was becoming increasingly commercialized. Private clinics, offering higher pay, kept poaching her staff. "Now, most IVF programs are funded by venture capital,” Shepard said. “Academic institutions have trouble competing with private clinics.”

In addition to the women she helped conceive through IVF, Shepard delivered countless babies over the course of a career that saw her retire from clinical work in 2021 – at age 84.

Aside from her medical practice, Shepard has been a long-time supporter of AMPATH, the IU co-founded collaborative health program that began in Kenya, making monthly payroll deductions to AMPATH and larger year-end gifts strategically from her IRA. She visited Kenya in 2020 and has taken a keen interest in fertility programs there. She’s also shipped some of her downloaded knowledge – her lectures about women’s health – to Kenya to help the residents and patients there.

“She’s shared her talent and time with trainees, along with the very first funding for infertility testing and care at Moi Teaching and Referral Hospital,” said Adrian Gardner, MD, director of the IU Center for Global Health Equity. “Her giving has transformed the lives of women in Kenya, enabling them to become mothers and to leave behind the shame and stigma of infertility.”

Today, Shepard remains a consultant to residents at IU. She coaches them on the art of ultrasound and the nuances of the menstrual cycle. Prakrithi Srinand, MD, an OB-GYN resident, considers Shepard “a giant in the field” for her advocacy on behalf of women and her trailblazing achievements. “To stand on her shoulders is a privilege,” Srinand said.

Lisa Landrum, MD, chair of the Department of Obstetrics and Gynecology, said Shepard has impacted generations of learners with her institutional knowledge of the department and unique insight into the specialty. “I feel so lucky to have her as a continued presence in our community,” Landrum said.

Now, after more than 60 years in the field, Shepard has a broad base of knowledge from which to draw. “I’m trying to download everything that’s up here,” she said, pointing to her head, “into digestible material, and do it now as opposed to later.”

Shepard is building a website to contain her decades of research on the menstrual cycle, which she says too many women – and some physicians – don’t adequately understand. Her work coaching residents on the art of ultrasound, including how to date the precise age of a fetus, has taken on new importance. "In Indiana, with the restrictions on abortion, getting the dates right has never been more critical," she said.

After six decades in the trenches, there’s an element of frustration in Shepard’s voice when it comes to the present state of women’s health. Indiana still has the third-highest maternal mortality rate in the country. America ranks poorly compared to other wealthy nations.

Shepard sees the current political climate as similar to when she was a young physician in the 1960s. IVF research was controversial then – and it has become so again now. Restrictions on abortion are tightening.

But she is determined to continue helping the next generation of OB-GYN doctors learn and improve their craft. "I’ve never had a desire to go beyond teaching and helping women,” she said. “That’s why I’m still here.”