Ob-Gyns Can Be the Secret Weapon in the Fight Against Heart Disease

As ob-gyns, we know that the care we provide to women goes far beyond reproductive health. Thirty-five percent of women consider their ob-gyn their sole health care provider, putting us in a unique position to address an array of common health conditions. Since heart disease is the number one killer of women—and February is Heart Health Month—now is a good time to remember the part we can play in changing the outcomes of this devastating disease.

Perhaps the biggest threat of heart disease is lack of awareness of the condition’s prevalence and dangers. Though heart disease causes one in three deaths among American women every year—and 90 percent of women have at least one risk factor for developing heart disease—only one in five believes that heart disease is her greatest health threat, according to the American Heart Association (AHA). Equipped with these statistics, ob-gyns should feel confident initiating a conversation with patients about their heart health.

Helping patients address heart disease risk factors, ideally before a heart disease diagnosis, is key. Nearly two-thirds of women who die suddenly of coronary heart disease have no previous symptoms, according to the Centers for Disease Control and Prevention. For many women, the first signs of heart disease are actually the symptoms of a stroke, heart failure or heart attack, when serious damage may have already occurred. However, a number of risk factors are mostly under a patient’s control: an unhealthy diet and/or lack of exercise (both of which can lead to other important risk factors, including being overweight and having high blood pressure, high LDL cholesterol, and diabetes); smoking; and drinking to excess. When women are educated about how to make important lifestyle changes, it can be lifesaving. According to the AHA, 330 fewer women are dying from heart disease every day as a result of making heart healthy choices.

There are some factors that are out of a patient’s control, including a family history of heart disease, preterm labor and delivery, and preeclampsia. Ob-gyns can play an essential role by communicating the steps women can take to reduce their odds of a heart disease diagnosis. Even by simply acknowledging and discussing the risks, ob-gyns can make a difference. So, while these conversations aren’t always comfortable, they’re important because many women may not be hearing this information from any other health provider.

Lastly, since the symptoms of heart disease are widely misunderstood, particularly in women, it’s critical to share them with at-risk women. While angina is the most common symptom associated with heart disease, women are actually more likely to experience pain in the neck, jaw, throat, abdomen or back; shortness of breath; and nausea/vomiting. Lightheadedness, dizziness or fainting are common signs, as well. These symptoms don’t always occur during exercise or periods of stress; they can happen during rest, too. By ensuring your at-risk patients are aware of these signs, it could mean they get treatment faster, which will ultimately lead to better outcomes.

Ob-gyns have a powerful opportunity to be the secret weapon in the fight against heart disease. We can help inform our patients about the dangers, symptoms, and necessary preventative care. Communicated early and effectively, we can help women manage the factors that are in their control to help them live healthier, longer lives.

OB-GYN’s Crucial Role in Protecting Women from Cervical Cancer

Every year, more than 12,000 American women are diagnosed with cervical cancer, and more than 4,000 of those women die from the disease. And, according to a reevaluation of existing data in a study recently published in the journal Cancer, the cervical cancer death rate may actually be much higher than previously estimated. Since January is Cervical Cancer Awareness Month, now is an excellent time to educate our patients about the steps they can take to not become a part of these terrible statistics.

We know Pap smears are one of the most effective tools we have to improve cervical cancer outcomes. Half of all cases of cervical cancer occur in women between the ages of 35 and 55; it’s rarely found in women under 20, and about 20 percent of cases are in women 65 and older. That’s why we recommend regular cervical cancer screenings in our patients starting at the age of 21 and through the age of 65 or longer based on individual risk factors. Pap smears screen for a cancer that’s often symptomless, and they help spot changes in the cervix before cancer develops—when treatments are most effective. Due to widespread adherence to Pap smear testing, deaths from cervical cancer have decreased by 50 percent over the last 30 years. So, encourage your patients to attend their annual well-woman visits. Along with the opportunity to offer Pap smears and screenings, these visits provide an ideal occasion to educate patients about cervical cancer risks and prevention.

Of course, virtually all cervical cancer cases are linked to HPV. HPV is the most common sexually transmitted infection: 80 percent of all sexually active people will contract the virus in their lifetimes. A family history of cervical cancer increases the risk two- to three-fold, since these women may have a genetically inherited condition that makes it harder for their bodies to fight off HPV infection. The three-dose HPV vaccine protects against 81 percent of cervical cancer cases. The CDC, AAP, AAFP and ACOG all recommend the vaccine for boys and girls between the ages of 11 to 12 years old. Full vaccination reduces risk of certain HPV-related cancer by up to 99 percent; boosting vaccination rates could prevent 29,000 HPV-related cases of cervical cancer every year.

Vaccine adherence rates, however, remain low, with only about one-third of girls and just over one in 10 boys receiving their full vaccination series. Educating your young patients or those who are parents of preteen children is important. Likewise, it’s important to ask your patients in their teens and 20s whether or not they’ve been vaccinated. Even if a patient missed the recommended vaccine as a child and is sexually active, if she’s under the age of 27, it may still be beneficial because there may not have been exposure to all of the virus strains the vaccine protects against. If a patient refuses vaccination at first, it never hurts to keep offering it at future visits.

Like many things we discuss with our patients, there is still a lot of misunderstanding about HPV and cervical cancer.  That’s why it’s so important to continue to encourage annual well woman visits and HPV vaccinations. For more information to help guide your conversations with patients, visit ACOG’s Immunization for Women website, shotbyshot.org, or the National Cervical Cancer Coalitions Cervical Cancer Awareness Month page.

We Cannot Afford to Have the Clock Turned Back on Women’s Health

As we begin a new year, a lot is at stake for Americans’ health. Our nation’s leaders have promised substantial changes to the Affordable Care Act, from partial to full repeal, without the certainty of a replacement plan. While it can be easy to get caught up in the politics of health care, as ob-gyns our focus has always been on our patients and ensuring that they have access to safe, high-quality health care. That is why a critical part of our work here at ACOG is to advocate for the health of women, and as millions of people face the possibility of losing health insurance coverage in the coming months or years, ACOG’s work has never been more important.

Earlier this month, ACOG partnered with three leading medical organizations—the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians—to urge Congress to avoid repealing the ACA without an immediate replacement which would protect and retain the landmark women’s health provisions in the law.

The ACA is not perfect. In fact, ACOG didn’t endorse it originally because we felt it didn’t meet the needs of our physician members. However, while there’s lots to improve, the ACA does include really important protections for our patients’ health. Insurers must now cover maternity and preventive care and contraceptives. It stops insurers from charging women more than men for the same coverage, prevents insurers from denying coverage to women who were victims of domestic violence or who had a Cesarean delivery in the past. The ACA also guarantees women direct access to their ob-gyns without any limitations.

The coverage provided under the ACA allowed many women to schedule routine doctor’s appointments for the first time in their lives. We all know that when people have insurance, they’re more likely to use preventive care like mammogram and diabetes screenings that prevent more costly and life threatening health problems down the line.

Whatever one’s reservations may be about the law, as physicians we know how devastating it would be for a cancer patient to suddenly lose her coverage or for a pregnant woman to go without prenatal care and deliver a baby preterm because she could no longer afford health coverage. The fact is, low-income women are more likely to suffer from often preventable pregnancy complications and, unfortunately, that is the very population that stands to lose the most unless Congress protects these important benefits, including Medicaid expansion.

Today, 31 states and D.C. have expanded their Medicaid programs, offering coverage to 11 million newly eligible individuals. The most important part of the expansion to women is that those Medicaid programs cover low-income women even if they’re not pregnant. Regular Medicaid programs routinely only cover pregnant women through delivery and a few weeks after.

But speaking more broadly, all women stand to lose essential preventive care if the ACA is repealed. Access to breast cancer screenings decreases women’s likelihood of dying from the disease by up to 50 percent. Routine cervical screenings decrease the odds of late-stage cancer diagnosis by 60 percent. Finally, when women have access to more choices of affordable and effective contraception, including IUDs and implants, rates of unintended pregnancy, unplanned birth, and abortion drop dramatically.

In 2016 alone, 6.8 million girls and women gained health insurance coverage. If the law is repealed, those gains will likely be lost. We cannot turn back the clock on women’s health. The care we provide doesn’t stop in our exam or delivery rooms. It’s our responsibility to advocate on our patients’ behalf and protect their access to affordable, comprehensive health care. So let’s mobilize and use our collective community’s influence and expertise to ensure access to health care in this country.

To become involved in ACOG’s advocacy efforts, join us at the 35th Congressional Leadership Conference, The President’s Conference in Washington, D.C., in March.

Prevention of Preterm Birth Starts with a Healthy Mom

November 17 is World Prematurity Day. It gives us, as health professionals, an opportunity to direct our attention to a devastating health issue that impacts 15 million babies each year and rededicate ourselves to reducing that number. Several organizations, including ACOG, are supporting the cause through education, awareness, and advocacy events. However, there’s one event in particular that, coincidentally, started this week and stands to make the most significant impact in terms of lowering the preterm birth rate in this country and that’s open enrollment through the Health Insurance Marketplace.

Prevention of preterm birth starts with a healthy mom and that means access to prenatal care and preventive services. There are several risk factors for preterm birth, some of which include high blood pressure, low pre-pregnancy weight, alcohol and drug abuse, smoking, a prior preterm birth and a birth less than 12 months ago. Adequate health insurance coverage can make the difference between a pregnant woman carrying to term or delivering too early and the Affordable Care Act has helped make that coverage accessible to millions of women.

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ACOG Joins National Obesity Care Week 2016: Take 5 to Change the Way We Care

Today, more than a third of the adult population, 36.5 percent, is affected by obesity. The number of adults who are affected by severe obesity continues to rise. It’s time for a change in obesity care. With senocw-supporter-web-visual-copyvere obesity on the rise, our nation, led by the health care community, must attack this disease from multiple angles and unite to overhaul the treatment of obesity. ACOG recognizes the important role that obstetrician-gynecologists play. Ob-gyns often meet their patients at a young age, when obesity is less likely to be an issue. Therefore, we are in an ideal position to help educate women and provide counsel on the importance of a healthy lifestyle and fighting obesity.

The 2nd Annual National Obesity Care Week (NOCW), October 30 through November 5, seeks to ignite a national movement to ensure anyone affected by obesity receives respectful and comprehensive care. ACOG is proud to join the Campaign, which was founded by The Obesity Society, the Obesity Action Coalition, Strategies to Overcome and Prevent Obesity Alliance and the American Society for Metabolic and Bariatric Surgery.

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“AIM”ing to Reduce U.S. Maternal Mortality

During the past several weeks, you would be hard-pressed not to find an article about the dismal maternal mortality rates in this country. In fact, it was a study published in our very own Green Journal that sparked the latest national conversation (with Texas at the epicenter) about why the most modern, industrialized country in the world is failing so miserably at reducing the numbers of deaths associated with pregnancy and childbirth. However, the truth of the matter is, we already know why.

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World Contraception Day

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Today, September 26th, is World Contraception Day (WCD). Now in its ninth year, WCD envisions a world where every pregnancy is wanted and women are empowered with the resources and knowledge to make informed decisions about their sexual and reproductive health. Part of the larger Family Planning 2020 mission, WCD takes a multi-faceted approach to women’s health, encouraging increased sexual education, improved access to health care services, and eliminating challenges to cultural taboos based on myth or misconception.

As women’s health care providers, this mission aligns with our everyday efforts.  We counsel and educate our patients, helping their personal and professional goals align with their sexual and reproductive choices. Empowering women with choice and control over their contraceptive choices and family planning leads to happy and healthy individuals and families. Continue reading

Setting the Record Straight on Drinking During Pregnancy

When confronted with so many different types of infections and viruses that can threaten the health of an unborn baby, it’s unfortunate that drinking during pregnancy is still the leading cause of birth defects in this country and abroad. Without knowledge of the devastating effects, it’s easy to have a casual attitude toward drinking but when a fetus is exposed to any amount of alcohol it can lead to a number of permanent and debilitating conditions. These are known as fetal alcohol spectrum disorders (FASD) and can include anything from severe brain damage and growth deficits to lifelong learning and behavioral problems in children. September is designated as FASD Awareness Month but my hope is that at some point in the near future there is no longer a need to observe it because the fact is—FASD is 100 percent preventable.

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Ob-Gyns Can Empower Women to Choose Breastfeeding

Only 22 percent of mothers in the United States are exclusively breastfeeding their babies at six months. Although most U.S. women initiate breastfeeding, more than half wean earlier than they desire and fall short of their personal goals. These are startling statistics given all the research and evidence we have that shows how beneficial it can be for both women and babies. That says to me that we, as providers, can do more to empower women with the knowledge to make this critical decision. As National Breastfeeding Month comes to a close, it seems like an appropriate time to remind us how important our guidance really is and the potential impact it could make on health outcomes.

There are many barriers to successful breastfeeding but I believe the key to overcoming them starts with education—the one factor that physicians have the most control over. Misinformation can often be the culprit when it comes to a mother making the decision not to breastfeed. Discussions about breastfeeding should be integrated into maternity care. Providers should obtain a thorough history and find out early what expectant mothers know or have heard about breastfeeding. Often times, it’s as simple as mitigating fears regarding pain associated with breastfeeding and letting mothers know that it might not come naturally at first and that, with the right support, techniques are learned and will improve over time. Providers should respect and support a woman’s informed decision whether to initiate or continue breastfeeding, as each woman is uniquely qualified to decide which feeding option is best for herself and her infant.  However, pregnant mothers take their doctors’ advice seriously, so we shouldn’t underestimate our influence. By saying nothing, we imply that it doesn’t matter—and it does.

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Immunization is Crucial for Pregnant Patients and Their Babies

As ob-gyns, we know the important role that vaccination plays in the health of mother and baby. It is one of our best options in reducing their chances of morbidity and mortality from vaccine-preventable diseases. Additionally, vaccination helps prevents the spread of certain infectious diseases.

The fall is usually when we start reminding women to get their annual flu vaccine, especially if they are pregnant. However, recent reports of whooping cough (pertussis) and measles exposure underscore the need to discuss other vaccinations with our patients. August is National Immunization Awareness Month and a great time to talk to your pregnant patients about immunization.

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