About Haywood L. Brown, MD

Dr. Haywood L. Brown is Professor in the Department of Obstetrics and Gynecology at Duke University Medical Center in Durham, NC. He received his undergraduate degree from North Carolina Agricultural and Technical State University in Greensboro, NC and his Medical Degree from Wake Forest University School of Medicine in Winston-Salem, NC. He completed his residency training in Obstetrics and Gynecology at the University of Tennessee Center for Health Sciences in Knoxville, TN, followed by subspecialty fellowship training in Maternal and Fetal Medicine at Emory University School of Medicine/Grady Memorial Hospital in Atlanta, GA. Dr. Brown has participated in ACOG activities in District IV, V and VII over his 30-year career in Obstetrics and Gynecology. This includes being the Scientific Program Chair and General Chair (2001-2002) for the Annual Clinical Meeting. He chaired the steering committee for the District of Columbia National Institutes of Health Initiative on Infant Mortality Reduction, the Perinatal and Patient Safety Health Disparities Collaborative for HRSA and serves as the Chief Evaluator for Indianapolis Healthy Start. Dr. Brown is especially committed to the care of women at high risk for adverse pregnancy outcome, particularly those disadvantaged. Dr. Brown has served as Chair of CREOG and has been on the Board of Directors for the Society for Maternal Fetal Medicine and is past President of the Society. He is past President of the American Gynecological Obstetrical Society (AGOS) and Chair of the Ob-Gyn Section of the National Medical Association. He also served as a Director of the American Board of Obstetrics and Gynecology. Dr. Brown is past president of the North Carolina Obstetrical and Gynecological Society and is immediate Past District IV Chair of ACOG.

Contraception Is Not a Luxury, It’s Preventive Care

As women’s health care providers, we witness firsthand the impact access, or lack thereof, to birth control has on a woman’s life daily. Access to contraception is essential to women’s health and livelihood. Though contraception’s most vital role is empowering women to take control over their reproductive health, it touches every corner of their lives, from helping with management of other health issues to ensuring women can pursue their educational goals and achieve professionally without interruption from unintended pregnancy.

Fortunately, the Affordable Care Act made landmark progress for women’s health care by guaranteeing women’s access to essential preventive care, including contraceptive access with no co-pay. As a result, women went from spending 30 to 44 percent of their out of pocket health care costs on contraception to saving $1.4 billion annually on birth control. This rule ensured that women’s decisions about birth control could be singularly focused on what was best for their health and their academic, professional, economic, and social priorities—not what they can afford.

However, in the coming days or weeks the U.S. Department of Health and Human Services is expected to publish a rule that will eliminate the contraceptive coverage benefit. A political move in direct contradiction to the clinical and scientific evidence pointing to the vital role of contraception in comprehensive preventive health care. Not to mention the mounting research verifying the profound positive impact increased access to contraception has on women’s economic and professional lives.

Prior to the ACA, cost was one of the greatest barriers to women’s contraceptive access. In many communities like the rural farming community in North Carolina where I was reared, people lived paycheck to paycheck, and many families did not have the privilege of prioritizing health care over basic needs of daily living. By assessing contraceptive choices by cost, we risk making birth control a luxury rather than a part of comprehensive preventive care. The average IUD costs $1000, or a month’s wages for a woman making the federal minimum wage, $7.25/hour, putting it totally out of reach for most of these women, despite being one of the most effective forms of birth control.

Women are 35 percent more likely to live in poverty, and therefore are disproportionately affected by unintended pregnancy and its consequences. Women with unintended pregnancies are more likely to delay prenatal care, resulting in a higher risk of birth defects, prematurity, low birth weight, and neonatal and infant morbidity and mortality.

This week we convened on Capitol Hill to present to a bipartisan group of representatives on maternal mortality and the role of affordable contraception on maternal health. Affordable and available contraception options enable women to make deliberate choices about if, when, and how many children they want to have and plan for pregnancy when they are more financially prepared. It can also be lifesaving for women who already face serious medical conditions. So, we cannot afford to return to a time where women did not have comprehensive reproductive health choices. This most certainly would turn back the clock on women’s health.

Our Moral Values, Our Core Values

It’s an interesting time for women’s health care, to say the least. With the recent passage of the American Health Care Act by the U.S. House of Representatives, obstetrician-gynecologists are faced with an uncertain political future. You may have the same questions that I do. Will this impact the way we practice and how we provide the best care for our patients?

As I took the reins as the 68th President of The American College of Obstetricians and Gynecologists last week, I discussed the importance of the Hippocratic Oath, one of the oldest binding commitments in history. Building from the central premise to ‘first do no harm,’ it outlines our responsibilities and obligations as ob-gyns to provide the best evidence-based care to all of our patients. These are our moral values, our core values and as women’s health care provides we have long demonstrated the passion and compassion in the clinical care of our patients.

At medical school graduations and hooding ceremonies at Duke University and many other institutions, all physicians in attendance have the opportunity to reaffirm and recite the Hippocratic Oath with the graduating medical school class. It’s a great reminder of why we do what we do:

“I will apply for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability.”

“My responsibilities include those related problems, if I am to care adequately for the sick.”

Regardless of the political climate, I urge you to remember that we are ACOG: the primary advocate for women’s health care. We cannot waiver on our position on key issues including the primacy of patient welfare, patient autonomy and social justice. These values address our societal contract as physicians; considering the available resources and needs of all while taking care of the individual.

We have many challenges ahead and hurdles to overcome especially in regard to access and affordability of essential benefits for pregnancy care and age appropriate preventative well woman’s screenings. However, we must remain steadfast in our commitment to women’s health care. I look forward to working with you, my colleagues, and our new Fellows who took the oath last week to provide the best clinical care to women of this country.