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.
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.
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.
The White House has declared this week Zika Provider Action Week. This call to action could not come at a better time. The Zika virus has occupied our profession and our patients nearly non-stop since news of it broke last fall. There is no doubt that Zika presents a very real concern to patients and challenge to health care providers. With the discovery of virus transmission by mosquitoes here in the United States, many of us are faced with the even more real possibility of treating patients with potential or confirmed exposure.
As ob-gyns, we are on the front lines of patients’ concerns about Zika. As each new finding is played out in the news, our patients call or come in looking for answers to help their understanding of the risk, and more often than not, assuage their fears. Unfortunately, in the instance of Zika, we too are often scrambling for knowledge, seeking elusive answers from research institutions and government agencies. The Centers for Disease Control and Prevention (CDC) has done an admirable job working quickly and efficiently to assess, address, and educate the American public about the Zika outbreak.
As ACOG President, I feel a great responsibility to help our members and our specialty lead and evolve in these changing and often challenging times. To do so, we must focus on building a strong foundation upon the rigorous standards of excellence that guide us every day. One of the things I most enjoy about membership in ACOG is the community. With a central goal at hand, superior care for women and families, we come together to learn from, support, and develop alongside our peers. As we face more constant, direct, and often negative forces beyond our exam rooms, our community has another imperative: advocacy.
By cultivating the knowledge and capability of our existing and newest members, we ensure the future of our profession and the patients we serve. In part, this requires legislative and political advocacy by all of our Fellows and Junior Fellows. We must lend the diversity and depth of our community’s knowledge and expertise to help reach safe and sustainable outcomes on issues regarding women’s healthcare.
Working in the field of global health has been a passion of mine since my wife, Melanie, and I served on a medical mission in the Dominican Republic many years ago. I saw first-hand the need to increase the quality of health care provided to women in other countries. All women require access to quality health care no matter where they live, and training and educating health workers is key to ensuring that care is available.
The World Health Organization reports that almost all (99 percent) of the nearly 300,000 maternal deaths every year occur in developing countries. Two of the most common cancers affecting women – breast and cervical cancers – are of growing global concern. These alarming statistics are what make our partnership with Health Volunteer Overseas (HVO) so important. For nearly 30 years, HVO has empowered health care professionals in resource-scarce countries with knowledge and skills to address the health care needs of their communities.
“The greatest reward for doing is the opportunity to do more.” ~Jonas Salk
This past Tuesday I was awarded a great opportunity to do more: I became ACOG’s 67th President. As the nation’s leading group of physicians providing health care for women, we have an unprecedented opportunity to do more and be empowered to make a difference in health care.
When I began my presidency, I ventured that we can make a difference in the next generation of health care through three main initiatives: global health, advocacy and new resident education models.
“The Times They Are A-changin”… That’s how I began my presidential inaugural address last year, and guess what? They are still changing! This theme underscored virtually everything we did this past year. Let me very briefly review where we are…
We began the year with a major legislative victory in that the SGR was repealed, and in its place is a more complicated program affecting physician payment, MACRA. I am finishing my year by appointing a work group of experts to better understand the new law and help translate it for our members. Stay tuned on that front.
Numerous issues arose during the year, ranging from over-the-counter contraception, home births, Planned Parenthood, TRAP laws, midwifery, Zika and many more. We have such an amazing staff in Practice and Communications…we were able to issue timely and meaningful statements about all of these issues and keep informed debate going on the national level about these and other important topics.
A woman dies from pregnancy or childbirth every two minutes. Almost all of these deaths (99%) are in developing countries. The most heartbreaking part is that the vast majority of these deaths are preventable.
As the nation’s leading group of physicians providing health care for women, ACOG strongly advocates for quality health care for women – everywhere.
That’s why, in an effort to demonstrate the urgency of global action to protect maternal health and rights, ACOG recognizes today as the International Day for Maternal Health and Rights.
As obstetrician-gynecologists, we understand the importance of providing safe, high quality care for our patients. But as the nation focuses on better ways to provide this care, the overuse of resources is an issue of considerable concern and many experts agree that the current way health care is delivered in this country contains too much waste and inefficiency. It’s crucial that providers across all specialties and patients work together to have conversations about wise treatment decisions. That’s why ACOG is a proud partner of Choosing Wisely®, a campaign led by the American Board of Internal Medicine (ABIM) Foundation, with a goal of advancing a national dialogue on avoiding unnecessary medical tests, treatments and procedures. The key word here is “unnecessary.”