Making the Tough Calls: Unmet—and Overmet—Needs

As physicians who care for women, ob-gyns must recognize the unmet needs of some of our patients—and the over-met needs of others. Carefully evaluating the needs of each of our patients will help improve care and reduce costs.

Every woman deserves health care that is necessary and appropriate for her. She also deserves a health care system that doesn’t burden everyone with unnecessary costs. In the changing healthcare environment, optimizing resources is critical for the continued improvement of women’s health care. Continue reading

Opening Our Office Doors to the Transgender Community

As ob-gyns, our goal is to provide the very best health care for our patients, regardless of age, race, ethnicity, religion, marital status, immigrant status, handicap, sexual orientation, or gender identity. Unfortunately, there are segments of our population that, for a variety of reasons, have problems getting necessary health care, whether due to poverty, a lack of health insurance, living in a rural setting, or fear of discrimination.

One group that often experiences problems with access to health care includes transgender individuals. That’s why ob-gyns are being encouraged to do more to provide for their care. The fact is that transgender people share many of the same health care needs as everyone else. By instituting non-discrimination policies, ensuring confidentiality, and referring to patients by their preferred name, physicians can help make transgender individuals feel welcome in their offices.

We want the transgender community to know that we care about their health and can provide screenings, preventive care, and other appropriate services. Many transgender individuals who were assigned female sex at birth but live as male will need breast and reproductive organ screening. Male-to-female individuals who have had genital reconstruction may need cancer screening of the neovagina and breast cancer screening if they take hormones.

By working together, we can ensure that our transgender patients receive the health care that they need.

Pregnant Prisoners Need Prenatal Care, Too

The number of women prisoners—many of them pregnant—has soared over the past decade but most states have failed to institute adequate policies to address their health care. Ob-gyns are committed to ensuring that incarcerated women receive the same prenatal and postpartum health care as other women.

Many women inmates have unplanned, high-risk pregnancies and need HIV testing, mental health screening, and drug and alcohol abuse treatment. It’s important that they receive nutritious food, along with prenatal supplements, be assigned bottom bunks during pregnancy to avoid falls, and have 24/7 access to obstetric care. 

Inmates should deliver their babies in licensed hospitals, preferably with high-risk facilities. However, no woman should be shackled during labor or delivery—it’s unnecessary and risks harming her and her baby. If restraint is used, it should be the least restrictive as possible and should never interfere with leg movement. 

Maintaining prison nurseries allows mothers to bond with their infants and breastfeed. It also helps prevent foster care placement and reduces recidivism rates. Prenatal care is important for all women, including those in prison. ACOG will continue advocating for better prenatal care for incarcerated women—every woman has the right to a healthy pregnancy.