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Welcome to ACOG Rounds

Hal C. Lawrence, MD, Executive Vice President and CEO

A new year always brings a sense of new beginnings. Here at ACOG, we have many reasons to be excited.

Hal C Lawrence III MD

Plans for the 2015 Annual Clinical and Scientific Meeting, May 2–6, in San Francisco, are in full gear. This year, the Annual Meeting has a new organization and a new five-day schedule, beginning on Saturday. In this issue, you’ll read about the unique offerings, including includingcollaborative sessions with 10 subspecialty organizations and special sessions for Junior Fellows and medical students.

We are also looking forward to the April arrival of a new Vice President, Practice Activities, Dr. Christopher M. Zahn, Col. (Ret.), USAF, MC, FACOG. Dr. Zahn is a specialist in comprehensive obstetrics and gynecology, which will help ACOG continue to lead in developing best practices in women’s healthcare, including the development of new guidelines and other resources for physicians and patients. We welcome Dr. Zahn to ACOG and look forward to his leadership in the Practice Activities Division. We are particularly pleased that Gerald Joseph, MD, currently Vice President, Practice Activities, will remain with ACOG in another important role—Vice President, Fellowship Activities. Dr. Albert Strunk, JD, MD, who also serves as the Deputy Executive President, will be retiring; we thank him for his extraordinary years of service. We’ll provide more information about these important transitions in April.

Our activities to support you continue on many fronts. If you haven’t already, please take a few minutes to complete the Liability Survey by March 13. Data from this survey plays a critical role in educating lawmakers and the public about the liability crisis and its negative effects on women’s access to healthcare in our country.

It’s not too late to vote in the election for ACOG Fellow Section and District Officers. But you only have until Sunday, February 1!

We also hope you’ll learn more about ACOG programs and projects in this issue of ACOG Rounds. Happy New Year! 

President's Blog

Preventing Birth Defects Begins Before Conception

January 15, 2015

This January, National Birth Defects Prevention Month, let’s dedicate ourselves to educating our patients about the importance of preconception planning – and lifelong health...Read More

The Future of the Ob-Gyn Workforce

December 29, 2014

Workforce issues in women’s healthcare continue to be a primary concern for ACOG...Read More

Clinical Practice

Give It Your Best Shot: ACOG’s Immunization Program

Immunization is one of the greatest public health achievements of all time, and maternal immunization is increasingly recognized as critical to the health of women—and their children. Are you taking advantage of this preventive service and protecting your patients against potentially life-threatening illnesses?

ACOG recommends that all adults receive an annual influenza vaccine, but it is particularly important that women who are or will be pregnant during influenza season receive an influenza vaccine. Influenza vaccination protects pregnant women from an increased risk of serious illness due to seasonal and pandemic influenza and provides newborns with protection from influenza before they can be vaccinated at six months.

ACOG also recommends that all pregnant women receive a Tdap vaccine, preferably between 27 and 36 weeks of each pregnancy to provide every newborn with protective antibodies against pertussis during the critical first two to three months of life, before they can begin a vaccine series against pertussis.

ACOG’s Immunization Department and Immunization Expert Work Group have worked diligently to increase provider education and encourage more ob-gyns to vaccinate and refer for vaccinations if they aren’t offered in their practice. The program offers resources ranging from patients’ frequently asked questions on vaccine-preventable disease to immunization coding information for ob-gyns.

ACOG’s Immunization Department was recognized in 2014 with two national awards for its work to increase adult immunization rates: the National Adult and Influenza Immunization Summit Adult Immunization Champion and the American Society for Association Executives Power of A.

Check out ACOG’s immunization resources available to you via the Immunization for Women website:

The ACOG smartphone app features an interactive immunization section that you can use to help determine which immunizations your patients may need.

Have questions about immunization recommendations or ACOG’s immunization guidelines? Contact us at


New Maternal Care Designations Outlined in Joint ACOG-SMFM Guidance

ACOG and SMFM published the first-ever consensus guidance establishing levels of care specific to pregnant women. Levels of Maternal Care, the second landmark document in the joint ACOG-SMFM Obstetric Care Consensus Series, proposes a classification system that would promote regionalized care, allowing pregnant women at high risk to receive care in facilities that are prepared to meet their specific needs. (The first in the series was Safe Prevention of the Primary Cesarean Delivery.)

The guidance recommends uniform designations for levels of maternal care that complement but are distinct from levels of neonatal care. Each designation is based on a facility’s ability to manage various levels of maternal care:

  • Birth Centers, Level I (Basic Care)
  • Level II (Specialty Care)
  • Level III (Subspecialty Care)
  • Level IV (Regional Perinatal Healthcare Centers)

Each healthcare facility should have a clear understanding of its own classification, as well as a well-defined threshold and system for transferring women to facilities that offer higher levels of care, if needed.

The success of these new designations depends on close collaboration between obstetricians, nurses, anesthesiologists, consultants, maternal-fetal medicine subspecialists, and other healthcare providers. Moreover, higher-level facilities, such as Level III (Subspecialty Care) and Level IV (Regional Perinatal Healthcare Centers) facilities, are responsible for providing perinatal regional leadership. This includes facilitation of maternal referral and transport from lower-level facilities, outreach education for facilities and healthcare providers in the region, and analysis and evaluation of regional data.

Levels of Maternal Care has received endorsement and support from an extensive number of multidisciplinary peer health organizations. This includes endorsement by the American Association of Birth Centers; the American College of Nurse-Midwives; the Association of Women’s Health, Obstetric and Neonatal Nurses; and the Commission for the Accreditation of Birth Centers. Separately, the leadership of the American Academy of Pediatrics, the American Society of Anesthesiologists, and the Society for Obstetric Anesthesia and Perinatology have reviewed and expressed support for the recommendations.

To learn more about the Levels of Maternal Care collaboration and for information about other guidelines published in the February issue of Obstetrics & Gynecology (the Green Journal), please see the press release “Women’s Health Experts Recommend Obstetric Care Designations to Improve Maternal Care.” 

Medical Education

PROLOG: Keep Your Knowledge Developing with the Latest Edition

What is PROLOG? The acronym stands for Personal Review of Learning in Obstetrics and Gynecology, and it was developed specifically as a personal study resource for practicing ob-gyns. It is one of the College’s key publications for learning and earning CME credits, and is a voluntary, strictly confidential, self-evaluation program for learners at all levels.The latest revised title, Reproductive Endocrinology and Infertility, 7th ed., is now available.

PROLOG boooksEach two-part publication includes an assessment book containing educational objectives, multiple-choice questions, and an answer sheet with return envelope. It also includes up-to-date practice information in the form of a critique book containing a discussion, or critique, of each item in the assessment book and a rationale for correct and incorrect answers.

Participants can work through the book at their own pace, choosing to use PROLOG as a closed- or open-book assessment. If you choose to return  the answer book, which is voluntary, you can earn  25 AMA PRA Category 1 Credits for each unit.
Reproductive Endocrinology and Infertility, 7th ed., covers more than 100 topics. The ob-gyn who completes this new edition will be able to:

  • Establish a differential diagnosis and screen with appropriate tests for specific gynecologic conditions
  • Determine the appropriate medical management for specific gynecologic conditions in adolescents and adult women
  • Identify appropriate surgical interventions for various gynecologic conditions and strategies to prevent and treat surgical complications
  • Apply concepts of anatomy, genetics, pathophysiology, and epidemiology to the understanding of diseases that affect women
  • Counsel women regarding treatment options and adjustment to crises that may alter their lifestyle
  • Apply professional medical ethics and the understanding of medical-legal issues relative to the practice of gynecology

Each title in the PROLOG series represents the efforts of a special task force of subject experts. The following colleagues served on the PROLOG task force for Reproductive Endocrinology and Infertility, 7th ed., and are responsible for bringing you this outstanding self-directed learning tool and reference guide.

  • Bruce R. Carr, MD, Dallas, Texas
  • Daniel R. Grow, MD, Boston, Massachusetts


  • Victor E. Beshay, MD, Dallas, Texas
  • Krystene B. DiPaola, MD, West Chester, Ohio
  • Erika B. Johnston-MacAnanny, MD, Winston-Salem, North Carolina
  • J. Ricardo Loret de Mola, MD, Springfield, Illinois
  • Jennifer E. Mersereau, MD, Chapel Hill, North Carolina
  • Steven T. Nakajima, MD, Palo Alto, California
  • Beth J. Plante, MD, Reading, Massachusetts
  • Thomas M. Price, MD, Durham, North Carolina
  • John T. Queenan Jr., MD, Rochester, New York
  • Spencer S. Richlin, MD, Norwalk, Connecticut

All five titles in the PROLOG series cover key areas of the specialty:

  • Reproductive Endocrinology and Infertility, 7th ed.
  • Obstetrics, 7th ed.
  • Gynecology and Surgery, 7th ed.
  • Gynecologic Oncology and Critical Care, 6th ed.
  • Patient Management in the Office, 6th ed.

PROLOG titles are reasonably priced at $120 for ACOG Junior Fellows, $150 for ACOG Fellows, and $180 for nonmembers. For more information, please visit

Events & Meetings

The 2015 Annual Meeting: Something for Every Ob-Gyn

New This Year

The 2015 Annual Meeting: Something for Every Ob-Gyn

The New Year is a time for change! ACOG’s 2015 Annual Clinical and Scientific Meeting, May 2–6, exemplifies change on all levels:

  • A new annual meeting start date: Saturday, May 2
  • A new theme: “Teaming Up for Women’s Health”
  • More collaboration with other societies
  • More educational sessions about surgery

The new meeting organization makes it easy to plan your attendance to maximize your specific interests.

Subspecialty Sessions for the Practicing Ob-Gyn

ACOG is collaborating with 10 subspecialty societies. Each will present a three-hour session at the Annual Meeting. Be sure to attend those that interest you most!

  • Society for Maternal Fetal Medicine (SMFM): Saturday, May 2, 2:00 pm to 5:00 pm
  • Society of Gynecologic Surgeons (SGS): Sunday, May 3, 9:00 am to 12:00 pm
  • Society of Gynecologic Oncology (SGO): Sunday, May 3, 9:00 am to 12:00 pm
  • Society of Family Planning (SFP): Monday, May 4, 9:00 am to 12:00 pm
  • Society of Ob-Gyn Hospitalists (SOGH): Monday, May 4, 9:00 am to 12:00 pm
  • American Association of Gynecologic Laparoscopists (AAGL): Monday, May 4, 2:00 pm to 5:00 pm
  • Society for Academic Generalists in Obstetrics and Gynecology (SASGOG): Monday, May 4, 2:00 pm to 5:00 pm
  • American Society for Reproductive Medicine (ASRM): Tuesday, May 5, 9:00 am to 12:00 pm
  • North American Society for Pediatric and Adolescent Gynecology (NASPAG): Tuesday, May 5, 9:00 am to 12:00 pm
  • American Urogynecologic Society (AUGS): Tuesday, May 5, 9:00 am to 12:00 pm

Junior Fellows

“Junior Fellow Monday,” May 4, will feature:

  • ABOG information for taking the exams: 8:15 am to 12:15 pm
  • Subspecialty roundtables: 12:45 pm to 1:15 pm
  • Dr. Scott and the Honorable Dr. Nan Hayworth Junior Fellow Course: 1:45 pm to 5:15 pm
  • Medical Student/Junior Fellow/Young Physician Reception: 5:30 pm to 7:00 pm

Medical Students

Events for medical students will take place on Sunday, Monday, and Tuesday. The “Step Up to Residency” CREOG/APGO Program will be held on Monday.

First, Second, and Third Years

  • John M. Gibbons Jr., MD, Medical Student Lecture: Sunday, May 3, 1:30 pm to 4:30 pm
  • Hands-On Skills Workshop: Monday, May 4, 9:00 am to 12:00 pm
  • Roundtable discussion, “Finding the Right Shoe and CV Personal Statement”: Monday, May 4, 2:00 pm to 4:00 pm

Fourth Years: “Step Up to Residency”

  • Course and Didactics: Monday, May 4, 8:00 am to 12:00 pm
  • Hands-On Skills Lab: Monday, May 4, 2:00 pm to 4:00 pm

All Medical Students

  • Medical Student Reception: Monday, May 4, 5:30 pm to 7:00 pm
  • Medical Student Residency Fair: Tuesday, May 5, 1:30 pm to 4:30 pm

Free Lunch

This year’s annual meeting truly offers something for everyone, including something you may have heard doesn’t exist: a free lunch. On Monday, May 4, come to the Exhibit Hall luncheon (12:30 pm to 1:45 pm). Stop in for free lunch and check out the exhibit opening!

All sessions above are free with meeting registration. Please visit to register today. Stay tuned for more information about the Annual Meeting in the February issue of ACOG Rounds. 

Advocacy and Health Policy

ACOG Government Affairs: Looking Back at 2014 and Ahead to 2015

ACOG Government Affairs had a busy 2014. During the final year of the 113th Congress, ACOG came closer than ever to the repeal of Medicare’s flawed Sustainable Growth Rate (SGR) formula, defended the patient/physician relationship against legislative interference, and laid the groundwork for extending the Medicaid primary care payment increase to include ob-gyns.

ACOG won passage of several key pieces of legislation, including:

ACOG also briefed Congress on many topics, including reproductive health and the environment, ob-gyns as primary care providers, and maternal opioid dependency.

The beginning of 2015 brings with it a new Congress and a plethora of opportunities for ACOG. We are gearing up for our biggest-ever Congressional Leadership Conference (CLC) in March, and we anticipate many changes with the start of the 114th Congress’ Republican-controlled House and Senate.

ACOG will continue our hard work on issues like the SGR and primary care payment bump, and we will continue to push for legislation that addresses emerging issues such as neonatal abstinence syndrome/maternal opioid dependency and the environment and reproductive health. Finally, building off the strong foundation established in the 113th Congress, ACOG will push for real progress on graduate medical education, ACOG President Dr. John Jennings’ presidential initiative and the top “ask” at this year’s CLC.

Membership Fellowship

Do You Know What ACOG’s Resource Center Can Do for You as an ACOG Member?

Are you looking for journal articles for an upcoming conference or lecture? Need background material for an article you’re authoring? Can’t find a copy of a piece you wrote that you want to include in your CV? Seeking information on patient care? ACOG has member benefits that can help: Contact the College’s Resource Center for a free literature search.

The Resource Center is the library of the American College of Obstetricians and Gynecologists. It provides literature searches on obstetric and gynecologic topics as a member benefit. A sampling of some recent topics that our Resource Center librarians have researched:

  • Intrauterine growth restriction
  • Use of prescription drugs during pregnancy
  • Sleep disturbances during menopause
  • Patients’ perceptions of the safety of various types of contraceptives
  • Reproductive healthcare for incarcerated women

When contacting the Resource Center with a search request, send us an email to: Please provide as much detail as possible about your topic of interest, including how you intend to use the information, your audience, whether you would like us to limit our search by year, and your deadline, if any. We will then search Medline and, depending on the topic and scope, other relevant databases, such as Embase, PsycInfo, the Cochrane Library, and PubMed.

We save our results using software called RefWorks, which allows us to share our results with you and allows you to manage the references. With RefWorks, you can sort results by date or author, display short references or longer references with abstracts, create bibliographies, and share results with others. We will send you a link to access your search results, usually by email, including detailed directions for how to manage your list of references.

RefWorks does not include full-text articles or links to the full text, so we also look through the results we find and save several potentially relevant articles from our collection of print and online journals. We also search for guidelines from the College and other organizations, if appropriate, and send those as well. The College has its own file-sharing system called ACOG FileDrop, which we use to share full-text articles with you. Our correspondence will include a link where you can pick up your items.

We might also be able to help if you find articles in the search results that sound interesting but aren’t included in the list we sent you. If you think they may be relevant to your research, but you don’t have access to a medical library, contact the Resource Center and ask us to obtain the articles for you.

If you need an article that we can’t access through our resources, we can request copies through interlibrary loan using Docline, the National Library of Medicine’s document delivery system. Docline automatically routes requests to libraries that have the item; requests are typically filled by email within a few days.

We look forward to helping you with your literature search requests. To request a search from the Resource Center, email or call our reference desk at (202) 863-2518.

Annual Fund Highlight: Guiding Ob-Gyns on Pregnancy and Substance Use

ACOG’s Provider’s Partnership, supported in part by the College’s Annual Fund, tackles many issues related to maternal safety. One of the most important areas is finding ways to support ob-gyns in their efforts to provide quality care for pregnant women who have substance dependence.

A pregnant woman addicted to prescription drugs or opiates may delay prenatal care and drug treatment for fear of legal penalties or losing custody of her children. This fear may be justified: In some jurisdictions, a woman must plead guilty to child neglect to be seen at a family drug treatment court. As a result, she relinquishes her right to a defense, is placed on the state list as a person who maltreats children, and suffers restricted housing and employment.

What’s more, some courts mandate that pregnant women undergo withdrawal and detoxification, which can be dangerous to the fetus, causing preterm labor, fetal distress, and pregnancy loss. The National Institute on Drug Abuse estimates that there are “between 26.4 million and 36 million people abusing opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.” While some physicians find it hard to believe that any of their patients have an addiction issue, odds are that some do—and are afraid to discuss it.

Understanding the unique complications pregnant women face, ACOG’s Provider’s Partnership collaborated with Fellows and staff to develop a toolkit to help guide patient wellness visits by encouraging nonthreatening screening and entry to substance use treatment. Additionally, the Partnership collaborated in training 25 obstetricians and gynecologists on the use of buprenorphine, which has a lower risk of overdose, fewer drug interactions, the benefit of allowing treatment on an outpatient basis without the need for daily visits to a licensed treatment program, and evidence of less severe neonatal abstinence syndrome. (For more on buprenorphine, see the Committee Opinion Opioid Abuse, Dependence, and Addiction in Pregnancy.)

Launched in the early 1990s, the Provider’s Partnership allows the College and the federal Department of Health and Human Services to coordinate maternal and child health (MCH) activities between federal and state MCH programs. Currently, the Partnership is focused on maternal safety, substance use, and disaster planning. Through the Partnership, state MCH directors have access to ACOG materials, particularly Committee Opinions, Practice Bulletins, and other guidelines, to develop state regulations and promote the most current practice guidance. State MCH leaders have direct access to Partnership staff who are able to triage technical questions to appropriate College staff or Fellows.

To support the Provider’s Partnership and programs like it, please consider donating to the Annual Fund. Membership dues represent only 32 percent of the budget; without donations, programs on maternal opiate use would not exist. Giving is easy! You can either make a donation online or mail a check, made payable to the American College of Obstetricians and Gynecologists, to 409 12th Street SW, Washington, DC 20024.

Practice Management

Medicare Coding Changes for 2015: Modifier 59

The new year brings a significant change in how medical practices must code procedures. For 2015, the Centers for Medicare and Medicaid Services (CMS) has established four new Healthcare Common Procedure Coding System (HCPCS) modifiers that define subsets of modifier 59 (distinct procedural service).

Currently, providers use modifier 59 to indicate that a procedure code represents a service that is separate and distinct from another service that the code would usually be bundled with. CMS believes that because modifier 59 is defined for use in a wide variety of circumstances, such as different encounters, different anatomic sites, and distinct services, this newly created subset of modifiers will provide more precise coding when circumstances requiring modifier 59 are present.

The subset modifiers should also help to eliminate incorrect usage of modifier 59 and resulting incorrect payment. Following are the new modifiers:

  • XE (separate encounter): Service occurred during a separate encounter
  • XS (separate structure): Service was performed on a separate organ/structure
  • XP (separate practitioner): Service was performed by a different practitioner
  • XU (unusual nonoverlapping service): Service does not overlap usual components of the main service

These modifiers that define the subsets of modifier 59 are referred to as X{EPSU} modifiers. CMS initially will continue to recognize modifier 59 but gradually will require one of the subset modifiers rather than modifier 59 when certain code pairs are reported. For example, CMS may specify that a particular NCCI code pair is payable only with the XE (separate encounter) modifier but not with modifier 59 or other X{EPSU} modifiers.

For more information on this change, please refer to CMS Manual System, Transmittal 1422, Date: August 15, 2014, Change Request 8863, or MLN Matters Number: MM8863, Related Change Request (CR) 8863, Related CR Transmittal R1422OTN.

The implementation date for this change was January 5, 2015.

To stay up to date on coding changes and initiatives, please visit: Questions and comments may be emailed to ACOG’s Coding Staff at

With the implementation of ICD-10 this fall, this is a great time for you and your staff to attend an upcoming coding workshop.  

Junior Fellows and Medical Students

The Junior Fellows Get Oriented

Early in January, ACOG held its annual Junior Fellow district officer orientation, during which the new district Junior Fellow vice chairs were welcomed and provided with the tools to plan a successful term as district Junior Fellow officers. This was followed by the January Junior Fellow Congress Advisory Council (JFCAC) interim meeting, which resulted in lively and productive discussions regarding upcoming Junior Fellow initiatives.

Junior Fellow

From left to right, the national JFCAC officers: Past Chair Meadow Good, DO; Chair Amanda Kallen, MD; Vice Chair Megan Evans, MD, MPH

The attendees gave a big thanks to President John C. Jennings, MD; Executive Vice President and CEO Hal Lawrence, MD; Immediate Past President Jeannie Conry, MD, PhD; President-Elect Mark DeFrancesco, MD, MBA; Tom Gellhaus, MD; Deputy Executive Vice President and Vice President for Fellowship, Albert Strunk, JD, MD; Vice President for Practice Activities Gerald Joseph, MD; Vice President for Advocacy Barbara Levy, MD; as well as ACOG staff and JFCAC advisor Patricia Miller, MD. All joined for the meeting and dinner and provided invaluable information, advice, and support. The Junior Fellows made it clear that they appreciate everything the leadership does for them.

Junior Fellow Day at the Annual Meeting
Junior Fellow Day at the Annual Clinical and Scientific Meeting in San Francisco will take place on Monday, May 4. District I Junior Fellow Chair Eilean I. Myer, MD, and District IX Junior Fellow Chair Ricci R. Sylla, MD, who are co-chairs of the workgroup on contests, meetings, and programs, provided highlights:

  • ABOG information for taking the exams
  • Dr. Scott and the Honorable Dr. Nan Hayworth Junior Fellow Course: Life After Residency—Transitioning from Training to Practice, including:
    • Expanded lunch roundtable options for discussion of career and lifestyle planning (applicable to both Junior Fellows in Training and Junior Fellows in Practice)
    • Contracts and business of medicine
    • Financial planning for Junior Fellows
    • Oral board hygiene: Cleaning up your case list 

The always popular Gerald and Barbara Holzman “Stump the Professors” program will return on Tuesday, May 5. Additionally, a new offering this year is the program “Are You Smarter Than a Junior Fellow?,” which pits two veteran ob-gyns against two relative newbies in a battle of knowledge. Who will call on the Junior Fellows to bail them out? Who will have to declare, “I am not smarter than a Junior Fellow!” You’ll have to show up to find out!

Deputy Executive Vice President, and Vice President, Fellowship Activites, Albert L. Strunk, JD, MD, addresses the Junior Fellow officers. 

Junior Fellow Legislative Activities
District II Junior Fellow Chair Kasandra Scales, MD, MPH, and the legislative work group are in the process of finalizing a group of interactive modules designed to teach ob-gyn trainees the importance of advocacy and to provide information on how to get involved. Be on the lookout for more updates as this exciting initiative moves forward. Additionally, Junior Fellow participation in the PAC and the Congressional Leadership Conference, which takes place March 8–10, continues to increase exponentially each year. If you know a Junior Fellow who is interested in advocacy, please encourage him or her to attend and donate.

ACOG Awareness and Medical Student Recruitment
District V Junior Fellow Chair Rosalyn E. Maben-Feaster, MD, and District VI Junior Fellow Chair Tashera Perry, MD, are finalizing an “ACOG Primer” specifically geared toward Junior Fellows. The presentation will be available by the time the Junior Fellows meet again in San Francisco, and it is anticipated that this will be an excellent addition to ob-gyn intern orientations around the country. Along these lines, a new ACOG program liaison position was piloted at the interim meeting, with the goal of increasing ACOG Junior Fellow involvement to all residency programs around the country.

The Junior Fellows also reviewed the Junior Fellow Leadership Survey, piloted by Armed Forces District Junior Fellow Chair Kristen Zeligs, MD, and District XI Junior Fellow Chair Helen Dunnington, MD. It showed that interest runs high in Junior Fellow leadership positions. If your residency does not have a residency liaison position, or if you know a Junior Fellow who’d like to get more involved, please reach out to your district’s Junior Fellow officers for more information or visit our website:

Other Business
JFCAC Past Chair Meadow M. Good, DO, is unable to be with her colleagues in San Francisco—she is expecting an arrival in the form of a new baby boy around that time!—so the JFs sent her off in style with a new diaper bag and some associated goodies. They also sent her off with something equally exciting: a recommendation for the AMA Foundation’s Excellence in Medicine Leadership award. Congratulations from everyone on the JFCAC for this exciting nomination.

All together now: The JFCAC officers

Section Officer Leadership Development Program
Leadership looks forward to welcoming all incoming section Junior Fellow vice chairs to Washington, DC, for the annual Section Officer Leadership Development Program on March 7, 2015.

As always, Junior Fellows remain dedicated to women’s health and to designing programs and initiatives to support residents, fellows, and new ob-gyns. Please feel free to reach out to JFCAC Chair Amanda Kallen, MD, at any point with questions or comments. Amanda looks forward to seeing you in San Francisco! Her email is


ACOG in the News

Abortion Bans, Episiotomies, Midwives, the HPV Test, Fertility Awareness, and the Annual Pelvic Exam

ACOG serves as an expert information source about women’s health for women and the media. The organization’s Office of Communications fields more than 1,200 media inquiries each year from newspapers, magazines, websites, radio, and TV broadcast outlets. In many cases, ACOG officers and members talk with the media, working with the Office of Communications. Here are several recent pieces in the media that prominently featured ACOG guidance and experts. We’ve included excerpts and links to the original articles.

Yahoo! Health: House Passes “No Taxpayer Funding for Abortion” Act on 42nd Anniversary of Roe v. Wade
In a statement earlier today from Hal Lawrence, MD, vice president and CEO of the American Congress of Obstetricians and Gynecologists (ACOG), said that while ACOG was glad to see that the vote on the Pain Capable Unborn Child Protection Act had been dropped, the organization remains “disappointed that House leadership continues to target abortion by pivoting to payment policies. All women should have access to the medical services they need—including reproductive care—regardless of the ability to pay. Medical care must be guided by sound science and by the patient’s individual needs, not by legislative mandates or financial concerns.”

Huffington Post: Episiotomies Are Becoming Less and Less Common, New Numbers Show
Though researchers are not sure what led to the decrease, they hypothesized that their findings “possibly” reflect recommendations of groups such as the American College of Obstetricians and Gynecologists, which in 2006 urged restricted use of the procedure. “The best available data do not support the liberal or routine use of episiotomy,” the group wrote at the time, noting that in 2002, episiotomies were performed in roughly one-quarter of all vaginal births. There is a place for episiotomy, ACOG added, but it should be limited to difficult deliveries or to avoid severe lacerations in the laboring woman, for example.

NPR/The Diane Rehm Show: New Research on the Safety of Using Midwives for Low-Risk Deliveries
According to a new study by Britain’s National Health Service, it’s safer for women with low-risk pregnancies to deliver under the supervision of a midwife than in a hospital maternity ward. According to the study, both mothers who were expected to have uncomplicated deliveries and their babies did better with midwives compared to doctors except in one circumstance: first-time mothers delivering at home. Of the 3.9 million babies born in the United States last year, only about 9% were delivered by midwives, and most of these in a hospital. But this may be changing. Join us to talk about best practices in maternity care.

Guest on the show: Mark DeFrancesco, MD, president-elect, American Congress of Obstetricians and Gynecologists, in private practice in Waterbury, Connecticut, and a founding member of Women’s Health Connecticut.

Shape: Should You Trade Your Pap Smear for the HPV Test?
The reason ACOG steers clear of using the HPV test on younger women? About 80% of them get HPV at some point in lives (usually in their 20s), but their body clears the virus on its own with no treatment the majority of the time, explains Barbara S. Levy, MD, ACOG’s vice president for health policy. There’s concern that routinely testing women under age 30 for HPV will lead to unnecessary and potentially harmful follow-up screenings.

CNN: For Birth Control, What’s Old Is New Again
The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists are quick to point out that the fertility awareness method (FAM) is one of the least-effective methods of birth control. “You hear about 25%, one in four, who use it correctly can expect to get to get pregnant.” says Dr. Nathaniel DeNicola, an ob-gyn with the University of Pennsylvania Health System.

Wall Street Journal: New Genetic Tests for Women Who Are Expecting
Nancy Rose, MD, director of reproductive genetics at Intermountain Healthcare in Salt Lake City, questions whether screening everyone might yield more worry than benefits. The tests frequently find genetic variations in parents, but these aren’t likely to affect their offspring, says Dr. Rose, who chairs the Committee on Genetics for the American College of Obstetricians and Gynecologists (ACOG), a professional association.

Yahoo! News: Four Things You Should Know About the Link Between Birth Control and Financial Security
A new recommendation from the American College of Obstetricians and Gynecologists (ACOG) supports even greater access to contraception, saying that its benefits “include improved health and well-being, reduced global maternal mortality, health benefits of pregnancy spacing for maternal and child health, female engagement in the workforce, and economic self-sufficiency for women.” Right now, about half of all pregnancies in the United States are unplanned—a rate higher than almost any other developed country, the ACOG notes. And the rate is even higher for low-income women.

Self: How Necessary Is That Annual Gyno Appointment Really?
The American College of Obstetricians and Gynecologists ardently opposes the proposed change. “Discovering a problem early in a seemingly healthy woman always leads to better outcomes,” says Barbara Levy, MD, vice president for health policy at ACOG. During a routine pelvic exam, your doctor is on the lookout for several things: She feels the uterus and ovaries for abnormalities, visually screens for infections, and can perform a Pap smear to test for cervical cancer. “Certain STDs do not have symptoms and can only be identified through this exam,” Dr. Levy says. Gynecologists can also initiate conversations about problems that a patient may be too embarrassed to raise, like pain during sex or incontinence, which is common after childbirth. The doctor can then discuss medical options.

Dr. Bob Palmer FCOGDistrict Newsletters

District VIII Newsletter January 2015
In this issue: 2014 Annual District Meeting; Presidential Task Force on Leadership and Workforce in the 21st Century; How to Be a Leader in ACOG, or Susan's Swan Song; Medical Student Report...Read More

District XII Newsletter Winter 2014-2015

I am writing this column shortly after the November midterm national elections and the Florida general elections. We all endured a very long, trashy, and by far the most expensive state elective process ever. Personally, I feel like I’ve watched six months of “The Jerry Springer Show” reruns...Read More

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998