The Executive Desk: San Francisco, Here We Come
Hal C. Lawrence, MD, Executive Vice President and CEO
Hal C. Lawrence, MD, Executive Vice President and CEO
Have you made your travel plans for the 2015 Annual Clinical and Scientific Meeting, May 2–6, in San Francisco yet? In “What’s New and Amazing at the 2015 Annual Meeting,” you’ll find even more reasons to go: more science, a live telesurgery session, “Appy Hour” to learn about clinically useful apps, an extraordinary President’s Program, and new colloquial debates on timely topics. And don’t forget to register before April 10 to get the early registration discount.
In this issue of ACOG Rounds, you’ll also find information about our Leadership Institute, which has served 350 leaders in its 10 years—including seven participants who went on to become ACOG presidents! Learn about the Congressional Leadership Conference, which recently completed its largest and most successful event, the Council on Patient Safety, and more.
Finally, please also take a few minutes to take the Liability Survey; the deadline has been extended to April 20. 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 health care in our country.
President's Blog: Angelina Jolie Pitt Discusses Ovarian Cancer
Once again, Angelina Jolie Pitt is shining a bright spotlight on women’s health.
Clinical Practice: The 9-Valent HPV Vaccine
On February 26, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) voted in favor of provisional recommendations for the routine use of a new 9-valent HPV vaccine in girls and boys as well as young adult males and females.
The 9-valent HPV vaccine, licensed by the Food and Drug Administration (FDA) in December 2014, covers five additional strains of HPV not covered in its quadrivalent-valent counterpart. The vaccine is licensed by the FDA for use in females age 9 to 26 years, and in males age 9 to 15 years1. Clinical trials have shown that it can prevent even more cancer-causing virus types than its quadrivalent and bivalent predecessors. Moreover, recent studies have conclusively demonstrated the safety of the HPV vaccine.
The new recommendations from ACIP remain provisional, pending the approval of the CDC director. To respond to this new information, ACOG issued a Practice Advisory on the new 9-valent HPV vaccine developed with subject matter experts. ACOG will continue to review this evolving issue and CDC’s forthcoming final published recommendations. Should ACOG’s guidance on HPV vaccination be updated, it will be published in Obstetrics & Gynecology.
Increasing HPV Vaccination Rates
As ACOG monitors emerging evidence to support adoption of the 9-valent vaccine, the College continues to encourage ob-gyns to play a leading role in driving HPV vaccinations in adolescent girls and boys, which remain strikingly low compared to other routinely recommended adolescent vaccines.
In 2013, coverage of at least one dose of HPV vaccine was 57.3% among adolescent girls and 34.6% among adolescent boys2. According to the CDC, for every year that coverage does not increase, an additional 4,400 women will develop cervical cancer3. Furthermore, if health care providers increase HPV vaccination coverage to 80%, it is estimated that an additional 53,000 cases of cervical cancer could be prevented during the lifetime of those younger than 12 years3. These data highlight the overwhelming importance of HPV vaccination efforts, including discussions with patients and parents of adolescents and young adults about the benefit of HPV immunization for cancer prevention.
HPV vaccination in pregnancy is not recommended. Currently, there are few data on HPV vaccine administration in pregnancy; however, the available safety data regarding the inadvertent administration of the vaccine during pregnancy are reassuring.
ACOG has developed several tools for providers and patients to increase HPV vaccination rates:
1. Merck & Company, Inc. Gardasil 9: highlights of prescribing information. Whitehouse Station (NJ): Merck; 2014. Available at: http://www.merck.com/product/usa/pi_circulars/g/gardasil_9/gardasil_9_pi.pdf
2. Human papillomavirus vaccination coverage among adolescents, 2007–2013, and postlicensure vaccine safety monitoring, 2006–2014 - United States. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep 2014;63:620-4
3. Human papillomavirus vaccination coverage among adolescent girls, 2007–2012, and postlicensure vaccine safety monitoring, 2006–2013 - United States. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep 2013;62:591–5.
Events & Meetings: What’s New and Amazing at the 2015 Annual Meeting
The 2015 Annual Clinical and Scientific Meeting is just around the corner. There are so many new and exciting programs to look forward to.
You asked and we listened
- More science: Nearly 400 electronic posters will be presented throughout the meeting and there will be a one hour session each day dedicated to oral research paper presentations.
- More surgery: View a live Laparoscopic and Hysteroscopic Telesurgery session, followed by Q & A, on Monday from 9 am – 12 pm. Also, there will be four surgical tutorials presented on Sunday from 8 am – 12 pm, plus the Film Festival shown on Sunday afternoon.
- Advanced innovative technology: A more interactive meeting app will be available to all attendees; you will be able to download your schedule and personalize it as needed.
- Want to learn more about apps that are most useful for your practice, and how to use them? Come to one of the two new “Appy Hour” sessions, on Sunday and Monday from 3:30 pm – 4:30 pm.
The Presidential Program: “Teaming Up for Women’s Health”
- “Improving Women’s Healthcare with Organized Medicine and Technology” by American Medical Association President Robert Wah, MD, FACOG
- “Leading a High Performing Women’s Healthcare Team: Your ‘How To’ Checklist” by C.M.A. “Max” Rogers, MD, FACOG
- “The Good Fight” by C. O. “Skip” Granal III, MD, FACOG
Colloquial session debates
These debates are a new education component this year. Topics include:
- Birthing Centers vs. Hospital Births
- Routine Salpingectomy
- Universal Cervical Length Screening
- Annual Routine Pelvic Exams
In addition to all of this, the meeting is in San Francisco! We hope to see you there. Remember that the meeting kicks off on Saturday morning, May 2. The Welcome Reception will be Saturday evening from 6 PM – 7:30 pm at EPIC Roasthouse and Waterbar. Bus service will be provided from all ACOG hotels and childcare is available at the Marriott Marquis.
For more information, please visit: www.acog.org/annualmeeting.
Medical Education: 2015 College Freestanding Postgraduate Courses
It is the mission of the College to advance women’s health care through the lifelong education of its members as well as other physicians. One of the many ways we accomplish that is through our freestanding postgraduate courses, which are held in various locations throughout the United States. Experts in their fields are selected to create and disseminate the most current advances in obstetrics and gynecology. This year we will span the areas of women’s health care from “Practical Obstetrics and Gynecology” to “Controversies in Ob/Gyn in Spanish.”
Practical Obstetrics and Gynecology
Beginning in the nation’s Capital, Patrick Duff, MD, and Jeanne Sheffield, MD, will guide you through the ever-changing field of gynecological care and management of co-occurring health conditions in the female patient. This course is intended for obstetricians-gynecologists, family medicine specialists, nurse midwives, and nurse practitioners. It will cover the topics of prenatal diagnosis, obstetric infections, and evaluation of life-threatening conditions such as septic shock and necrotizing fasciitis.
Update in Cervical Diseases
In Chicago, Mark Spitzer, MD, and his faculty will update clinicians on the recent changes in the new unified screening guidelines, new consensus terminology for lower anogenital tract squamous disease, and the new management guidelines that were developed for cytological and histological abnormalities.
Advanced Ob-Gyn Ultrasound with Practical Application
James Shwayder, MD, will have San Diego as the backdrop for this course designed for the practicing physician or sonographer. The new requirements for basic ultrasound evaluation in pregnancy as well as the proper ultrasound coding and liability will be discussed. There will be small group sessions to allow for personal interaction with the faculty.
This and much more is being offered to keep your learning momentum going throughout the year. Visit ACOG’s Upcoming Postgraduate Courses to learn more.
Advocacy & Health Policy: A Powerful Voice for Women’s Health
Safe health care for every woman.
That is the mission of the Council on Patient Safety in Women’s Health Care, formed in 2011. Its purpose is not to develop new content, but to act as a collaborative, dissemination body—driving implementation, encouraging research/learning, facilitating culture change, and providing a collective voice for women’s health. Since its launch, the council has grown significantly and is now home to 16 core member organizations and 10 corporate partners, who serve in an advisory capacity. Through its work, it has taken on a leadership role in the ever-evolving conversation of patient safety, through these programs:
National Partnership for Maternal Safety
In May 2013, the National Partnership for Maternal Safety was adopted as the Council’s first initiative. The partnership is a multi-stakeholder consensus body designed to address the rising rates of maternal morbidity and mortality through the rollout of various educational tools and resources, including patient safety bundles. Bundles and supporting content will be released on the following topics:
- Obstetric Hemorrhage – released in 2014
- Hypertension in Pregnancy – expected in 2015
- Venous Thromboembolism in Pregnancy – expected in 2016
Safety Action Series
To support its efforts, in May 2014 the Council launched the Safety Action Series. This series is comprised of free one hour interactive sessions focused on topics relevant to the work of the Council. Since its introduction, the series has focused on obstetric hemorrhage and has garnered over 1,500 participants. The series will expand as additional content is rolled out.
National Improvement Challenge
The Council’s newest program was launched in November 2014. The National Improvement Challenge is an innovative program that seeks to improve care by encouraging the development of collaborative patient safety and quality improvement programs at the residency and educational program level. The council has designed this program to encourage the utilization of tools created by its initiatives. Prizes are available for the top submissions.
With each new program, the council is continuing to grow and evolve into a robust and dynamic resource for patient safety information. We hope that you will take a few minutes to explore our website (www.safehealthcareforeverywoman.org) and get involved with one of our current or future initiatives.
Government Affairs and Health Policy: The Congressional Leadership Conference
ACOG Presidential Officers at the 33rd Annual Congressional Leadership Conference. L-R Drs. Tom Gellhaus, Mark DeFrancesco, Jeanne Conry, Jim Breeden, and John Jennings.
On March 8—10, an impressive 450 of ACOG’s top ob-gyn advocates made the trip to Washington, DC, for the 33rd Annual Congressional Leadership Conference (CLC)—the President’s Conference. Convened by ACOG President John C. Jennings, MD, participants attended three days of intense advocacy training on ACOG’s top legislative issues before taking to Capitol Hill to meet with their elected officials in the United States Congress. In total, ACOG Fellows, Junior Fellows and medical students met with every single US senator, and 250 offices in the House of Representatives.
They brought with them ACOG’s four “asks”:
- Enact meaningful graduate medical education reform
- Address maternity care shortage
- Repeal Independent Payment Advisory Board (IPAB)
- Ensure access to primary care for women and children
ACOG President John C. Jennings, MD welcomed CLC participants—advocates from all 50 states—to Washington and briefed them on our four asks for the 2015 Conference. Dr. Jennings highlighted yet another year of amazing CLC growth, our legislative achievements and discussed the motivation for our theme: “Bridging the Gap: Coming Together for Women’s Health.” ACOG Executive Vice President and CEO Hal C. Lawrence, MD welcomed and briefed advocates on ACOG’s CLC asks.
Remembering Dr. Kaminetzky
Prior to the welcome, CLC participants took part in a heartfelt tribute to ACOG Past President Dr. Harold Kaminetzky, who passed away in 2014. Members of Dr. Kaminetzky’s family joined attendees for a special presentation honoring him, followed by remarks from close friends Drs. Joseph Apuzzio, Donald Chervenak, Richard Henderson, and Ralph Hale. Dr. Kaminetzky was the undeniable father of ACOG Advocacy, attended 31 out of the last 32 Congressional Leadership Conferences, and was awarded ACOG’s Lifetime Advocacy Achievement Award in 2012. To honor and remember him, Ob-GynPAC’s $5K Founders Circle has been renamed the $5K Kaminetzky Club. To see the slideshow honoring Dr. Kaminetzky’s life, click here.
Members of District IV, winners of the Capital Cup, L-R Drs. Lydia Jeffries, Ben Cheek, Haywood Brown, Wade Nieman, Holly Puritz, and Connie Bohon
Tips from Washington insiders on delivering a message
Christopher Davis of the Congressional Research Service briefed CLC participants on the legislative process, how Congress works, and how they fit in. Bradford Fitch (President of the Congressional Management Foundation), Chad Obermiller (Chief of Staff for Rep. Ami Bera [D-CA]), and Rodney Whitlock (Health LA for Senator Charles Grassley [R-IA]), offered advice on how best to foster valuable relationships with elected officials.
Attendees were later treated to the ultimate insider’s perspective when veteran ABC White House correspondent Ann Compton shared some of her most interesting stories from covering every president from Gerald Ford to Barack Obama. (We wish we could tell you more, but most stories were off the record!) Finally, US Senator Tim Kaine (D-VA) was warmly welcomed as he gave his perspective on the state of politics in Congress and what legislators need to do to bridge the gap and get things done.
Ob-GynPAC Legislative Awards breakfast
ACOG Immediate Past President and Ob-GynPAC Chair Jeanne Conry, MD, honored the winners of the 2014 PAC MVP awards. Drs. Laura David of District V and Kasandra Scales of District II were commended for exceptional work in support of Ob-GynPAC and took home the awards. Winners of the inaugural Capito/al Cup Competition were also recognized. The Capitol Cup, which recognizes the highest participation, went to District III. The Capital Cup, which recognizes the most dollars raised, went to District IV.
ACOG’s 2014 State Legislative Advocacy Award Winners were Texas for Legislative Accomplishment and Michigan for Legislative Improvement. The ACOG Junior Fellow Rising Star in Advocacy Award went to Ahizechukwu Eke, MD, MPH, for his Eliminate Breast Cancer Advocacy Program and work to oppose a controversial ACOG-opposed breast density bill in the Michigan State Legislature.
CLC participants were enthusiastic supporters of our PAC, raising over $170,000 by selling out the Ob-GynPAC fundraiser at Newseum. Our thanks to all ACOG members who support Ob-GynPAC.
From L to R: Dr. James Breeden, Dr. Hal Lawrence, Secretary Kathleen Sebelius, Dr. John Jennings, Ann Compton, Dr. Mark DeFrancesco, and Dr. Tom Gellhaus
ACOG welcomed one the most important health policy figures in the last decade, former HHS Secretary Kathleen Sebelius, to speak about her experience overseeing the Department and the crafting and implementation of the Affordable Care Act. Secretary Sebelius offered her insights into the future of health care in our country, especially as it pertains to women’s health.
Our first ask: Enact meaningful graduate medical education reform
Rep. Aaron Schock (R-IL) joined by video, and his health LA Margie Almonza and Leonard Marquez of the Association of American Medical Colleges joined in person, to discuss with Dr. Jennings the challenges that pose serious barriers to needed care for women across the country. Rep. Schock’s legislation creates 15,000 new residency slots, includes ob-gyn in the 30% allocation of new primary care slots, and institutes accountability measures for GME program. He provided a video for attendees requesting their help in gathering support before introduction.
Our second ask: Address maternity care shortage (S 628/HR 1209)
ACOG CLC’ers heard from bill authors Reps. Michael Burgess, MD, FACOG (R-TX) and Lois Capps (D-CA), by video, and Burgess’ Deputy Legislative Director, J.P. Paluskewicz, in person, about their bipartisan legislation that creates a maternity care shortage area designation within the National Health Service Corps (NHSC) to help women in underserved areas receive timely access to quality maternity care.
ACOG Junior Fellow Advisory Council Chair and NHSC Participant Megan Evans, MD, MPH, discussed the importance of the NHSC legislation, including the language that requires HRSA to collect and analyze data to determine national maternity care shortage locations.
Our third ask: Repeal the Independent Payment Advisory Board (S 141/HR 1190)
With a Republican Majority now in the House and Senate, repeal of IPAB has more momentum than ever. IPAB Repeal Congressional champion Congressman and ACOG Fellow Phil Roe (R-TN), who has long been dedicated to working across the aisle to get this bill signed into law, joined forces with lead Democratic sponsor, Rep. Linda Sanchez, (D-CA), and introduced the bill with over 200 original co-sponsors. We were joined by two experts; Katie Oricco, Director at the American Academy of Neurology, and Amanda Uherek of the Healthcare Leadership Council, both discussed how to get the bill over the finish line.
Members of California ACOG Present Senator Barbara Boxer with the ACOG Women’s Health Champion Award.
Our fourth ask: Ensuring access to primary care for women and children
We introduced our fourth and final ask Tuesday morning of our Hill day, after getting word that ACOG women’s health champions Senators Sherrod Brown (D-OH) and Patty Murray (D-WA) had chosen our Hill Day to reintroduce critical legislation to extend the Medicaid primary care payment bump and include ob-gyn participation in the program. In turn, 450 participants went to the Hill recruiting original co-sponsors to sign onto this legislation.
ACOG CLC in the media—social and otherwise
Days before CLC attendees stormed Capitol Hill, inside the beltway publication Politico ran a story highlighting our big event. Titled “Sebelius at ACOG, as the Ob-Gyns Descend on DC”, the story hailed ACOG’s large numbers and legislative ‘asks.’
Social media was buzzing with CLC activity. ACOG’s advocacy Twitter account @acogAction tweeted throughout the conference, as did many participants—posting pictures and other items in real time. Click here to check out some of the activity, found under #acogclc2015.
Drilling down on all the issues
The 33rd Annual CLC was unique in that it covered a broad array of issues affecting ob-gyns both nationally and in the states, ensuring attendees are well prepared to continue advocacy even after they leave Washington, DC, including:
- Safe Harbors and medical liability
- Opioid use and neonatal abstinence
- Reproductive health issues
- Payment issues and SGR
- Medicaid access and Medicaid payment parity in states
- King v. Burwell—ACA and the Supreme Court
For background on all of the topics covered at this year’s Congressional Leadership Conference, download the full agenda book here. Remember, advocacy doesn’t stop when you get home. Continue to read ACOG News and follow @acogAction on Twitter for new updates. And save the date to attend ACOG's 34th Annual Congress: March 6-8, 2016.
Membership & Fellowship: The ACOG Leadership Institute Going Strong for 10 Years
From February 25 through March 1, the ACOG Robert C. Cefalo National Leadership Institute celebrated its 10th anniversary. You can see the thirty-five Fellows and Junior Fellows who participated in the 2015 program in the photo below, proudly wearing their green 10th Anniversary jackets at the snowy retreat center at the University of North Carolina, Chapel Hill.
The ACOG Leadership Institute is targeted towards practicing ob-gyns who are active in the College and who have a strong potential to provide advocacy and leadership on women’s health policy issues. Over these 10 years, seven participants have gone on to become ACOG presidents.
Alumni have included Past President Vivian M. Dickerson, MD, FACOG, who initially conceptualized the program and participated in the inaugural year. Dr. Dickerson—along with College leaders Bob Cefalo, MD, FACOG (for whom the program is named); Herbert Peterson, MD, FACOG; and ACOG Division of Women's Health Issues Jan Chapin RN, MPH—shared a vision that leaders need more than a thorough knowledge of medicine. They also need to have the capacity to appraise, synthesize, and use best evidence regarding costs and effectiveness to advocate for and guide policy recommendations. Increasingly, physicians who are leaders are also called upon to translate complex scientific medical findings into simple understandable language for the media as well as for other physicians.
The goal of the Robert C. Cefalo ACOG National Leadership Institute is to provide the participating physicians with the perspectives, self-insight, data, and tools to help them succeed in leading this transformation. The program focuses on developing strong leadership skills through understanding self, understanding others, creating organizational culture, and capitalizing on motivation and engagement at work. The program develops practical skills through experiential-based learning.
The Leadership is popular and effective. Over the past decade, the 325 program alumni have given the experience an overall rating of 4.99—out of 5.0. Recently, Claudia Fernandez, DrPH, UNC faculty member, studied program outcomes in a 6-month post-program follow-up survey of Cohort 8 Fellows. Her findings: 96% of respondents noted they had made changes to their communication and leadership approaches since participating, 62% had new opportunities for leadership within those 6 months that they attributed to their experience and learning in the program, and 100% would recommend the experience to their colleagues. Fellows also noted that their leadership skills had increased on the 10 competencies focused on in the program—to an extent which reached statistical significance across the board. The program strives to be the best professional development experience ever for its participants. The website is ACOGLeadershipInstitute.org.
ACOG works with the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health’s Department of Maternal and Child Health and the UNC Health System for this program. Dr. Fernandez serves as the program director at UNC and teaches the leadership components.
ACOG members interested in participating in a future cohort of the Cefalo Leadership Institute should contact their district chairs. Many districts have also participated in one-day District Leadership Program, which provides a subset of the skills focused on at the National level. District chairs should contact Jan Chapin for more information about District Leadership program opportunities associated with the ACOG Robert C. Cefalo National Leadership Institute program.
Congratulations to Cohort 10 ACOG Robert C. Cefalo National Leadership Institute graduates!
Row 1 (Left to Right):
Janie Pak, John “Pres” Parry, Chrystie Fujimoto, Virginia Rauth, Ravi Johar, Mireille Truong, Andrea Friall, Mary Rosser, Sarah Samuel, Lameck Chinula, Vashali Bhargava, Rachel Casey, Ricci Sylla, Marian Steininger, Liz Etkin-Kramer, Elisa Fernandez
Row 2 (Left to Right):
Scott Mawdsley, Simon Patton, Eilean Myer, Eileen Farwick, Susan Crowe, Ryan Cuff, Anthony Sierra, Rozalyn Farmer Love, Leanne Komorowski, Mary Holm
Row 3 (Left to Right):
Randall Gibb, R. Todd Ivey, David Lovejoy, Albert Strunk, John Fischer, Susan Raine, Scott Petersen, Lance Bruck, Kristin Lyerly
Membership and Fellowship: New Career Opportunities for Ob-Gyns
Demand for health care services is predicted to swell over the next ten years, driven by an aging baby boomer population and increased access to health care for all Americans through the Affordable Care Act. However, the supply of health care providers will simultaneously decrease, with shortages of qualified physicians and nurses predicted. This gap between supply and demand will create intense hiring challenges for health care employers and recruiters.
What that means is that there has never been a better time to test the waters, even if you are gainfully employed now. The best way to do this is to post your CV or resume in ACOG’s Career Connection. Here, employers and recruiters find you. Passive job seekers are like gold to employers and recruiters.
If you are in the job market, ACOG’s Career Connection has hundreds of jobs for obstetricians and gynecologists, from California to New York and everywhere in between. Start your search today with some of these hot jobs we spotted:
Looking for jobs in other locations? Visit ACOG Career Connection to find over 400 jobs!
Will you be in San Francisco for the ACOG Annual Meeting? Attend the ACOG Career Fair to meet with great employers face to face.
District Newsletters: District V Newsletter March 2015
In this issue: From the Chair; From the Editor; Junior Fellow Chair Report; Junior Fellow Advocacy Chair Report; Advocacy Report and Update; New Feature! All in for Advocacy; Section Reports
District Newsletters: District IX Newsletter March 2015
In this issue: Message from the Chair; Interview with Ruth Haskins; Saving Lives with Vaccinations; OB Disaster Planning; SB 138; Gratitude
ACOG in the News: Jolie's Cancer Decision, Match Day for Ob-Gyns, IUDs for Teens, Fewer Episiotomies, Labiaplasty, and More
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.
HLN/CNN: Jolie's cancer decision: When is it the right move?
Jolie's decision tipped off heightened conversations about women's health issues and the possibility of preventive measures. HLN talked to Dr. Jed Delmore, a professor of obstetrics and gynecology and the Director of the Division of Gynecologic Oncology at the University of Kansas School of Medicine. Delmore is also the chair of the Gynecologic Oncology subcommittee for the American Congress of Obstetricians and Gynecologists.
ObGyn News: Match Day 2015: Ob.gyn. remains desirable for U.S. grads
Nevertheless, “leaders in obstetrics and gynecology are still concerned about shortages, especially in rural and underserved areas.” John C. Jennings, MD, president of the American Congress of Obstetricians and Gynecologists, said, “There’s a tremendous geographic maldistribution of our graduates.” Dr. Jennings added, “We’ve got to do something to correct that.” Dr. Jennings called for “more ob.gyn residencies...to allow us to better meet the growing needs of American women.”
USA TODAY: Report: Women embrace more effective birth control
In 2014, the American Academy of Pediatrics said doctors should counsel sexually active teen girls that IUDs and implants are the most effective methods. The American College of Obstetricians and Gynecologists also lists them as first-line choices for teens and adults.
The Seattle Times: Public cord-blood banking expands across region
But groups such as the American Medical Association encourage public banking, and the American Congress of Obstetricians and Gynecologists says the chance of a child needing his or her own cord blood is remote—as low as 1 in 2,700 people.
ABC News: Pregnant Model Sarah Stage's Tiny Belly Causes Social Media Uproar
Women should gain between 20 and 40 pounds throughout their pregnancy, according to the American College of Obstetricians and Gynecologists. She will probably gain about half a pound a week from here on in so her bump will, no doubt, grow larger in the coming weeks, Ashton said.
Philadelphia Inquirer: Cutting back on episiotomies
The rate has been steadily falling since, and nine years ago, the American College of Obstetrician-Gynecologists officially recommended that "restricted use is preferable to routine use."
Prevention: 5 Solutions for Miserably Heavy Periods
The hormones they contain prevent ovulation and make the lining of the uterus thinner, so there's less blood to shed. "Some types of birth control pills allow you to have a period just four times a year, which makes my patients very happy," says Cheryl Iglesia, MD, a spokesperson for the American College of Obstetricians and Gynecologists. It's easiest to take "continuous combination" pills, which contain both estrogen and progestin, since you don't have to take them at the exact same time every day, as you do with progestin-only mini pills.
NBC News: Butt Augmentation, Labiaplasty on the Rise, Plastic Surgeons Say
Dr. Barbara Levy, vice president for health policy for the American College of Obstetricians and Gynecologists, agrees. She said the popularity of the Brazilian bikini wax made women more aware of what their genitals looked like, and plastic surgeons saw that as an opportunity to drum up new business.
The upshot: thousands of women undergoing labiaplasty, in which the inner lips of female genitalia are trimmed. "It's one more body part that we as women are being told to be insecure about," Levy said.
Detroit Free Press: It’s healthier to lose weight before you get pregnant
“Obesity can adversely affect fertility, pregnancy, childbirth, postpartum recovery and the baby,” said Dr. Raul Artal of the American College of Obstetricians and Gynecologists.
TODAY.com: More women using IUDs, hormone implants: 5 things you need to know
“Ultimately it’s the woman who should decide what she wants, but there are very few who aren’t good candidates,” says Espey. “If I had a daughter, I’d say ‘you need an IUD.'”