Practice Updates for May/June: Zika Updates, Optimizing Postpartum Care, Refusal of Medically Recommended Treatment During Pregnancy, Breast Cancer Screening


Stay up to date with ACOG's authoritative clinical guidance and helpful patient education materials. The following provides Practice Updates for May and June 2016.




Featured Committee Opinion: Refusal of Medically Recommended Treatment During Pregnancy


On May 23, 2016, ACOG released an updated Committee Opinion that addresses the ethical considerations surrounding the care of an obstetrical patient who refuses recommended medical treatment and states that ACOG opposes the use of forced medical interventions for pregnant women.
“The refusal of medically recommended treatment during pregnancy is a complex and challenging, but incredibly rare scenario. While such situations can cause distress to both the patient and her physician, it is imperative that the pregnant woman be supported and that her wishes be respected,” said Sigal Klipstein, MD, chair of ACOG’s Committee on Ethics, which developed the Committee Opinion.

Committee Opinion #664: Refusal of Medically Recommended Treatment During Pregnancy," is published in the June issue of Obstetrics & Gynecology.


Featured Committee Opinion: Optimizing Postpartum Care


ACOG released a new Committee Opinion on May 23, 2016 to guide women’s health care providers on how to best care for new mothers. "Optimizing Postpartum Care," states that patient-centered, maternal postpartum care has the potential to improve outcomes for women, infants and families and to support ongoing health and well-being. In the weeks after birth, a woman must adapt to multiple physical, social and psychological changes. She must recover from childbirth, adjust to changing hormones, and learn to feed and care for her newborn. In addition to being a time of joy and excitement, this “fourth trimester” can present major challenges like lack of sleep, pain, depression, lack of sexual desire and urinary incontinence. Postpartum care visits with obstetrician-gynecologists or other obstetric care providers can help women navigate the challenges of motherhood. For more information on postpartum care, visit ACOG’s resource page on Postpartum Care.

Committee Opinion #666, "Optimizing Postpartum Care,"is published in the June issue of Obstetrics & Gynecology.


Zika Updates: Zika Testing on Urine & US Zika Pregnancy Registry

The Centers for Disease Control and Prevention (CDC) issued interim guidance on May 13, 2016 that recommends Zika virus rRT-PCR testing of urine collected less than 14 days after symptom onset, along with testing of patient-matched serum samples, for the diagnosis of suspected Zika infection.

Read the CDC’s Interim Guidance for Zika Virus Testing of Urine

ACOG also strongly encourages members to improve care for patients who have come into contact with the Zika virus by supporting the US Zika Pregnancy Registry, created by the CDC in collaboration with state, tribal, local, and territorial health departments to track cases of Zika virus by reporting eligible cases. To support the registry, assign staff who will assist in the completion of pregnancy data collection forms and be responsible for reporting pregnant women with Zika virus or who have any laboratory evidence of Zika virus infection (positive or equivocal test results, regardless of whether or not they have symptoms) to their health department. Reporting pregnant women with laboratory evidence of Zika virus infection to the state health department aids in expanding our knowledge about the virus.

CDC Provider and Patient fact sheets on the Zika registry reporting requirements

ACOG helps you stay informed of the latest Zika information:

ACOG’s Zika webpage

ACOG/SMFM Practice Advisory on Zika

CDC Zika Virus Website

State Health Department Contact list for ob-gyns (members only) for questions on CDC’s Zika Registry

State Health Department Contact list for ob-gyns (members only) for questions on testing

CDC Zika Pregnancy Hotline for Healthcare Providers: Ob-gyns can contact the CDC Zika Pregnancy Hotline at 770-488-7100 or email for any concerns related to clinical management or the US Zika Pregnancy Registry 

ACOG Practice Advisory: Breast Cancer Screening

Based on the release of new breast cancer screening recommendations from the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF), the College is reviewing these guidelines to evaluate the need to update its breast cancer screening recommendations. The review will focus on screening mammography and the role of the clinical breast examination in screening for breast cancer, which are no longer recommended by both ACS and USPSTF. To address the need for harmony among recommendations, the College convened a multidisciplinary forum in January 2016. Forum participants included representatives from 30 organizations including women’s health care providers, radiologists, patient advocate organizations, and allied women’s health professional communities as well as patient representatives. It is hoped that the outcome of this discussion will assist informed decision making about breast cancer screening among women and their health care providers.

Read the full Practice Advisory on Breast Cancer Screening, which was released on May 19, 2016 



New Committee Opinions

See all Committee Opinions

New Practice Bulletins (members only) 

See all Practice Bulletins


New Patient Education Pamphlets (members only)

See all Patient Education Pamphlets

New Frequently Asked Questions (FAQs) for Patients

See all Frequently Asked Questions 


American College of Obstetricians and Gynecologists
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Mailing Address: PO Box 96920, Washington, DC 20024-9998