Optimizing Support for Breastfeeding as Part of Obstetric Practice

Committee Opinion Number 756, October 2018

(Replaces Committee Opinion Number 658, February 2016)

ABSTRACT: As reproductive health experts and advocates for women’s health who work in conjunction with other obstetric and pediatric health care providers, obstetrician–gynecologists are uniquely positioned to enable women to achieve their infant feeding goals. Maternity care policies and practices that support breastfeeding are improving nationally; however, more work is needed to ensure all women receive optimal breastfeeding support during prenatal care, during their maternity stay, and after the birth occurs. Enabling women to breastfeed is a public health priority because, on a populatio...

Access to Emergency Contraception

Committee Opinion Number 707, July 2017

(Replaces Committee Opinion Number 542, November 2012)(Reaffirmed 2019)

ABSTRACT: Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special po...

Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy

Committee Opinion Number 642, October 2015

(Replaces Committee Opinion Number 450, December 2009) (Reaffirmed 2018)

ABSTRACT: Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires multiple approaches, individual obstetrician–gynecologists may contribute by increasing access to contraceptive implants and intrauterine devices. Obstetrician–gynecologists should encourage consideration of implants and intrauterine devices for all appropriate candidates, including nulliparous women and adolescents. Obstetrician–gynecologists should adopt best practices for long-acting reversible contraception insertion. Obstetrician–gynecologis...

Access to Contraception

Committee Opinion Number 615, January 2015

(Reaffirmed 2019)

ABSTRACT: Nearly all U.S. women who have ever had sexual intercourse have used some form of contraception at some point during their reproductive lives. However, multiple barriers prevent women from obtaining contraceptives or using them effectively and consistently. All women should have unhindered and affordable access to all U.S. Food and Drug Administration-approved contraceptives. This Committee Opinion reviews barriers to contraceptive access and offers strategies to improve access.

Increasing Access to Abortion

Committee Opinion Number 613, November 2014

(Replaces Committee Opinion Number 424, January 2009) (Reaffirmed 2019)

ABSTRACT: Safe, legal abortion is a necessary component of women’s health care. The American College of Obstetricians and Gynecologists supports the availability of high-quality reproductive health services for all women and is committed to improving access to abortion. Access to abortion is threatened by state and federal government restrictions, limitations on public funding for abortion services and training, stigma, violence against abortion providers, and a dearth of abortion providers. Legislative restrictions fundamentally interfere with the patient-provider relationship and decrease a...

Abortion Training and Education

Committee Opinion Number 612, November 2014

(Replaces Committee Opinion Number 424, January 2009) (Reaffirmed 2019)

ABSTRACT: Access to safe abortion hinges upon the availability of trained abortion providers. The American College of Obstetricians and Gynecologists supports education for students in health care fields as well as clinical training for residents and advanced practice clinicians in abortion care in order to increase the availability of trained abortion providers. The American College of Obstetricians and Gynecologists supports the expansion of abortion education and an increase in the number and types of trained abortion providers in order to ensure women’s access to safe abortions. Integrate...

Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding

Committee Opinion Number 570, August 2013

(Reaffirmed 2018)

ABSTRACT: Maternal and infant benefits from breastfeeding are well documented and are especially important to underserved women. Underserved women are disproportionately likely to experience adverse health outcomes that may improve with breastfeeding. They face unique barriers and have low rates of initiation and continuation of breastfeeding. Through a multidisciplinary approach that involves practitioners, family members, and child care providers, obstetrician–gynecologists can help underserved women overcome obstacles and obtain the benefits of breastfeeding for themselves and their infant...

Health Care for Women in the Military and Women Veterans

Committee Opinion Number 547, December 2012

(Reaffirmed 2019)

Abstract: Military service is associated with unique risks to women’s reproductive health. As increasing numbers of women are serving in the military, and a greater proportion of United States Veterans are women, it is essential that obstetrician–-gynecologists are aware of and well prepared to address the unique health care needs of this demographic group. Obstetrician–-gynecologists should ask about women’s military service, know the Veteran status of their patients, and be aware of high prevalence problems (eg, posttraumatic stress disorder, intimate partner violence, and military sexual t...

Preparing for Disasters: Perspectives on Women

Committee Opinion Number 457, June 2010

(Reaffirmed 2018)

ABSTRACT: Emergency plans that specifically address the needs of women, infants, and children during disasters are currently underdeveloped in the United States. Pregnant women, infants, and children are adversely affected by disasters resulting in an increased number of infants with intrauterine growth restriction, low birth weight, and a small head circumference. There is an increased incidence of preterm delivery. To provide for a healthy pregnancy and delivery, pregnant women affected by disasters need to be assured of a continuation of prenatal care. Those in the third trimester should b...

Induced Abortion and Breast Cancer Risk

Committee Opinion Number 434, June 2009

(Replaces Committee Opinion Number 285, August 2003) Reaffirmed 2018

Abstract: The relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.

Misoprostol for Postabortion Care

Committee Opinion Number 427, February 2009

ABSTRACT: The World Health Organization estimates that 67,000 women, mostly in developing countries, die each year from untreated or inadequately treated abortion complications. Postabortion care, a term commonly used by the international reproductive health community, refers to a specific set of services for women experiencing problems from all types of spontaneous or induced abortion. There is increasing evidence that misoprostol is a safe, effective, and acceptable method to achieve uterine evacuation for women needing postabortion care. To reduce maternal mortality, availability of postab...

The Limits of Conscientious Refusal in Reproductive Medicine

Committee Opinion Number 385, November 2007

Reaffirmed 2019

ABSTRACT: Health care providers occasionally may find that providing indicated, even standard, care would present for them a personal moral problem—a conflict of conscience—particularly in the field of reproductive medicine. Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient's health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities. Conscientious refusals that conflict with patient well-being should be a...