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Committee Opinion Number 599, May 2014

(Reaffirmed 2016)

ABSTRACT: Confidentiality concerns are heightened during adolescence, and these concerns can be a critical barrier to adolescents in receiving appropriate health care. Health care providers caring for minors should be aware of federal and state laws that affect confidentiality. State statutes on the rights of minors to consent to health care services vary by state, and health care providers should be familiar with the regulations that apply to their practice. Parents and adolescents should be informed, both separately and together, that the information each of them shares with the health care...


Committee Opinion Number 624, February 2015

Reaffirmed 2017

ABSTRACT: Cytology-based cervical cancer screening programs require a number of elements to be successful. Certain low-resource settings, like the U.S. Affiliated Pacific Islands, lack these elements. Implementing alternative cervical cancer screening strategies in low-resource settings can provide consistent, accessible screening opportunities.


Committee Opinion Number 591, March 2014

(Reaffirmed 2016. Replaces Committee Opinion Number 470, October 2010)

ABSTRACT: Overweight and obesity are epidemic in the United States. Obesity is a risk factor for numerous conditions, including diabetes, hypertension, high cholesterol, stroke, heart disease, certain types of cancer, and arthritis. The prevalence of obesity is high, exceeding 30% in adult women and men. Many women, irrespective of demographic characteristics or income, are vulnerable to becoming overweight or obese because of limited resources for physical activity and healthy food choices, work commitments, and family demands. Clinicians and public health officials should address not only i...


Committee Opinion Number 437, July 2009

Reaffirmed 2016

Abstract: As professional and community leaders, obstetrician–gynecologists have unlimited opportunities to become involved in and have a positive impact on local, national, and international communities and organizations. Volunteering outside of daily work routines often revitalizes a commitment to medicine while serving as a much needed resource to the community.


Committee Opinion Number 653, February 2016

ABSTRACT: Although there are many positive aspects of social media for adolescents and young adults, there are also risks. Adolescence is a time of significant developmental changes, during which adolescents exhibit a limited capacity for self-regulation and an increased risk of susceptibility to peer pressure and experimentation. Social media can be harmful, and obstetrician–gynecologists may screen their adolescent and young adult patients for high-risk sexual behaviors, especially if sexualized text communication (sexting), exposure to pornography, online dating, or other risk-taking behav...


Committee Opinion Number 493, May 2011

(Reaffirmed 2013)

ABSTRACT: Communication with patients can be improved and patient care enhanced if health care providers can bridge the divide between the culture of medicine and the beliefs and practices that make up patients' value systems. These may be based on ethnic heritage, nationality of family origin, age, religion, sexual orientation, disability, or socioeconomic status. Every health care encounter provides an opportunity to have a positive effect on patient health. Health care providers can maximize this potential by learning more about patients' cultures.


Committee Opinion Number 587, February 2014

(Reaffirmed 2016. Replaces Committee Opinion Number 492, May 2011)

ABSTRACT: Physicians’ ability to effectively and compassionately communicate information is key to a successful patient–physician relationship. The current health care environment demands increasing clinical productivity and affords less time with each patient, which can impede effective patient–physician communication. The use of patient-centered interviewing, caring communication skills, and shared decision making improves patient–physician communication. Involving advanced practice nurses or physician assistants may improve the patient’s experience and understanding of her visit. Electroni...


Committee Opinion Number 466, September 2010

(Reaffirmed 2016)

ABSTRACT: International humanitarian medical efforts provide essential services to patients who would not otherwise have access to specific health care services. The Committees on Ethics and Global Women's Health of the American College of Obstetricians and Gynecologists encourage College Fellows and other health care professionals to participate in international humanitarian medical efforts for this reason. However, such programs present Fellows with a unique set of practical and ethical challenges. It is important for health care providers to consider these challenges before participating i...


Committee Opinion Number 600, June 2014

(Reaffirmed 2017)

ABSTRACT: Rates of obesity in the United States have increased rapidly over the past several decades, and physicians should be prepared to care for obese patients in a nonjudgmental manner, being cognizant of the medical, social, and ethical implications of obesity. It is the responsibility of the physician to recognize the medical risks that are associated with obesity and to counsel the patient regarding these risks in an unbiased manner, respecting her autonomy and maintaining her dignity. Classifying obesity as a medical condition can serve to reduce bias toward obese patients and to chan...


Committee Opinion Number 575, October 2013

Reaffirmed 2016

ABSTRACT: Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals. Patient exposure to toxic environmental chemicals and other stressors is ubiquitous, and preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course. Prenatal exposure to certain chemicals has been documented to increase the risk of cancer in childhood; adult male exposure to pesticides is linked to altered semen quality, sterili...


Committee Opinion Number 456, March 2010

(Reaffirmed 2017)

ABSTRACT: In this Committee Opinion, the Committee on Ethics of the American College of Obstetricians and Gynecologists endorses the College's ongoing efforts to promote a just health care system, explores justifications that inform just health care, and identifies professional responsibilities to guide the College and its members in advancing the cause of health care reform.


Committee Opinion Number 619, January 2015

(Reaffirmed 2017)

ABSTRACT: Obesity is a serious problem worldwide and particularly in the United States, and in women is associated with an increased risk of death and morbid conditions (including hypertension, diabetes mellitus, obstructive sleep apnea, and hypercholesterolemia) as well as malignancies such as endometrial and postmenopausal breast cancer. Adverse effects after gynecologic surgery, such as surgical site infection, venous thromboembolism, and wound complications, are more prevalent in obese women than in normal-weight women. Preoperative consultation with an anesthesiologist should be consider...


Committee Opinion Number 516, January 2012

(Reaffirmed 2016)

ABSTRACT: Underserved women are those who are unable to obtain quality health care by virtue of barriers created by poverty, cultural differences, race or ethnicity, geography, sexual orientation, gender identity, or other factors that contribute to health care inequities. With passage of the Patient Protection and Affordable Care Act Public Law 111–148 and 152, there is promise for increased health insurance coverage for underserved women. There is concern, however, that specific populations of underserved women may be left out. These women must continue to have access to existing safety net...


Committee Opinion Number 576, October 2013

(Replaces No. 454, February 2010, Reaffirmed 2016)

ABSTRACT: Homelessness continues to be a significant problem in the United States. Women and families represent the fastest growing segment of the homeless population. Health care for these women is a challenge but an important issue that needs to be addressed. Homeless women are at higher risk of injury and illness and are less likely to obtain needed health care than women who are not homeless. It is essential to undertake efforts to prevent homelessness, to expand community-based services for the homeless, and to provide adequate health care for this underserved population. Health care pro...


Committee Opinion Number 511, November 2011

Reaffirmed 2016

ABSTRACT: Clinicians who provide care for incarcerated women should be aware of the special health care needs of pregnant incarcerated women and the specific issues related to the use of restraints during pregnancy and the postpartum period. The use of restraints on pregnant incarcerated women and adolescents may not only compromise health care but is demeaning and rarely necessary.


Committee Opinion Number 627, March 2015

(Replaces Committee Opinion Number 425, January 2009, Reaffirmed 2017)

ABSTRACT: Unauthorized (undocumented) immigrants are less likely than other residents of the United States to have health insurance. The American College of Obstetricians and Gynecologists has long supported a basic health care package for all women living within the United States without regard to their country of origin or documentation. Providing access to quality health care for unauthorized immigrants and their children, who often were born in the United States and have U.S. citizenship, is essential to improving the nation’s public health.


Committee Opinion Number 515, January 2012

(Reaffirmed 2017)

ABSTRACT: Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites that are limited even in the scope of outpatient services provided. Compared with other urban populations, urban American Indian and Alaska Native women have higher rates of teenaged pregnancy, late or no prenatal care, and alcohol and tobacco use in pregnancy. Their infan...


Committee Opinion Number 586, February 2014

(Reaffirmed 2016. Replaces Committee Opinion Number 429, March 2009)

ABSTRACT: Rural women experience poorer health outcomes and have less access to health care than urban women. Many rural areas have limited numbers of health care providers, especially women’s health providers. Rural America is heterogeneous where problems vary depending on the region and state. Health care professionals should be aware of this issue and advocate for reducing health disparities in rural women.


Committee Opinion Number 676, October 2016

(Replaces Committee Opinion Number 585, February 2014)

ABSTRACT: Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Multiple factors affect a patient’s understanding of health information, including cultural factors, a physician’s health knowledge and communication skills, the demands of the situation, the environment in which the health information is being conveyed, and time constraints. The responsibility for recognizing and addressing the problem of limited health literacy lies with all enti...


20.
September 2011

Committee Opinion Number 507, September 2011

ABSTRACT: Human trafficking is a widespread problem with estimates ranging from 14,000 to 50,000 individuals trafficked into the United States annually. This hidden population involves the commercial sex industry, agriculture, factories, hotel and restaurant businesses, domestic workers, marriage brokers, and some adoption firms. Because 80% of trafficked individuals are women and girls, women's health care providers may better serve their diverse patient population by increasing their awareness of this problem. The exploitation of people of any race, gender, sexual orientation, or ethnicity ...


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