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JOINT STATEMENT

Obstetrics and Gynecology: Collective Action Addressing Racism       Download PDF

August 27, 2020

As our nation confronts systemic racism and consequences of persistent inequities and disparate outcomes in health care, our organizations—which include the leading professional organizations in the fields of obstetrics and gynecology—are committed to changing the culture of medicine, eliminating racism and racial inequities that lead to disparate health outcomes, and promoting equity in women’s health and health care. Our commitment to a better future requires an honest examination of the past and the present.

Recognizing that race is a social construct, not biologically based, is important to understanding that racism, not race, impacts health care, health, and health outcomes. Systemic and institutional racism are pervasive in our country and in our country’s health care institutions, including the fields of obstetrics and gynecology.

Many examples of foundational advances in the specialty of obstetrics and gynecology are rooted in racism and oppression. For example, the mid-1800s surgical experimentation of James Marion Sims leading to successful treatment of vesicovaginal fistula was performed on enslaved Black women, including three women, Betsey, Lucy, and Anarcha, who underwent repetitive gynecologic procedures without consent.

Additionally, among many injustices, women of color have been subject to sterilization and experimentation with high-dose hormonal contraception without consent.

It is beyond the scope of this document to describe all the injustices inextricably linked to the fields of obstetrics and gynecology or recognize all the contributions made both willingly and unwillingly by oppressed and marginalized persons. Our organizations commit to working with scholars, advocates, and activists with diverse expertise and experiences as part of an intentional, sustained, and team-based effort to more extensively acknowledge the wide range of injustices.

We recognize that history weighs upon on the present and the future. Racism in overt and covert forms persists in the delivery of health care. Black women are three times more likely to experience maternal mortality or severe maternal morbidity than white women. American Indian and Alaska Native women experience adverse maternal outcomes at a greater rate than white women. Black and Latinx populations experience higher rates of mortality from cervical cancer than white women. Unacceptable inequities in access to care and outcomes are not limited to these examples; inequities are found across our specialty including reproductive and gynecological health care. Differences in outcomes result from many factors, including racism and bias in access to and delivery of quality health care, and must be acknowledged and addressed.

Eliminating inequities in women’s health care requires transformational change. Our organizations are committed to making this change and pledge, individually and collectively, to undertake the following initial actions:

Collaboration: Our organizations recognize that transformative work is being done within the profession and the broader public health community by committed advocates, activists, scholars, and leaders. We will collaboratively consult, support, and partner with those presently engaged and leading work to achieve racial justice, reproductive justice, and equity in women’s health care.
  
Education: We are committed to active listening and education in obstetrics and gynecology and in the broader women’s health community about the profession’s history and role in the oppression and mistreatment of Black enslaved women, Black women, and other women of color in the name of scientific advancement. Drawing upon the expertise of scholars, advocates, and activists, curricula will be developed and available to medical and health professional students, residents, faculty, practicing obstetricians, gynecologists, and all health care professionals.

Recognition: We are committed to officially designating February 28 and March 1, the dates that bridge Black History and Women’s History months, as days for formal acknowledgement of Betsey, Lucy, and Anarcha, the enslaved women operated on by Dr. J. Marion Sims, and other enslaved Black women who were subjected to abuse in the name of advancing science.

Scholarship, research, publication, guidance:
Racism continues to be prevalent in research, in its conduct as well as its scholarship and publication. We will promote the conduct of research, publications, presentations, and other types of programming that incorporate anti-racism and address systemic and institutional racism manifested through disparate outcomes. We will make intentional and concerted efforts to support research that ethically addresses the needs of Black and Indigenous populations and populations of color and to promote the work and scholarship of physicians, clinicians, and public health professionals of color. We are committed to a comprehensive review of scholarship, clinical documents, research, and publications guidelines produced or directed through our organizations to address racism, in particular ensuring that race is not treated as a biological factor.

Inclusive Excellence:
We will work to achieve greater diversity and inclusion in the leadership of our own organizations at all levels. We will adopt policies and procedures that facilitate these goals and create an equitable and inclusive organizational culture. Within the specialty of obstetrics and gynecology, we will support policies, procedures, and the development of professional cultures where people of color are supported and promoted.

Caring for patients and communities:
We will work to ensure that health care is free from racism and bias. We will recognize the impact that history, racism, and violence have on our patients and their communities. We will treat discrimination and racism as evidence-based risk factors for poor health outcomes and will teach and encourage clinicians to recognize this in caring for patients. We will lift up, support, and amplify the work that community-based organizations, advocates, and activists are doing to advance reproductive justice and equity in the delivery of health care.

Policy and advocacy:
We will collectively advocate for public policies that seek to eliminate racial and other inequities in the delivery of health care and in health outcomes, including policies addressing systemic and institutional inequities outside of health care that lead to poor health outcomes.

Our organizations recognize that these actions require sustained, intentional commitment. We also recognize that to embark on this work will require team-based approaches with measurable goals and accountability structures. We also recognize that while these initial actions are a starting point, more work will need to be done. Through active listening, discernment, and humility, we will—individually and collectively—expand upon these actions and objectives as we undertake a commitment to embrace antiracism, learn and unlearn, change the culture of medicine, and eliminate racism and racial bias in the delivery of women’s health care. 


American Association of Gynecologic Laparoscopists (AAGL) 
| American Board of Obstetrics & Gynecology (ABOG) | American College of Obstetricians and Gynecologists (ACOG) | American College of Osteopathic Obstetricians and Gynecologists (ACOOG) | American Gynecological and Obstetrical Society (AGOS) | American Osteopathic Board of Obstetrics and Gynecology (AOBOG) | American Society for Colposcopy and Cervical Pathology (ASCCP) | American Society for Reproductive Medicine (ASRM) | American Urogynecologic Society (AUGS) | Association of Professors of Gynecology and Obstetrics (APGO) | Council of University Chairs of Obstetrics and Gynecology (CUCOG) | Council on Resident Education in Obstetrics and Gynecology (CREOG) | Infectious Diseases Society for Obstetrics and Gynecology (IDSOG) | National Medical Association (NMA) | Society for Academic Specialists in General Obstetrics and Gynecology (SASGOG) | Society for Maternal-Fetal Medicine (SMFM) | Society for Reproductive Endocrinology and Infertility (SREI) | Society of Family Planning (SFP) | Society of Gynecologic Surgeons (SGS)



ACOOG Advocacy Update  

Jodi Benett, DO
June 28, 2020

I am excited to update the ACOOG community about this committee and improved advocacy awareness. As chair of the Government Affairs Committee, I am a bridge between the ACOOG and ACOG. I want to help fulfill one of President Woodman’s presidential initiatives of advocacy by promoting a message of:
     

YOUR VOICE MATTERS! YOUR ACTION MATTERS!

This committee was increased to 12 positions as part of the ACOOG Strategic Plan and initiative of Past President and loyal women’s health advocate, Dr. Dardarian.  Geographic representation on the committee has been expanded to enhance a more regional view of current health policies and awareness.  I apologize in the delay in this message, but the timing of the conference was the precipice of the COVID-19 pandemic.

First, a review of the year.  There was a kick off meeting January 22, 2020, to set the agenda for the new year and to raise enthusiasm for the AGOG Congressional Leadership Conference that took place March 8-10 in Washington DC. Attendees this year included Jodi Benett DO, Thomas Dardarian DO, Guy Sneed DO and Harika Kantamneni, DO (Gelhaus Fellow). 

The following summarizes the 2020 Commitment to Action Policy:

  • Drive policy action to promote health equity in access to care and health outcomes
  • Ensure the care obstetrician-gynecologists provide is valued, equitable, and fair
  • Have a meaningful impact in the 2020 election cycle

Over the three days of this exciting conference, there are lectures on the current ASKS, along with lessons on how to advocate effectively, meaningfully, and efficiently. On the third day, attendees met with their local US Congress Representatives and Senators to discuss specific policies.  The three ASKS for 2020 were:

  1. Enhance awareness of Maternal Mortality, and to extend Medicaid Coverage for 12 months Postpartum. In the House to support HR 4996, HR 4995 and in the Senate to introduce companion bills.
  2. Cut Maternal Mortality Rates, not Maternity Care, Stop Payment Reductions for Obstetric Care, by signing on to a letter to the CMS to correct an oversight in payment policy
  3. Support Women’s Research Funding at the National Institute of Health


















































































































Dr. Jodi Benett had the honor of introducing
US Rep. Brian Fitzpatrick (PA-01)