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How the Dobbs decision shapes the ObGyn workforce and training landscape
Six months after the Supreme Court decision that overturned the constitutional right to abortion, trainees across the United States are asking a critical question in the current resident recruitment season: How will the restrictions on abortion access affect my training as an obstetrician-gynecologist, and will they impact my ability to be the kind of provider I want to be in the future?
Among the myriad of downstream effects to patient care, the Dobbs decision will indisputably impact the scope of residency training for those that provide reproductive health services. Almost half of ObGyn residents train in states that have abortion restrictions in place.1 New educational milestones for abortion training, which are a requirement by the Accreditation Council for Graduate Medical Education (ACGME), were proposed quickly after Dobbs, guiding programs to offer opportunities for training in nonrestricted areas or the “combination of didactic activities, including simulation” to meet the training requirement in abortion care.2
Like many providers, residents already are grappling with precarious and risky circumstances, balancing patient safety and patient-driven care amidst pre-existing and newly enforced abortion restrictions. Whether managing a patient with an undesired pregnancy, severe medical comorbidities, unexpected pregnancy complications such as preterm premature rupture of membranes, or bleeding, or substantial fetal anomalies, ObGyn residents cannot gain the experience of providing the full scope of reproductive health care without the ability to offer all possible management options. While some enacted abortion restrictions have exceptions for the health of or life-saving measures for the mother, there is no standard guidance for timing of interventions, leaving providers confused and in fear of legal retribution. At a time when trainees should be learning to provide patient-centered, evidence-based care, they are instead paralyzed by the legal or professional consequences they may face for offering their best medical judgements.
Furthermore, the lack of exposure to dilation and evacuation procedures for residents in restricted practice areas will undoubtably decrease their confidence in managing acute complications, which is one of the critical facets of residency training. In a surgical field where repetition is crucial for technical competence, highlighted by ACGME minimum case requirements, the decreased volume of abortion procedures is a disadvantage for trainees and a disservice for patients. While anti-choice promoters may argue that involvement in surgical management of early pregnancy loss should suffice for ObGyn training in family planning, this piecemeal approach will leave gaps in technical skills.
The fear of legal ramifications, moral injury, and inadequate surgical training may lead to the siphoning of talented trainees to areas in the country with fewer restrictions.3Dobbs already has demonstrated how limiting abortion access will deepen inequities in reproductive health care service delivery. Approximately 55% of ObGyn trainees and nearly two-thirds of maternal-fetal medicine graduates join the workforce in the state where they received their training.4 Medical students will seek opportunities for high-quality ObGyn training in areas that will help them to be well-prepared, competent physicians—and more often than not, stay in the area or region that they trained in. This will lead to provider shortages in areas where access to reproductive health care and subspecialist providers already is limited, further exacerbating existing health disparities.
During this recruitment season, trainees and residency programs alike will need to reckon with how the ramifications of Dobbs will alter both the immediate and long-term training in comprehensive reproductive health care for the ObGyn workforce. ObGyn trainees have taken a stand in response to the Dobbs decision, and nearly 750 current residents signed onto the statement below as a commitment to high-quality training and patient-centered care. Clinical experience in performing abortions is essential to the provision of comprehensive evidence-based reproductive health care, and access to these procedures is as important for physicians-in-training as it is for patients.
Actions to take to ensure high-quality abortion training in ObGyn residencies include the following:
- Connect with and stay involved with organizations such as the American College of Obstetricians and Gynecologists (ACOG), Physicians for Reproductive Health (PRH), and Medical Students for Choice (MSFC) for initiatives, toolkits, and resources for training at your institutions.
- Seek specific abortion training opportunities through the Leadership Training Academy (offered through PRH) or the Abortion Training Institute (offered through MSFC).
- Ensure that your residency program meets the ACGME criteria of providing opportunities for clinical experiences for abortion care and work with program leadership at a program, state, or regional level to enforce these competencies.
- Reach out to your local American Civil Liberties Union or other local reproductive legal rights organizations if you want to be involved with advocacy around abortion access and training but have concerns about legal protections.
- Have a voice at the table for empowering training opportunities by seeking leadership positions through ACOG, ACGME, Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics, American Medical Association, Student National Medical Association, and subspecialty organizations.
- Vote in every election and promote voting registration and access to your patients, colleagues, and communities. ●
Continue to: The implications of the Dobbs v Jackson Women’s Health Organization decision on the health care and wellbeing of our patients...
On June 24, 2022, the Supreme Court of the United States ruled in a 6-3 majority decision to overturn the constitutional right to abortion protected by Roe v Wade since 1973. As health care providers, we are outraged at the Court’s disregard for an individual’s right to make reproductive decisions for themselves and their families and are deeply concerned about the devastating consequences to reproductive care and outcomes in this country for all people. Reproductive health decisions, including growing a family and whether or not to continue a pregnancy, are complex and incredibly personal. Our role as health care providers is to help guide those decisions with empathy and evidencebased clinical recommendations. This ruling undermines a patient’s right to bodily autonomy, free of impositions from government and political pressures, and it threatens the sanctity of complex medical decision-making between a patient, their family, and their medical team.
As medical professionals, we know that every patient’s situation is unique—banning abortion procedures ties the hands of physicians trying to provide the most medically appropriate options in a compassionate manner. We know that both medical and surgical abortions are safe and can save lives. These procedures can help patients with potentially life-threatening conditions worsened by pregnancy, a poor prognosis for the fetus, or a complication from the pregnancy itself. Physicians use scientific research and individualized approaches to help patients in unique situations, and attempts to legislate personal health decisions compromise the practice of evidence-based medicine.
We also know that this decision will impact some communities more than others. Access to safe abortion care will become dependent on which region of the country a person lives in and whether or not a person has resources to seek this care. Due to continued systemic racism and oppression, patients of color will be disproportionately impacted and likely will suffer worse health outcomes from unsafe abortions. Those that rely on public insurance or who are uninsured will face overwhelming barriers in seeking abortion services. These disparities in reproductive care, which contribute to our nation’s health crises in maternal morbidity and mortality, unintended pregnancy, and neonatal complications, will further entrench health inequities, and patient lives and livelihoods will suffer.
We acknowledge the impact that this decision will have on restricting access to reproductive care. We stand by the fact that abortion care is health care. We vow to uphold the tenets of our profession to place patient autonomy and provision of safe quality medical care at the forefront of our practices.
We, as health care providers and physician trainees, hereby pledge:
- To continue to provide evidence-based, nonjudgmental counseling for all pregnancy options, including abortion, and support our patients through all reproductive health decisions
- To promote equity in providing comprehensive reproductive health care, recognizing the impacts of systemic racism and oppression
- To promote high quality training in providing safe reproductive care in our respective institutions
- To use our voices in our communities to advocate for all our patients to have the freedom to access the safe and compassionate health care they deserve.
Sincerely,
The undersigned 747 ObGyn resident physicians
Please note that we sign this statement on our own behalf as individuals and not on behalf of our respective institutions.
Orchideh Abar, MD
Laurel S. Aberle, MD
Kathleen E. Ackert, DO
Lauryn Adams, MD
Temiloluwa Adejuyigbe, MD
Oluwatoyosi M. Adeoye, MD
Hufriya Y. Aderianwalla, MD
Fareeza Afzal, MD
Adelaide Agyepong, MD
Erin R. Ahart, MD
Noha T. Ahmed, DO
Faria Ahmed, MD
Tracey O. Akanbi, MD
Eloho E. Akpovi, MD
Austin H. Allen, DO
Amanda M. Allen, MD
Alexis L. Allihien, MD
Jorge L. Alsina, MD
Paulina C. Altshuler, DO
Sivani Aluru, MD
Amal Amir, DO
Jon Anderson, DO
Andreas Antono, MD
Annie N. Apple, MD
Janine Appleton, DO
Aarthi Arab, MD
Sydney R. Archer, MD
Youngeun C. Armbuster, MD
Kara Arnold, MD
Blessing C. Aroh, MD
Savannah Pearson Ayala, MD
Archana K. Ayyar, MD
Ann-Sophie Van Backle, DO
Connor R. Baker, MD
Japjot K. Bal, MD
Abigail E. Barger, MD
Kathryn E. Barron, MD
Silvia Bastea, MD
Samantha V.H. Bayer, MD
Kristen Beierwaltes, MD
Gisel Bello, MD
Michelle A. Benassai, MD
Dana Benyas, MD
Alice F. Berenson, MD
Hanna P. Berlin, MD
Abigail L. Bernard, MD
Eli H. Bernstein, MD
Julia T. Berry, MD
Bryce L. Beyer, MD
Caroline Bilbe, MD
Grace E. Binter, DO
Erin E. Bishop, MD
Sierra G. Bishop, MD
Stephanie S. Bista, MD
Tara E. Bjorklund, DO
Alyssa N. Black, MD
Continue to: Kelsey Boghean, DO...
Kelsey Boghean, DO
Areta Bojko, MD
Grace E. Bommarito, DO
Aditi R. Bommireddy, MD
Genna C. Bonfiglio, MD
Mary E. Booker, MD
Kayce L. Booth, MD
Samantha T. Boothe, DO
William Borenzweig, MD
Rebecca M. Borneman, MD
Alexander L. Boscia, MD
Gina M. Botsko, MD
Glenn P. Boyles, MD
Avery C. Bramnik, MD
Sophia N. Brancazio, MD
Katarina M. Braun, MD
Anthony Brausch, MD
Emily L. Brekke, MD
Sara E. Brenner, MD
Bailey A. Brown, DO
Kathryn S. Brown, MD
Denese C. Brown, MD
Abena Bruce, MD
Sabrina C. Brunozzi, MD
Madison Buchman, DO
Deirdre G. Buckley, MD
Rachel L. Budker, MD
Leeann M. Bui, MD
Anthony H. Bui, MD
Jessie Bujouves, MD
Kimberley A. Bullard, MD
Sophia G. Bunde, MD
Emily R. Burdette, MD
Iris Burgard, DO
Korbi M. Burkey, MD
Lindsey K. Burleson, MD
Lindsay M. Burton, MD
Brianna N. Byers, MD
Stephanie Cai, MD
Alexandra S. Calderon, MD
Alexandra G. Caldwell, MD
Natalia Calzada, MD
Tamara Cameo, MD
Arielle Caplin, MD
Angela M. Carracino, DO
Anna L. Carroll, MD
Leigha M. Carryl, MD
Ashlie S. Carter, MD
Stephanie Casey, DO
Chase W. Cataline, DO
Carson L. Catasus, MD
Alena R. Cave, MD
Kelly M. Chacon, MD
Avis L. Chan, MD
Shruthi Chandra, MD
Jennifer Chang, MD
Shannon Chang, DO
Gillian Chase, MD
Cindy Chen, MD
Jessie C. Chen, MD
Jessica T. Chen, MD
Wenjin Cheng, MB
Laura J. Cheng, MD
Lucy Cheng, MD
Monica S. Choo, MD
Jody S. Chou, MD
Hannah C. Christopher, DO
Continue to: David J. Chromey, DO...
David J. Chromey, DO
Grace V. Clark, MD
Celeste Colegrove, MD
Sarah C. Combs, MD
Victoria L. Conniff, MD
Hannah C. Connor, MD
Angela J. Conway, MD
Steffany A. Conyers, MD
Alexandra Cooke, MD
Ashley A. Cooney, MD
Anna Cornelius-Schecter, MD
Alexa M. Corso, DO
Krysten A. Costley, MD
Madeline Coulter, MD
Kelsey Cramer, MD
Anna E. Cronin, MD
Bethany N. Croyle, DO
Carmen A. Cueto, MD
Nicole Cumbo, MD
Mackenzie A. Cummings, MD
Carrie Cummiskey, MD
Hannah M. Cunningham, MD
Sarah D’Souza, DO
Rachael M. D’Auria, MD
Caitlin Dane, MD
Rachel N. Dang, MD
Talin R. Darian, MD
Abigail C. Davies, MD
Berkley Davis, MD
Lois A. Davis, MD
Jennie J. DeBlanc, MD
Ayana G.R. DeGaia, MD, MPH
Katerina N. DeHaan, MD
Rebekka M. Delgado, MD
Brettany C. DeMier, MD
Bonnie W. DePaso, MD
Hemaxi H. Desai, DO
Amberly T. Diep, MD
Abigail K. Dillaha, MD
Sarah K. Dominguez, MD
Abbey P. Donahue, MD
Allan C. Dong, MD
James Doss, MD
Taylor B. Douglas, MD
Abigail G. Downey, MD
Janelle M. Driscoll, MD
Emily Du, MD
Leslie V. Dunmire, MD
Jennifer Duong, DO
Leigh C. Durudogan, MD
Mai N. Dyer, MD, MPH
Rebecca A. Ebbott, MD
Lindsey P. Eck, MD
Molly C. Eckman, MD
Alex Ede, MD, ScM
Claire E. Edelman, MD
Sara E. Edwards, MD
David J. Eggert, DO
Michelle Eide, MD
Etoroabasi Ekpe, MD
Tressa L. Ellett, MD
Laura Peyton Ellis, MD
Kaitlin H. Ellis, MD
Mariah G. Elly, MD
Jennifer Embry, MD
Claire Englert, MD
Brenna Espelien, MD
Kamilah Evans, MD
Joshua A. Ewy, MD
Elana D. Fackler, MD
Lauren E. Falk, MD
Brianna A. Farley, MD
Amanda Stephanie R. Farrell, MD
Sara Fassio, DO
Daniela A. Febres-Cordero, MD
Jasmin E. Feliciano, MD
Alayna H. Feng, MD
Amanda M. Ferraro, MD
Brittany A. Fickau, MD
Brittany H. File, MD
Shannon M. Finner, DO
Mia E. Fischbein, DO
Briah Fischer, MD
Shira Fishbach, MD
Alison C. Fitzgerald, MD
Evan R. Fitzgerald, MD
Margaret R. Flanigan, MD
Kevin C. Flatley, MD
Jordan A. Fletcher, MD
Claudia E. Flores, MD
Lauren A. Forbes, MD
Rana K. Fowlkes, MD
Jennifer M. Franks, MD, MPH
Christina M. Frasik, MD
Haven N. Frazier, DO
Sarah W. Freeman, MD
Emilie O. Fromm, DO
Anna R. Fuchss, MD
Emma K. Gaboury, MD
Madeline H. Ganz, MD
Lex J. Gardner, MD
Keri-Lee Garel, MD
Hailey B. Gaskamp, DO
Brittney A. Gaudet, MD
Gabrielle M. Gear, MD
Eleanor R. Germano, MD
Lauren G. Gernon, MD
Allen Ghareeb, MD
Patricia Giglio Ayers, MD
Jordana L. Gilman, MD
Mianna M. Gilmore, DO
Brian W. Goddard, MD
Julia L. Goldberg, MD
M. Isabel Gonzaga, MD
Fred P. Gonzales, MD
Lillian H. Goodman, MD, MPH
Ashley Goreshnik, MD
Lauren E. Gottshall, MD
Lindsay L. Gould, MD
Kelsea R. Grant, MD
Dorender A. Gray, MD
Sophie Green, MD
Erica A. Green, MD
Danielle C. Greenberg, MD
Kalin J. Gregory-Davis, MD
David M. Greiner, MD
Tyler M. Gresham, MD
Continue to: Nelly Grigorian, MD...
Nelly Grigorian, MD
Erin L. Grimes, MD
Whitney Grither, MD
Jared M. Grootwassink, MD
Maya E. Gross, MD
Paoula Gueorguieva, MD
Margot M. Gurganus, DO
Rachel L. Gutfreund, MD
Andres Gutierrez, MD
Dorothy L. Hakimian, DO
Ashley N. Hamati, DO
Marie M. Hanna-Wagner, MD
Katie Hansen, MD
Courtney Hargreaves, MD
Stephanie Harlow, MD
Kelsey B. Harper, MD
Devon A. Harris, MD
Lauren E. Harris, MD
Emily S. Hart, DO
Sarah A. Hartley, MD
Becky K. Hartman, MD
Abigail K. Hartmann, MD
Charlotte V. Hastings, MD
Cherise Hatch, DO
Jordan Hauck, DO
Sarena Hayer, MD
Jenna M. Heath, MD
Eric D. Helm, MD
Julie A. Hemphill, MD
Ric A.S. Henderson, MD
Nicola A. Hendricks, MD
Andrea A. Henricks, MD
Jesse M. Herman, DO
Alyssa M. Hernandez, DO
Melissa Hernandez, MD
Alyssa R. Hersh, MD
Alexandra Herweck, MD
Brianna Hickey, MD
Allix M. Hillebrand, MD
Alessandra I. Hirsch, MD
Emily A. Hoffberg, MD
Chloe L. Holmes, DO
Cameron M. Holmes, MD
Helena Y. Hong, MD
Wakako Horiuchi, MD
Shweta Hosakoppal, MD
Jaycee E. Housh, MD
Shannon M. Howard, MD
Meredith C. Huszagh, MD
Yihharn P. Hwang, MD
Emma C. Hyde, MD
Brooke Hyman, MD
Hala Ali Ibrahim, MD
Gnendy Indig, MD
Erin E. Isaacson, MD
Shruti S. Iyer, DO
Audrey J. Jaeger, DO
Shobha Jagannatham, MD
Cyrus M. Jalai, MD
Emma V. James, MD
Isabel Janmey, MD
Phoebe Jen, DO
Corey L. Johnson, MD
Crystal J. Johnson, MD
Andrea M. Johnson, MD
Nat C. Jones, MD
Briana L. Jones, DO
Rebecca J. Josephson, MD
Sarah Natasha Jost-Haynes, MD
Continue to: Hannah S. Juhel, MD...
Hannah S. Juhel, MD
Erin Jun, DO
Katherine B. Kaak, MD
Dhara N. Kadakia, MD
Amanda D. Kadesh, MD
Riana K. Kahlon, MD
Nadi N. Kaonga, MD
Moli Karsalia, MD
Stephanie L. Kass, MD
Amanda M. Katz, MD
Chelsea S. Katz, MD
Virginia Kaufman, MD
Gurpinder Kaur, MD
Jessica A. Keesee, MD
Cassandra N. Kelly, MD
Whitney Kelly, DO
Hannah V. Kennedy, MD
Bethany H. Kette, MD
Iman Khan, MD
Maryam M. Khan, MD
Alisa Jion Kim, MD
Tesia G. Kim, MD
Anne E. Kim, MD
Emily H. King, MD
Tarynne E. Kinghorn, MD
Holly T. Kiper, DO
Thomas Kishkovich, MD
Quinn M. Kistenfeger, MD
Sofia E. Klar, DO
Jessica B. Klugman, MD
Hope E. Knochenhauer, MD
Kathleen J. Koenigs, MD
Olga Kontarovich, DO
Alison Kosmacki, MD
Ana E. Kouri, MD
Olga M. Kovalenko, MD
Leigh T. Kowalski, MD
Kayla A. Krajick, MD
Elizabeth S. Kravitz, MD
Shruti Rani Kumar, MD
Alyssa Kurtz, DO
Lauren H. Kus, MD
Arkadiy Kusayev, DO
Amanda E. Lacue, MD
Nava Lalehzari, MD
Amber Lalla, MD
Allie C. Lamari, DO
Kelly L. Lamiman, MD
Stephen Lammers, MD
Monet Lane, MD
Madeline L. Lang, MD
Liana Langdon-Embry, MD
Carolyn Larkins, MD
Leah E. Larson, MD
Matthew W. Lee, MD
Eunjae Lee, MD
Alice Lee, MD
Jared Z. Lee, MD
Charlotte M. Lee, MD
Nicole R. Legro, MD
Aurora Leibold, MD
Rosiris Leon-Rivera, MD, PhD
Anna M. Leone, MD
Keiko M. Leong, MD
Lindsey M. LePoidevin, MD
Molly E. Levine, MD
Khrystyna Levytska, MD
Dana L. Lewis, DO
Jessica L. Li, MD
Kristina Lilja, MD
Deanna M. Lines, DO
Annalise Littman, MD
Julia F. Liu, MD
Tyler B. Lloyd, MD
Alyssa Lo, MD
K’ara A. Locke, MD
Minica Long, MD
Melissa Lopez, MD
Wilfredo A. Lopez, MD
Connie F. Lu, MD
Tyler J. Lueck, MD
Katherine L. Lukas, MD
Davlyn L. Luke, MD
Shani Ma, MD
Colton Mabis, MD
Lauren T. MacNeill, MD
Rachel Madding, MD
Mona Makhamreh, MD
Francesca R. Mancuso, MD
Kelsey L. Manfredi, MD
Valeria Mantilla, MD
Kaitlin M. Mar, MD
Starcher R. Margaret, MD
Audrey M. Marinelli, MD
Brittany A. Marinelli, MD
Emily S. Markovic, MD
Hannah L. Marshall, MD
Aaron Masjedi, MD
Isabelle M. Mason, MD
Akailah T. Mason-Otey, MD
Nicole Massad, MD
Megan M. Masten, MD
Stephanie M. Masters, MD
Anastasia Matthews, MD
Natalia del Mazo, MD
Sara A. McAllaster, MD
Continue to: Nicole McAndrew, DO...
Nicole McAndrew, DO
Madeline G. McCosker, MD
Jamie L. McDowell, DO
Christine E. McGough, MD
Mackenzi R. McHugh, MD
Madeline M. McIntire, MD
Cynthia R. McKinney, MD
Kirsten D. McLane, MD
Shian F. McLeish, MD
Megan I. McNitt, MD
Sarah R. McShane, MD
Grace R. Meade, MD
Nikki Ann R. Medina, DO
Tiffany L. Mei, MD
Jenna Meiman, MD
Anna M. Melicher, MD
Rosa M. Mendez, MD
Riley Mickelsen, MD
Sage A. Mikami, MD
Aletheia B. Millien, MD
Hannah C. Milthorpe, MD
Caroline J. Min, MD
Julie A. Mina, MD
Annie G. Minns, MD
Natalie Mironov, DO
Elizabeth L. Mirsky, MD
Astha Mittal, MD
Rachel E. Mnuk, MD
Silki Modi, MD
Sudarshan J. Mohan, MD
Roxana Mohhebali-Solis, MD
Mugdha V. Mokashi, MD
Jessica A. Montgomery, MD
Ellen Moore, MD
Savannah J. Morehouse, MD
Kristen L. Moriarty, MD
Alexa P. Morrison, MD
Bijan Morshedi, MD
Matthew H. Mossayebi, MD
Kathy Mostajeran, DO
Sharan Mullen, DO
Ellen C. Murphy, MD
Emma Chew Murphy, MD
Lauren M. Murphy, MD
Bria Murray, MD
Erin C. Nacev, MD
Preetha Nandi, MD
Blaire E. Nasstrom, DO
Hallie N. Nelson, MD
Katherine A. Nelson, MD
Margaret S. Nemetz, MD
Daniela Ben Neriah, DO
Cosima M. Neumann, MD
Mollie H. Newbern, DO
Gisella M. Newbery, MD
Stephanie Nguyen, MD
Christine G.T. Nguyen, MD
Desiree Nguyen, MD
Jacqueline W. Nichols, MD
Annika M. Nilsen, MD
Margaret A. Nixon, MD
Emily M. Norkett, MD
Allison N. Nostrant, DO
Susan E. Nourse, MD
Aliya S. Nurani, MD
Emily E. Nuss, MD
Jeanne O. Nwagwu, DO
Kelsey E. O’Hagan, MD
Margaret O’Neill, MD
Emily A. O’Brien, MD
Carly M. O’Connor-Terry, MD, MS
Madison O. Odom, MD
Cynthia I. Okot-Kotber, MD
Sarah P. Oliver, MD
Leanne P. Ondreicka, MD
Ngozika G. Onyiuke, MD
Erika Gonzalez Osorio, MD
Marika L. Osterbur Badhey, MD
Linda A. Otieno, MD
Claire H. Packer, MD
Chloe W. Page, DO
Marissa Palmor, MD
Rishitha Panditi, MD
Katherine A. Panushka, MD
Kelsey J. Pape, MD
Rachel R. Paquette, DO
Hillary C. Park, DO
Kendall M. Parrott, MD
Ekta Partani, MD
Karishma Patel, MD
Shivani Patel, MD
Continue to: Priya Patel, MD...
Priya Patel, MD
Jenna M. Patterson, MD
Ashleigh Pavlovic, MD
Katie M. Peagler, MD
Katherine T. Pellino, MD
Nicholas Per, MD
Elana Perry, MD
Emily J. Peters, MD
Sara E. Peterson, MD
Michelle R. Petrich, MD
Destiny L. Phillips, MD
Chloe Phillips, MD
Megan E. Piacquadio, DO
Sara C. Pierpoint, MD
Celeste M. Pilato, MD
Emma Pindra, MD
Minerva L.R. Pineda, MD
Rebecca Pisan, MD
Alessandra R. Piscina, MD
Rachael Piver, MD
Andrew J. Polio, MD
Hector S. Porragas, MD
Natalie Posever, MD
Allison R. Powell, MD
Mahima V. Prasad, MD
Angelina D. Prat, DO
Rebecca L. Purvis, MD
Teresa L. Qi, MD
Nicholas R. Quam, MD
Candice A. Quarella, MD
Nicholas W. Racchi, DO
Jeannie G. Radoc, MD
Samuel Raine, MD
Anna C. Raines, MD
Stephanie A. Rains, MD
Nicole M. Rainville, DO
Karissa Rajagopal, DO
Kristian R. Ramage, MD
Praveen Ramesh, MD
Tia M. Ramirez, MD
Jania Ramos, MD
Neel K. Rana, MD
Urvi Rana, DO
Indira Ranaweera, MD
Sindhuja Ranganathan, DO
Chloe R. Rasmussen, MD
Laura P. Reguero-Cadilla, MD
Devin M. Reilly, MD
Kimberly E. Reimold, MD
Cory R. Reiter, MD, PhD
Maya E. Reuven, DO
Jessica Reyes-Peterson, MD
Jacqueline Rice, MD
Rebecca L. Richardson, MD
Mikaela J. Rico, DO
Katelyn Rittenhouse, MD
Giuliana A. Rivera Casul, MD
Jill N.T. Roberts, MD
Luke N. Roberts, MD
Esther Robin, MD
Marcella Israel Rocha, MD
Zoe A. Roecker, MD
Hilary E. Rogers, MD
Kelsey A. Roof, MD
Zarah Rosen, MD
Cecilia M. Rossi, MD
Eva S. Rostonics, MD
Felix Rubio, MD
Amela Rugova, MD
Anna J. Rujan, MD
Erika T. Russ, MD
Colin Russell, MD
Ruby L. Russell, MD
Isabella A. Sabatina, MD
Gouri Sadananda, MD
Aashna Saini, MD
Salomeh M. Salari, MD
Ndeye N. Sall, MD
Nicole M. Salvador, MD
Aayushi Sardana, MD
Kendall M. Sarson, MD
Rita Abigail Sartor, MD
Continue to: Haley A. Scarbrough, MD...
Haley A. Scarbrough, MD
Kimberly Schaefer, MD
Demetra Schermerhorn, MD
Ellen C. Schleckman, MD
Maura A. Schlussel, MD
Ellie Schmidt, MD
Alison M. Schmidt, MD
Evan A. Schrader, MD
Morgan A. Schriever, MD
Brianna L. Schumaker Nguyen, DO
Whitney E. Scott, MD
Claire Scrivani, MD
Catherine E. Seaman, MD
Rachel D. Seaman, MD
Danielle J. Seltzer, MD
Joshua R. Shaffer, MD
Emily A. Shaffer, MD
Delia S. Shash, MD
Ishana P. Shetty, MD
Tushar Shetty, MD
Carol Shi, MD
Sarah P. Shim, MD
Emma C. Siewert, MD
Seth M. Sigler, DO
Rebecca L. SigourneyTennyck, MD
Daniella D. Silvino, DO
Andrea M. Simi, MD
Amelia R. Simmons, MD
Amy E. Skeels, DO
Ashley E.S. Keith, MD
Hannah C. Smerker, DO
Katarina Smigoc, MD
Madeline I. Smith, MD
Jessica D. Smith, MD
Melanie R. Smith, MD
Alicia L. Smith, MD
Chloe Smith, MD
Ayanna Smith, MD
Melanie R. Smith, MD
Megan M. Smith, MD
Haverly J. Snyder, MD
Beatrice R. Soderholm, DO
Brianna C. Sohl, MD
Samantha A. Solaru, MD
Michael Solotke, MD
Dara A.H. Som, MD
Alexandra R. Sotiros-Lowry, MD
Melanie Spall, DO
Alicia C. Speak, DO
Lisa M. Spencer, MD
Prakrithi Srinand, MD
Sierra M. Starr, MD
Kathryne E. Staudinger, MD
Emily K. Steele, MD
Morgan R. Steffen, DO
Tricia R. Stepanek, MD
Taylor P. Stewart, MD
Kelsey A. Stewart, MD
Alyssa M. Stiff, MD
Alexandra B. Stiles, MD
Nairi K. Strauch, MD
Margaret J. Stroup, DO
Sean C. Stuart, DO
Hannah M. Stump, MD
Shalini B. Subbarao, MD
Lakshmi Subramani, MD
Heather E. Sweeney, MD
Kristin I. Swope, MD
Suha Syed, MD
Mireya P. Taboada, MD
Eneti S. Tagaloa, MD
Rachel Tang, DO
Adam R. Taylor, MD
Simone R. Thibault, MD
Kimberly A. Thill, MD
Dhanu Thiyag, MD
Andrew T. Thornton, MD
Wendy Tian, MD
Stephanie Tilberry, MD
Amanda L. Tillett, MD
Amanda M. Tjitro, MD
Logan P. Todhunter, DO
David Toffey, MD
Maris K. Toland, MD
Rachel E. Tomassi, MD
Sarah Tounsi, MD
Antonia K. Traina, MD
Taylor Tran, MD
Diem Samantha Tran, DO
Emily C. Trautner, MD
Emma Trawick, MD
Continue to: Elissa Trieu, MD...
Elissa Trieu, MD
Ariel Trilling, MD
Samantha Truong, MD
Mary M. Tsaturian, MD
Athena Tudino, MD
Kati A. Turner, MD
Nicole-Marie Tuzinkiewicz, MD
Gayathri D. Vadlamudi, MD
Stylianos Vagios, MD
Pauline V. Van Dijck, DO
Kaylee A. VanDommelen, MD
Isha B. Vasudeva, MD
Shivani J. Vasudeva, DO
Diana Q. Vazquez Parker, MD
Ridhima Vemula, MD
Elena C. Vinopal, MD
Caroline J. Violette, MD
Pascal T. Vo, DO
Michelle H. Vu, MD
Macy M. Walz, MD
Angelia Wang, MD
Eileen Wang, MD
Courtney Y. Wang, MD
Joyce Wang, MD
Meryl G. Warshafsky, MD
Sophie E.N. Weinstein, MD
Sarah H. Weinstein, MD
Annalyn M. Welp, MD
Shannon M. Wentworth, MD
Erika M. Wert, MD
Rachel C. White, MBchB
Morgan N. Wilhoite, DO
Mercedes Williams, MD
Hayley Williams, MD
Jacquelyn D. Williams, MD
Mary H. Williamson, MD
Elise Wilson, MD
Lauren M. Witchey, MD
Emily A. Wolverton, MD
Stephanie Y. Wong, MD
Jenny Wu, MD
Jackie Xiang, MD
Nancy S. Yang, MD
Kevin P. Yeagle, MD
Halina M. Yee, MD
Alyssa M. Yeung, MD
Samuel K. Yost, MD
Megan Yuen, MD
Nayab Zafar, DO
Cindy X. Zhang, DO
Yingao Zhang, MD
Helen Zhao, MD
Chelsea Zhu, MD
Billie E. Zidel, MD
Ryan A. Zoldowski, MD
- Vinekar K, Karlapudi A, Nathan L, et al. Projected implications of overturning Roe v Wade on abortion training in US obstetrics and gynecology residency programs. Obstet Gynecol. 2022;140:146-149.
- ACGME program requirements for graduate medical education in obstetrics and gynecology summary and impact of interim requirement revisions. ACGME website. Accessed December 18, 2022. https://www.acgme.org/globalassets/pfassets/reviewandcomment/220_obstetricsandgynecology_2022-06-24_impact.pdf
- Crear-Perry J, Hassan A, Daniel S. Advancing birth equity in a post-Dobbs US. JAMA. 2022;328:1689-1690.
- Report on residents. AAMC website. Accessed December 18, 2022. https://www.aamc.org/data-reports/students-residents/interactive-data/report-residents/2021/table-c4-physician-reten tion-state-residency-training-last-completed-gme
Dr. Nandi is Resident, Tufts University School of Medicine, Boston, Massachusetts.
Dr. Toland is Resident, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
Dr. Evans is Associate Director for Residency Program and Assistant Professor, Obstetrics and Gynecology, Tufts University School of Medicine.
The authors report no financial relationships relevant to this article.
Dr. Nandi is Resident, Tufts University School of Medicine, Boston, Massachusetts.
Dr. Toland is Resident, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
Dr. Evans is Associate Director for Residency Program and Assistant Professor, Obstetrics and Gynecology, Tufts University School of Medicine.
The authors report no financial relationships relevant to this article.
Dr. Nandi is Resident, Tufts University School of Medicine, Boston, Massachusetts.
Dr. Toland is Resident, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
Dr. Evans is Associate Director for Residency Program and Assistant Professor, Obstetrics and Gynecology, Tufts University School of Medicine.
The authors report no financial relationships relevant to this article.
Six months after the Supreme Court decision that overturned the constitutional right to abortion, trainees across the United States are asking a critical question in the current resident recruitment season: How will the restrictions on abortion access affect my training as an obstetrician-gynecologist, and will they impact my ability to be the kind of provider I want to be in the future?
Among the myriad of downstream effects to patient care, the Dobbs decision will indisputably impact the scope of residency training for those that provide reproductive health services. Almost half of ObGyn residents train in states that have abortion restrictions in place.1 New educational milestones for abortion training, which are a requirement by the Accreditation Council for Graduate Medical Education (ACGME), were proposed quickly after Dobbs, guiding programs to offer opportunities for training in nonrestricted areas or the “combination of didactic activities, including simulation” to meet the training requirement in abortion care.2
Like many providers, residents already are grappling with precarious and risky circumstances, balancing patient safety and patient-driven care amidst pre-existing and newly enforced abortion restrictions. Whether managing a patient with an undesired pregnancy, severe medical comorbidities, unexpected pregnancy complications such as preterm premature rupture of membranes, or bleeding, or substantial fetal anomalies, ObGyn residents cannot gain the experience of providing the full scope of reproductive health care without the ability to offer all possible management options. While some enacted abortion restrictions have exceptions for the health of or life-saving measures for the mother, there is no standard guidance for timing of interventions, leaving providers confused and in fear of legal retribution. At a time when trainees should be learning to provide patient-centered, evidence-based care, they are instead paralyzed by the legal or professional consequences they may face for offering their best medical judgements.
Furthermore, the lack of exposure to dilation and evacuation procedures for residents in restricted practice areas will undoubtably decrease their confidence in managing acute complications, which is one of the critical facets of residency training. In a surgical field where repetition is crucial for technical competence, highlighted by ACGME minimum case requirements, the decreased volume of abortion procedures is a disadvantage for trainees and a disservice for patients. While anti-choice promoters may argue that involvement in surgical management of early pregnancy loss should suffice for ObGyn training in family planning, this piecemeal approach will leave gaps in technical skills.
The fear of legal ramifications, moral injury, and inadequate surgical training may lead to the siphoning of talented trainees to areas in the country with fewer restrictions.3Dobbs already has demonstrated how limiting abortion access will deepen inequities in reproductive health care service delivery. Approximately 55% of ObGyn trainees and nearly two-thirds of maternal-fetal medicine graduates join the workforce in the state where they received their training.4 Medical students will seek opportunities for high-quality ObGyn training in areas that will help them to be well-prepared, competent physicians—and more often than not, stay in the area or region that they trained in. This will lead to provider shortages in areas where access to reproductive health care and subspecialist providers already is limited, further exacerbating existing health disparities.
During this recruitment season, trainees and residency programs alike will need to reckon with how the ramifications of Dobbs will alter both the immediate and long-term training in comprehensive reproductive health care for the ObGyn workforce. ObGyn trainees have taken a stand in response to the Dobbs decision, and nearly 750 current residents signed onto the statement below as a commitment to high-quality training and patient-centered care. Clinical experience in performing abortions is essential to the provision of comprehensive evidence-based reproductive health care, and access to these procedures is as important for physicians-in-training as it is for patients.
Actions to take to ensure high-quality abortion training in ObGyn residencies include the following:
- Connect with and stay involved with organizations such as the American College of Obstetricians and Gynecologists (ACOG), Physicians for Reproductive Health (PRH), and Medical Students for Choice (MSFC) for initiatives, toolkits, and resources for training at your institutions.
- Seek specific abortion training opportunities through the Leadership Training Academy (offered through PRH) or the Abortion Training Institute (offered through MSFC).
- Ensure that your residency program meets the ACGME criteria of providing opportunities for clinical experiences for abortion care and work with program leadership at a program, state, or regional level to enforce these competencies.
- Reach out to your local American Civil Liberties Union or other local reproductive legal rights organizations if you want to be involved with advocacy around abortion access and training but have concerns about legal protections.
- Have a voice at the table for empowering training opportunities by seeking leadership positions through ACOG, ACGME, Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics, American Medical Association, Student National Medical Association, and subspecialty organizations.
- Vote in every election and promote voting registration and access to your patients, colleagues, and communities. ●
Continue to: The implications of the Dobbs v Jackson Women’s Health Organization decision on the health care and wellbeing of our patients...
On June 24, 2022, the Supreme Court of the United States ruled in a 6-3 majority decision to overturn the constitutional right to abortion protected by Roe v Wade since 1973. As health care providers, we are outraged at the Court’s disregard for an individual’s right to make reproductive decisions for themselves and their families and are deeply concerned about the devastating consequences to reproductive care and outcomes in this country for all people. Reproductive health decisions, including growing a family and whether or not to continue a pregnancy, are complex and incredibly personal. Our role as health care providers is to help guide those decisions with empathy and evidencebased clinical recommendations. This ruling undermines a patient’s right to bodily autonomy, free of impositions from government and political pressures, and it threatens the sanctity of complex medical decision-making between a patient, their family, and their medical team.
As medical professionals, we know that every patient’s situation is unique—banning abortion procedures ties the hands of physicians trying to provide the most medically appropriate options in a compassionate manner. We know that both medical and surgical abortions are safe and can save lives. These procedures can help patients with potentially life-threatening conditions worsened by pregnancy, a poor prognosis for the fetus, or a complication from the pregnancy itself. Physicians use scientific research and individualized approaches to help patients in unique situations, and attempts to legislate personal health decisions compromise the practice of evidence-based medicine.
We also know that this decision will impact some communities more than others. Access to safe abortion care will become dependent on which region of the country a person lives in and whether or not a person has resources to seek this care. Due to continued systemic racism and oppression, patients of color will be disproportionately impacted and likely will suffer worse health outcomes from unsafe abortions. Those that rely on public insurance or who are uninsured will face overwhelming barriers in seeking abortion services. These disparities in reproductive care, which contribute to our nation’s health crises in maternal morbidity and mortality, unintended pregnancy, and neonatal complications, will further entrench health inequities, and patient lives and livelihoods will suffer.
We acknowledge the impact that this decision will have on restricting access to reproductive care. We stand by the fact that abortion care is health care. We vow to uphold the tenets of our profession to place patient autonomy and provision of safe quality medical care at the forefront of our practices.
We, as health care providers and physician trainees, hereby pledge:
- To continue to provide evidence-based, nonjudgmental counseling for all pregnancy options, including abortion, and support our patients through all reproductive health decisions
- To promote equity in providing comprehensive reproductive health care, recognizing the impacts of systemic racism and oppression
- To promote high quality training in providing safe reproductive care in our respective institutions
- To use our voices in our communities to advocate for all our patients to have the freedom to access the safe and compassionate health care they deserve.
Sincerely,
The undersigned 747 ObGyn resident physicians
Please note that we sign this statement on our own behalf as individuals and not on behalf of our respective institutions.
Orchideh Abar, MD
Laurel S. Aberle, MD
Kathleen E. Ackert, DO
Lauryn Adams, MD
Temiloluwa Adejuyigbe, MD
Oluwatoyosi M. Adeoye, MD
Hufriya Y. Aderianwalla, MD
Fareeza Afzal, MD
Adelaide Agyepong, MD
Erin R. Ahart, MD
Noha T. Ahmed, DO
Faria Ahmed, MD
Tracey O. Akanbi, MD
Eloho E. Akpovi, MD
Austin H. Allen, DO
Amanda M. Allen, MD
Alexis L. Allihien, MD
Jorge L. Alsina, MD
Paulina C. Altshuler, DO
Sivani Aluru, MD
Amal Amir, DO
Jon Anderson, DO
Andreas Antono, MD
Annie N. Apple, MD
Janine Appleton, DO
Aarthi Arab, MD
Sydney R. Archer, MD
Youngeun C. Armbuster, MD
Kara Arnold, MD
Blessing C. Aroh, MD
Savannah Pearson Ayala, MD
Archana K. Ayyar, MD
Ann-Sophie Van Backle, DO
Connor R. Baker, MD
Japjot K. Bal, MD
Abigail E. Barger, MD
Kathryn E. Barron, MD
Silvia Bastea, MD
Samantha V.H. Bayer, MD
Kristen Beierwaltes, MD
Gisel Bello, MD
Michelle A. Benassai, MD
Dana Benyas, MD
Alice F. Berenson, MD
Hanna P. Berlin, MD
Abigail L. Bernard, MD
Eli H. Bernstein, MD
Julia T. Berry, MD
Bryce L. Beyer, MD
Caroline Bilbe, MD
Grace E. Binter, DO
Erin E. Bishop, MD
Sierra G. Bishop, MD
Stephanie S. Bista, MD
Tara E. Bjorklund, DO
Alyssa N. Black, MD
Continue to: Kelsey Boghean, DO...
Kelsey Boghean, DO
Areta Bojko, MD
Grace E. Bommarito, DO
Aditi R. Bommireddy, MD
Genna C. Bonfiglio, MD
Mary E. Booker, MD
Kayce L. Booth, MD
Samantha T. Boothe, DO
William Borenzweig, MD
Rebecca M. Borneman, MD
Alexander L. Boscia, MD
Gina M. Botsko, MD
Glenn P. Boyles, MD
Avery C. Bramnik, MD
Sophia N. Brancazio, MD
Katarina M. Braun, MD
Anthony Brausch, MD
Emily L. Brekke, MD
Sara E. Brenner, MD
Bailey A. Brown, DO
Kathryn S. Brown, MD
Denese C. Brown, MD
Abena Bruce, MD
Sabrina C. Brunozzi, MD
Madison Buchman, DO
Deirdre G. Buckley, MD
Rachel L. Budker, MD
Leeann M. Bui, MD
Anthony H. Bui, MD
Jessie Bujouves, MD
Kimberley A. Bullard, MD
Sophia G. Bunde, MD
Emily R. Burdette, MD
Iris Burgard, DO
Korbi M. Burkey, MD
Lindsey K. Burleson, MD
Lindsay M. Burton, MD
Brianna N. Byers, MD
Stephanie Cai, MD
Alexandra S. Calderon, MD
Alexandra G. Caldwell, MD
Natalia Calzada, MD
Tamara Cameo, MD
Arielle Caplin, MD
Angela M. Carracino, DO
Anna L. Carroll, MD
Leigha M. Carryl, MD
Ashlie S. Carter, MD
Stephanie Casey, DO
Chase W. Cataline, DO
Carson L. Catasus, MD
Alena R. Cave, MD
Kelly M. Chacon, MD
Avis L. Chan, MD
Shruthi Chandra, MD
Jennifer Chang, MD
Shannon Chang, DO
Gillian Chase, MD
Cindy Chen, MD
Jessie C. Chen, MD
Jessica T. Chen, MD
Wenjin Cheng, MB
Laura J. Cheng, MD
Lucy Cheng, MD
Monica S. Choo, MD
Jody S. Chou, MD
Hannah C. Christopher, DO
Continue to: David J. Chromey, DO...
David J. Chromey, DO
Grace V. Clark, MD
Celeste Colegrove, MD
Sarah C. Combs, MD
Victoria L. Conniff, MD
Hannah C. Connor, MD
Angela J. Conway, MD
Steffany A. Conyers, MD
Alexandra Cooke, MD
Ashley A. Cooney, MD
Anna Cornelius-Schecter, MD
Alexa M. Corso, DO
Krysten A. Costley, MD
Madeline Coulter, MD
Kelsey Cramer, MD
Anna E. Cronin, MD
Bethany N. Croyle, DO
Carmen A. Cueto, MD
Nicole Cumbo, MD
Mackenzie A. Cummings, MD
Carrie Cummiskey, MD
Hannah M. Cunningham, MD
Sarah D’Souza, DO
Rachael M. D’Auria, MD
Caitlin Dane, MD
Rachel N. Dang, MD
Talin R. Darian, MD
Abigail C. Davies, MD
Berkley Davis, MD
Lois A. Davis, MD
Jennie J. DeBlanc, MD
Ayana G.R. DeGaia, MD, MPH
Katerina N. DeHaan, MD
Rebekka M. Delgado, MD
Brettany C. DeMier, MD
Bonnie W. DePaso, MD
Hemaxi H. Desai, DO
Amberly T. Diep, MD
Abigail K. Dillaha, MD
Sarah K. Dominguez, MD
Abbey P. Donahue, MD
Allan C. Dong, MD
James Doss, MD
Taylor B. Douglas, MD
Abigail G. Downey, MD
Janelle M. Driscoll, MD
Emily Du, MD
Leslie V. Dunmire, MD
Jennifer Duong, DO
Leigh C. Durudogan, MD
Mai N. Dyer, MD, MPH
Rebecca A. Ebbott, MD
Lindsey P. Eck, MD
Molly C. Eckman, MD
Alex Ede, MD, ScM
Claire E. Edelman, MD
Sara E. Edwards, MD
David J. Eggert, DO
Michelle Eide, MD
Etoroabasi Ekpe, MD
Tressa L. Ellett, MD
Laura Peyton Ellis, MD
Kaitlin H. Ellis, MD
Mariah G. Elly, MD
Jennifer Embry, MD
Claire Englert, MD
Brenna Espelien, MD
Kamilah Evans, MD
Joshua A. Ewy, MD
Elana D. Fackler, MD
Lauren E. Falk, MD
Brianna A. Farley, MD
Amanda Stephanie R. Farrell, MD
Sara Fassio, DO
Daniela A. Febres-Cordero, MD
Jasmin E. Feliciano, MD
Alayna H. Feng, MD
Amanda M. Ferraro, MD
Brittany A. Fickau, MD
Brittany H. File, MD
Shannon M. Finner, DO
Mia E. Fischbein, DO
Briah Fischer, MD
Shira Fishbach, MD
Alison C. Fitzgerald, MD
Evan R. Fitzgerald, MD
Margaret R. Flanigan, MD
Kevin C. Flatley, MD
Jordan A. Fletcher, MD
Claudia E. Flores, MD
Lauren A. Forbes, MD
Rana K. Fowlkes, MD
Jennifer M. Franks, MD, MPH
Christina M. Frasik, MD
Haven N. Frazier, DO
Sarah W. Freeman, MD
Emilie O. Fromm, DO
Anna R. Fuchss, MD
Emma K. Gaboury, MD
Madeline H. Ganz, MD
Lex J. Gardner, MD
Keri-Lee Garel, MD
Hailey B. Gaskamp, DO
Brittney A. Gaudet, MD
Gabrielle M. Gear, MD
Eleanor R. Germano, MD
Lauren G. Gernon, MD
Allen Ghareeb, MD
Patricia Giglio Ayers, MD
Jordana L. Gilman, MD
Mianna M. Gilmore, DO
Brian W. Goddard, MD
Julia L. Goldberg, MD
M. Isabel Gonzaga, MD
Fred P. Gonzales, MD
Lillian H. Goodman, MD, MPH
Ashley Goreshnik, MD
Lauren E. Gottshall, MD
Lindsay L. Gould, MD
Kelsea R. Grant, MD
Dorender A. Gray, MD
Sophie Green, MD
Erica A. Green, MD
Danielle C. Greenberg, MD
Kalin J. Gregory-Davis, MD
David M. Greiner, MD
Tyler M. Gresham, MD
Continue to: Nelly Grigorian, MD...
Nelly Grigorian, MD
Erin L. Grimes, MD
Whitney Grither, MD
Jared M. Grootwassink, MD
Maya E. Gross, MD
Paoula Gueorguieva, MD
Margot M. Gurganus, DO
Rachel L. Gutfreund, MD
Andres Gutierrez, MD
Dorothy L. Hakimian, DO
Ashley N. Hamati, DO
Marie M. Hanna-Wagner, MD
Katie Hansen, MD
Courtney Hargreaves, MD
Stephanie Harlow, MD
Kelsey B. Harper, MD
Devon A. Harris, MD
Lauren E. Harris, MD
Emily S. Hart, DO
Sarah A. Hartley, MD
Becky K. Hartman, MD
Abigail K. Hartmann, MD
Charlotte V. Hastings, MD
Cherise Hatch, DO
Jordan Hauck, DO
Sarena Hayer, MD
Jenna M. Heath, MD
Eric D. Helm, MD
Julie A. Hemphill, MD
Ric A.S. Henderson, MD
Nicola A. Hendricks, MD
Andrea A. Henricks, MD
Jesse M. Herman, DO
Alyssa M. Hernandez, DO
Melissa Hernandez, MD
Alyssa R. Hersh, MD
Alexandra Herweck, MD
Brianna Hickey, MD
Allix M. Hillebrand, MD
Alessandra I. Hirsch, MD
Emily A. Hoffberg, MD
Chloe L. Holmes, DO
Cameron M. Holmes, MD
Helena Y. Hong, MD
Wakako Horiuchi, MD
Shweta Hosakoppal, MD
Jaycee E. Housh, MD
Shannon M. Howard, MD
Meredith C. Huszagh, MD
Yihharn P. Hwang, MD
Emma C. Hyde, MD
Brooke Hyman, MD
Hala Ali Ibrahim, MD
Gnendy Indig, MD
Erin E. Isaacson, MD
Shruti S. Iyer, DO
Audrey J. Jaeger, DO
Shobha Jagannatham, MD
Cyrus M. Jalai, MD
Emma V. James, MD
Isabel Janmey, MD
Phoebe Jen, DO
Corey L. Johnson, MD
Crystal J. Johnson, MD
Andrea M. Johnson, MD
Nat C. Jones, MD
Briana L. Jones, DO
Rebecca J. Josephson, MD
Sarah Natasha Jost-Haynes, MD
Continue to: Hannah S. Juhel, MD...
Hannah S. Juhel, MD
Erin Jun, DO
Katherine B. Kaak, MD
Dhara N. Kadakia, MD
Amanda D. Kadesh, MD
Riana K. Kahlon, MD
Nadi N. Kaonga, MD
Moli Karsalia, MD
Stephanie L. Kass, MD
Amanda M. Katz, MD
Chelsea S. Katz, MD
Virginia Kaufman, MD
Gurpinder Kaur, MD
Jessica A. Keesee, MD
Cassandra N. Kelly, MD
Whitney Kelly, DO
Hannah V. Kennedy, MD
Bethany H. Kette, MD
Iman Khan, MD
Maryam M. Khan, MD
Alisa Jion Kim, MD
Tesia G. Kim, MD
Anne E. Kim, MD
Emily H. King, MD
Tarynne E. Kinghorn, MD
Holly T. Kiper, DO
Thomas Kishkovich, MD
Quinn M. Kistenfeger, MD
Sofia E. Klar, DO
Jessica B. Klugman, MD
Hope E. Knochenhauer, MD
Kathleen J. Koenigs, MD
Olga Kontarovich, DO
Alison Kosmacki, MD
Ana E. Kouri, MD
Olga M. Kovalenko, MD
Leigh T. Kowalski, MD
Kayla A. Krajick, MD
Elizabeth S. Kravitz, MD
Shruti Rani Kumar, MD
Alyssa Kurtz, DO
Lauren H. Kus, MD
Arkadiy Kusayev, DO
Amanda E. Lacue, MD
Nava Lalehzari, MD
Amber Lalla, MD
Allie C. Lamari, DO
Kelly L. Lamiman, MD
Stephen Lammers, MD
Monet Lane, MD
Madeline L. Lang, MD
Liana Langdon-Embry, MD
Carolyn Larkins, MD
Leah E. Larson, MD
Matthew W. Lee, MD
Eunjae Lee, MD
Alice Lee, MD
Jared Z. Lee, MD
Charlotte M. Lee, MD
Nicole R. Legro, MD
Aurora Leibold, MD
Rosiris Leon-Rivera, MD, PhD
Anna M. Leone, MD
Keiko M. Leong, MD
Lindsey M. LePoidevin, MD
Molly E. Levine, MD
Khrystyna Levytska, MD
Dana L. Lewis, DO
Jessica L. Li, MD
Kristina Lilja, MD
Deanna M. Lines, DO
Annalise Littman, MD
Julia F. Liu, MD
Tyler B. Lloyd, MD
Alyssa Lo, MD
K’ara A. Locke, MD
Minica Long, MD
Melissa Lopez, MD
Wilfredo A. Lopez, MD
Connie F. Lu, MD
Tyler J. Lueck, MD
Katherine L. Lukas, MD
Davlyn L. Luke, MD
Shani Ma, MD
Colton Mabis, MD
Lauren T. MacNeill, MD
Rachel Madding, MD
Mona Makhamreh, MD
Francesca R. Mancuso, MD
Kelsey L. Manfredi, MD
Valeria Mantilla, MD
Kaitlin M. Mar, MD
Starcher R. Margaret, MD
Audrey M. Marinelli, MD
Brittany A. Marinelli, MD
Emily S. Markovic, MD
Hannah L. Marshall, MD
Aaron Masjedi, MD
Isabelle M. Mason, MD
Akailah T. Mason-Otey, MD
Nicole Massad, MD
Megan M. Masten, MD
Stephanie M. Masters, MD
Anastasia Matthews, MD
Natalia del Mazo, MD
Sara A. McAllaster, MD
Continue to: Nicole McAndrew, DO...
Nicole McAndrew, DO
Madeline G. McCosker, MD
Jamie L. McDowell, DO
Christine E. McGough, MD
Mackenzi R. McHugh, MD
Madeline M. McIntire, MD
Cynthia R. McKinney, MD
Kirsten D. McLane, MD
Shian F. McLeish, MD
Megan I. McNitt, MD
Sarah R. McShane, MD
Grace R. Meade, MD
Nikki Ann R. Medina, DO
Tiffany L. Mei, MD
Jenna Meiman, MD
Anna M. Melicher, MD
Rosa M. Mendez, MD
Riley Mickelsen, MD
Sage A. Mikami, MD
Aletheia B. Millien, MD
Hannah C. Milthorpe, MD
Caroline J. Min, MD
Julie A. Mina, MD
Annie G. Minns, MD
Natalie Mironov, DO
Elizabeth L. Mirsky, MD
Astha Mittal, MD
Rachel E. Mnuk, MD
Silki Modi, MD
Sudarshan J. Mohan, MD
Roxana Mohhebali-Solis, MD
Mugdha V. Mokashi, MD
Jessica A. Montgomery, MD
Ellen Moore, MD
Savannah J. Morehouse, MD
Kristen L. Moriarty, MD
Alexa P. Morrison, MD
Bijan Morshedi, MD
Matthew H. Mossayebi, MD
Kathy Mostajeran, DO
Sharan Mullen, DO
Ellen C. Murphy, MD
Emma Chew Murphy, MD
Lauren M. Murphy, MD
Bria Murray, MD
Erin C. Nacev, MD
Preetha Nandi, MD
Blaire E. Nasstrom, DO
Hallie N. Nelson, MD
Katherine A. Nelson, MD
Margaret S. Nemetz, MD
Daniela Ben Neriah, DO
Cosima M. Neumann, MD
Mollie H. Newbern, DO
Gisella M. Newbery, MD
Stephanie Nguyen, MD
Christine G.T. Nguyen, MD
Desiree Nguyen, MD
Jacqueline W. Nichols, MD
Annika M. Nilsen, MD
Margaret A. Nixon, MD
Emily M. Norkett, MD
Allison N. Nostrant, DO
Susan E. Nourse, MD
Aliya S. Nurani, MD
Emily E. Nuss, MD
Jeanne O. Nwagwu, DO
Kelsey E. O’Hagan, MD
Margaret O’Neill, MD
Emily A. O’Brien, MD
Carly M. O’Connor-Terry, MD, MS
Madison O. Odom, MD
Cynthia I. Okot-Kotber, MD
Sarah P. Oliver, MD
Leanne P. Ondreicka, MD
Ngozika G. Onyiuke, MD
Erika Gonzalez Osorio, MD
Marika L. Osterbur Badhey, MD
Linda A. Otieno, MD
Claire H. Packer, MD
Chloe W. Page, DO
Marissa Palmor, MD
Rishitha Panditi, MD
Katherine A. Panushka, MD
Kelsey J. Pape, MD
Rachel R. Paquette, DO
Hillary C. Park, DO
Kendall M. Parrott, MD
Ekta Partani, MD
Karishma Patel, MD
Shivani Patel, MD
Continue to: Priya Patel, MD...
Priya Patel, MD
Jenna M. Patterson, MD
Ashleigh Pavlovic, MD
Katie M. Peagler, MD
Katherine T. Pellino, MD
Nicholas Per, MD
Elana Perry, MD
Emily J. Peters, MD
Sara E. Peterson, MD
Michelle R. Petrich, MD
Destiny L. Phillips, MD
Chloe Phillips, MD
Megan E. Piacquadio, DO
Sara C. Pierpoint, MD
Celeste M. Pilato, MD
Emma Pindra, MD
Minerva L.R. Pineda, MD
Rebecca Pisan, MD
Alessandra R. Piscina, MD
Rachael Piver, MD
Andrew J. Polio, MD
Hector S. Porragas, MD
Natalie Posever, MD
Allison R. Powell, MD
Mahima V. Prasad, MD
Angelina D. Prat, DO
Rebecca L. Purvis, MD
Teresa L. Qi, MD
Nicholas R. Quam, MD
Candice A. Quarella, MD
Nicholas W. Racchi, DO
Jeannie G. Radoc, MD
Samuel Raine, MD
Anna C. Raines, MD
Stephanie A. Rains, MD
Nicole M. Rainville, DO
Karissa Rajagopal, DO
Kristian R. Ramage, MD
Praveen Ramesh, MD
Tia M. Ramirez, MD
Jania Ramos, MD
Neel K. Rana, MD
Urvi Rana, DO
Indira Ranaweera, MD
Sindhuja Ranganathan, DO
Chloe R. Rasmussen, MD
Laura P. Reguero-Cadilla, MD
Devin M. Reilly, MD
Kimberly E. Reimold, MD
Cory R. Reiter, MD, PhD
Maya E. Reuven, DO
Jessica Reyes-Peterson, MD
Jacqueline Rice, MD
Rebecca L. Richardson, MD
Mikaela J. Rico, DO
Katelyn Rittenhouse, MD
Giuliana A. Rivera Casul, MD
Jill N.T. Roberts, MD
Luke N. Roberts, MD
Esther Robin, MD
Marcella Israel Rocha, MD
Zoe A. Roecker, MD
Hilary E. Rogers, MD
Kelsey A. Roof, MD
Zarah Rosen, MD
Cecilia M. Rossi, MD
Eva S. Rostonics, MD
Felix Rubio, MD
Amela Rugova, MD
Anna J. Rujan, MD
Erika T. Russ, MD
Colin Russell, MD
Ruby L. Russell, MD
Isabella A. Sabatina, MD
Gouri Sadananda, MD
Aashna Saini, MD
Salomeh M. Salari, MD
Ndeye N. Sall, MD
Nicole M. Salvador, MD
Aayushi Sardana, MD
Kendall M. Sarson, MD
Rita Abigail Sartor, MD
Continue to: Haley A. Scarbrough, MD...
Haley A. Scarbrough, MD
Kimberly Schaefer, MD
Demetra Schermerhorn, MD
Ellen C. Schleckman, MD
Maura A. Schlussel, MD
Ellie Schmidt, MD
Alison M. Schmidt, MD
Evan A. Schrader, MD
Morgan A. Schriever, MD
Brianna L. Schumaker Nguyen, DO
Whitney E. Scott, MD
Claire Scrivani, MD
Catherine E. Seaman, MD
Rachel D. Seaman, MD
Danielle J. Seltzer, MD
Joshua R. Shaffer, MD
Emily A. Shaffer, MD
Delia S. Shash, MD
Ishana P. Shetty, MD
Tushar Shetty, MD
Carol Shi, MD
Sarah P. Shim, MD
Emma C. Siewert, MD
Seth M. Sigler, DO
Rebecca L. SigourneyTennyck, MD
Daniella D. Silvino, DO
Andrea M. Simi, MD
Amelia R. Simmons, MD
Amy E. Skeels, DO
Ashley E.S. Keith, MD
Hannah C. Smerker, DO
Katarina Smigoc, MD
Madeline I. Smith, MD
Jessica D. Smith, MD
Melanie R. Smith, MD
Alicia L. Smith, MD
Chloe Smith, MD
Ayanna Smith, MD
Melanie R. Smith, MD
Megan M. Smith, MD
Haverly J. Snyder, MD
Beatrice R. Soderholm, DO
Brianna C. Sohl, MD
Samantha A. Solaru, MD
Michael Solotke, MD
Dara A.H. Som, MD
Alexandra R. Sotiros-Lowry, MD
Melanie Spall, DO
Alicia C. Speak, DO
Lisa M. Spencer, MD
Prakrithi Srinand, MD
Sierra M. Starr, MD
Kathryne E. Staudinger, MD
Emily K. Steele, MD
Morgan R. Steffen, DO
Tricia R. Stepanek, MD
Taylor P. Stewart, MD
Kelsey A. Stewart, MD
Alyssa M. Stiff, MD
Alexandra B. Stiles, MD
Nairi K. Strauch, MD
Margaret J. Stroup, DO
Sean C. Stuart, DO
Hannah M. Stump, MD
Shalini B. Subbarao, MD
Lakshmi Subramani, MD
Heather E. Sweeney, MD
Kristin I. Swope, MD
Suha Syed, MD
Mireya P. Taboada, MD
Eneti S. Tagaloa, MD
Rachel Tang, DO
Adam R. Taylor, MD
Simone R. Thibault, MD
Kimberly A. Thill, MD
Dhanu Thiyag, MD
Andrew T. Thornton, MD
Wendy Tian, MD
Stephanie Tilberry, MD
Amanda L. Tillett, MD
Amanda M. Tjitro, MD
Logan P. Todhunter, DO
David Toffey, MD
Maris K. Toland, MD
Rachel E. Tomassi, MD
Sarah Tounsi, MD
Antonia K. Traina, MD
Taylor Tran, MD
Diem Samantha Tran, DO
Emily C. Trautner, MD
Emma Trawick, MD
Continue to: Elissa Trieu, MD...
Elissa Trieu, MD
Ariel Trilling, MD
Samantha Truong, MD
Mary M. Tsaturian, MD
Athena Tudino, MD
Kati A. Turner, MD
Nicole-Marie Tuzinkiewicz, MD
Gayathri D. Vadlamudi, MD
Stylianos Vagios, MD
Pauline V. Van Dijck, DO
Kaylee A. VanDommelen, MD
Isha B. Vasudeva, MD
Shivani J. Vasudeva, DO
Diana Q. Vazquez Parker, MD
Ridhima Vemula, MD
Elena C. Vinopal, MD
Caroline J. Violette, MD
Pascal T. Vo, DO
Michelle H. Vu, MD
Macy M. Walz, MD
Angelia Wang, MD
Eileen Wang, MD
Courtney Y. Wang, MD
Joyce Wang, MD
Meryl G. Warshafsky, MD
Sophie E.N. Weinstein, MD
Sarah H. Weinstein, MD
Annalyn M. Welp, MD
Shannon M. Wentworth, MD
Erika M. Wert, MD
Rachel C. White, MBchB
Morgan N. Wilhoite, DO
Mercedes Williams, MD
Hayley Williams, MD
Jacquelyn D. Williams, MD
Mary H. Williamson, MD
Elise Wilson, MD
Lauren M. Witchey, MD
Emily A. Wolverton, MD
Stephanie Y. Wong, MD
Jenny Wu, MD
Jackie Xiang, MD
Nancy S. Yang, MD
Kevin P. Yeagle, MD
Halina M. Yee, MD
Alyssa M. Yeung, MD
Samuel K. Yost, MD
Megan Yuen, MD
Nayab Zafar, DO
Cindy X. Zhang, DO
Yingao Zhang, MD
Helen Zhao, MD
Chelsea Zhu, MD
Billie E. Zidel, MD
Ryan A. Zoldowski, MD
Six months after the Supreme Court decision that overturned the constitutional right to abortion, trainees across the United States are asking a critical question in the current resident recruitment season: How will the restrictions on abortion access affect my training as an obstetrician-gynecologist, and will they impact my ability to be the kind of provider I want to be in the future?
Among the myriad of downstream effects to patient care, the Dobbs decision will indisputably impact the scope of residency training for those that provide reproductive health services. Almost half of ObGyn residents train in states that have abortion restrictions in place.1 New educational milestones for abortion training, which are a requirement by the Accreditation Council for Graduate Medical Education (ACGME), were proposed quickly after Dobbs, guiding programs to offer opportunities for training in nonrestricted areas or the “combination of didactic activities, including simulation” to meet the training requirement in abortion care.2
Like many providers, residents already are grappling with precarious and risky circumstances, balancing patient safety and patient-driven care amidst pre-existing and newly enforced abortion restrictions. Whether managing a patient with an undesired pregnancy, severe medical comorbidities, unexpected pregnancy complications such as preterm premature rupture of membranes, or bleeding, or substantial fetal anomalies, ObGyn residents cannot gain the experience of providing the full scope of reproductive health care without the ability to offer all possible management options. While some enacted abortion restrictions have exceptions for the health of or life-saving measures for the mother, there is no standard guidance for timing of interventions, leaving providers confused and in fear of legal retribution. At a time when trainees should be learning to provide patient-centered, evidence-based care, they are instead paralyzed by the legal or professional consequences they may face for offering their best medical judgements.
Furthermore, the lack of exposure to dilation and evacuation procedures for residents in restricted practice areas will undoubtably decrease their confidence in managing acute complications, which is one of the critical facets of residency training. In a surgical field where repetition is crucial for technical competence, highlighted by ACGME minimum case requirements, the decreased volume of abortion procedures is a disadvantage for trainees and a disservice for patients. While anti-choice promoters may argue that involvement in surgical management of early pregnancy loss should suffice for ObGyn training in family planning, this piecemeal approach will leave gaps in technical skills.
The fear of legal ramifications, moral injury, and inadequate surgical training may lead to the siphoning of talented trainees to areas in the country with fewer restrictions.3Dobbs already has demonstrated how limiting abortion access will deepen inequities in reproductive health care service delivery. Approximately 55% of ObGyn trainees and nearly two-thirds of maternal-fetal medicine graduates join the workforce in the state where they received their training.4 Medical students will seek opportunities for high-quality ObGyn training in areas that will help them to be well-prepared, competent physicians—and more often than not, stay in the area or region that they trained in. This will lead to provider shortages in areas where access to reproductive health care and subspecialist providers already is limited, further exacerbating existing health disparities.
During this recruitment season, trainees and residency programs alike will need to reckon with how the ramifications of Dobbs will alter both the immediate and long-term training in comprehensive reproductive health care for the ObGyn workforce. ObGyn trainees have taken a stand in response to the Dobbs decision, and nearly 750 current residents signed onto the statement below as a commitment to high-quality training and patient-centered care. Clinical experience in performing abortions is essential to the provision of comprehensive evidence-based reproductive health care, and access to these procedures is as important for physicians-in-training as it is for patients.
Actions to take to ensure high-quality abortion training in ObGyn residencies include the following:
- Connect with and stay involved with organizations such as the American College of Obstetricians and Gynecologists (ACOG), Physicians for Reproductive Health (PRH), and Medical Students for Choice (MSFC) for initiatives, toolkits, and resources for training at your institutions.
- Seek specific abortion training opportunities through the Leadership Training Academy (offered through PRH) or the Abortion Training Institute (offered through MSFC).
- Ensure that your residency program meets the ACGME criteria of providing opportunities for clinical experiences for abortion care and work with program leadership at a program, state, or regional level to enforce these competencies.
- Reach out to your local American Civil Liberties Union or other local reproductive legal rights organizations if you want to be involved with advocacy around abortion access and training but have concerns about legal protections.
- Have a voice at the table for empowering training opportunities by seeking leadership positions through ACOG, ACGME, Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics, American Medical Association, Student National Medical Association, and subspecialty organizations.
- Vote in every election and promote voting registration and access to your patients, colleagues, and communities. ●
Continue to: The implications of the Dobbs v Jackson Women’s Health Organization decision on the health care and wellbeing of our patients...
On June 24, 2022, the Supreme Court of the United States ruled in a 6-3 majority decision to overturn the constitutional right to abortion protected by Roe v Wade since 1973. As health care providers, we are outraged at the Court’s disregard for an individual’s right to make reproductive decisions for themselves and their families and are deeply concerned about the devastating consequences to reproductive care and outcomes in this country for all people. Reproductive health decisions, including growing a family and whether or not to continue a pregnancy, are complex and incredibly personal. Our role as health care providers is to help guide those decisions with empathy and evidencebased clinical recommendations. This ruling undermines a patient’s right to bodily autonomy, free of impositions from government and political pressures, and it threatens the sanctity of complex medical decision-making between a patient, their family, and their medical team.
As medical professionals, we know that every patient’s situation is unique—banning abortion procedures ties the hands of physicians trying to provide the most medically appropriate options in a compassionate manner. We know that both medical and surgical abortions are safe and can save lives. These procedures can help patients with potentially life-threatening conditions worsened by pregnancy, a poor prognosis for the fetus, or a complication from the pregnancy itself. Physicians use scientific research and individualized approaches to help patients in unique situations, and attempts to legislate personal health decisions compromise the practice of evidence-based medicine.
We also know that this decision will impact some communities more than others. Access to safe abortion care will become dependent on which region of the country a person lives in and whether or not a person has resources to seek this care. Due to continued systemic racism and oppression, patients of color will be disproportionately impacted and likely will suffer worse health outcomes from unsafe abortions. Those that rely on public insurance or who are uninsured will face overwhelming barriers in seeking abortion services. These disparities in reproductive care, which contribute to our nation’s health crises in maternal morbidity and mortality, unintended pregnancy, and neonatal complications, will further entrench health inequities, and patient lives and livelihoods will suffer.
We acknowledge the impact that this decision will have on restricting access to reproductive care. We stand by the fact that abortion care is health care. We vow to uphold the tenets of our profession to place patient autonomy and provision of safe quality medical care at the forefront of our practices.
We, as health care providers and physician trainees, hereby pledge:
- To continue to provide evidence-based, nonjudgmental counseling for all pregnancy options, including abortion, and support our patients through all reproductive health decisions
- To promote equity in providing comprehensive reproductive health care, recognizing the impacts of systemic racism and oppression
- To promote high quality training in providing safe reproductive care in our respective institutions
- To use our voices in our communities to advocate for all our patients to have the freedom to access the safe and compassionate health care they deserve.
Sincerely,
The undersigned 747 ObGyn resident physicians
Please note that we sign this statement on our own behalf as individuals and not on behalf of our respective institutions.
Orchideh Abar, MD
Laurel S. Aberle, MD
Kathleen E. Ackert, DO
Lauryn Adams, MD
Temiloluwa Adejuyigbe, MD
Oluwatoyosi M. Adeoye, MD
Hufriya Y. Aderianwalla, MD
Fareeza Afzal, MD
Adelaide Agyepong, MD
Erin R. Ahart, MD
Noha T. Ahmed, DO
Faria Ahmed, MD
Tracey O. Akanbi, MD
Eloho E. Akpovi, MD
Austin H. Allen, DO
Amanda M. Allen, MD
Alexis L. Allihien, MD
Jorge L. Alsina, MD
Paulina C. Altshuler, DO
Sivani Aluru, MD
Amal Amir, DO
Jon Anderson, DO
Andreas Antono, MD
Annie N. Apple, MD
Janine Appleton, DO
Aarthi Arab, MD
Sydney R. Archer, MD
Youngeun C. Armbuster, MD
Kara Arnold, MD
Blessing C. Aroh, MD
Savannah Pearson Ayala, MD
Archana K. Ayyar, MD
Ann-Sophie Van Backle, DO
Connor R. Baker, MD
Japjot K. Bal, MD
Abigail E. Barger, MD
Kathryn E. Barron, MD
Silvia Bastea, MD
Samantha V.H. Bayer, MD
Kristen Beierwaltes, MD
Gisel Bello, MD
Michelle A. Benassai, MD
Dana Benyas, MD
Alice F. Berenson, MD
Hanna P. Berlin, MD
Abigail L. Bernard, MD
Eli H. Bernstein, MD
Julia T. Berry, MD
Bryce L. Beyer, MD
Caroline Bilbe, MD
Grace E. Binter, DO
Erin E. Bishop, MD
Sierra G. Bishop, MD
Stephanie S. Bista, MD
Tara E. Bjorklund, DO
Alyssa N. Black, MD
Continue to: Kelsey Boghean, DO...
Kelsey Boghean, DO
Areta Bojko, MD
Grace E. Bommarito, DO
Aditi R. Bommireddy, MD
Genna C. Bonfiglio, MD
Mary E. Booker, MD
Kayce L. Booth, MD
Samantha T. Boothe, DO
William Borenzweig, MD
Rebecca M. Borneman, MD
Alexander L. Boscia, MD
Gina M. Botsko, MD
Glenn P. Boyles, MD
Avery C. Bramnik, MD
Sophia N. Brancazio, MD
Katarina M. Braun, MD
Anthony Brausch, MD
Emily L. Brekke, MD
Sara E. Brenner, MD
Bailey A. Brown, DO
Kathryn S. Brown, MD
Denese C. Brown, MD
Abena Bruce, MD
Sabrina C. Brunozzi, MD
Madison Buchman, DO
Deirdre G. Buckley, MD
Rachel L. Budker, MD
Leeann M. Bui, MD
Anthony H. Bui, MD
Jessie Bujouves, MD
Kimberley A. Bullard, MD
Sophia G. Bunde, MD
Emily R. Burdette, MD
Iris Burgard, DO
Korbi M. Burkey, MD
Lindsey K. Burleson, MD
Lindsay M. Burton, MD
Brianna N. Byers, MD
Stephanie Cai, MD
Alexandra S. Calderon, MD
Alexandra G. Caldwell, MD
Natalia Calzada, MD
Tamara Cameo, MD
Arielle Caplin, MD
Angela M. Carracino, DO
Anna L. Carroll, MD
Leigha M. Carryl, MD
Ashlie S. Carter, MD
Stephanie Casey, DO
Chase W. Cataline, DO
Carson L. Catasus, MD
Alena R. Cave, MD
Kelly M. Chacon, MD
Avis L. Chan, MD
Shruthi Chandra, MD
Jennifer Chang, MD
Shannon Chang, DO
Gillian Chase, MD
Cindy Chen, MD
Jessie C. Chen, MD
Jessica T. Chen, MD
Wenjin Cheng, MB
Laura J. Cheng, MD
Lucy Cheng, MD
Monica S. Choo, MD
Jody S. Chou, MD
Hannah C. Christopher, DO
Continue to: David J. Chromey, DO...
David J. Chromey, DO
Grace V. Clark, MD
Celeste Colegrove, MD
Sarah C. Combs, MD
Victoria L. Conniff, MD
Hannah C. Connor, MD
Angela J. Conway, MD
Steffany A. Conyers, MD
Alexandra Cooke, MD
Ashley A. Cooney, MD
Anna Cornelius-Schecter, MD
Alexa M. Corso, DO
Krysten A. Costley, MD
Madeline Coulter, MD
Kelsey Cramer, MD
Anna E. Cronin, MD
Bethany N. Croyle, DO
Carmen A. Cueto, MD
Nicole Cumbo, MD
Mackenzie A. Cummings, MD
Carrie Cummiskey, MD
Hannah M. Cunningham, MD
Sarah D’Souza, DO
Rachael M. D’Auria, MD
Caitlin Dane, MD
Rachel N. Dang, MD
Talin R. Darian, MD
Abigail C. Davies, MD
Berkley Davis, MD
Lois A. Davis, MD
Jennie J. DeBlanc, MD
Ayana G.R. DeGaia, MD, MPH
Katerina N. DeHaan, MD
Rebekka M. Delgado, MD
Brettany C. DeMier, MD
Bonnie W. DePaso, MD
Hemaxi H. Desai, DO
Amberly T. Diep, MD
Abigail K. Dillaha, MD
Sarah K. Dominguez, MD
Abbey P. Donahue, MD
Allan C. Dong, MD
James Doss, MD
Taylor B. Douglas, MD
Abigail G. Downey, MD
Janelle M. Driscoll, MD
Emily Du, MD
Leslie V. Dunmire, MD
Jennifer Duong, DO
Leigh C. Durudogan, MD
Mai N. Dyer, MD, MPH
Rebecca A. Ebbott, MD
Lindsey P. Eck, MD
Molly C. Eckman, MD
Alex Ede, MD, ScM
Claire E. Edelman, MD
Sara E. Edwards, MD
David J. Eggert, DO
Michelle Eide, MD
Etoroabasi Ekpe, MD
Tressa L. Ellett, MD
Laura Peyton Ellis, MD
Kaitlin H. Ellis, MD
Mariah G. Elly, MD
Jennifer Embry, MD
Claire Englert, MD
Brenna Espelien, MD
Kamilah Evans, MD
Joshua A. Ewy, MD
Elana D. Fackler, MD
Lauren E. Falk, MD
Brianna A. Farley, MD
Amanda Stephanie R. Farrell, MD
Sara Fassio, DO
Daniela A. Febres-Cordero, MD
Jasmin E. Feliciano, MD
Alayna H. Feng, MD
Amanda M. Ferraro, MD
Brittany A. Fickau, MD
Brittany H. File, MD
Shannon M. Finner, DO
Mia E. Fischbein, DO
Briah Fischer, MD
Shira Fishbach, MD
Alison C. Fitzgerald, MD
Evan R. Fitzgerald, MD
Margaret R. Flanigan, MD
Kevin C. Flatley, MD
Jordan A. Fletcher, MD
Claudia E. Flores, MD
Lauren A. Forbes, MD
Rana K. Fowlkes, MD
Jennifer M. Franks, MD, MPH
Christina M. Frasik, MD
Haven N. Frazier, DO
Sarah W. Freeman, MD
Emilie O. Fromm, DO
Anna R. Fuchss, MD
Emma K. Gaboury, MD
Madeline H. Ganz, MD
Lex J. Gardner, MD
Keri-Lee Garel, MD
Hailey B. Gaskamp, DO
Brittney A. Gaudet, MD
Gabrielle M. Gear, MD
Eleanor R. Germano, MD
Lauren G. Gernon, MD
Allen Ghareeb, MD
Patricia Giglio Ayers, MD
Jordana L. Gilman, MD
Mianna M. Gilmore, DO
Brian W. Goddard, MD
Julia L. Goldberg, MD
M. Isabel Gonzaga, MD
Fred P. Gonzales, MD
Lillian H. Goodman, MD, MPH
Ashley Goreshnik, MD
Lauren E. Gottshall, MD
Lindsay L. Gould, MD
Kelsea R. Grant, MD
Dorender A. Gray, MD
Sophie Green, MD
Erica A. Green, MD
Danielle C. Greenberg, MD
Kalin J. Gregory-Davis, MD
David M. Greiner, MD
Tyler M. Gresham, MD
Continue to: Nelly Grigorian, MD...
Nelly Grigorian, MD
Erin L. Grimes, MD
Whitney Grither, MD
Jared M. Grootwassink, MD
Maya E. Gross, MD
Paoula Gueorguieva, MD
Margot M. Gurganus, DO
Rachel L. Gutfreund, MD
Andres Gutierrez, MD
Dorothy L. Hakimian, DO
Ashley N. Hamati, DO
Marie M. Hanna-Wagner, MD
Katie Hansen, MD
Courtney Hargreaves, MD
Stephanie Harlow, MD
Kelsey B. Harper, MD
Devon A. Harris, MD
Lauren E. Harris, MD
Emily S. Hart, DO
Sarah A. Hartley, MD
Becky K. Hartman, MD
Abigail K. Hartmann, MD
Charlotte V. Hastings, MD
Cherise Hatch, DO
Jordan Hauck, DO
Sarena Hayer, MD
Jenna M. Heath, MD
Eric D. Helm, MD
Julie A. Hemphill, MD
Ric A.S. Henderson, MD
Nicola A. Hendricks, MD
Andrea A. Henricks, MD
Jesse M. Herman, DO
Alyssa M. Hernandez, DO
Melissa Hernandez, MD
Alyssa R. Hersh, MD
Alexandra Herweck, MD
Brianna Hickey, MD
Allix M. Hillebrand, MD
Alessandra I. Hirsch, MD
Emily A. Hoffberg, MD
Chloe L. Holmes, DO
Cameron M. Holmes, MD
Helena Y. Hong, MD
Wakako Horiuchi, MD
Shweta Hosakoppal, MD
Jaycee E. Housh, MD
Shannon M. Howard, MD
Meredith C. Huszagh, MD
Yihharn P. Hwang, MD
Emma C. Hyde, MD
Brooke Hyman, MD
Hala Ali Ibrahim, MD
Gnendy Indig, MD
Erin E. Isaacson, MD
Shruti S. Iyer, DO
Audrey J. Jaeger, DO
Shobha Jagannatham, MD
Cyrus M. Jalai, MD
Emma V. James, MD
Isabel Janmey, MD
Phoebe Jen, DO
Corey L. Johnson, MD
Crystal J. Johnson, MD
Andrea M. Johnson, MD
Nat C. Jones, MD
Briana L. Jones, DO
Rebecca J. Josephson, MD
Sarah Natasha Jost-Haynes, MD
Continue to: Hannah S. Juhel, MD...
Hannah S. Juhel, MD
Erin Jun, DO
Katherine B. Kaak, MD
Dhara N. Kadakia, MD
Amanda D. Kadesh, MD
Riana K. Kahlon, MD
Nadi N. Kaonga, MD
Moli Karsalia, MD
Stephanie L. Kass, MD
Amanda M. Katz, MD
Chelsea S. Katz, MD
Virginia Kaufman, MD
Gurpinder Kaur, MD
Jessica A. Keesee, MD
Cassandra N. Kelly, MD
Whitney Kelly, DO
Hannah V. Kennedy, MD
Bethany H. Kette, MD
Iman Khan, MD
Maryam M. Khan, MD
Alisa Jion Kim, MD
Tesia G. Kim, MD
Anne E. Kim, MD
Emily H. King, MD
Tarynne E. Kinghorn, MD
Holly T. Kiper, DO
Thomas Kishkovich, MD
Quinn M. Kistenfeger, MD
Sofia E. Klar, DO
Jessica B. Klugman, MD
Hope E. Knochenhauer, MD
Kathleen J. Koenigs, MD
Olga Kontarovich, DO
Alison Kosmacki, MD
Ana E. Kouri, MD
Olga M. Kovalenko, MD
Leigh T. Kowalski, MD
Kayla A. Krajick, MD
Elizabeth S. Kravitz, MD
Shruti Rani Kumar, MD
Alyssa Kurtz, DO
Lauren H. Kus, MD
Arkadiy Kusayev, DO
Amanda E. Lacue, MD
Nava Lalehzari, MD
Amber Lalla, MD
Allie C. Lamari, DO
Kelly L. Lamiman, MD
Stephen Lammers, MD
Monet Lane, MD
Madeline L. Lang, MD
Liana Langdon-Embry, MD
Carolyn Larkins, MD
Leah E. Larson, MD
Matthew W. Lee, MD
Eunjae Lee, MD
Alice Lee, MD
Jared Z. Lee, MD
Charlotte M. Lee, MD
Nicole R. Legro, MD
Aurora Leibold, MD
Rosiris Leon-Rivera, MD, PhD
Anna M. Leone, MD
Keiko M. Leong, MD
Lindsey M. LePoidevin, MD
Molly E. Levine, MD
Khrystyna Levytska, MD
Dana L. Lewis, DO
Jessica L. Li, MD
Kristina Lilja, MD
Deanna M. Lines, DO
Annalise Littman, MD
Julia F. Liu, MD
Tyler B. Lloyd, MD
Alyssa Lo, MD
K’ara A. Locke, MD
Minica Long, MD
Melissa Lopez, MD
Wilfredo A. Lopez, MD
Connie F. Lu, MD
Tyler J. Lueck, MD
Katherine L. Lukas, MD
Davlyn L. Luke, MD
Shani Ma, MD
Colton Mabis, MD
Lauren T. MacNeill, MD
Rachel Madding, MD
Mona Makhamreh, MD
Francesca R. Mancuso, MD
Kelsey L. Manfredi, MD
Valeria Mantilla, MD
Kaitlin M. Mar, MD
Starcher R. Margaret, MD
Audrey M. Marinelli, MD
Brittany A. Marinelli, MD
Emily S. Markovic, MD
Hannah L. Marshall, MD
Aaron Masjedi, MD
Isabelle M. Mason, MD
Akailah T. Mason-Otey, MD
Nicole Massad, MD
Megan M. Masten, MD
Stephanie M. Masters, MD
Anastasia Matthews, MD
Natalia del Mazo, MD
Sara A. McAllaster, MD
Continue to: Nicole McAndrew, DO...
Nicole McAndrew, DO
Madeline G. McCosker, MD
Jamie L. McDowell, DO
Christine E. McGough, MD
Mackenzi R. McHugh, MD
Madeline M. McIntire, MD
Cynthia R. McKinney, MD
Kirsten D. McLane, MD
Shian F. McLeish, MD
Megan I. McNitt, MD
Sarah R. McShane, MD
Grace R. Meade, MD
Nikki Ann R. Medina, DO
Tiffany L. Mei, MD
Jenna Meiman, MD
Anna M. Melicher, MD
Rosa M. Mendez, MD
Riley Mickelsen, MD
Sage A. Mikami, MD
Aletheia B. Millien, MD
Hannah C. Milthorpe, MD
Caroline J. Min, MD
Julie A. Mina, MD
Annie G. Minns, MD
Natalie Mironov, DO
Elizabeth L. Mirsky, MD
Astha Mittal, MD
Rachel E. Mnuk, MD
Silki Modi, MD
Sudarshan J. Mohan, MD
Roxana Mohhebali-Solis, MD
Mugdha V. Mokashi, MD
Jessica A. Montgomery, MD
Ellen Moore, MD
Savannah J. Morehouse, MD
Kristen L. Moriarty, MD
Alexa P. Morrison, MD
Bijan Morshedi, MD
Matthew H. Mossayebi, MD
Kathy Mostajeran, DO
Sharan Mullen, DO
Ellen C. Murphy, MD
Emma Chew Murphy, MD
Lauren M. Murphy, MD
Bria Murray, MD
Erin C. Nacev, MD
Preetha Nandi, MD
Blaire E. Nasstrom, DO
Hallie N. Nelson, MD
Katherine A. Nelson, MD
Margaret S. Nemetz, MD
Daniela Ben Neriah, DO
Cosima M. Neumann, MD
Mollie H. Newbern, DO
Gisella M. Newbery, MD
Stephanie Nguyen, MD
Christine G.T. Nguyen, MD
Desiree Nguyen, MD
Jacqueline W. Nichols, MD
Annika M. Nilsen, MD
Margaret A. Nixon, MD
Emily M. Norkett, MD
Allison N. Nostrant, DO
Susan E. Nourse, MD
Aliya S. Nurani, MD
Emily E. Nuss, MD
Jeanne O. Nwagwu, DO
Kelsey E. O’Hagan, MD
Margaret O’Neill, MD
Emily A. O’Brien, MD
Carly M. O’Connor-Terry, MD, MS
Madison O. Odom, MD
Cynthia I. Okot-Kotber, MD
Sarah P. Oliver, MD
Leanne P. Ondreicka, MD
Ngozika G. Onyiuke, MD
Erika Gonzalez Osorio, MD
Marika L. Osterbur Badhey, MD
Linda A. Otieno, MD
Claire H. Packer, MD
Chloe W. Page, DO
Marissa Palmor, MD
Rishitha Panditi, MD
Katherine A. Panushka, MD
Kelsey J. Pape, MD
Rachel R. Paquette, DO
Hillary C. Park, DO
Kendall M. Parrott, MD
Ekta Partani, MD
Karishma Patel, MD
Shivani Patel, MD
Continue to: Priya Patel, MD...
Priya Patel, MD
Jenna M. Patterson, MD
Ashleigh Pavlovic, MD
Katie M. Peagler, MD
Katherine T. Pellino, MD
Nicholas Per, MD
Elana Perry, MD
Emily J. Peters, MD
Sara E. Peterson, MD
Michelle R. Petrich, MD
Destiny L. Phillips, MD
Chloe Phillips, MD
Megan E. Piacquadio, DO
Sara C. Pierpoint, MD
Celeste M. Pilato, MD
Emma Pindra, MD
Minerva L.R. Pineda, MD
Rebecca Pisan, MD
Alessandra R. Piscina, MD
Rachael Piver, MD
Andrew J. Polio, MD
Hector S. Porragas, MD
Natalie Posever, MD
Allison R. Powell, MD
Mahima V. Prasad, MD
Angelina D. Prat, DO
Rebecca L. Purvis, MD
Teresa L. Qi, MD
Nicholas R. Quam, MD
Candice A. Quarella, MD
Nicholas W. Racchi, DO
Jeannie G. Radoc, MD
Samuel Raine, MD
Anna C. Raines, MD
Stephanie A. Rains, MD
Nicole M. Rainville, DO
Karissa Rajagopal, DO
Kristian R. Ramage, MD
Praveen Ramesh, MD
Tia M. Ramirez, MD
Jania Ramos, MD
Neel K. Rana, MD
Urvi Rana, DO
Indira Ranaweera, MD
Sindhuja Ranganathan, DO
Chloe R. Rasmussen, MD
Laura P. Reguero-Cadilla, MD
Devin M. Reilly, MD
Kimberly E. Reimold, MD
Cory R. Reiter, MD, PhD
Maya E. Reuven, DO
Jessica Reyes-Peterson, MD
Jacqueline Rice, MD
Rebecca L. Richardson, MD
Mikaela J. Rico, DO
Katelyn Rittenhouse, MD
Giuliana A. Rivera Casul, MD
Jill N.T. Roberts, MD
Luke N. Roberts, MD
Esther Robin, MD
Marcella Israel Rocha, MD
Zoe A. Roecker, MD
Hilary E. Rogers, MD
Kelsey A. Roof, MD
Zarah Rosen, MD
Cecilia M. Rossi, MD
Eva S. Rostonics, MD
Felix Rubio, MD
Amela Rugova, MD
Anna J. Rujan, MD
Erika T. Russ, MD
Colin Russell, MD
Ruby L. Russell, MD
Isabella A. Sabatina, MD
Gouri Sadananda, MD
Aashna Saini, MD
Salomeh M. Salari, MD
Ndeye N. Sall, MD
Nicole M. Salvador, MD
Aayushi Sardana, MD
Kendall M. Sarson, MD
Rita Abigail Sartor, MD
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Haley A. Scarbrough, MD
Kimberly Schaefer, MD
Demetra Schermerhorn, MD
Ellen C. Schleckman, MD
Maura A. Schlussel, MD
Ellie Schmidt, MD
Alison M. Schmidt, MD
Evan A. Schrader, MD
Morgan A. Schriever, MD
Brianna L. Schumaker Nguyen, DO
Whitney E. Scott, MD
Claire Scrivani, MD
Catherine E. Seaman, MD
Rachel D. Seaman, MD
Danielle J. Seltzer, MD
Joshua R. Shaffer, MD
Emily A. Shaffer, MD
Delia S. Shash, MD
Ishana P. Shetty, MD
Tushar Shetty, MD
Carol Shi, MD
Sarah P. Shim, MD
Emma C. Siewert, MD
Seth M. Sigler, DO
Rebecca L. SigourneyTennyck, MD
Daniella D. Silvino, DO
Andrea M. Simi, MD
Amelia R. Simmons, MD
Amy E. Skeels, DO
Ashley E.S. Keith, MD
Hannah C. Smerker, DO
Katarina Smigoc, MD
Madeline I. Smith, MD
Jessica D. Smith, MD
Melanie R. Smith, MD
Alicia L. Smith, MD
Chloe Smith, MD
Ayanna Smith, MD
Melanie R. Smith, MD
Megan M. Smith, MD
Haverly J. Snyder, MD
Beatrice R. Soderholm, DO
Brianna C. Sohl, MD
Samantha A. Solaru, MD
Michael Solotke, MD
Dara A.H. Som, MD
Alexandra R. Sotiros-Lowry, MD
Melanie Spall, DO
Alicia C. Speak, DO
Lisa M. Spencer, MD
Prakrithi Srinand, MD
Sierra M. Starr, MD
Kathryne E. Staudinger, MD
Emily K. Steele, MD
Morgan R. Steffen, DO
Tricia R. Stepanek, MD
Taylor P. Stewart, MD
Kelsey A. Stewart, MD
Alyssa M. Stiff, MD
Alexandra B. Stiles, MD
Nairi K. Strauch, MD
Margaret J. Stroup, DO
Sean C. Stuart, DO
Hannah M. Stump, MD
Shalini B. Subbarao, MD
Lakshmi Subramani, MD
Heather E. Sweeney, MD
Kristin I. Swope, MD
Suha Syed, MD
Mireya P. Taboada, MD
Eneti S. Tagaloa, MD
Rachel Tang, DO
Adam R. Taylor, MD
Simone R. Thibault, MD
Kimberly A. Thill, MD
Dhanu Thiyag, MD
Andrew T. Thornton, MD
Wendy Tian, MD
Stephanie Tilberry, MD
Amanda L. Tillett, MD
Amanda M. Tjitro, MD
Logan P. Todhunter, DO
David Toffey, MD
Maris K. Toland, MD
Rachel E. Tomassi, MD
Sarah Tounsi, MD
Antonia K. Traina, MD
Taylor Tran, MD
Diem Samantha Tran, DO
Emily C. Trautner, MD
Emma Trawick, MD
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Elissa Trieu, MD
Ariel Trilling, MD
Samantha Truong, MD
Mary M. Tsaturian, MD
Athena Tudino, MD
Kati A. Turner, MD
Nicole-Marie Tuzinkiewicz, MD
Gayathri D. Vadlamudi, MD
Stylianos Vagios, MD
Pauline V. Van Dijck, DO
Kaylee A. VanDommelen, MD
Isha B. Vasudeva, MD
Shivani J. Vasudeva, DO
Diana Q. Vazquez Parker, MD
Ridhima Vemula, MD
Elena C. Vinopal, MD
Caroline J. Violette, MD
Pascal T. Vo, DO
Michelle H. Vu, MD
Macy M. Walz, MD
Angelia Wang, MD
Eileen Wang, MD
Courtney Y. Wang, MD
Joyce Wang, MD
Meryl G. Warshafsky, MD
Sophie E.N. Weinstein, MD
Sarah H. Weinstein, MD
Annalyn M. Welp, MD
Shannon M. Wentworth, MD
Erika M. Wert, MD
Rachel C. White, MBchB
Morgan N. Wilhoite, DO
Mercedes Williams, MD
Hayley Williams, MD
Jacquelyn D. Williams, MD
Mary H. Williamson, MD
Elise Wilson, MD
Lauren M. Witchey, MD
Emily A. Wolverton, MD
Stephanie Y. Wong, MD
Jenny Wu, MD
Jackie Xiang, MD
Nancy S. Yang, MD
Kevin P. Yeagle, MD
Halina M. Yee, MD
Alyssa M. Yeung, MD
Samuel K. Yost, MD
Megan Yuen, MD
Nayab Zafar, DO
Cindy X. Zhang, DO
Yingao Zhang, MD
Helen Zhao, MD
Chelsea Zhu, MD
Billie E. Zidel, MD
Ryan A. Zoldowski, MD
- Vinekar K, Karlapudi A, Nathan L, et al. Projected implications of overturning Roe v Wade on abortion training in US obstetrics and gynecology residency programs. Obstet Gynecol. 2022;140:146-149.
- ACGME program requirements for graduate medical education in obstetrics and gynecology summary and impact of interim requirement revisions. ACGME website. Accessed December 18, 2022. https://www.acgme.org/globalassets/pfassets/reviewandcomment/220_obstetricsandgynecology_2022-06-24_impact.pdf
- Crear-Perry J, Hassan A, Daniel S. Advancing birth equity in a post-Dobbs US. JAMA. 2022;328:1689-1690.
- Report on residents. AAMC website. Accessed December 18, 2022. https://www.aamc.org/data-reports/students-residents/interactive-data/report-residents/2021/table-c4-physician-reten tion-state-residency-training-last-completed-gme
- Vinekar K, Karlapudi A, Nathan L, et al. Projected implications of overturning Roe v Wade on abortion training in US obstetrics and gynecology residency programs. Obstet Gynecol. 2022;140:146-149.
- ACGME program requirements for graduate medical education in obstetrics and gynecology summary and impact of interim requirement revisions. ACGME website. Accessed December 18, 2022. https://www.acgme.org/globalassets/pfassets/reviewandcomment/220_obstetricsandgynecology_2022-06-24_impact.pdf
- Crear-Perry J, Hassan A, Daniel S. Advancing birth equity in a post-Dobbs US. JAMA. 2022;328:1689-1690.
- Report on residents. AAMC website. Accessed December 18, 2022. https://www.aamc.org/data-reports/students-residents/interactive-data/report-residents/2021/table-c4-physician-reten tion-state-residency-training-last-completed-gme
Confronting the epidemic of racism in ObGyn practice
CASE Black woman in stable labor expresses fear
A 29-year-old Black woman (G1) at 39 0/7 weeks’ gestation presents to your labor and delivery unit reporting leaking fluid and contractions. She is found to have ruptured membranes and reassuring fetal testing. Her cervix is 4 cm dilated, and you recommend admission for expectant management of labor. She is otherwise healthy and has no significant medical history.
As you are finishing admitting this patient, you ask if she has any remaining questions. She asks quietly, “Am I going to die today?”
You provide reassurance of her stable clinical picture, then pause and ask the patient about her fears. She looks at you and says, “They didn’t believe Serena Williams, so why would they believe me?”
Your patient is referencing Serena Williams’ harrowing and public postpartum course, complicated by a pulmonary embolism and several reoperations.1 While many of us in the medical field may read this account as a story of challenges with an ultimate triumph, many expectant Black mothers hold Serena’s experience as a cautionary tale about deep-rooted inequities in our health care system that lead to potentially dangerous outcomes.
Disparities in care
They are right to be concerned. In the United States, Black mothers are 4 times more likely to die during or after pregnancy, mostly from preventable causes,2 and nearly 50% more likely to have a preterm delivery.3 These disparities extend beyond the delivery room to all aspects of ObGyn care. Black women are 2 to 3 times more likely to die from cervical cancer, and they are more likely to be diagnosed at a later stage, thus rendering treatment less effective.4 Black patients also have a higher burden of obesity, diabetes, and cardiac disease, and when they present to the hospital, receive evidence-based treatment at lower rates compared with White patients.5
Mourning the deaths of Ahmaud Arbery, Breonna Taylor, and George Floyd, amongst the many other Black lives taken unjustly in the United States, has highlighted egregious practices against people of color embedded within the systems meant to protect and serve our communities. We as ObGyn physicians must take professional onus to recognize a devastating but humbling truth—systemic racism has long pervaded our health care practices and systems, and now more than ever, we must do more to stand by and for our patients.
As ObGyns, we help support patients through some of the happiest, most vulnerable, and potentially most dire moments of their lives. We help patients through the birth of their children, reproductive struggles, gynecologic concerns, and cancer diagnoses. Many of us chose this field for the privilege of caring for patients at these critical moments in their lives, but we have often neglected the racism present in our practices, our hospital settings, and the medical system itself. We often fail to acknowledge our own implicit bias and the role that we play in contributing to acts and experiences of racism that our patients and our colleagues face on a daily basis.
Racism in our origins
The history of obstetrics and gynecology shows us a long record of physicians perpetrating injustices that target marginalized communities of color. Dr. James Sims, often given the title of “father of modern gynecology,” performed numerous experiments on unanesthetized Black female slaves to develop procedures for fistulae repair and other surgical techniques.6 Throughout the twentieth century, dating as recent as 1979, state laws written in the name of public safety forcibly sterilized women of color to control an “undesirable population.”7 When a patient of color declines a method of long-acting reversible contraception, birth control pills, or tubal ligation, do you take the time to reflect on the potential context of the patient’s decision?
It is critical to recognize the legacy that these acts have on our patients today, leading to a higher burden of disease and an understandable distrust of the medical system. The uncovering of the unethical practices of the National Institutions of Health‒funded Tuskegee syphilis study, in which hundreds of Black men with latent syphilis were passively monitored despite the knowledge of a proven treatment, has attributed to a measurable decrease in life expectancy among Black males.8 Even as we face the COVID-19 pandemic, the undercurrent of racism continues to do harm. Black patients are 5 times more likely to be hospitalized with COVID-19 than their White counterparts. This disparity, in part, is a product of a higher burden of comorbidities and the privilege associated with shelter-in-place policies, which disproportionately strain communities of color.9
We as a medical community need to do better for our patients. No matter how difficult to confront, each of us must acknowledge our own biases and our duty to combat persistent and perpetual racism in our medical system. We need to commit to amplifying the voices of our Black patients and colleagues. It is not enough to celebrate diversity for performance sake—it is time to recognize that diversity saves lives.
We have a responsibility to rectify these traditions of injustice and work toward a safer, more equitable, healthy future for our patients and their families. While this pledge may seem daunting, changes at individual and systems levels can make a difference for all patients that come through our doors. In addition, to honor our oath to “do no harm,” we must act; Black lives matter, and we are charged as medical providers to help our patients thrive, especially those from historically oppressed communities and who continue to suffer inexcusable injustices in health care and beyond.
Take action
Here is a collection of ways to institute an antiracist environment and more equitable care for your patients.
Self-reflect and educate
- Learn about the role racism plays in ObGyn and modern medicine. One place to start: read “Medical Bondage: Race, Gender and the Origins of American Gynecology” by Deidre Cooper Owens. Also check out articles and key readings curated by the Black Mamas Matter Alliance.
- Introduce and sustain antiracism training for all staff in your clinic or hospital system. To start, consider taking these free and quick implicit bias tests at a staff or department meeting.
- Familiarize yourself and your colleagues with facets of reproductive justice—the human right to have children, to not have children, and to nurture children in a safe and healthy environment—and incorporate these values in your practice. Request trainings in reproductive justice from community groups like Sister Song.
- Sign up for updates for state and national bills addressing health inequity and access to reproductive health services. Show your support by calling your congress-people, testifying, or donating to a cause that promotes these bills. You can stay up to date on national issues with government affairs newsletters from the American College of Obstetricians and Gynecologists. Sign up here.
- Continue the conversation and re-evaluate your personal and institution’s efforts to combat racism and social and reproductive injustices.
Provide access to high-quality reproductive health care
- Ask your patients what barriers they faced to come to your clinic and receive the care they needed. Consider incorporating the following screening tools regarding social determinants of health: PRAPARE screening tool, AAFP screening tool.
- Promote access to insurance and support programs, including nutrition, exercise and wellness, and safe home and school environments. Look up resources available to your patients by their zip codes using AAFP’s Neighborhood Navigator.
- Help patients access their medications at affordable prices in their neighborhoods by using free apps. Use the GoodRx app to identify discounts for prescriptions at various pharmacies, and search the Bedsider app to find out how your patients can get their birth control for free and delivered to their homes.
- Expand access to language services for patients who do not speak English as their first language. If working in a resource-limited setting, use the Google Translate app. Print out these free handouts for birth control fact sheets in different languages.
- Establish standardized protocols for common treatment paradigms to reduce the influence of bias in clinical scenarios. For example, institute a protocol for managing postoperative pain to ensure equal access to treatment.
- Institute the AIM (Alliance for Innovation on Maternal Health) patient safety bundle on the Reduction of Peripartum Racial/Ethnic Disparities. Learn more about AIM’s maternal safety and quality improvement initiative to reduce maternal morbidity and mortality here.
Support a diverse workforce
- Designate and/or hire a Diversity and Inclusion Officer at your institution to ensure that hiring practices actively achieve a diverse workforce and that employees feel supported in the work environment. Consider coalition-building between hospitals, like the UPHS-CHOP Alliance of Minority Physicians.
- Recruit diverse applicants by advertising positions to groups that focus on the advancement of underrepresented minorities in medicine. Engage with your local chapter of the National Medical Association and American Medical Women’s Association.
- Have a system in place for anonymous reporting of incidents involving bias or discrimination against staff, and develop a protocol to ensure action is taken in case of such incidents.
- Institute a recurring conference or Grand Rounds across disciplines to discuss the impacts of bias and discrimination on patients and providers at your institution. View examples of these conferences here.
- Ensure invited speakers and other educational opportunities are comprised of diverse representation.
- Create a work environment with safe spaces for the discussion of racism, discrimination, and bias.
- Haskell R. Serena Williams on motherhood, marriage, and making her comeback. January 10, 2018. https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018. Accessed July 1, 2020.
- Louis JM, Menard MK, Gee RE. Racial and ethnic disparities in maternal morbidity and mortality. Obstet Gynecol. 2015;125:690-694.
- Sigurdson K, Mitchell B, Liu J, et al. Racial/ethnic disparities in neonatal intensive care: a systematic review. Pediatrics. 2019;144:e20183114.
- Garner EI. Cervical cancer: disparities in screening, treatment, and survival. Cancer Epidemiol Biomarkers Prev. 2003;12:242s-247s.
- Arora S, Stouffer GA, Kucharska‐Newton A, et al. Fifteen‐year trends in management and outcomes of non–ST‐segment–elevation myocardial infarction among black and white patients: the ARIC community surveillance study, 2000–2014. J Am Heart Assoc. 2018;7:e010203.
- Zellars R. Black subjectivity and the origins of American gynecology. May 31, 2018. https://www.aaihs.org/black-subjectivity-and-the-origins-of-american-gynecology/. Accessed June 28, 2020.
- Ko K. Unwanted sterilization and eugenics programs in the United States. January 29, 2016. https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenics-programs-in-the-united-states/. Accessed June 28, 2020.
- Alsan M, Wanamaker M. Tuskegee and the health of black men. Q J Econ. 2018;133:407-455.
- Hooper MW, Nápoles AM, Pérez-Stable EJ. COVID-19 and racial/ethnic disparities. JAMA. 2020 May 11. doi: 10.1001/jama.2020.8598.
CASE Black woman in stable labor expresses fear
A 29-year-old Black woman (G1) at 39 0/7 weeks’ gestation presents to your labor and delivery unit reporting leaking fluid and contractions. She is found to have ruptured membranes and reassuring fetal testing. Her cervix is 4 cm dilated, and you recommend admission for expectant management of labor. She is otherwise healthy and has no significant medical history.
As you are finishing admitting this patient, you ask if she has any remaining questions. She asks quietly, “Am I going to die today?”
You provide reassurance of her stable clinical picture, then pause and ask the patient about her fears. She looks at you and says, “They didn’t believe Serena Williams, so why would they believe me?”
Your patient is referencing Serena Williams’ harrowing and public postpartum course, complicated by a pulmonary embolism and several reoperations.1 While many of us in the medical field may read this account as a story of challenges with an ultimate triumph, many expectant Black mothers hold Serena’s experience as a cautionary tale about deep-rooted inequities in our health care system that lead to potentially dangerous outcomes.
Disparities in care
They are right to be concerned. In the United States, Black mothers are 4 times more likely to die during or after pregnancy, mostly from preventable causes,2 and nearly 50% more likely to have a preterm delivery.3 These disparities extend beyond the delivery room to all aspects of ObGyn care. Black women are 2 to 3 times more likely to die from cervical cancer, and they are more likely to be diagnosed at a later stage, thus rendering treatment less effective.4 Black patients also have a higher burden of obesity, diabetes, and cardiac disease, and when they present to the hospital, receive evidence-based treatment at lower rates compared with White patients.5
Mourning the deaths of Ahmaud Arbery, Breonna Taylor, and George Floyd, amongst the many other Black lives taken unjustly in the United States, has highlighted egregious practices against people of color embedded within the systems meant to protect and serve our communities. We as ObGyn physicians must take professional onus to recognize a devastating but humbling truth—systemic racism has long pervaded our health care practices and systems, and now more than ever, we must do more to stand by and for our patients.
As ObGyns, we help support patients through some of the happiest, most vulnerable, and potentially most dire moments of their lives. We help patients through the birth of their children, reproductive struggles, gynecologic concerns, and cancer diagnoses. Many of us chose this field for the privilege of caring for patients at these critical moments in their lives, but we have often neglected the racism present in our practices, our hospital settings, and the medical system itself. We often fail to acknowledge our own implicit bias and the role that we play in contributing to acts and experiences of racism that our patients and our colleagues face on a daily basis.
Racism in our origins
The history of obstetrics and gynecology shows us a long record of physicians perpetrating injustices that target marginalized communities of color. Dr. James Sims, often given the title of “father of modern gynecology,” performed numerous experiments on unanesthetized Black female slaves to develop procedures for fistulae repair and other surgical techniques.6 Throughout the twentieth century, dating as recent as 1979, state laws written in the name of public safety forcibly sterilized women of color to control an “undesirable population.”7 When a patient of color declines a method of long-acting reversible contraception, birth control pills, or tubal ligation, do you take the time to reflect on the potential context of the patient’s decision?
It is critical to recognize the legacy that these acts have on our patients today, leading to a higher burden of disease and an understandable distrust of the medical system. The uncovering of the unethical practices of the National Institutions of Health‒funded Tuskegee syphilis study, in which hundreds of Black men with latent syphilis were passively monitored despite the knowledge of a proven treatment, has attributed to a measurable decrease in life expectancy among Black males.8 Even as we face the COVID-19 pandemic, the undercurrent of racism continues to do harm. Black patients are 5 times more likely to be hospitalized with COVID-19 than their White counterparts. This disparity, in part, is a product of a higher burden of comorbidities and the privilege associated with shelter-in-place policies, which disproportionately strain communities of color.9
We as a medical community need to do better for our patients. No matter how difficult to confront, each of us must acknowledge our own biases and our duty to combat persistent and perpetual racism in our medical system. We need to commit to amplifying the voices of our Black patients and colleagues. It is not enough to celebrate diversity for performance sake—it is time to recognize that diversity saves lives.
We have a responsibility to rectify these traditions of injustice and work toward a safer, more equitable, healthy future for our patients and their families. While this pledge may seem daunting, changes at individual and systems levels can make a difference for all patients that come through our doors. In addition, to honor our oath to “do no harm,” we must act; Black lives matter, and we are charged as medical providers to help our patients thrive, especially those from historically oppressed communities and who continue to suffer inexcusable injustices in health care and beyond.
Take action
Here is a collection of ways to institute an antiracist environment and more equitable care for your patients.
Self-reflect and educate
- Learn about the role racism plays in ObGyn and modern medicine. One place to start: read “Medical Bondage: Race, Gender and the Origins of American Gynecology” by Deidre Cooper Owens. Also check out articles and key readings curated by the Black Mamas Matter Alliance.
- Introduce and sustain antiracism training for all staff in your clinic or hospital system. To start, consider taking these free and quick implicit bias tests at a staff or department meeting.
- Familiarize yourself and your colleagues with facets of reproductive justice—the human right to have children, to not have children, and to nurture children in a safe and healthy environment—and incorporate these values in your practice. Request trainings in reproductive justice from community groups like Sister Song.
- Sign up for updates for state and national bills addressing health inequity and access to reproductive health services. Show your support by calling your congress-people, testifying, or donating to a cause that promotes these bills. You can stay up to date on national issues with government affairs newsletters from the American College of Obstetricians and Gynecologists. Sign up here.
- Continue the conversation and re-evaluate your personal and institution’s efforts to combat racism and social and reproductive injustices.
Provide access to high-quality reproductive health care
- Ask your patients what barriers they faced to come to your clinic and receive the care they needed. Consider incorporating the following screening tools regarding social determinants of health: PRAPARE screening tool, AAFP screening tool.
- Promote access to insurance and support programs, including nutrition, exercise and wellness, and safe home and school environments. Look up resources available to your patients by their zip codes using AAFP’s Neighborhood Navigator.
- Help patients access their medications at affordable prices in their neighborhoods by using free apps. Use the GoodRx app to identify discounts for prescriptions at various pharmacies, and search the Bedsider app to find out how your patients can get their birth control for free and delivered to their homes.
- Expand access to language services for patients who do not speak English as their first language. If working in a resource-limited setting, use the Google Translate app. Print out these free handouts for birth control fact sheets in different languages.
- Establish standardized protocols for common treatment paradigms to reduce the influence of bias in clinical scenarios. For example, institute a protocol for managing postoperative pain to ensure equal access to treatment.
- Institute the AIM (Alliance for Innovation on Maternal Health) patient safety bundle on the Reduction of Peripartum Racial/Ethnic Disparities. Learn more about AIM’s maternal safety and quality improvement initiative to reduce maternal morbidity and mortality here.
Support a diverse workforce
- Designate and/or hire a Diversity and Inclusion Officer at your institution to ensure that hiring practices actively achieve a diverse workforce and that employees feel supported in the work environment. Consider coalition-building between hospitals, like the UPHS-CHOP Alliance of Minority Physicians.
- Recruit diverse applicants by advertising positions to groups that focus on the advancement of underrepresented minorities in medicine. Engage with your local chapter of the National Medical Association and American Medical Women’s Association.
- Have a system in place for anonymous reporting of incidents involving bias or discrimination against staff, and develop a protocol to ensure action is taken in case of such incidents.
- Institute a recurring conference or Grand Rounds across disciplines to discuss the impacts of bias and discrimination on patients and providers at your institution. View examples of these conferences here.
- Ensure invited speakers and other educational opportunities are comprised of diverse representation.
- Create a work environment with safe spaces for the discussion of racism, discrimination, and bias.
CASE Black woman in stable labor expresses fear
A 29-year-old Black woman (G1) at 39 0/7 weeks’ gestation presents to your labor and delivery unit reporting leaking fluid and contractions. She is found to have ruptured membranes and reassuring fetal testing. Her cervix is 4 cm dilated, and you recommend admission for expectant management of labor. She is otherwise healthy and has no significant medical history.
As you are finishing admitting this patient, you ask if she has any remaining questions. She asks quietly, “Am I going to die today?”
You provide reassurance of her stable clinical picture, then pause and ask the patient about her fears. She looks at you and says, “They didn’t believe Serena Williams, so why would they believe me?”
Your patient is referencing Serena Williams’ harrowing and public postpartum course, complicated by a pulmonary embolism and several reoperations.1 While many of us in the medical field may read this account as a story of challenges with an ultimate triumph, many expectant Black mothers hold Serena’s experience as a cautionary tale about deep-rooted inequities in our health care system that lead to potentially dangerous outcomes.
Disparities in care
They are right to be concerned. In the United States, Black mothers are 4 times more likely to die during or after pregnancy, mostly from preventable causes,2 and nearly 50% more likely to have a preterm delivery.3 These disparities extend beyond the delivery room to all aspects of ObGyn care. Black women are 2 to 3 times more likely to die from cervical cancer, and they are more likely to be diagnosed at a later stage, thus rendering treatment less effective.4 Black patients also have a higher burden of obesity, diabetes, and cardiac disease, and when they present to the hospital, receive evidence-based treatment at lower rates compared with White patients.5
Mourning the deaths of Ahmaud Arbery, Breonna Taylor, and George Floyd, amongst the many other Black lives taken unjustly in the United States, has highlighted egregious practices against people of color embedded within the systems meant to protect and serve our communities. We as ObGyn physicians must take professional onus to recognize a devastating but humbling truth—systemic racism has long pervaded our health care practices and systems, and now more than ever, we must do more to stand by and for our patients.
As ObGyns, we help support patients through some of the happiest, most vulnerable, and potentially most dire moments of their lives. We help patients through the birth of their children, reproductive struggles, gynecologic concerns, and cancer diagnoses. Many of us chose this field for the privilege of caring for patients at these critical moments in their lives, but we have often neglected the racism present in our practices, our hospital settings, and the medical system itself. We often fail to acknowledge our own implicit bias and the role that we play in contributing to acts and experiences of racism that our patients and our colleagues face on a daily basis.
Racism in our origins
The history of obstetrics and gynecology shows us a long record of physicians perpetrating injustices that target marginalized communities of color. Dr. James Sims, often given the title of “father of modern gynecology,” performed numerous experiments on unanesthetized Black female slaves to develop procedures for fistulae repair and other surgical techniques.6 Throughout the twentieth century, dating as recent as 1979, state laws written in the name of public safety forcibly sterilized women of color to control an “undesirable population.”7 When a patient of color declines a method of long-acting reversible contraception, birth control pills, or tubal ligation, do you take the time to reflect on the potential context of the patient’s decision?
It is critical to recognize the legacy that these acts have on our patients today, leading to a higher burden of disease and an understandable distrust of the medical system. The uncovering of the unethical practices of the National Institutions of Health‒funded Tuskegee syphilis study, in which hundreds of Black men with latent syphilis were passively monitored despite the knowledge of a proven treatment, has attributed to a measurable decrease in life expectancy among Black males.8 Even as we face the COVID-19 pandemic, the undercurrent of racism continues to do harm. Black patients are 5 times more likely to be hospitalized with COVID-19 than their White counterparts. This disparity, in part, is a product of a higher burden of comorbidities and the privilege associated with shelter-in-place policies, which disproportionately strain communities of color.9
We as a medical community need to do better for our patients. No matter how difficult to confront, each of us must acknowledge our own biases and our duty to combat persistent and perpetual racism in our medical system. We need to commit to amplifying the voices of our Black patients and colleagues. It is not enough to celebrate diversity for performance sake—it is time to recognize that diversity saves lives.
We have a responsibility to rectify these traditions of injustice and work toward a safer, more equitable, healthy future for our patients and their families. While this pledge may seem daunting, changes at individual and systems levels can make a difference for all patients that come through our doors. In addition, to honor our oath to “do no harm,” we must act; Black lives matter, and we are charged as medical providers to help our patients thrive, especially those from historically oppressed communities and who continue to suffer inexcusable injustices in health care and beyond.
Take action
Here is a collection of ways to institute an antiracist environment and more equitable care for your patients.
Self-reflect and educate
- Learn about the role racism plays in ObGyn and modern medicine. One place to start: read “Medical Bondage: Race, Gender and the Origins of American Gynecology” by Deidre Cooper Owens. Also check out articles and key readings curated by the Black Mamas Matter Alliance.
- Introduce and sustain antiracism training for all staff in your clinic or hospital system. To start, consider taking these free and quick implicit bias tests at a staff or department meeting.
- Familiarize yourself and your colleagues with facets of reproductive justice—the human right to have children, to not have children, and to nurture children in a safe and healthy environment—and incorporate these values in your practice. Request trainings in reproductive justice from community groups like Sister Song.
- Sign up for updates for state and national bills addressing health inequity and access to reproductive health services. Show your support by calling your congress-people, testifying, or donating to a cause that promotes these bills. You can stay up to date on national issues with government affairs newsletters from the American College of Obstetricians and Gynecologists. Sign up here.
- Continue the conversation and re-evaluate your personal and institution’s efforts to combat racism and social and reproductive injustices.
Provide access to high-quality reproductive health care
- Ask your patients what barriers they faced to come to your clinic and receive the care they needed. Consider incorporating the following screening tools regarding social determinants of health: PRAPARE screening tool, AAFP screening tool.
- Promote access to insurance and support programs, including nutrition, exercise and wellness, and safe home and school environments. Look up resources available to your patients by their zip codes using AAFP’s Neighborhood Navigator.
- Help patients access their medications at affordable prices in their neighborhoods by using free apps. Use the GoodRx app to identify discounts for prescriptions at various pharmacies, and search the Bedsider app to find out how your patients can get their birth control for free and delivered to their homes.
- Expand access to language services for patients who do not speak English as their first language. If working in a resource-limited setting, use the Google Translate app. Print out these free handouts for birth control fact sheets in different languages.
- Establish standardized protocols for common treatment paradigms to reduce the influence of bias in clinical scenarios. For example, institute a protocol for managing postoperative pain to ensure equal access to treatment.
- Institute the AIM (Alliance for Innovation on Maternal Health) patient safety bundle on the Reduction of Peripartum Racial/Ethnic Disparities. Learn more about AIM’s maternal safety and quality improvement initiative to reduce maternal morbidity and mortality here.
Support a diverse workforce
- Designate and/or hire a Diversity and Inclusion Officer at your institution to ensure that hiring practices actively achieve a diverse workforce and that employees feel supported in the work environment. Consider coalition-building between hospitals, like the UPHS-CHOP Alliance of Minority Physicians.
- Recruit diverse applicants by advertising positions to groups that focus on the advancement of underrepresented minorities in medicine. Engage with your local chapter of the National Medical Association and American Medical Women’s Association.
- Have a system in place for anonymous reporting of incidents involving bias or discrimination against staff, and develop a protocol to ensure action is taken in case of such incidents.
- Institute a recurring conference or Grand Rounds across disciplines to discuss the impacts of bias and discrimination on patients and providers at your institution. View examples of these conferences here.
- Ensure invited speakers and other educational opportunities are comprised of diverse representation.
- Create a work environment with safe spaces for the discussion of racism, discrimination, and bias.
- Haskell R. Serena Williams on motherhood, marriage, and making her comeback. January 10, 2018. https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018. Accessed July 1, 2020.
- Louis JM, Menard MK, Gee RE. Racial and ethnic disparities in maternal morbidity and mortality. Obstet Gynecol. 2015;125:690-694.
- Sigurdson K, Mitchell B, Liu J, et al. Racial/ethnic disparities in neonatal intensive care: a systematic review. Pediatrics. 2019;144:e20183114.
- Garner EI. Cervical cancer: disparities in screening, treatment, and survival. Cancer Epidemiol Biomarkers Prev. 2003;12:242s-247s.
- Arora S, Stouffer GA, Kucharska‐Newton A, et al. Fifteen‐year trends in management and outcomes of non–ST‐segment–elevation myocardial infarction among black and white patients: the ARIC community surveillance study, 2000–2014. J Am Heart Assoc. 2018;7:e010203.
- Zellars R. Black subjectivity and the origins of American gynecology. May 31, 2018. https://www.aaihs.org/black-subjectivity-and-the-origins-of-american-gynecology/. Accessed June 28, 2020.
- Ko K. Unwanted sterilization and eugenics programs in the United States. January 29, 2016. https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenics-programs-in-the-united-states/. Accessed June 28, 2020.
- Alsan M, Wanamaker M. Tuskegee and the health of black men. Q J Econ. 2018;133:407-455.
- Hooper MW, Nápoles AM, Pérez-Stable EJ. COVID-19 and racial/ethnic disparities. JAMA. 2020 May 11. doi: 10.1001/jama.2020.8598.
- Haskell R. Serena Williams on motherhood, marriage, and making her comeback. January 10, 2018. https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018. Accessed July 1, 2020.
- Louis JM, Menard MK, Gee RE. Racial and ethnic disparities in maternal morbidity and mortality. Obstet Gynecol. 2015;125:690-694.
- Sigurdson K, Mitchell B, Liu J, et al. Racial/ethnic disparities in neonatal intensive care: a systematic review. Pediatrics. 2019;144:e20183114.
- Garner EI. Cervical cancer: disparities in screening, treatment, and survival. Cancer Epidemiol Biomarkers Prev. 2003;12:242s-247s.
- Arora S, Stouffer GA, Kucharska‐Newton A, et al. Fifteen‐year trends in management and outcomes of non–ST‐segment–elevation myocardial infarction among black and white patients: the ARIC community surveillance study, 2000–2014. J Am Heart Assoc. 2018;7:e010203.
- Zellars R. Black subjectivity and the origins of American gynecology. May 31, 2018. https://www.aaihs.org/black-subjectivity-and-the-origins-of-american-gynecology/. Accessed June 28, 2020.
- Ko K. Unwanted sterilization and eugenics programs in the United States. January 29, 2016. https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenics-programs-in-the-united-states/. Accessed June 28, 2020.
- Alsan M, Wanamaker M. Tuskegee and the health of black men. Q J Econ. 2018;133:407-455.
- Hooper MW, Nápoles AM, Pérez-Stable EJ. COVID-19 and racial/ethnic disparities. JAMA. 2020 May 11. doi: 10.1001/jama.2020.8598.