if you are interested in submitting a nomination for either yourself or someone else for one of the open board positions, please do so by Friday, May 20! 

APAOG 2022 Board Positions Available:

• Vice President
• Secretary
• Director-At-Large
• Student Representative (2)
• Non-PA Board Member

APAOG 2022 Nominations/Elections Timeline:

• May 1 ‐ Call for Nominations Opens
• May 20 – Call for Nominations Closes
• May 30 – Nominating Committee/Board begins to review nominations and approve a final slate of candidates
• June 6 – Electronic Elections Open (Eligible voters include APAOG Fellow Members and APAOG Student Representatives)
• June 15 - Announcement of Election Results
• July 1– New Board Positions Begin Term

Click here for more information and to submit!

PA Foundation | Melissa Rodriguez, DMSc, PA-C

Have you heard? Maternal mortality rates are increasing in the U.S. We now have the highest maternal mortality rates in all developed countries. The 2020 report from the National Center for Health Statistics, based on data from the National Vital Statistics System, showed that 861 women died due to maternal causes, up to 42 days after the end of pregnancy, with a general maternal mortality rate of 23.8 deaths per 100,000 live births in 2020 (Hoyert, 2022). When stratified by race, non-Hispanic Black women had 55.3 deaths per 100,000 live births, 2.9 times that of non-Hispanic White women. Several medical causes are identified, including cardiac disease, hypertension, hemorrhage, and venous thromboembolism. Social determinants of health also strongly correlate with mortality, as they contribute to preexisting health conditions and why people of color avoid seeking care.

Racism and inadequate access to care further isolate people in need. For instance, maternity care deserts, caused by the increasing number of hospital closures in rural communities, have increased and led to an increase in out-of-hospital and preterm births and births in hospitals without obstetric units in the following year after closure (Kozhimannil et al., 2018). The degree of isolation and lack of services may contribute to maternal mortality in the U.S. and exacerbate the socioeconomic differences within contrasting populations. This phenomenon was highlighted in a study in Louisiana, where those with a lack of maternity care experienced a 91% increase in the risk of death during pregnancy and up to one year postpartum (Wallace et al., 2021). Sadly, even with access, women of color may choose to deliver outside of the hospital due to racism and obstetric birth trauma. We need to improve our services.

Most pregnancies in the U.S. are considered low risk. “High risk” describes a pregnancy with risk to the woman, fetus, or both, increasing the likelihood of a complication, adverse event, or poor outcomes occurring during or after the pregnancy or birth. However, there is always a risk of complications in pregnancy and delivery. The rising number of obese patients, the increasing age at first delivery, the increasing use of fertility treatments, and societal factors play a role in increasing the risk of pregnancy. Women aged 35 or above are at greater risk of maternal mortality, preeclampsia, poor fetal growth, fetal distress, and stillbirth when compared to mothers aged 25-29 (SMFM 2014; Cavazos-Rehg et al., 2015), and this age range accounted for 18% of all births in 2017. Despite this risk, mothers ages 35 and older were more likely to birth at home (23.6%) or at a birth center (18.1%) compared to a hospital birth (17.5%), without available specialty-specific interventions.

Read more.

We are excited to share a new resource that we hope you will find very useful! The American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) have developed the Prevention and Early Diagnosis of Uterine Cancer online course, which summarizes the relevant literature and existing recommendations to guide clinicians in the equitable prevention, early diagnosis, and special considerations of uterine cancer.

The free, CME-accredited course will help clinicians:

• Identify risk factors for uterine cancer
• Summarize key health disparities in uterine cancer
• Identify effective methods for risk modification and early diagnosis of uterine cancer

As an APAOG member, we encourage you to take this course. You can register for the course here. For more information, contact Julia O’Hara at johara@acog.org.

UPDATED: Guidance from the Women’s Preventive Services Initiative

When women are healthy, communities thrive. Yet too many women in the U.S. are not receiving the life-saving preventive care they need. To address this gap, we’re supporting the Women’s Preventive Services Initiative (WPSI), a federally funded program led by ACOG and HRSA that creates comprehensive, evidence-based recommendations for women’s preventive health. WPSI’s recommendations address pressing and often overlooked issues facing women’s care.

WPSI recently updated five of its preventive services recommendations on contraceptive care, breastfeeding, well-woman visits, STI counseling, and HIV screening. With WPSI’s recommendations adopted by HRSA, the updates allow more essential services to be covered without cost-sharing. Help patients stay healthier throughout their lives by using WPSI’s complete set of recommendations and Well-Woman Chart to address your patients’ preventive health needs at every age.

We are working to advocate for labor and delivery privileges for PAs! If you are a PA who works in labor and delivery, please share your story with us. We want to know what you are doing, and in the end, create a resource to help others. Thank you! Please contact our office with any questions: APAOG@badgerbay.co (not.com). 

Please complete the short survey below. 

The New York Times | Maryland General Assembly

The new law allows trained medical professionals other than physicians to perform abortions and requires insurance providers to cover more costs.

Maryland is joining 14 other states in allowing trained medical professionals other than physicians to perform abortions. That change is part of a bill expanding abortion rights that was passed Saturday by state lawmakers, overriding the veto of Gov. Larry Hogan.

Under the new law, which will take effect July 1, nurse practitioners, nurse midwives and trained physician assistants will be able to perform abortions. The law will also require most insurance providers in the state to cover the cost of an abortion, at no cost to the resident, and directs the state to invest $3.5 million a year into abortion-care training.

“They stood up for health care, they stood up for access to abortion care — which we believe is health care, and health care is a human right — so they did what was right for the women in the state of Maryland,” said Karen J. Nelson, the president and chief executive of Planned Parenthood of Maryland, referring to Maryland legislators.

Laura Bogley, the director of legislation for Maryland Right to Life, an anti-abortion organization, said, “This is an example of what happens when you have a partisan monopoly in a state legislature.” She added, “The monopoly breeds extremism.”

Finish the article

Review the Abortion Care Access Act

Alan T. Tita, M.D., Ph.D., Jeff M. Szychowski, Ph.D., Kim Boggess, M.D., Lorraine Dugoff, M.D., Baha Sibai, M.D., Kirsten Lawrence, M.D., Brenna L. Hughes, M.D., Joseph Bell, M.D., Kjersti Aagaard, M.D., Ph.D., Rodney K. Edwards, M.D., Kelly Gibson, M.D., David M. Haas, M.D., et al., for the Chronic Hypertension and Pregnancy (CHAP) Trial Consortium*

Abstract

BACKGROUND

The benefits and safety of the treatment of mild chronic hypertension (blood pressure, <160/100 mm Hg) during pregnancy are uncertain. Data are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the incidence of adverse pregnancy outcomes without compromising fetal growth.

METHODS

In this open-label, multicenter, randomized trial, we assigned pregnant women with mild chronic hypertension and singleton fetuses at a gestational age of less than 23 weeks to receive antihypertensive medications recommended for use in pregnancy (active-treatment group) or to receive no such treatment unless severe hypertension (systolic pressure, ≥160 mm Hg; or diastolic pressure, ≥105 mm Hg) developed (control group). The primary outcome was a composite of preeclampsia with severe features, medically indicated preterm birth at less than 35 weeks’ gestation, placental abruption, or fetal or neonatal death. The safety outcome was small-for-gestational-age birth weight below the 10th percentile for gestational age. Secondary outcomes included composites of serious neonatal or maternal complications, preeclampsia, and preterm birth.

RESULTS

A total of 2408 women were enrolled in the trial. The incidence of a primary-outcome event was lower in the active-treatment group than in the control group (30.2% vs. 37.0%), for an adjusted risk ratio of 0.82 (95% confidence interval [CI], 0.74 to 0.92; P<0.001). The percentage of small-for-gestational-age birth weights below the 10th percentile was 11.2% in the active-treatment group and 10.4% in the control group (adjusted risk ratio, 1.04; 0.82 to 1.31; P=0.76). The incidence of serious maternal complications was 2.1% and 2.8%, respectively (risk ratio, 0.75; 95% CI, 0.45 to 1.26), and the incidence of severe neonatal complications was 2.0% and 2.6% (risk ratio, 0.77; 95% CI, 0.45 to 1.30). The incidence of any preeclampsia in the two groups was 24.4% and 31.1%, respectively (risk ratio, 0.79; 95% CI, 0.69 to 0.89), and the incidence of preterm birth was 27.5% and 31.4% (risk ratio, 0.87; 95% CI, 0.77 to 0.99).

CONCLUSIONS

In pregnant women with mild chronic hypertension, a strategy of targeting a blood pressure of less than 140/90 mm Hg was associated with better pregnancy outcomes than a strategy of reserving treatment only for severe hypertension, with no increase in the risk of small-for-gestational-age birth weight. (Funded by the National Heart, Lung, and Blood Institute; CHAP ClinicalTrials.gov number, NCT02299414. opens in new tab.)

Read more.

National Center for Health Statistics | Donna L. Hoyert, Ph.D., Division of Vital Statistics

This report presents maternal mortality rates for 2020 based on data from the National Vital Statistics System. A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes” (1). Maternal mortality rates, which are the number of maternal deaths per 100,000 live births, are shown in this report by age group and race and Hispanic origin.

This report updates a previous one that showed maternal mortality rates for 2018 and 2019 (2). In 2020, 861 women were identified as having died of maternal causes in the United States, compared with 754 in 2019 (3). The maternal mortality rate for 2020 was 23.8 deaths per 100,000 live births compared with a rate of 20.1 in 2019 (Table).

In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women (19.1) (Figure 1 and Table). Rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women. The increases from 2019 to 2020 for non-Hispanic Black and Hispanic women were significant. The observed increase from 2019 to 2020 for non-Hispanic White women was not significant.

Read more.

In an effort to make the U.S. Preventive Services Task Force (USPSTF) recommendations clearer and its processes more transparent, the Task Force started posting draft Recommendation Statements online for public comment in 2009. To further enhance its work, the Task Force began inviting public comment on all its draft Research Plans in December 2011 and its draft Evidence Reviews in March 2013. Submitted comments will be handled on a confidential basis.

To learn more about and comment on USPSTF draft Research Plans, Evidence Reviews, or Recommendation Statements, continue reading here.

APAOG is pleased to have our first #ADayInTheLife host of 2022 joining us on Wednesday, February 23. Head over to our Instagram account to follow along on our stories as Monika Adeni shares her day working as a PA! Visit the APAOG Instagram here: https://www.instagram.com/apaogorg/

We are looking for additional individuals who are interested in committing to taking over APAOG's Instagram for one day and leading us around their life. If this interests you, let us know! Our office will follow up with you to confirm a date and provide more information. We look forward to getting to know you. Introduce yourself here: https://form.jotform.com/220304425699053