Co-authorDenise J. Jamieson, MD, MPH,the James Robert McCord Professor and chair of the department of gynecology and obstetrics at Emory University in Atlanta, told Healio thatclimate changeimpacts three components of pregnant people’s health: the pregnant person themself, the fetus or newborn and access to health care.
“These effects are not limited to one generation; there can be intergenerational effects,” Jamieson said. “For example, if a baby is born small for gestational age or preterm due to the effects of climate change, that may have lasting health effects, and these health effects may influence, in turn, their future children.”
The aim of this ranking is to inspire female scholars, women considering an academic career, as well as decision-makers worldwide with the example of successful women in the scientific community.
The parameters for what qualifies as a maternity care desert are strict, according to Denise Jamieson, department chair for gynecology and obstetrics at Emory University, who follows March of Dimes’ work. For her, this means that the new data represent the tip of the iceberg when it comes to access.
“The report is certainly discouraging,” Jamieson said.
According toDr. Heather Hipp, an associate professor in the department of gynecology and obstetrics at Emory University School of Medicine, many people with PCOS struggle with acne.
“Acne is really common in a lot of young patients, but patients with PCOS tend to have more severe acne and then it persists even as [they] get older,” Hipp said.
This acne is a result of higher production of oil ―particularly a production of sebum. In addition to the face, PCOS-induced acne can appear on the chest and back, too, Hipp said.
Reproductive endocrinologist Dr. Jennifer Kawwass said she’s had to reassure many of the patients she’s treating with in-vitro fertilization since the state’s abortion law was enacted in July.
“These changes have added to the duress that fertility patients are already facing and they have reached out to us for clarification,” Kawwass said. “We have continued to reassure them that at the moment we’re able to practice IVF and offer the full spectrum of care.”
While the study data are statistically significant, they present what's ultimately "a small attributable — or extra — risk," says Susan Modesitt, MD, the director of the gynecologic oncology division at Emory University's Winship Cancer Institute and editor-in-chief of Gynecologic Oncology Reports. "People just hear 80-percent increased risk and panic, but it's 80 percent of a really tiny risk." In other words, your entire risk isn't 80 percent; it's 80 percent of that 1.64 percent among those who've never used relaxers — an increase of 1.18 percent, which, she says, is still pretty small.
That exception is unclear and has “hand-tied” doctors in the state, who are struggling to determine what conditions meet the standard and when, said Martina Badell, a doctor who specializes in maternal and fetal health at Emory University School of Medicine.
“In some situations now, we may counsel and say, ‘That is the standard of care and you should have this option, but I’m sorry, it’s not clear we can provide that for you here in Georgia,'” she testified on the second day of the trial over Georgia’s abortion law.
Each year, as part of School of Medicine Researcher Appreciation Day, the Emory School of Medicine Faculty Recognitions Committee allows for nominating colleagues performing groundbreaking research. Once the committee reviews all nominations, the final honorees are recognized throughout the broader Emory community. This year, the Department of Gynecology and Obstetrics saw four faculty members recognized.
Lisa Flowers, MD, MPH, (left) and Canhua Xiao, PhD, RN, are principal investigators of a study aiming to understand the role of the oral microbiome and periodontal diseases in oral HPV infection among people with HIV.
Because the effects of climate change are increasing in frequency and intensity, we believe plans specific to the needs of pregnant people should be developed now; such plans could include recommendations for patient-level, health-system–level, and community-level interventions to mitigate these effects. As an example of an intervention that could have an immediate influence, ensuring that all pregnant patients — particularly those living in areas at high risk for extreme weather events — have access to their electronic medical records could support the transfer of prenatal care to a new location in the event of disruption.
“‘The womb’ is not a medical term, but really ‘the womb’ means ‘uterine cavity,’” said Dr. Carrie Ann Cwiak, an OB-GYN, professor of obstetrics and gynecology at Emory School of Medicine, and one of several plaintiffs in a new lawsuit against Georgia’s abortion law. “If [an embryo] is outside the uterine cavity, then it appears that this isn’t anything that’s included in this bill.”
“The best data to date indicate insulin is the best first-line treatment option; however, confounding this is access to care,” Suchitra Chandrasekaran, MD, assistant professor in the department of maternal and fetal medicine at Emory Healthcare, told Endocrine Today. “The access and comfort of initiating insulin is challenging, and patient compliance is another issue. If a patient doesn’t like to take insulin, then there is the risk for uncontrolled glucose. This might be where the oral medication metformin is a reasonable option to consider.”
"Accessing contraception over the counter could be a game changer for people who experience common barriers to accessing clinics," said Melissa Kottke, MD, associate professor in the Department of Gynecology and Obstetrics at Emory University in Atlanta, Georgia. "For example, this may help people who can't get an appointment for several months, who don't have a nearby clinician for care, who can't get off work or school to attend a clinic appointment, who do not have transportation, who need additional privacy, [or] who prefer to self-manage their contraception. Expanding contraceptive access is particularly important in a political landscape that is increasingly restrictive for reproductive rights."
We acknowledge that this is a complex issue and members of our community have a wide variety of personal beliefs. We also know that when abortion care is restricted, the health risks associated with pregnancy increase, the quality of abortion care and other pregnancy care suffers, patients and their families experience negative social outcomes, and health and social inequities are exacerbated.
After a comprehensive search, we are very excited to announce that Dr. Susan C. Modesitt is the new Division Director of Gynecologic Oncology at Emory University, Department of Gynecology and Obstetrics and Winship Cancer Institute.
At the end of April, Denise J. Jamieson, M.D., a member of the Covid-19 task force at the American College of Obstetricians and Gynecologists and chairwoman of gynecology and obstetrics at the Emory University School of Medicine, noted in an email that it was “remarkable” how much we still do not know about Covid-19 in pregnancy. “Even basic questions, such as whether or not pregnant women are more severely affected by Covid-19, remain unanswered,” she said at the time. Now it’s July, and little has changed.
Pregnant women present particularly vexing issues. The new data, reported in CDC’s Morbidity and Mortality Weekly Report, compared more than 90,000 women with confirmed cases of COVID-19 who were between 15 and 44. The study has several important limitations, but in an age-adjusted analysis, the 8200 women who were pregnant had a 1.5 times higher risk of being admitted to an intensive care unit and a 1.7 times higher risk of requiring mechanical ventilation. “That is fairly compelling evidence” pregnant women should be prioritized for a vaccine, though their risk isn’t pronounced as the elderly,” says Denise Jamieson, an obstetrician/gynecologist at Emory University who is not an ACIP member.
