The following statement comes from the UW–Madison Department of Obstetrics and Gynecology Interim Chair Lisa Barroilhet, MD, MS:
The U.S. Supreme Court decision in the Dobbs v. Jackson Women’s Health Organization case may all but eliminate access to abortion in Wisconsin, except to save the life of the patient. The uncertainty over the status of existing state law interferes with the relationship between physician and patient in determining what’s best for patients’ health and overall wellbeing. Abortion care is an essential component of comprehensive reproductive health care. Lack of access to abortion care will have a profound, lasting impact on the health of individuals, families and communities across Wisconsin.
As we enter a time of rapid change and uncertainty, the UW–Madison Department of Obstetrics and Gynecology affirms the autonomy and dignity of every patient we serve. In alignment with UW Health, we will put the needs of our patients at the forefront of all we do, making sure they receive the best possible medical advice and care. We also acknowledge the significant impact this change may have on the wellbeing of our faculty, and the educational experience of the resident and fellow physicians who are training within our department.
While this U.S. Supreme Court decision disrupts 50 years of constitutionally protected access to abortion in Wisconsin, the UW Department of Ob-Gyn remains committed to our mission of improving the health of women and families in Wisconsin and beyond.
Read statements on the U.S. Supreme Court decision from the University of Wisconsin–Madison and the UW School of Medicine and Public Health.
On June 10, 2022, UW Ob-Gyn assistant professor Tiffany Green, PhD, of the Division of Reproductive and Population Health, spoke with Here and Now on Wisconsin Public Television about economic and racial disparities likely to increase after Roe v. Wade is overturned:
“…the effects of abortion or limiting access have been very well established and as we said, they can lead to adverse financial outcomes. They can lead to poor pregnancy-related outcomes. Those outcomes are exacerbated among Black and/or indigenous people so there have been studies that show that laws that limit access to abortion can increase levels of pre-term births, death from congenital abnormalities among Black infants of Black women. So this isn’t — that’s not debatable. The science is always evolving and growing but the fact that we have a very robust body of evidence that shows there are negative implications to restricting abortion is not really debatable.”
Watch the whole interview here!
UW Ob-Gyn resident Connor Wang, MD, PGY-4, is lead author on a new publication in Gynecologic Oncology!
In “Mechanical and oral antibiotic bowel preparation in ovarian cancer debulking: Are we lowering or just trading surgical complications?”, Wang and co-authors Rana Al-Rubaye, MD, Lauren Montemorano, MD, Vienna Tran, MD, and Ahmed Al-Niaimi, MD, examined postoperative complications associated with preoperative mechanical and oral antibiotic bowel preparation (MOABP) for patients with ovarian cancer who underwent bowel resection at cytoreductive surgery (CRS):
“Patients who underwent preoperative MOABP prior to ovarian cancer CRS with bowel resection had lower odds or deep/organ-space infections and readmissions, shorter hospital stays, fewer diverting ostomies, and more optimal resections. However, these patients also experienced higher odds of ICU admissions and grade 3 or higher cardiac and gastrointestinal complications. The positive and negative postoperative outcomes in this population should be considered in clinical practice.”
Read the whole study here! Congratulations to the research team!
A recent article in the Wisconsin Examiner investigated potential difficulties for physician training programs after the U.S. Supreme Court overturned Roe v. Wade.
“Medical training programs teach abortion procedures. What happens if abortion is outlawed?” outlines the national standards for training set by the Accreditation Council for Graduate Medical Education (ACGME), which requires a family planning curriculum and the option for resident physicians to be trained in the provision of abortion.
In the article, UW Ob-Gyn assistant professor Abigail Cutler, MD, discusses the potential downstream effects of limiting training in abortion procedures:
“In surveys of OB/GYN doctors, those who have had less training in abortion care or none at all have reported that they “felt less prepared to offer comprehensive care to people who are experiencing a miscarriage,” Cutler says. For doctors with more exposure to and practice in abortion care, “there was a correlation between that and their comfort level with surgically managing miscarriage later on.””
Also in the article, Division of Reproductive and Population Health and UW Collaborative for Reproductive Equity Director Jenny Higgins, MD, MPH, shares results from UW research that found broad support for abortion among physicians:
“In 2019, the Collaborative for Reproductive Equity (CORE) at the UW medical school polled the school’s doctors on the impact of restrictions on abortion that had been enacted since 2011. More than 900 doctors responded to the survey, and more than 90% said overturning Roe v Wade “would worsen Wisconsin women’s health,” says Jenny Higgins, CORE’s director.
“We surveyed people across all medical specialties, and we found overwhelming support for abortion services as well as abortion providers,” Higgins says. In addition to the concerns for women’s health, a majority said that more restrictions on abortion “make it more difficult to recruit faculty and trainees.””
Read the whole article here.
Incoming UW Ob-Gyn gynecologic oncology fellow (and recent residency graduate) Matt Wagar, MD, is co-author on a new publication in Reproductive Medicine.
“A Standardized Protocol for Post-Partum Salpingectomy with Suture Ligation: A Prospective Feasibility Study” compared operative outcomes of 157 patients who underwent post-partum salpingectomy with 300 historical cases of tubal ligation. The study primarily evaluated for operative time and blood loss:
“Our work establishes that salpingectomy with the PPS protocol can be easily learned and is feasible in a limited-resource environment using suture ligation with only a minimal increase in blood loss and operative time. The use of this procedure may create a unique opportunity to potentially reduce the worldwide incidence of ovarian cancer with little or no additional expenditure of healthcare resources. Future long-term studies will be needed to evaluate whether these procedures ultimately reduce the risk of high-grade serious ovarian cancers.”
Read the whole article here.
A new article in STAT talks to researchers who specialize in reproductive health about what the U.S. Supreme Court’s June 24 decision overturning Roe v. Wade might mean for research about abortion in the future.
In “These researchers study abortion in states likely to ban it. That will make their jobs even harder”, UW Ob-Gyn Division of Reproductive and Population Health and UW Collaborative for Reproductive Equity Director Jenny Higgins, PhD, MPH provides perspective on why research on reproductive health care access is more important now than ever:
“It will also prove difficult for the researchers themselves, who already face an uphill battle trying to do rigorous evaluation in such a highly politicized area. Higgins, who helped to found CORE in 2019, faced significant pushback from mentors who warned she’d have to constantly be combating accusations about bias in her work. But she and a small cadre of experts around the country have made it their priority to collect the kind of data that’s needed to inform local policy — even when policymakers don’t want to hear it.”
Read the whole article here.
Heidi Brown, MD, MAS, interim Division of Female Pelvic Medicine and Reconstructive Surgery Director, and Makeba Williams, MD published a new article in the American Journal of Obstetrics and Gynecology. Williams presented the research in this article at the annual Society of Academic Specialists in General Obstetrics and Gynecology conference in May, where it earned the first-place oral abstract award!
“Improving primary care follow-up for gynecologic patients with hypertension: an implementation science pilot study” evaluated the feasibility of implementing BP Connect, a staff protocol for specialty clinics, in gynecology clinics:
“Overall, the rate of timely primary care follow-up for high BP increased from 28% before implementation to 48% after implementation (P<.001) despite implementation during the COVID-19 pandemic. BP Connect implementation resulted in a 12-fold increase in BP remeasurement among patients with high BP in unadjusted (odds ratio [OR], 12.6; 95% confidence interval [CI], 9.6–16.6; P<.001) and adjusted (OR, 12.9; 95% CI, 9.7–17.1; P<.001) models. Timely primary care follow-up for hypertension doubled after BP Connect implementation (adjusted OR, 2.2; 95% CI, 1.5–3.1; P<.001).”
Read the whole study here!
The UW SMPH Department of Medicine’s Hospice and Palliative Care fellows recently named UW Ob-Gyn gynecologic oncology fellow Catherine Zhang, MD the 2022 recipient of their annual Humanism in Medicine Award. Congratulations, Dr. Zhang!
The Humanism in Medicine award is given to a non-palliative care member of the UW SMPH community who most embodies the attributes of compassion, collaboration, and person-centered care.
Professor and Chief of Palliative Care Toby Campbell, MD, MSCI says, “clearly, Catherine has influenced and impressed our fellows very positively.” What an incredible – and well-deserved – honor! Congratulations, Dr. Zhang!