Collaboration between maternal-fetal medicine and family planning: a survey of Northeast US academic medical centers
-
Audrey A. Merriam
,
Lisbet Lundsberg
Abstract
Objectives
To explore how complex family planning (CFP) and maternal-fetal medicine (MFM) in Northeast academic medical centers work together to provide abortion care.
Methods
We distributed an exploratory cross-sectional online survey to CFP and MFM faculty and fellows at academic medical centers in the Northeast between July and September of 2020. The survey included demographic information, assessment of practice patterns, hospital/administration support and assessment of collaboration. Likert scale questions examined opinions about collaboration and an open-ended question solicited ideas for improvement. We performed bivariate analysis to examine the association between subspecialty and practice location regarding provision of abortion care and perceived barriers to care.
Results
The response rate was 31 % and was similar by specialty. Of the 69 respondents, 83 % were MFMs, 75 % were faculty, and 54 % practiced in New York. More than 85 % reported personal participation in some portion of abortion care. The two most common perceived barriers to care were “lack or reluctance of physicians/staff” and state laws prohibiting termination. Nearly all (95 %) stated there was a good working relationship between CFP and MFM divisions; however, almost one-third agreed with or were neutral to the statements “MFM and CFP are siloed in terms of work/patient care.”
Conclusions
Academic MFM and CFP providers in the Northeast collaborate well in providing abortion care, though our findings highlight areas that would benefit from improvement. Optimizing collaboration in the Northeast is important given its regional role for ensuring abortion access in the current national landscape. Improved education of all members of the patient care team on the importance of abortion access may also help provide optimal patient care where abortion services still legally exist.
Funding source: Society of Maternal-Fetal Medicine
-
Research ethics: The local Institutional Review Board deemed the study exempt from review.
-
Informed consent: Informed consent was obtained from all individuals included in this study.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: The authors state no conflict of interest.
-
Research funding: This work was made possible through the Reproductive Health Services Policy Award 2019–2020 through the Society for Maternal-Fetal Medicine.
References
1. Guttmacher Institute. Abortion policy in the absence of Roe. Written; 2021. https://www.guttmacher.org/state-policy/explore/abortion-policy-absence-roe [Accessed 22 Jul 2021].Suche in Google Scholar
2. Heuser, CC, Gibbins, KJ, Smid, MC, Branch, DW. Reproductive rights advocacy: not just for the family-planning community. AJOG 2017;217:322.e1–4. https://doi.org/10.1016/j.ajog.2017.06.006.Suche in Google Scholar PubMed PubMed Central
3. The Society for Maternal-Fetal Medicine. Access to abortion services. Official Society for Maternal-Fetal Medicine Position Statement; 2017. https://s3.amazonaws.com/cdn.smfm.org/media/2418/Access_to_Abortion_Services_(2020).pdf [Accessed 22 Jul 2021].Suche in Google Scholar
4. Blackwell, S, Louis, JM, Norton, ME, Lappen, JR, Pettker, CM, Kaimal, A, et al.. Reproductive services for women at high risk for maternal mortality: a report of the workshop of the society for maternal-fetal medicine, the American college of obstetricians and gynecologists, the fellowship in family planning, and the society of family planning. AJOG 2020;222:B2–18. https://doi.org/10.1016/j.ajog.2019.12.008.Suche in Google Scholar PubMed
5. Li, J, Talari, P, Kelly, A, Latham, B, Dotson, S, Manning, K, et al.. Interprofessional teamwork innovation model (ITIM) to promote communication and patient-centered, coordinated care. BMJ Qual Saf 2018;27:700–9. https://doi.org/10.1136/bmjqs-2017-007369.Suche in Google Scholar PubMed
6. Gupta, R, Arora, VM. Merging the health system and education silos to better educate future physicians. JAMA 2015;314:2349–50. https://doi.org/10.1001/jama.2015.13574.Suche in Google Scholar PubMed
7. Birdas, TJ, Rozycki, GF, Dunnington, GL, Stevens, L, Liali, V, Schmidt, CM. “Show me the data”: a recipe for quality improvement success in an academic surgical department. J Am Coll Surg 2019;228:368–73. https://doi.org/10.1016/j.jamcollsurg.2018.12.013.Suche in Google Scholar PubMed
8. Reiter-Brennan, C, Dzaye, O, Davis, D, Blaha, M, Eckel, RH. Comprehensive care models for cardiometabolic disease. Curr Cardiol Rep 2021;23:22. https://doi.org/10.1007/s11886-021-01450-1.Suche in Google Scholar PubMed PubMed Central
9. Sloan, CE, Zhong, J, Mohottige, D, Hall, R, Diamantidis, CJ, Boulware, LE, et al.. Fragmentation of care as a barrier to optimal ESKD management. Semin Dial 2020;33:440–8. https://doi.org/10.1111/sdi.12929.Suche in Google Scholar PubMed
10. WHO. Framework for action on interprofessional education & collaborative practice (WHO/HRH/HPN/10.3). Geneva: WHO; 2017.Suche in Google Scholar
11. Reeves, S, Pelone, F, Harrison, R, Goldman, J, Zwarenstein, M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database Syst Rev 2017;6:CD000072. https://doi.org/10.1002/14651858.cd000072.pub3.Suche in Google Scholar
12. National Center for Health Statistics. Maternal mortality by state. Centers for Disease Control; 2018. https://www.cdc.gov/nchs/maternal-mortality/MMR-2018-State-Data-508.pdf [Accessed 22 Jul 2021].Suche in Google Scholar
13. Turk, JK, Steinauer, JE, Landy, U, Kerns, JL. Barriers to D&E practice among family planning subspecialists. Contraception 2013;88:561–7. https://doi.org/10.1016/j.contraception.2013.04.011.Suche in Google Scholar PubMed
14. Rosenstein, MG, Turk, JK, Caughey, AB, Steinauer, JE, Kerns, JL. Dilation and evacuation training in maternal-fetal medicine fellowships. Am J Obstet Gynecol 2014;210:569.e1–5. https://doi.org/10.1016/j.ajog.2014.01.038.Suche in Google Scholar PubMed PubMed Central
15. Turner, KL, Pearson, E, George, A, Andersen, KL. Values clarification workshops to improve abortion knowledge, attitudes and intentions: a pre-post assessment in 12 countries. Reprod Health 2018;15:15–26. https://doi.org/10.1186/s12978-018-0480-0.Suche in Google Scholar PubMed PubMed Central
16. McLemore, MR, Levi, A, James, EA. Recruitment and retention strategies for expert nurses in abortion care provision. Contraception 2015;91:474–9. https://doi.org/10.1016/j.contraception.2015.02.007.Suche in Google Scholar PubMed PubMed Central
17. Guiahi, M, Wilson, C, Claymore, E, Simonson, K, Steinauer, J. Influence of a values clarification workshop on residents training at catholic hospital programs. Contraception: X 2021;3:100054. https://doi.org/10.1016/j.conx.2021.100054.Suche in Google Scholar PubMed PubMed Central
18. Treder, K, Amutah‐Onukagha, N, White, KO. Abortion bans will exacerbate already severe racial inequities in maternal mortality. Womens Health Iss. 2017;33:328–32.10.1016/j.whi.2023.04.007Suche in Google Scholar PubMed
19. Tai, X, Smith, AM, McGeer, AJ, Dubé, E, Holness, DL, Katz, K, et al.. Comparison of response rates on invitation mode of a web-based survey on influenza vaccine adverse events among healthcare workers: a pilot study. BMC Med Res Methodol 2018;18:59. https://doi.org/10.1186/s12874-018-0524-8.Suche in Google Scholar PubMed PubMed Central
20. Doss, AE, Davidson, JD, Cliver, SP, Wetta, LA, Andrews, WW, Tita, AT. Antibiotic prophylaxis for cesarean delivery: survey of maternal-fetal medicine physicians in the U.S. J Matern Fetal Neonatal Med 2012;25:1264–6. https://doi.org/10.3109/14767058.2011.605485.Suche in Google Scholar PubMed PubMed Central
Supplementary Material
This article contains supplementary material (https://doi.org/10.1515/jpm-2023-0118).
© 2023 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature
- Original Articles – Obstetrics
- Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q)
- Outcomes of cesarean delivery in placenta accreta: conservative delivery vs. cesarean hysterectomy
- Maternal and neonatal complications in pregnancies with and without pre-gestational diabetes mellitus
- Down-regulated Wnt7a and GPR124 in early-onset preeclampsia placentas reduce invasion and migration of trophoblast cells
- Pregnancy, delivery and neonatal outcomes in women with gastrointestinal system cancer in pregnancy. An evaluation of a population database
- Paternal age and perinatal outcomes: an observational study
- The association between maternal colonization with Group B Streptococcus and infectious morbidity following transcervical Foley catheter-assisted labor induction
- Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis
- Comparison between trans-vaginal and trans-abdominal ultrasound examination of the cervix in the second trimester of pregnancy: a prospective study
- Collaboration between maternal-fetal medicine and family planning: a survey of Northeast US academic medical centers
- Original Articles – Fetus
- Association of low pregnancy associated plasma protein-A with increased umbilical artery pulsatility index in cases of fetal weight between the 3rd and 10th percentiles: a retrospective cohort study
- Genetic analysis, ultrasound phenotype, and pregnancy outcomes of fetuses with Xp22.33 or Yp11.32 microdeletions
- Original Articles – Neonates
- Umbilical cord blood hematological parameters in predicting early onset neonatal sepsis (EOS) – a prospective cohort study
- Changes in circMyt1l/rno-let-7d-5p/brain-derived neurotrophic factor. A damaged periventricular white matter damage model in neonatal rats
- Short Communication
- Effects of gender on fetal cortical development: a secondary analysis of a prospective cross-sectional study
- Acknowledgment
- Acknowledgment
Artikel in diesem Heft
- Frontmatter
- Review
- Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature
- Original Articles – Obstetrics
- Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q)
- Outcomes of cesarean delivery in placenta accreta: conservative delivery vs. cesarean hysterectomy
- Maternal and neonatal complications in pregnancies with and without pre-gestational diabetes mellitus
- Down-regulated Wnt7a and GPR124 in early-onset preeclampsia placentas reduce invasion and migration of trophoblast cells
- Pregnancy, delivery and neonatal outcomes in women with gastrointestinal system cancer in pregnancy. An evaluation of a population database
- Paternal age and perinatal outcomes: an observational study
- The association between maternal colonization with Group B Streptococcus and infectious morbidity following transcervical Foley catheter-assisted labor induction
- Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis
- Comparison between trans-vaginal and trans-abdominal ultrasound examination of the cervix in the second trimester of pregnancy: a prospective study
- Collaboration between maternal-fetal medicine and family planning: a survey of Northeast US academic medical centers
- Original Articles – Fetus
- Association of low pregnancy associated plasma protein-A with increased umbilical artery pulsatility index in cases of fetal weight between the 3rd and 10th percentiles: a retrospective cohort study
- Genetic analysis, ultrasound phenotype, and pregnancy outcomes of fetuses with Xp22.33 or Yp11.32 microdeletions
- Original Articles – Neonates
- Umbilical cord blood hematological parameters in predicting early onset neonatal sepsis (EOS) – a prospective cohort study
- Changes in circMyt1l/rno-let-7d-5p/brain-derived neurotrophic factor. A damaged periventricular white matter damage model in neonatal rats
- Short Communication
- Effects of gender on fetal cortical development: a secondary analysis of a prospective cross-sectional study
- Acknowledgment
- Acknowledgment
