Perinatal responsibility in a fragmented world: reflections from the 2024 international academy of perinatal medicine New York meeting

Introduction

From June 27 to 29, 2024, the International Academy of Perinatal Medicine (IAPM) held a landmark meeting at the Hilton Midtown in New York City. The gathering brought together distinguished clinicians, scientists, and thought leaders committed to advancing maternal and infant health worldwide. This Special Issue of the Journal of Perinatal Medicine (JPM) comprises selected contributions from the New York meeting, reflecting the scientific discourse, ethical concerns, and visionary outlook that shaped this important event. At a time of escalating geopolitical instability, climate disruption, and erosion of women’s rights in multiple regions, the IAPM’s convening power has never been more vital. This meeting served not only as a scientific forum but as a moral and global call to action – reaffirming that maternal and perinatal health is a foundational pillar of human development and social justice.

The international academy of perinatal medicine: a global voice for maternal and infant health

Since its founding, the IAPM has positioned itself as a platform not only for scientific collaboration but also for advocacy. The Academy’s core mission – promoting maternal and perinatal well-being across all regions, particularly in the Global South – was reaffirmed in New York [1]. As emphasized by President Asim Kurjak in his opening address, IAPM continues to serve as a “torchbearer” for equity, integrity, and professional responsibility [1], [2], [3], [4], [5]. At a time when disparities in health access and outcomes are widening, the Academy remains a consistent voice for those too often unheard: mothers and newborns in under-resourced and marginalized settings [1], [2], [3], [4], [5].

The IAPM’s role extends beyond academia and clinical practice; it serves as a conscience for global health, especially when maternal mortality reflects systemic neglect and political failure. In 2024, with ongoing humanitarian crises, rising authoritarianism, and the rollback of reproductive rights in several nations, the Academy reasserts that safeguarding maternal and newborn health is a non-negotiable global responsibility – not a regional luxury.

Prenatal life and the foundations of lifelong health

Several contributions to the New York meeting emphasized the pivotal role of fetal life in shaping health across the lifespan [6], 7]. The concept of fetal programming – now supported by an expanding body of epigenetic and longitudinal data – has profound implications for how we design public health interventions [6], 7]. Maternal nutrition, stress, environmental exposure, and systemic inequality during pregnancy do not merely influence birth outcomes; they leave a lasting biological imprint [6], 7]. Thus, investments in prenatal care are not simply beneficial – they are foundational to sustainable population health.

Sustainable development goals and the reality of global inequity

Despite remarkable advances in perinatal medicine, preventable maternal and neonatal deaths remain a daily reality in many parts of the world [1], 5]. The gap between high-income and low-income regions persists, even as global declarations commit to the Sustainable Development Goals (SDGs), particularly SDG 3: ensuring healthy lives and promoting well-being for all [1], 5]. The IAPM New York Declaration on “Professional Responsibility and Abortion” drew attention to the complex and often contentious landscape of reproductive health, highlighting the tension between evolving societal norms, professional ethics, and legal frameworks [8], [9], [10]. These challenges underscore the need for globally informed yet locally respectful policies that center the dignity of patients and the autonomy of healthcare professionals.

The battle between smartocracy and stupidoracy

A recurrent theme during the meeting was the duality of our time: unprecedented access to knowledge and technology coexisting with the erosion of science-based decision-making [11], [12], [13]. The term “smartocracy” was invoked to describe governance led by evidence, reason, and expert consensus. Its antithesis – “stupidoracy” – represents the proliferation of misinformation, pseudoscience, and ideologically driven policy [11], [12], [13]. In perinatal medicine, this battle plays out in debates over vaccinations, abortion rights, digital health, and medical training [11], [12], [13]. The Academy advocates for reclaiming the primacy of informed, ethical leadership – placing the needs of women and newborns above politics or populism.

Artificial intelligence: promise and prudence

Artificial intelligence (AI) emerged as both a promising tool and a subject of caution in the New York discussions [14], [15], [16], [17]. From predicting preterm birth to analyzing fetal imaging, AI is rapidly transforming clinical practice [14], [15], [16], [17]. However, participants stressed the necessity of critical oversight: AI must enhance, not replace, human expertise and compassion [14], [15], [16], [17]. Algorithmic bias, data privacy, and the risk of clinical dehumanization require ongoing ethical scrutiny [14], [15], [16], [17]. The IAPM supports the thoughtful integration of AI within a framework that safeguards equity, transparency, and patient safety [16], 17].

Are we at the end of the beginning or the beginning of the end?

This provocative question, posed during one of the final sessions, encapsulated the complexity of the current global moment [16]. Climate change, migration, conflict, and economic instability are intersecting with fragile healthcare systems. Yet the meeting also showcased resilience: the determination of clinicians in low-resource settings, the solidarity among researchers across borders, and the unyielding commitment of the Academy to its mission. Whether we are entering decline or renewal depends, in part, on the choices we now make and the values we uphold in doing so.

Conclusions

The IAPM New York Meeting of 2024 offered more than a series of scientific presentations; it was a reaffirmation of perinatal medicine’s ethical foundation and global responsibility. In an era marked by misinformation, widening inequality, and political volatility, the Academy’s enduring message is clear: the health of mothers and infants is not a peripheral concern; it is central to humanity’s collective future and the stability of nations. We invite readers of this Special Issue to engage deeply with the contributions presented, which offer not only insight but also a call to action [18], [19], [20], [21], [22], [23]. In a fragmented world, perinatal medicine – anchored by institutions like the IAPM – can be a unifying force for knowledge, justice, and compassion.