Letters to the Editor Transcending Politics to Promote Women’s Health To the Editor: It is erroneous to argue that regulation of medical practice by federal and state governments represents the politicizing of medicine. We are able to provide medical care to women because we have been licensed by our state medical boards. We prescribe U.S. Food and Drug Administration–approved medicine through state-licensed pharmacies and receive a significant proportion of our reimbursement from government dollars through Medicare and Medicaid. When doing research, we seek out National Institutes of Health funding for our proposals. In a host of other ways, our government—with its complex interplay of political parties—has and will continue to have inextricable involvement in the provision of health care in the United States. Although McNicholas suggests rhetorically that we would not allow the government to dictate medical practice to us in matters other than abortion,1 a little reflection would reveal that it happens in every field of medicine every day. Can it really be asserted that this legislative regulation represents a condescending denial of our rights as autonomous individuals purely for political gain? The American Congress of Obstetricians and Gynecologists’ (ACOG) Letters to the Editor Guidelines. Letters posing a question or challenge to an article appearing in Obstetrics & Gynecology should be submitted within 6 weeks of the article’s publication online. Letters received after 6 weeks will rarely be considered. Letters should not exceed 350 words, including signatures and 5 references. A word count should be provided. The maximum number of authors permitted is four, and a corresponding author should be designated (and contact information listed). Letters will be published at the discretion of the Editor. The Editor may send the letter to the authors of the original paper so their comments may be published simultaneously. The Editor reserves the right to edit and shorten letters. A signed author agreement form is required from all authors before publication. Letters should be submitted using the Obstetrics & Gynecology online submission and review system, Editorial Manager (http://ong.edmgr.com).

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Fellows and districts have been active in lobbying state legislatures to prevent lay midwives and naturopaths from providing medical services to patients. Why? Because ACOG correctly recognizes that one function of the state is to ensure the safe provision of health care, even when a given piece of legislation may restrict a patient’s right to choose how (or from whom) she receives her health care. Why would we think that the provision of abortion services should somehow be immune to legislative oversight? Financial Disclosure: The author did not report any potential conflicts of interest.

Andrew Steele, MD St. Louis University, Department of Obstetrics and Gynecology, St. Louis, Missouri

REFERENCE 1. McNicholas C. Transcending politics to promote women’s health. Obstet Gynecol 2013;122:151–3.

Transcending Politics to Promote Women’s Health

face the exact situation or make the same choices as those who came before her. Women, as patients, deserve to be treated like the unique and sentient beings that they are. As physicians, it is incumbent on us to meet each woman and her needs as fully and individually as we can. Legislative interference in the doctor– patient relationship is at new and alarming levels. While the country has watched Texas decimate access to abortion, 43 other restrictive and paternalistic measures targeting women’s reproductive health have been enacted across the country.2 If we stand idly by, we, as physicians, will see more laws that regulate our medical practices and threaten our relationships with our patients. These laws are not based on scientific evidence, and they threaten not only the ethical responsibilities of physicians but also the autonomy of women.3 As Dr. McNicholas perceptively notes, these laws perpetuate and worsen a system in which pregnant women are not afforded the same rights, autonomy, and trust as other people. This is an affront to all physicians who are devoted to protecting and preserving the health of women. The urgency is profound. We are up for the challenge that Dr. McNicholas presents. We will stand with our patients. Who is with us?

To the Editor: We applaud Dr. McNicholas for her inspiring and thoughtful call to action, and we thank the Editorial Board for publishing it.1 Dr. McNicholas makes a strong argument for preserving the rights of our patients. Our patients deserve confidential and medically sound conversations with providers they trust. If this trust is lost, women cannot make the best decisions about their own reproductive health and the health of their families. Dr. McNicholas incisively parses the nuance and complexity of the decision-making process in which patients engage when consulting with their physicians about having an abortion. We, as women’s health care providers, know each woman’s decision is mediated by her own social, economic, physical, and psychological environment. No woman will ever

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For a complete list of members of the Physicians for Reproductive Health Leadership Training Academy, see the Appendix online at http://links.lww. com/AOG/A441. Financial Disclosure: The authors did not report any potential conflicts of interest.

Jennifer Lesko, MD, MPH Washington, DC Rebecca Mercier, MD, MPH Philadelphia, Pennsylvania Sara Imershein, MD, MPH Washington, DC Caron R Kim, MD, MSc Los Angeles, California for the Physicians for Reproductive Health Leadership Training Academy

OBSTETRICS & GYNECOLOGY