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A statement on abortion by 100 professors of obstetrics: 40 years later

  • One Hundred Professors of Obstetrics and Gynecology
Published:March 18, 2013DOI:https://doi.org/10.1016/j.ajog.2013.03.007
      In this Journal in 1972, 100 leaders in obstetrics and gynecology published a compelling statement that recognized the legalization of abortion in several states and anticipated the 1973 Supreme Court decision in Roe v Wade. They projected the numbers of legal abortions that likely would be required by women in the United States and described the role of the teaching hospital in meeting that responsibility. They wrote to express their concern for women’s health in a new legal and medical era of reproductive control and to define the responsibilities of academic obstetrician-gynecologists. Forty years later, 100 professors examine the statement of their predecessors in light of medical advances and legal changes and suggest a further course of action for obstetrician gynecologists.

      Key words

      Forty years ago, leaders in obstetrics and gynecology published a compelling statement that recognized the legalization of abortion in several states and anticipated the 1973 Supreme Court decision in Roe v Wade (Supplementary Data available at www.AJOG.org).
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      They projected the numbers of legal abortions that likely would be required by women in the United States and described the role of the teaching hospital in meeting that responsibility.
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      They wrote to express their concern for women’s health in a new legal and medical era of reproductive control and to define the responsibilities of academic obstetrician-gynecologists.
      Since then, we have advanced the fields of reproduction and family planning. Thanks to these developments, women can now prevent pregnancy with safer and more effective forms of contraception (most recently long-acting reversible methods), with simple and sensitive hormonal and sonographic methods to determine pregnancy status and duration, and with new methods of infertility treatment and prenatal testing that rely on the option of terminating intended pregnancies that are diagnosed as abnormal. To terminate pregnancies, clinicians now use misoprostol and mifepristone for “medical abortion” (which in 2009 accounted for 16.5% of terminations in the United States and can be office-based) and use sonographic guidance of intrauterine procedures along with new methods for inducing cervical dilation and uterine contraction; patients benefit from innovations in counseling and new approaches to pain control.
      • Winner B.W.
      • Peipert J.F.
      • Zhao Q.
      • et al.
      Effectiveness of long-acting reversible contraception.
      • Gabbe S.G.
      • Niebyl J.R.
      • Simpson J.L.
      • et al.
      Obstetrics: normal and problem pregnancies.
      • Veltman-Verhulst S.M.
      • Cohlen B.J.
      • Hughes E.
      • Heineman M.J.
      Intra-uterine insemination for unexplained subfertility.
      • Perrucci A.
      Decision assessment and counseling in abortion care: philosophy and practice.
      • Pazol K.
      • Creanga A.A.
      • Zane S.B.
      • Burley K.D.
      • Jamieson D.J.
      Centers for Disease Control and Prevention (CDC)
      Abortion surveillance: United States, 2009.
      Studies of abortion practice and outcomes are also much more sophisticated than they were 40 years ago.
      • Munk-Olsen T.
      • Laursen T.M.
      • Pedersen C.B.
      • Lidegaard O.
      • Mortensen P.B.
      Induced first-trimester abortion and risk of mental disorder.
      • Raymond E.
      • Grimes D.A.
      The comparative safety of legal induced abortion and childbirth in the United States.
      We have had 40 years of medical progress but have witnessed political regression that the 100 professors did not anticipate. In 2011 alone, 24 states passed 92 legislative restrictions on abortion.

      Guttmacher Institute. States enact record number of abortion restrictions in 2011. Available at: http://www.guttmacher.org/media/inthenews/2012/01/05/endofyear.html. Accessed June 5, 2012.

      Waiting periods after consent are now law in 26 states. Alabama, Arizona, Florida, Kansas, Louisiana, North Carolina, Oklahoma, and Texas require patients to view ultrasound images and, in Arizona, Louisiana, Mississippi, and Texas, to listen to fetal heart beats.
      Collaborative Group on Hormonal Factors in Breast Cancer
      Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries.
      Laws in 27 states force physicians to provide deceptive counseling including false statements about risks of breast cancer, infertility, and mental health. They include laws to limit second-trimester abortion under the guise of protecting the fetus from pain (Alabama, Idaho, Indiana, Kansas, Louisiana, Nebraska, and Oklahoma).
      • Lee S.J.
      • Ralston H.J.P.
      • Drey E.A.
      • Partridge J.C.
      • Rosen M.A.
      Fetal pain: a systematic multidisciplinary review of the evidence.
      Laws directed specifically at medical education in Arizona, Kansas, and Texas prohibit abortion training in public institutions and another 7 states ban abortion in public hospitals, precluding training in them.

      Guttmacher Institute. Counseling and waiting periods for abortion. Available at: http://www.guttmacher.org/statecenter/spibs/spib_MWPA.pdf. Accessed June 22, 2012.

      What vision of the future of legalized abortion did the 100 professors have? How accurately did they estimate the need for safe, legal abortion and anticipate their colleagues’ willingness and commitment to meeting it? They wrote, “In view of the impending change in abortion practices generated by new state legislation and federal court decisions, we believe it helpful to [respond] to this increasingly liberal course of events…by contributing to the solution of an imminent problem.”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      Forty years later, the change is not liberal. Its effects will threaten, not improve, women’s health and already obstruct physicians’ evidence-based and patient-centered practices. We review our predecessors’ 1972 statement and judge how it comports with what actually occurred and with legislation that has been adopted over the 40 years since their writing and the passage of Roe v Wade.
      The 100 professors were remarkably prescient in anticipating the need for 1 million legal abortions and today’s abortion rate of 1 in 4 pregnancies.
      • White K.W.
      • Grossman D.
      • Hopkins K.
      • Potter J.
      Cutting family planning in Texas.
      • Jones R.K.
      • Zolna M.R.S.
      • Henshaw S.K.
      • Finer L.B.
      Abortion in the United States: incidence and access to services, 2005.
      They predicted that teaching hospitals with specialized outpatient facilities could meet the demand and believed that abortions were the responsibility of hospitals. But today, 90% of abortions, which include the 10% that are in the second trimester, are done away from hospitals.

      Bazelon E. The new abortion providers: The New York Times. Available at: http://www.nytimes.com/2010/07/18/magazine/18abortion-t.html?pagewanted=all&_r=0. Accessed Nov. 9, 2012.

      Many hospitals enforce fetal and maternal health restrictions that are not based in the law but are contrived and enforced by the same kind of “ethics committees” that were common before the professors’ 1972 statement.
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      Some institutions offer terminations only to save a woman’s life; others will perform the procedure under no circumstances at all. At the same time, many states have passed legislation to shut down the freestanding clinics that are now responsible for most abortions by enacting cumbersome and expensive building regulations that are disguised as patient safety requirements.

      NARAL Pro-Choice America Web site. Targeted regulation of abortion providers (TRAP). Available at: http://www.prochoiceamerica.org/what-is-choice/fast-facts/issues-trap.html. Accessed June 25, 2012.

      There are now 25 states that, under the guise of patient safety, restrict abortions to hospitals that have their own restrictions or to specialized facilities.
      In our view, hospitals have disregarded the responsibility that our academic predecessors expected them to assume. Although most first-trimester and many second-trimester abortions can be done safely and efficiently in a clinic setting, some second-trimester abortions, particularly those that are complicated by medical conditions, should be done in a hospital with rapid access to the operating room, interventional radiology, blood bank, and other emergency interventions.
      • Diedrich J.
      • Steinauer J.
      Complications of surgical abortion.
      Hospitals and expert clinicians are essential for the education of students and training residents who care for complicated cases and for treating complications.
      The 100 professors went on to say that physicians should learn uterine aspiration, which is an outpatient procedure that today accounts for 82.3% of abortions, and local anesthesia and analgesia, which includes conscious sedation, so that complications and expense of general anesthesia would be reduced.
      • Pazol K.
      • Creanga A.A.
      • Zane S.B.
      • Burley K.D.
      • Jamieson D.J.
      Centers for Disease Control and Prevention (CDC)
      Abortion surveillance: United States, 2009.
      Today, some hospitals confine pregnancy termination, even routine first and uncomplicated second-trimester spontaneous and induced abortions, to operating rooms and have credentialing rules that prohibit the use of conscious sedation for these patients.

      Associated Press. Federal judge continues to block Mississippi anti-abortion law: Fox News. Available at: http://www.foxnews.com/us/2012/07/11/federal-judge-continues-to-block-mississippi-anti-abortion-law/. Accessed Jan. 11, 2013.

      Ignoring the 100 professors’ counsel not only dramatically increases patients’ recovery time and expense, but also adds significant and unnecessary staffing and clinical costs that discourage hospitals from providing abortions at all.
      Regarding hospital policies and the role of “abortion committees,” the 100 professors wrote “therapeutic abortion boards will have no place…in states with laws which stipulate that abortion decisions are to be made by the physician and his [her] patient.”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      The 100 professors commented on the physician’s duty to counsel regarding abortion: “There are patients…who should be actively encouraged to consider abortion—for example, women who are unaware of a teratogenic threat to their pregnancies.” At that time, the professors would have been thinking of rubella and did not know that advances in prenatal diagnosis would give obstetricians the opportunity and responsibility to make their patients aware of a wide range of genetic anomalies and to offer abortion if requested. The 100 professors certainly would not have envisioned the legislation recently proposed in Oklahoma to entitle physicians to withhold information in cases of known fetal deformity because a knowledgeable patient might choose termination.
      Writing about doctors with conscientious objections, the 100 professors said that these physicians must be excused from performing abortion but must refer patients to colleagues who can care for them. Recent “conscience clause” legislation does not require referral for abortion, and some states (Colorado, Ohio, Wisconsin, Michigan, and Texas) specifically prohibit referral for abortion by physicians who work in institutions that receive state funding for women’s health services.

      Guttmacher Institute Web site. State family planning funding restrictions. Available at: http://www.guttmacher.org/statecenter/spibs/spib_SFPFR.pdf. Accessed June 26, 2012.

      The American College of Obstetricians and Gynecologists, which discussed the limits of objection, recommends that “Any conscientious refusal that conflicts with a patient’s well-being should be accommodated only if the primary duty to the patient can be fulfilled.”
      American College of Obstetricians and Gynecologists
      The limits of conscientious refusal in reproductive medicine: ACOG Committee Opinion no. 385.
      Despite this guidance, many physicians are now prohibited by law from referring patients to vital services. In Texas, for example, referral for abortion can result in denial of contraceptive funding.
      The 100 professors predicted that space and resources for hospitals to provide abortion would result from “…the lessened number of septic abortions.”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      The Centers for Disease Control and Prevention and others subsequently documented a steep decline in hospital admissions and morbidity and mortality rates from illegal abortion promptly after Roe v Wade made abortion legal in all the states.
      • Cates W.
      • Grimes D.A.
      • Schultz K.
      Abortion surveillance at CDC: creating public health light out of political heat.
      The savings in lives and money from legalization were soon forgotten, and many hospitals now claim they cannot afford to provide abortions even if they wanted to because, among other arguments, reimbursement rates are too low (but abortion is certainly not the only service in this category), free-standing clinics provide faster and cheaper services with which hospitals cannot hope to compete (but some hospitals are able to provide cost-effective abortions), and hospital employees, notably nurses, refuse to provide abortion care (unlikely true of all or most nurses).
      Some hospitals with abortion services still face legislative challenges. Even though many residency programs have integrated abortion training successfully, individual states and, recently the US Congress, have legislated restrictions on abortion training in disregard of Accreditation Council on Graduate Medical Education training mandates.
      • Freedman L.
      • Landy U.
      • Steinauer J.
      Obstetrician-gynecologist experiences with abortion training: physician insights from a qualitative study.

      Guttmacher Institute. Monthly state update: major developments in 2012. Available at: http://www.guttmacher.org/statecenter/updates/index.html#Training. Accessed Nov. 9, 2012.

      These restrictions ultimately threaten women’s health by denying residents training in uterine evacuation, which further reduces access to safe abortion.
      The 100 professors considered the consent process for abortion, stating that “…it has been ruled by [some] courts that an adult woman is free to make this decision by herself.”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      However, several state legislatures have interfered in the consent process by requiring that irrelevant, even untrue, information be given by the physician (eg, abortion causes breast cancer and fetal pain) and enacting burdensome waiting periods that increase risks and costs.

      Guttmacher Institute. States enact record number of abortion restrictions in 2011. Available at: http://www.guttmacher.org/media/inthenews/2012/01/05/endofyear.html. Accessed June 5, 2012.

      • Lee S.J.
      • Ralston H.J.P.
      • Drey E.A.
      • Partridge J.C.
      • Rosen M.A.
      Fetal pain: a systematic multidisciplinary review of the evidence.
      They further predicted “that the courts will someday decide that “any girl who is physically mature enough to conceive should, ipso facto, be granted the freedom to determine the fate of her pregnancies.” Yet politicians in 37 states have restricted freedom of access of minors to abortion by implementing parental consent or notification laws, often with clumsy, prolonged “judicial bypass” requirements that lead to dangerous delays.

      Guttmacher Institute. Parental involvement in minors’ abortions. Available at: http://www.guttmacher.org/statecenter/spibs/spib_PIMA.pdf. Accessed June 22, 2012.

      The professors addressed the need for postabortion contraception to decrease the need for abortion, endorsing it as “an integral part of any abortion program,”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      but today the most effective contraceptives are still not easily accessible immediately after abortion when women most want them. Although the American College of Obstetricians and Gynecologists, Planned Parenthood, and other organizations promote postabortion use of long-acting reversible contraception, the family planning funding regulations of many states do not pay for immediate postabortion methods, and several states (eg, Indiana and Texas) and the US House of Representatives have attempted to eliminate family planning from their budgets entirely.

      Guttmacher Institute Web site. State family planning funding restrictions. Available at: http://www.guttmacher.org/statecenter/spibs/spib_SFPFR.pdf. Accessed June 26, 2012.

      Finally, the 100 professors recommended that “abortion should be made equally available to the rich and the poor.”
      A statement on abortion by one hundred professors of obstetrics (copyright Elsevier).
      Ironically, shortly after the 1973 Roe v Wade decision that our predecessors anticipated, the Hyde Amendment prohibited the use of federal dollars for abortion so that women in the military or who have received Medicaid have had severely limited access to abortion for nearly 40 years, unless they can pay themselves or happen to live in one of the 13 states that use their own funds for abortion.

      American Civil Liberties Union. Public funding for abortion. Available at: http://www.aclu.org/reproductive-freedom/public-funding-abortion. Accessed Nov. 9, 2012.

      Richer women, on the other hand, usually have private health insurance for abortions but there, too, the US Congress threatens women’s health by insisting that the Affordable Care Act restrict even private payers from directly including abortion.
      In consideration of current legislative threats to the autonomy of our patient relationships, to evidence-based medical practice, to the training of our students and residents, and ultimately to the health of our patients, we 100, including 2 of the original signers, join the 100 of 1972 in affirming our academic responsibilities to (1) teach future practitioners about all methods of contraception and about uterine evacuation throughout pregnancy, which ranges from miscarriage management to emergent evacuations and the treatment of complications in accordance with our professional mandate from Accreditation Council for Graduate Medical Education; (2) provide evidence-based information to all patients who seek family planning or pregnancy termination; (3) provide evidenced-based information to legislators who propose laws requiring inaccurate information or unindicated procedures for women seeking to terminate a pregnancy; (4) insist that the hospitals where we care for women and teach students and residents admit patients who require hospital-based pregnancy terminations, and (5) ensure the availability of all methods of contraception, particularly long-acting reversible contraception methods, to reduce the need for abortion.

      Appendix

      100 Professors
      Dr David F. Archer
      Professor of Obstetrics and Gynecology
      Eastern Virginia Medical School
      Norfolk, VA
      Dr Amy (Meg) Autry
      President-elect, Association of Professors of Gynecology and Obstetrics
      Professor of Obstetrics, Gynecology and Reproductive Sciences
      University of California, San Francisco
      San Francisco, CA
      Dr Robert L. Barbieri
      Kate Macy Ladd Professor and Chair
      Department of Obstetrics and Gynecology
      Brigham and Women's Hospital
      Harvard Medical School
      Boston, MA
      Dr Jonathan S. Berek
      Laurie Kraus Lacob Professor and Chair
      Department of Obstetrics and Gynecology
      Stanford University
      Stanford, CA
      Dr Sarah L. Berga
      Professor and Chair
      Associate Dean Women's Health Research
      Department of Obstetrics and Gynecology
      Wake Forest University
      Winston-Salem, NC
      Dr Ira M. Bernstein
      John Van Sicklen Maeck Professor and Chair
      Department of Obstetrics and Gynecology
      Senior Associate Dean for Research
      University of Vermont
      Burlington, VT
      Dr Michael Brodman
      Professor and Chair
      Department of Obstetrics, Gynecology and Reproductive Science
      The Mount Sinai Medical Center
      New York, NY
      Dr Haywood Brown
      Professor and Chair
      Department of Obstetrics and Gynecology
      Duke University
      Durham, NC
      Dr Pierre Buekens
      W.H. Watkins Professor
      Tulane University School of Public Health and Tropical Medicine
      New Orleans, LA
      Dr Serdar E. Bulun
      John J. Sciarra Professor and Chair
      Department of Obstetrics and Gynecology
      Northwestern University
      Chicago, IL
      Dr Ronald T. Burkman
      Professor of Obstetrics and Gynecology
      Tufts University
      Springfield, MA
      Dr Winston A. Campbell
      Professor and Interim Chair
      Department of Obstetrics and Gynecology
      University of Connecticut Health Center
      Farmington, CT
      Dr Linda F. Carson
      Professor and Head
      Department of Obstetrics, Gynecology and Women's Health
      University of Minnesota
      Minneapolis, MN
      Dr Aaron B. Caughey
      Professor and Chair
      Department of Obstetrics and Gynecology
      Oregon Health and Science University
      Portland, OR
      Dr Gautam Chaudhuri
      Distinguished Professor and Executive Chair
      Department of Obstetrics and Gynecology
      University of California, Los Angeles
      Los Angeles, CA
      Dr David Chelmow
      Leo J. Dunn Distinguished Professor and Chair
      Department of Obstetrics and Gynecology
      Virginia Commonwealth University Medical Center
      Richmond, VA
      Dr Frank Chervenak
      Professor and Chair
      Department of Obstetrics and Gynecology
      Cornell University
      New York, NY
      Dr Daniel L. Clarke-Pearson
      Robert A. Ross Distinguished Professor and Chair
      Department of Obstetrics and Gynecology
      University of North Carolina
      Chapel Hill, NC
      Dr Mitchell Creinin
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of California, Davis
      Sacramento, CA
      Dr Mary D'Alton
      Willard C. Rappleye Professor and Chair
      Department of Obstetrics and Gynecology
      Columbia University
      New York, NY
      Dr Vani Dandolu
      Associate Professor and Chair
      Department of Obstetrics and Gynecology
      University of Nevada School of Medicine
      Reno, NV
      Dr Philip D. Darney
      Distinguished Professor
      Department of Obstetrics, Gynecology and Reproductive Sciences
      University of California, San Francisco
      San Francisco, CA
      Dr Richard Derman
      Endowed Chair of Obstetrics and Gynecology
      Christiana Care Health Services
      Newark, DE
      Dr Deborah A. Driscoll
      Luigi Mastroianni, Jr Professor and Chair
      Department of Obstetrics and Gynecology
      University of Pennsylvania
      Philadelphia, PA
      Dr David A. Eschenbach
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Washington
      Seattle, WA
      Dr James E. Ferguson
      The W. Norman Thornton, Jr Professor and Chair
      Department of Obstetrics and Gynecology
      University of Virginia School of Medicine
      Charlottesville, VA
      Dr Harold E. Fox
      Dr Dorothy Edwards Professor and Chair
      Department of Obstetrics and Gynecology
      Johns Hopkins University
      Baltimore, MD
      Dr Arnold J. Friedman
      Chair, Department of Obstetrics and Gynecology
      Beth Israel Medical Center
      New York, NY
      Dr Melissa Gilliam
      Professor of Obstetrics, Gynecology and Pediatrics, Associate Dean for Diversity
      Division of the Biological Sciences
      The University of Chicago
      Chicago, IL
      Dr Todd Griffin
      Associate Professor and Chair
      Department of Obstetrics and Gynecology
      Stonybrook Medicine
      Stony Brook, NY
      Dr David A. Grimes
      Clinical Professor Department of Obstetrics and Gynecology
      University of North Carolina
      Chapel Hill, NC
      Dr Daniel R. Grow
      Professor and Deputy Chair
      Department of Obstetrics and Gynecology
      Tufts University
      Boston, MA
      Dr Linda Giudice
      Distinguished Professor and Chair
      Department of Obstetrics, Gynecology and Reproductive Sciences
      University of California, San Francisco
      San Francisco, CA
      Dr Arthur Haney
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Chicago
      Chicago, IL
      Dr Wendy F. Hansen
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Kentucky
      Lexington, KY
      Dr Christopher Harman
      Professor and Chair
      Department of Obstetrics, Gynecology and Reproductive Sciences
      University of Maryland
      Baltimore, MD
      Dr Linda J. Heffner
      Professor of Obstetrics and Gynecology
      Boston University School of Medicine
      Boston, MA
      Dr Paul Hendessi
      Interim Chair and Clinical Associate Professor
      Department of Obstetrics and Gynecology
      Boston Medical Center
      Boston, MA
      Dr William Allen Hogge
      Milton C. McCall Professor and Chair
      Department of Obstetrics, Gynecology, and Reproductive Sciences
      University of Pittsburgh
      Pittsburgh, PA
      Dr Ira R. Horowitz
      John D. Thompson Professor and Chair
      Department of Gynecology and Obstetrics
      Emory University
      Atlanta, GA
      Dr Jeffrey Jensen
      Leon Speroff Professor of Obstetrics and Gynecology
      Oregon Health and Science University
      Portland, OR
      Dr Timothy R.B. Johnson
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Michigan
      Ann Arbor, MI
      Dr Donna Johnson
      Professor and Chair
      Department of Obstetrics and Gynecology
      Medical University of South Carolina
      Charleston, SC
      Dr Julia Johnson
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Massachusetts Medical School
      Worcester, MA
      Dr Harry S. Jonas
      Professor Emeritus and Dean Emeritus
      University of Missouri-Kansas City
      Kansas City, MO
      Dr Howard W. Jones III
      Professor and Chair
      Department of Obstetrics and Gynecology
      Vanderbilt University
      Nashville, TN
      Dr David Keefe
      Stanley H. Kaplan Professor and Chair
      Department of Obstetrics and Gynecology
      New York University Medical Center
      New York, NY
      Dr Sarah J. Kilpatrick
      Professor and Chair
      Department of Obstetrics and Gynecology
      Cedars-Sinai Medical Center
      West Hollywood, CA
      Dr Mark B. Landon
      Professor and Chair
      Department of Obstetrics and Gynecology
      Ohio State University
      Columbus, OH
      Dr John W. Larsen
      Professor and Chair
      Department of Obstetrics and Gynecology
      The George Washington University
      Washington, DC
      Dr Douglas W. Laube
      Professor and Past Chair
      Department of Obstetrics and Gynecology
      University of Wisconsin–Madison
      Madison, WI
      Dr Lee A. Learman
      Clarence E. Ehrlich Professor and Chair
      Department of Obstetrics and Gynecology
      Indiana University School of Medicine
      Indianapolis, IN
      Dr Kimberly K. Leslie
      Professor and Head
      Jennifer R. Niebyl Endowed Chair
      Department of Obstetrics and Gynecology
      University of Iowa
      Iowa City, IA
      Dr Edward Linn
      Associate Professor and Chair
      Department of Obstetrics and Gynecology
      Cook County Health and Hospitals System
      Northwestern University
      Chicago, IL
      Dr James H. Liu
      Arthur H. Bill Professor and Chair
      Department of Reproductive Biology
      Case Western Reserve University
      Cleveland, OH
      Dr Curtis Lowery
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Arkansas for Medical Sciences
      Little Rock, AR
      Dr George A. Macones
      Professor and Chair
      Department of Obstetrics and Gynecology
      Washington University in St Louis
      St. Louis, MS
      Dr Veronica Mallet
      Professor and Founding Chair
      Department of Obstetrics and Gynecology
      Texas Tech University
      Lubbock, TX
      Dr Dev Maulik
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Missouri–Kansas City
      Kansas City, MO
      Dr Irwin R. Merkatz
      Professor and Chair
      Department of Obstetrics and Gynecology and Women's Health
      Albert Einstein College of Medicine
      Bronx, NY
      Dr Daniel R. Mishell Jr
      Endowed Professor of Obstetrics and Gynecology
      University of Southern California
      Los Angeles, CA
      Dr Owen Montgomery
      Chair
      Department of Obstetrics and Gynecology
      Drexell University
      Philadelphia, PA
      Dr Valerie Montgomery Rice
      Dean and Executive Vice President
      Morehouse School of Medicine
      Atlanta, GA
      Dr Thomas Moore
      Professor and Chair
      Department of Reproductive Medicine
      University of California, San Diego
      San Diego, CA
      Dr Laila Muderspach
      Associate Professor and Chair
      Department of Obstetrics and Gynecology
      University of Southern California
      Los Angeles, CA
      Dr Anita L. Nelson
      Professor of Obstetrics and Gynecology
      Harbor Hospital University of California, Los Angeles
      Los Angeles, CA
      Dr Jennifer R. Niebyl
      Professor and Vice-Chair
      Department of Obstetrics and Gynecology
      University of Iowa Hospitals and Clinics
      Iowa City, IA
      Dr Errol R. Norwitz
      Louis E. Phaneuf Professor and Chair
      Department of Obstetrics and Gynecology
      Tufts University
      Boston, MA
      Dr Valerie Parisi
      Professor of Obstetrics and Gynecology
      Dean, School of Medicine
      Wayne State University
      Detroit, MI
      Dr Kirtly Parker Jones
      Professor and Vice Chair of Educational Affairs
      Department of Obstetrics and Gynecology
      University of Utah
      Salt Lake City, UT
      Dr Maureen G. Phipps
      Associate Professor and Interim Chair
      Department of Obstetrics & Gynecology
      Brown University
      Providence, RI
      Dr Manuel Porto
      Professor and the E.J. Quilligan Endowed Chair
      Department of Obstetrics and Gynecology
      University of California, Irvine
      Irvine, CA
      Dr Gabriella Pridjian
      C. Jeff Miller Professor and Chair
      Department of Obstetrics and Gynecology
      Tulane University
      New Orleans, LA
      Dr J. Gerald Quirk
      Professor of Obstetrics, Gynecology and Reproductive Medicine
      Stony Brook University
      Stony Brook, NY
      Dr Janet S. Rader
      Jack A. and Elaine D. Klieger Professor and Chair
      Department of Obstetrics and Gynecology
      Medical College of Wisconsin
      Milwaukee, WI
      Dr William F. Rayburn
      Randolph Seligman Professor and Chair
      Department of Obstetrics and Gynecology
      University of New Mexico
      Albuquerque, NM
      Dr Richard Reindollar
      Professor and Chair
      Department of Obstetrics and Gynecology
      Dartmouth-Hitchcock Medical Center
      Hanover, NH
      Dr Hope A. Ricciotti
      Acting Chair and Associate Professor
      Beth Israel Deaconess Medical Center
      Harvard Medical School
      Boston, MA
      Dr Laurel Rice
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Wisconsin
      Madison, WI
      Dr Gloria Richard-Davis
      Professor and Chair
      Department of Obstetrics and Gynecology
      Meharry Medical College
      Nashville, TN
      Dr Juana I. Rivera-Vinas
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Puerto
      San Juan, PR
      Dr Nanette Santoro
      Professor and E Stewart Taylor Chair
      Department of Obstetrics and Gynecology
      University of Colorado
      Aurora, CO
      Dr Andrew J. Satin
      Professor and Vice Chair
      Department of Gynecology and Obstetrics
      Johns Hopkins University
      Baltimore, MD
      Dr Lynnae Millar Sauvage
      Professor and Chair
      Department of Obstetrics, Gynecology and Women's Health
      University of Hawaii
      Honolulu, HI
      Dr William D. Schlaff
      Professor and Chair
      Department of Obstetrics and Gynecology
      Thomas Jefferson University
      Philadelphia, PA
      Dr Jack Sciarraa
      Professor and Chair Emeritus
      Department of Obstetrics and Gynecology
      Northwestern University Medical School
      Chicago, IL
      Dr Robert K. Silverman
      Professor and Chair
      Department of Obstetrics and Gynecology
      SUNY-Upstate Medical University
      Syracuse, NY
      Dr Carl V. Smith
      Professor and Chair
      Department of Obstetrics and Gynecology
      University of Nebraska
      Omaha, NE
      Dr Leon Speroff
      Professor Emeritus of Obstetrics and Gynecology
      Oregon Health and Science University
      Portland, OR
      Dr Morton Stenchevera
      Professor and Chair Emeritus
      University of Washington
      Seattle, WA
      Dr Jerome F. Strauss, III
      Professor and Dean
      Department of Obstetrics and Gynecology
      Virginia Commonwealth University
      Richmond, VA
      Dr Phillip Stubblefield
      Emeritus Professor of Obstetrics and Gynecology
      Boston University
      Boston, MA
      Dr Hugh S. Taylor
      Anita O'Keeffe Young Professor and Chair
      Department of Obstetrics, Gynecology and Reproductive Sciences
      Yale University
      New Haven, CT
      Dr J. Peter Van Dorsten
      Professor and Past Chair
      Department of Obstetrics and Gynecology
      Medical University of South Carolina
      Charleston, SC
      Dr Eugene Washington
      Vice Chancellor of UCLA Health Sciences
      Dean of the David Geffen School of Medicine
      University of California, Los Angeles
      Los Angeles, CA
      Dr Gerson Weiss
      Professor and Chair
      Department of Obstetrics and Gynecology
      The University of Medicine and Dentistry of New Jersey
      Newark, NJ
      Dr Carolyn Westhoff
      Professor of Obstetrics, Gynecology, and Public Health
      Columbia University
      New York, NY
      Dr Robert Stanford Williams
      Harry Prystowsky Professor and Chair
      Department of Obstetrics and Gynecology
      University of Florida
      Gainesville, FL
      Dr James Woods
      Henry A. Thiede Professor and Chair
      Department of Obstetrics and Gynecology
      University of Rochester
      Rochester, NY
      Dr Jerome Yankowitz
      James M. Ingram Professor and Chair
      Department of Obstetrics and Gynecology
      University of South Florida
      Tampa, FL
      aOriginal signer of 1972 list.

      Supplementary data

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