Increasing NIH funding for academic departments of obstetrics and gynecology: a call to action

Published:April 06, 2020DOI:
      The National Institutes of Health funding for reproductive sciences research, specifically in academic departments of obstetrics and gynecology, is disproportionately low. Research is one of the most important pillars in advancing healthcare. Despite US Congress’ vision in providing increased funding to the National Institutes of Health as a whole, underfunding for research in the departments of obstetrics and gynecology remains one of the several critical drivers in the decline in reproductive health and healthcare for women in the United States.

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        • Krzyzanowska M.K.
        • Kaplan R.
        • Sullivan R.
        How may clinical research improve healthcare outcomes?.
        Ann Oncol. 2011; 22 (vii10–5)
        • Dorsey E.R.
        • de Roulet J.
        • Thompson J.P.
        • et al.
        Funding of US biomedical research, 2003–2008.
        JAMA. 2010; 303: 137-143
        • Blue Ridge Institute for Medical Research
        Ranking tables of NIH funding to US Medical Schools in 2018 as compiled by Robert Roskoski Jr.
        (Available at:)
        • Stonehocker J.
        • Muruthi J.
        • Rayburn W.F.
        Is There a shortage of obstetrician-gynecologists?.
        Obstet Gynecol Clin North Am. 2017; 44: 121-132
        • Association of American Medical Colleges
        Table 2.2. Number and percentage of ACGME residents and fellows by sex and specialty, 2017.
        (Available at:)
        • United States Department of Health & Human Services
        Research portfolio online reporting tools expenditures and results.
        (Available at:)
        Date accessed: December 4, 2019
        • Spencer R.J.
        • Rice L.W.
        • Ye C.
        • Woo K.
        • Uppal S.
        Disparities in the allocation of research funding to gynecologic cancers by Funding to Lethality scores.
        Gynecol Oncol. 2019; 152: 106-111
        • United States Department of Health & Human Services
        Research portfolio online reporting tools. Estimates of funding for various research, condition, and disease categories (RCDC).
        (Available at:)
        • Jemal A.
        • Ward E.M.
        • Johnson C.J.
        • et al.
        Annual report to the nation on the status of cancer, 1975–2014, featuring survival.
        J Natl Cancer Inst. 2017; 109: djx030
      1. Institute of Medicine (US) Committee on Research Capabilities of Academic Departments of Obstetrics and Gynecology, Townsend J, editor. Strengthening Research in Academic OB/GYN Departments. Washington, DC: National Academies Press; 1992.

        • Association of American Medical Colleges
        National MD-PhD Program Outcomes Study.
        CreateSpace Independent Publishing Platform, Washington, DC2018
      2. Institute of Medicine (US) Committee on Health Research and the Privacy of Health Information. The HIPAA privacy rule.
        in: Nass S.J. Levit L.A. Gostin L.O. Beyond the HIPAA privacy rule: enhancing privacy, improving health through research. National Academies Press, Washington, DC2009
        • Gluckman P.D.
        • Hanson M.A.
        • Cooper C.
        • Thornburg K.L.
        Effect of in utero and early-life conditions on adult health and disease.
        N Engl J Med. 2008; 359: 61-73
        • Centers for Disease Control and Prevention
        Pregnancy mortality surveillance system; 2019.
        (Available at:)
        • Centers for Disease Control and Prevention
        National Center for Health Statistics. National vital statistics systems.
        (Available at:)
        Date accessed: December 5, 2019
        • Lane-Cordova A.D.
        • Khan S.S.
        • Grobman W.A.
        • Greenland P.
        • Shah S.J.
        Long-term cardiovascular risks associated with adverse pregnancy outcomes: JACC review topic of the week.
        J Am Coll Cardiol. 2019; 73: 2106-2116
        • American Cancer Society
        Cancer facts and statistics.
        (Available at:)
        Date accessed: November 20, 2019
        • Henley S.J.
        • Miller J.W.
        • Dowling N.F.
        • Benard V.B.
        • Richardson L.C.
        Uterine cancer incidence and mortality—United States, 1999–2016.
        MMWR Morb Mortal Wkly Rep. 2018; 67: 1333-1338
        • Daniels K.
        • Mosher W.D.
        Contraceptive methods women have ever used: United States, 1982-2010.
        Natl Health Stat Report. 2013; 62: 1-15
        • Jones R.K.
        • Jerman J.
        Population Group Abortion Rates and Lifetime Incidence of Abortion: United States; 2008–2014.
        (Available at:)
        • Sonfield A.
        • Hasstedt K.
        • Gold R.B.
        Moving forward: family planning in the era of health reform.
        (Available at:)
        • Dehlendorf C.
        • Rodriguez M.I.
        • Levy K.
        • Borrero S.
        • Steinauer J.
        Disparities in family planning.
        Am J Obstet Gynecol. 2010; 202: 214-220
        • Kost K.
        • Lindberg L.
        Pregnancy intentions, maternal behaviors, and infant health: investigating relationships with new measures and propensity score analysis.
        Demography. 2015; 52: 83-111
        • Guttmacher Institute
        Testimony of Guttmacher Institute submitted to the Committee on Preventive Services for Women, Institute of Medicine.
        (Available at:)
        • Sonfield A.
        • Hasstedt K.
        • Kavanaugh M.
        • Anderson R.
        The social and economic benefits of women’s ability to determine whether and when to have children.
        (Available at:)
        • Bearak J.M.
        • Jones R.K.
        Did contraceptive use patterns change after the Affordable Care Act? A descriptive analysis.
        Womens Health Issues. 2017; 27: 316-321
        • Wheeler L.J.
        • Desanto K.
        • Teal S.B.
        • Sheeder J.
        • Guntupalli S.R.
        Intrauterine device use and ovarian cancer risk: a systematic review and meta-analysis.
        Obstet Gynecol. 2019; 134: 791-800
        • Cortessis V.K.
        • Barrett M.
        • Brown Wade N.
        • et al.
        Intrauterine device use and cervical cancer risk: a systematic review and meta-analysis.
        Obstet Gynecol. 2017; 130: 1226-1236
        • Felix A.S.
        • Gaudet M.M.
        • La Vecchia C.
        • et al.
        Intrauterine devices and endometrial cancer risk: a pooled analysis of the Epidemiology of Endometrial Cancer Consortium.
        Int J Cancer. 2015; 136: E410-E422
        • World Health Organization
        Medical eligibility criteria for contraceptive use. 5th ed.
        (Available at:)
        • Schreiber C.A.
        • Creinin M.D.
        • Atrio J.
        • Sonalkar S.
        • Ratcliffe S.J.
        • Barnhart K.T.
        Mifepristone pretreatment for the medical management of early pregnancy loss.
        N Engl J Med. 2018; 378: 2161-2170
        • Nygaard I.
        • Barber M.D.
        • Burgio K.L.
        • et al.
        Prevalence of symptomatic pelvic floor disorders in US women.
        JAMA. 2008; 300: 1311-1316
        • Wu J.M.
        • Vaughan C.P.
        • Goode P.S.
        • et al.
        Prevalence and trends of symptomatic pelvic floor disorders in U.S. women.
        Obstet Gynecol. 2014; 123: 141-148
        • Erekson E.A.
        • Lopes V.V.
        • Raker C.A.
        • Sung V.W.
        Ambulatory procedures for female pelvic floor disorders in the United States.
        Am J Obstet Gynecol. 2010; 203: 497.e1-497.e5
        • Jonsson Funk M.
        • Levin P.J.
        • Wu J.M.
        Trends in the surgical management of stress urinary incontinence.
        Obstet Gynecol. 2012; 119: 845-851
        • DevCan
        Probability of developing or dying of cancer software, Version 6.7.7. Statistical research and Applications Branch. National Cancer Institute; 2019.
        (Available at:)
        • Jonsson Funk M.
        • Edenfield A.L.
        • Pate V.
        • Visco A.G.
        • Weidner A.C.
        • Wu J.M.
        Trends in use of surgical mesh for pelvic organ prolapse.
        Am J Obstet Gynecol. 2013; 208: 79.e1-79.e7
        • United States Food and Drug Administration
        Urogynecologic surgical mesh: update and the safety and effectiveness of transvaginal placement for pelvic organ prolapse.
        (Available at:)
        Date accessed: December 5, 2019
        • United States Food and Drug Administration
        FDA strengthens requirements for surgical mesh for the transvaginal repair of pelvic organ prolapse to address safety risks.
        (Available at:)
        • United States Food and Drug Administration
        Urogynecologic surgical mesh implants.
        (Available at:)
        • Hoppe T.A.
        • Litovitz A.
        • Willis K.A.
        • et al.
        Topic choice contributes to the lower rate of NIH awards to African-American/black scientists.
        Sci Adv. 2019; 5eaaw7238
        • Legro R.S.
        • Brzyski R.G.
        • Diamond M.P.
        • et al.
        Letrozole versus clomiphene for infertility in the polycystic ovary syndrome.
        N Engl J Med. 2014; 371: 119-129
        • Geller S.E.
        • Koch A.R.
        • Roesch P.
        • Filut A.
        • Hallgren E.
        • Carnes M.
        The more things change, the more they stay the same: a study to evaluate compliance with inclusion and assessment of women and minorities in randomized controlled trials.
        Acad Med. 2018; 93: 630-635
        • Onarheim K.H.
        • Iversen J.H.
        • Bloom D.E.
        Economic benefits of investing in women’s health: a systematic review.
        PLoS One. 2016; 11e0150120