Translating Guidelines and Public Policy Into Optimal Health Care for Women

Abstract

T he mission of the American Congress of Obstetricians and Gynecologists (the Congress) is to advance women's health care and the interests of its members through advocacy and public policy. Clinical and practice guidelines and research are the primary means through which the American College of Obstetricians (the College) affects practice patterns to help make women's health care safe and effective. Our field is now under greater scrutiny from policymakers, purchasers of health care, and patients owing to the unprecedented number of women with coverage through health reform. This expanded access of care drives the policy lens to focus on both quality and outcomes of women's health care. We identify three examples where College guidelines and public policy intersect: 1) a national focus on elective deliveries before 39 weeks of gestation, 2) attention to maternal mortality, and 3) the requirement for coverage of women's clinical preventive services as a result of the Affordable Care Act. Each of these areas provides examples of current or potential "carrots and sticks," offering rewards or punishments to motivate behavior change. The College/Congress and its members have opportunities to take action in implementing recommended policy and improving the quality of care for women, but Fellows also may be penalized if well-established guidelines are not followed.