JEANNE CONRY, KAISER PERMANENTE MEDICAL GROUP AND PRESIDENT-ELECT OF THE AMERICAN CONGRESS OF OBSTETRICIANS AND GYNECOLOGISTS

Most women try to conceive at least once, and many women have more than one pregnancy, and of those women who get pregnant, many experience complications during their pregnancies. As a result, pregnancy is a time when clinicians have various opportunities to talk with women about a range of health issues, including the importance of achieving and maintaining a healthy weight.

As an organization that represents 56,000 physicians and the women they serve, the American Congress of Obstetricians and Gynecologists (ACOG) has a key role to play in helping women gain weight appropriately during pregnancy. ACOG has powerful tools for educating clinicians, such as its well-known evidence-based guidelines for care and its webinars, meetings, online learning opportunities, newsletter, and journal. It also partners with the American Board of Obstetricians and Gynecologists, which provides an opportunity to incorporate new information, including the new IOM pregnancy weight gain guidelines, into the annual tests that obstetricians and gynecologists (OB-GYNs) must take to maintain their board certification.

The goal of reproductive health care is to produce healthy women, healthy mothers, and healthy babies, but the United States is currently comparable to a third-world country in terms of maternal mortality. In some states, maternal mortality has tripled in the past decade. In California, huge racial disparities exist; for example, an African American woman is four times more likely to die from a pregnancy-related cause than a white woman. Many factors are related to maternal mortality, with obesity and the preconception health of the woman being significant components.

The National Maternal Health Initiative of the Department of Health and Human Services is focused on improving the health of women once they become pregnant. However, because 50 percent of pregnancies are unplanned, it is critically important for health care providers to help non-pregnant women be healthy at all times over their reproductive lives. All physicians, no matter their specialty (e.g., internists, family physicians, or neurologists), should collaborate in goal-directed conversations with women about their overall health and their reproductive goals, and these conversations should be ongoing, for a woman may have very different reproductive goals at age 18 than at 25 or 32.

Conry offered an example from her own medical group to illustrate the importance of sharing information among health care providers and



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