Sign Out: Who will deliver our babies?

Awakening America to the current liability crisis and its impact on women's access to health care has been a slow process. Only within the past year have women begun to personally experience the burden of longer waiting times, less preventive care, decreased antenatal care, and delayed or denied gynecologic surgeries. In some cases, an ob/gyn is no longer available in their communities.

Personal injury lawyers, nevertheless, are fighting hard to convince America that this is a manufactured crisis brought on by greedy and irresponsible insurance companies and economically motivated physicians. Recent information from Pennsylvania, a crisis state, illustrates the undeniable impact of the personal injury lawsuit industry on our economy and our citizens. According to the Health Resources and Services Administration, Pennsylvania medical liability insurers paid out $448 million last year, a 13.5% increase over the $395 million paid out in 2003. In fact, Pennsylvania insurers have paid out over $2.01 billion since 2000. At the average contingent fee agreement of 40%, Pennsylvania's personal injury lawyers pocketed $805 million in the interval. Make no mistake, personal injury litigation is a multibillion dollar industry and personal injury lawyers will fight hard to keep those contingency fees coming in.

The crisis of diminished, delayed, or denied access to care for women will only deepen in 2005. ACOG is on Capitol Hill every day to educate Congress, especially US senators, about this plight. In addition to its annual Congressional Leadership Conference, ACOG leads a variety of grassroots efforts to ensure that elected representatives understand what is happening to women's health care and the physicians in their home districts and states. Physician input and leadership has been superb and is vital to these educational efforts.

However, the voices that must be heard more by our legislators are those of our patients. ACOG has created patient communication materials that all Fellows can give to their patients to help women communicate their concerns to elected representatives. A fold-over mailer framing the question "Who will deliver my baby?" will allow patients to send their individual messages, along with photographs of their babies, to Congress, particularly to their senators. Our patients and their babies speak in the most elemental and effective language of the democratic process: The need of the constituency, the will of the electorate, the voice of the people.

Until the Senate, particularly six to eight key Democratic senators, hears the outcry of women whose health care is at risk, whose safe motherhood is compromised, and whose babies' well-being is imperiled, the current crisis will not abate. ACOG and its Fellows will persevere in providing needed medical and surgical care to women. We will also continue to support our patients in demanding medical liability reform. As guardians of safe motherhood and caregivers to women of all ages, we can do no less.