• Evaluation of the accessibility of structured exercise programs for pregnant women: An analysis of offerings at the YMCAs of Massachusetts

      Driscoll, Janelle; Iyer, Vidya; Medeiros, Ashley; Parameshwaran, Shobhana; Dangel, Alissa (2018-03-09)
      The American Congress of Obstetrics and Gynecology recommends that exercise should be encouraged in women with uncomplicated pregnancies. Potential benefits of exercise include a decreased incidence of medical complications of pregnancy, including gestational diabetes and preterm labor. Additional benefits include decreased incidence of excessive maternal weight gain, cesarean sections and low birthweight of the newborn. The Massachusetts' rate of gestational diabetes was 4.7% in 2015 with 7.8% babies being born at low birth weight and 8.6% born preterm statewide. The aim of this project was to evaluate the availability of structured exercise programs tailored specifically to pregnant women, as a lack of options may limit a woman's ability to benefit from the health-protective effects of exercise during pregnancy. A telephone survey was conducted in 2017 to gather information about exercise programs available to pregnant women at YMCAs across Massachusetts. YMCAs were chosen because of their accessibility, affordability and history of health-centered initiatives. Our analysis revealed that of the 73 Massachusetts YMCA facilities contacted; only three indicated a specific class for prenatal exercise. Two offered prenatal yoga and the other a stretching class. This study revealed that easily accessible options for exercise tailored to pregnant women are currently limited at YMCA facilities in Massachusetts. This may reflect an overall limitation of exercise options for pregnant women. Further investigation regarding the specific barriers women face when attempting to exercise during pregnancy may provide valuable insight into how community organizations can help maximize the number of women who partake in exercise during pregnancy.
    • Supporting Family Physician Maternity Care Providers

      Goldstein, Jessica Taylor; Hartman, Scott G.; Meunier, Matthew R.; Panchal, Bethany; Pecci, Christine Chang; Zink, Nancy M.; Shields, Sara G. (2018-10-01)
      Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers.