Disclaimer: Opinions expressed in this guest post are solely those of the guest author.
After 25 years of clinical practice of obstetrics and gynecology in both bedside and academic medicine, I still absolutely love what I do. I find it exceptionally rewarding to be able to teach medical students, train residents, and help care for patients across the OBGYN spectrum. Additionally, I’m thankful to have gained valuable experience by participating in various clinical trials throughout the years, and I have learned valuable insights in navigating the turbulent road of academic publishing.
Yet despite the diverse experiences, there is nothing more satisfying than guiding a patient through a complex obstetrical or gynecological condition successfully. Though we also encounter devastating conditions, this is the world of medicine overall. We celebrate the wins and we grieve the losses.
I have always had a passion to get more involved — to push for positive change in my field, to help shape medicine. So, when the American College of Obstetrics and Gynecology (ACOG) had an open call for national officers in 2022, I jumped right in. I already had experience serving on an ACOG team, assisting with the obstetrical care consensus committee. I found it extremely rewarding. Joining the national board of directors was a no-brainer for me.
I entered the national office as the fellow-at-large in spring of 2024 with wildfire enthusiasm. But in March 2025, I tenured my resignation from the Board.
A strange virus has now infected professional medical societies like the ACOG — one that also infects society, preventing those infected from having rational, open, and honest discussions with others who might have different worldviews than their own. Gone are the days of “we can agree to disagree.” Now, it is “we will disagree until I MAKE you agree.”
Primarily medical or primarily political?
Per organizational bylaws, professional medical organizations like the ACOG are fiduciary bodies and are self-described “apolitical” in nature. In a fiduciary, the views, perspectives, and opinions of all members are recognized, accepted, and represented; the professional organization via its leadership, therefore, must work on behalf and in support of the diverse world views of all its members. This, however, is not occurring.
This is not a problem unique to the ACOG. This is being manifested across other professional medical societies as well and is the main reason for shrinking memberships. In a May 2024 publication by Richard A. Robbins, he writes:
For example, in the early 1950’s, about 75% of US physicians were American Medical Association (AMA) members. That percentage has steadily decreased over the years. In 2019 there were only 132,133 practicing physicians or about 12.1% of physicians who are AMA members.
The same can be said for the AAFP, AAP, and the ACOG. The unfortunate reality is that these professional medical organizations have gone from being primarily medical organizations with political undertones, to being primary political organizations with medical undertones. And it is wrong.
On February 9, 2024, the ACOG released a statement on traveling to states with abortion bans in place. Stated in that brief:
Obstetrician–gynecologists are clinical experts, not legal experts, so they may be uncertain whether they could face recrimination when traveling to states where the care that they provide patients is banned, especially when that travel is conducted for professional reasons. Moreover, obstetrician–gynecologists who are pregnant have valid fears about exposing themselves to the same legal restrictions to care that have caused harm to people living in restricted states.
Stated differently, the ACOG would not go to abortion ban states for fear of “recrimination” of physicians who may provide abortions back in their own state. Not only has this never been proposed in states with abortion bans, but it is also a surprising misunderstanding of the actual language in the abortion statutes.
Any pregnant physician should never fear traveling to a state with an abortion ban for fear of lack of treatment in case of an emergency. All states, even those with abortion bans in effect, allow for appropriate obstetrical intervention in cases of ectopic pregnancy, spontaneous miscarriage, or events where a woman’s health would be in jeopardy. This includes allowance for complications such as spontaneous rupture of membranes before fetal viability.
The ACOG’s decision to not hold its annual clinical meetings in “red states” robs those OBGYN physicians of their ability to attend these meetings based solely on the political “color” of the state. This is disappointing, heartbreaking, and wrong. Where is the fiduciary responsibility to its membership in these states?
In this same vein, upon hearing that the ACOG was considering leaving one social media platform for another, based simply on the political views of the owner, I had heard enough. It seemed that these decisions were being made based on the individual perspectives and worldviews of the directors, rather than acting on behalf of its membership.
This lack of fiduciary representation is also evident in the ACOG stance on abortion. Through direct messages sent to me on my various social media platforms, as well as through in-person communications with other OBGYN physicians at various professional meetings throughout the country, I have had many inform me that this issue in particular was the reason they withdrew membership from the ACOG.
This likely also explains the growing interest in parallel OBGYN societies like the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG).
The Abominable Argument of Induced Abortion
The ACOG is a staunch supporter of induced abortion. Based on the high percentage of ACOG communications regarding induced abortion, many in the community believe that most of the practicing OBGYN physicians perform induced abortion. This is not the case.
ACOG notes in its Committee Opinion 612 (2014), “only 14% of currently practicing obstetrician–gynecologists provide abortions,” and this was before the Dobbs ruling in 2022. A 2017 analysis by the Guttmacher Institute found that only 7% of OBGYNs in private practice settings provided abortions. More recently, a 2023 Kaiser Family Foundation national survey of OBGYNs found that only one in five (approximately 18%) office-based OBGYNs are providing abortion services. In states where abortion is available under most circumstances, that percentage is 29%.
No, most practicing OBGYNs, like me, do not perform induced abortion. They are busy providing an otherwise diverse offering of obstetrical, gynecologic, and/or subspecialty care to their communities.
Nonetheless, any alternative view to the abortion stance was not entertained, nor welcome, at the ACOG.
The ACOG’s guidance on non-directed patient counseling regarding an unplanned pregnancy acknowledges that the healthcare provider should offer three options as a plan of care for the pregnancy: 1. Continue the pregnancy and parent the child, 2. Continue the pregnancy and place the child for adoption, or 3. Elect an induced abortion.
Despite all three options being clearly described in the guidance, only the option for abortion is highlighted and emphasized by the ACOG.
I recently posted statistics regarding induced abortion from the CDC ‘s abortion surveillance report to my social media accounts. Based on the response, you would have thought I posted something obscene. Responses questioned whether I was “anti-choice” or a “forced birther” (I have to admit, that one was a new term to me). What has become of trained medical professionals — of highly educated men and women who have somehow lost the ability or willingness to hear another perspective and instead resort to name-calling and bullying? It is unreal. It is disappointing.
The stranger aspect of those responses was that 99% of the ill-toned replies posted came from individuals who do not even know me personally. There is a silver lining to this, however. The number of direct messages I received in support of my post and message was refreshing. Some samples of those direct messages are below:
“Thank you for standing up for the silent majority of OBGYNs who do not perform abortion.”
“You are not alone, we are here, we are just too intimated to say anything.”
“Please, keep posting your support for us in the shadows.”
Numerous responses in this same tone and spirit prompted me to draft this narrative. Although the ACOG’s stance on induced abortion was my main impetus from leaving the Board of Directors, the polarizing stance on gender-affirming care, the admonishing of gender-neutral terminology, and the clearly political nature of this “apolitical organization” were all contributors.
And I wondered: did these stances represent the views of the entire body of practicing OBGYNs?
What I Ask: Allow the Differences
The present reality of medicine and healthcare is that both are heavily political. Professional medical organizations have a long history of political advocacy across disciplines, and physicians seem to have political affiliations based on their type of specialty. For example, according to one review, “In psychiatry, infectious disease medicine, and pediatrics, more than two-thirds were registered Democrats. In surgery, anesthesiology, and urology, on the other hand, approximately two-thirds of physicians were registered Republicans. Oncologists fell somewhere in the middle: 43% were registered Republicans.”
High-trust organizations allow their members to have varying opinions, express themselves freely, challenge concepts, and innovate.
What I would ask is not that we ignore any or all political entanglements or that the ACOG would go away. Its evidence-based guidelines across obstetrics and gynecology are a model for patent care in the USA and internationally. Rather, I would ask that medical organizations would become what the members expect them to be. Represent the diversity of worldviews and political spectrum held by all the membership. Allow for professional and courteous discourse. Allow for differing options especially on topics where some members may possess deeply held, personal moral convictions. Open communication facilitates the building of a trusting and efficient organization.
While so many forces in the media, public square, and even our local communities attempt to divide us by sociopolitical platforms, the practice of medicine should rise above discord.
Bio: Hector O. Chapa, M.D. is an OBGYN and Diplomat for the American Board of Obstetricians and Gynecologists.
