AAPA | Divya Williams

Nidhi Reva, MPH, PA-C, didn’t discover the PA profession until she was 20 years old. But ever since then, her passion for women’s health has driven her career and taken her role as a PA to new heights. From starting her own business to volunteering overseas, Reva has built her career on providing high quality care to expectant parents and underserved populations.

Discovering the PA profession
When Reva was in her undergraduate program at Michigan State University, she knew she loved science and caring for people, but she didn’t know where that would lead. During her senior year, she was in the hospital with a severe concussion after a car accident, and she heard a voice that she remembers to this day. “This voice was the most calming thing. She explained everything about what was going on and that my parents were on their way. She was wonderful, but I never saw her face or knew who it was.”

Two months later, when Reva went back to the hospital for a physical exam, a woman entered the examining room, and Reva immediately recognized her voice. This was the PA from the emergency room after Reva’s accident. “I told her that I was so scared and that she was the only person who walked me through things and reassured me. I was really grateful,” Reva says. “And then I was like, ‘What’s a PA?’ And that’s how I found out about the career, and once I did, that was it.”

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Wyoming Governor Mark Gordon signed legislation today that repeals requirements for PAs to have a specific relationship with a physician or other provider in order to practice. The new law also recognizes PAs‘ ability to practice medicine consistent with their education, training, and experience.

Senate File 0033, sponsored by Senator Fred Baldwin, PA-C, makes historic improvements to PA practice in the state and is the result of the dedication and hard work of the Wyoming Association of PAs (WAPA).

“I sponsored this bill to increase patient access to care,” said Sen. Baldwin, PA-C. “I know firsthand that PAs provide high-quality care and are vital to meeting patient demand for health care in our state. For too long, unnecessary state law requirements have created barriers limiting PAs’ ability to meet this demand and I appreciate my legislative colleagues’ support of these important changes.”

The new law also states that PAs may collaborate with or refer to the appropriate member of a health care team as indicated by the patient’s condition; the current standard of care; and the PA’s education, experience, and competence. Collaboration is determined at the practice level, which allows for greater flexibility among treating providers.

Read more.

Physician Assistant History Society

During Women’s History Month, the PA History Society has been featuring notable female PAs and their inspiring stories on its special exhibit webpage and on social media. 

Stories include (but are not limited to):

Catherine Dragon, a female PA in the early years of the profession 

Clara Vanderbilt, one of the first PAs to be trained in surgery

Karen Bass, the first PA to sit on the US House of Representatives

Pauline Gross, the second female PA to receive Colonel rank in the Army

Jacqueline Barnett, a PA educator and advocate for diversity in the profession

A new article located at the bottom of the exhibit page also features exciting news about Certified PA Hayley Arceneaux. Arceneaux is a bone cancer survivor and the youngest American to be going into space this October!  

Also, please check out the AAPA Women’s Interest Caucus article here to read about Evelyn Stead (the wife of Dr. Stead and an innovator!), and learn more about these PAs who are making history by making a difference outside the United States: Ruth Ballweg, Kathy Pedersen and Dana Sayre-Stanhope.

As this month marked a year since the pandemic began, the PA History Society would like to send a huge thank you to all of the PAs who have continued to work relentlessly to treat and care for patients battling COVID-19.

For all things PA history, please visit our website and be sure to “like” PA History Society on Facebook to receive weekly updates, follow us on Twitter, and Instagram.

Please keep in mind that NCCPA extended the December 31, 2020 deadline for maintaining certification to March 31, 2021. If you've earned and/or logged CME with the AAPA or PAEA , you must log those credits with NCCPA in order to maintain your certification.  Since you typically take care of certification maintenance at the end of the year, we wanted to make sure you aren't missing important deadlines with NCCPA.

For more information, log onto your NCCPA record at www.nccpa.net. 

NCCPA understands that things can happen and have policies in place to help in specific situations. If you need to request an exception to policy (ETP) or extension of certification maintenance requirements, you can sign in to your online record to submit an ETP. For more information visit:  www.nccpa.net/Legal.

The awards process is the single most important means that APAOG has for recognizing PAs who have made significant contributions in women's health. See below for more information on the awards available. To submit a new nomination or view past winners, please click here.

U.S. birthing persons are more likely to die from complications related to pregnancy or childbirth than in our peer nations, and many health inequities are present among those who are dying. ORWH recently led the development of a special issue of the Journal of Women’s Health , bringing MMM to the forefront. The special issue offers a research road map to help end this public health crisis. It showcases the work of NIH, other Federal agencies, and the scientific community to understand contributing factors, improve care, and prevent these devastating losses. We encourage you to review the special issue’s open-access articles to learn more.

In response to rising U.S. rates of MMM, NIH is supporting efforts to address this public health crisis in a number of ways:

• ORWH held the inaugural webinar in its Diverse Voices: COVID-19, Intersectionality, and the Health of Women speaker series on January 27, 2021. It featured Ana Langer, M.D., and Jewel Gausman, Sc.D., M.H.S., who discussed intersectionality and highlighted maternal and perinatal care in the context of COVID-19.

• To further encourage people to stay engaged and informed around MMM, ORWH hosted a Twitter chat on February 24. Thank you if you were able to participate! In addition, ORWH’s “Maternal Health Mondays” on Twitter and Facebook will bring attention to MMM by highlighting one of the 21 articles in the Journal of Women’s Health’s special issue articles over the next several months.
• To rapidly award and fund regional coalitions testing evidence-based interventions to improve heart, lung, and sleep health outcomes before and during pregnancy among disproportionately affected populations, NIH issued the Maternal Health Community Implementation Project. Applications are due March 29, 2021.

• The NIH Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative focuses on the leading causes of maternal mortality in the U.S. and prioritizes comprehensive, interdisciplinary research that engages communities with high rates of maternal deaths and complications. Two new funding opportunities have recently been released under this initiative for FY 2021:
• • Notice of Special Interest (NOSI): Small Business Initiatives for Innovative Diagnostic Technology for Improving Outcomes for Maternal Health, with a first application due date of April 6, 2021
  • Notice of Special Interest (NOSI): Administrative Supplements and Urgent Competitive Revisions for NIH Grants to Add or Expand Research Focused on Maternal Health, Structural Racism and Discrimination, and COVID-19, with applications due on April 14, 2021

• To expand upon research and research capacity building in States that have less access to health care and suffer poorer health outcomes in the U.S., NIH reissued Notice of Special Interest (NOSI): Administrative Supplements for Research on Women’s Health in the IDeA States with a particular interest in maternal and infant morbidity and mortality. The first application due date is April 14, 2021.
• To test the effectiveness of an implementation-ready intervention designed to promote cardiovascular health (CVH) and address CVH disparities in marginalized birthing people and children in clinical or community sites, NIH issued the Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH) program. ENRICH Multisite Clinical Centers (Collaborative UG3/UH3 Clinical Trial Required) and ENRICH Multisite Resource and Coordinating Center (U24 Clinical Trial Required) have a first application due date of June 11, 2021.
• NIH will fund research of racial disparities in pregnancy-related complications and deaths. This opportunity will provide research grants to six institutions to support original, innovative, and multidisciplinary efforts to advance the understanding, prevention, and reduction of pregnancy-related complications and deaths among disproportionately affected women.

For more NIH resources on maternal health and MMM, feel free to visit the following:

• MMM Web Portal
• MMM Booklet
• MMM Video 
• MMM-related Funding Opportunities
• Spring 2019 issue of Women’s Health in Focus at NIH
• ORWH Director’s Message: Toward an Improved Vision for Maternal Health and Pregnancy Outcomes
• COVID-19 and Maternal Health Webpage

For more on other U.S. Department of Health and Human Services (HHS) resources relevant to maternal health and MMM, please visit the following:

• Healthy Women, Healthy Pregnancies, Healthy Futures: Action Plan to Improve Maternal Health in America
• The Surgeon General’s Call to Action to Improve Maternal Health
• The Centers for Disease Control and Prevention’s Hear Her campaign
• OS-PCORTF State Data for Conducting Patient-Centered Outcomes Research to Improve Maternal Health Stakeholder Discussion Report

American College of Obstetrics and Gynecology | March 16

Newsweek (3/15, Georgiou) reports there are rumors online that SARS-CoV-2 vaccines can cause infertility, but “experts say such claims are unfounded.” For example, the Association of Reproductive and Clinical Scientists and the British Fertility Society said in their published guidance on the topic, “There is absolutely no evidence, and no theoretical reason, that any of the vaccines can affect the fertility of women or men.” Meanwhile, ACOG “has also issued a statement debunking claims that the COVID-19 vaccines currently available in the U.S. are a cause of infertility, noting that they have been ‘scientifically disproven.’” In their statement, ACOG explains how the different vaccines work and why those mechanisms cannot cause infertility in women or men. In addition, ACOG also “recommend that people of reproductive age who are eligible should get vaccinated, including women who are contemplating or trying to have a baby.”

CDC’s  Advisory Committee on Immunization Practices (ACIP) is seeking qualified PAs for ACIP Membership. ACIP members are acknowledged experts with an outstanding record of achievement in their own field and an understanding of the immunization issues covered by ACIP. They have a responsibility to provide CDC with high quality, well-considered advice and recommendations on matters described in the ACIP Charter.

• If you would like to be considered for nomination for this opportunity by AAPA’s  Board of Directors, please submit a Statement of Interest along with your CV no later than Thursday, April 22, 2021. Your application will be considered by the External Affairs Committee and the AAPA Board of Directors. If selected for nomination, you would then complete the ACIP application and the AAPA Board Recommendation would be considered as one of your four Letters of Recommendation.
• If you would like to apply independently from AAPA, visit the ACIP application page and complete the application by July 23, 2021: https://www.cdc.gov/vaccines/acip/apply-for-membership/index.html 

If appointed by the ACIP, your appointment term would begin July 1, 2022.

Click here for more information!

AP NEWS| RICARDO ALONSO-ZALDIVAR

WASHINGTON (AP) — Labor and delivery are thought of as the riskiest times for new mothers, but many women die in the weeks and months after giving birth. Now a provision in the COVID-19 relief bill could help change that.

The legislation gives states the option of extending Medicaid coverage to women with low to modest incomes for a full year after childbirth. States are currently required to provide 60 days of coverage, but medical experts point to research showing that women can die from pregnancy-related conditions up to a year after giving birth, and that 3 in 5 of all such deaths are preventable.

The maternal health provisions would make it easier for states to cover new mothers for a full year by cutting the time and paperwork needed to obtain approval from Washington under Medicaid, as well as the Children’s Health Insurance Program. Maternal health advisory groups in 19 states, from Texas to Massachusetts, and Washington to Tennessee, have recommended such an extension. Last year a bipartisan bill to do so cleared the House but failed to advance in the Senate.

The legislation has been shepherded by Rep. Robin Kelly, D-Ill., who serves on the House committee that oversees Medicaid, the federal-state program covering about 1 in 5 Americans, from many newborns, to low-income adults and frail nursing home residents. Kelly explained that a constituent brought the problem to her attention several years ago.

“I never realized that maternal mortality was such a big issue in this country,” said Kelly, who represents Chicago.

It’s particularly serious for Black women, whose pregnancy-related death rate is three times that of white women. “For Black women, it cuts across socio-economic levels,” said Kelly, who is Black. “It’s a health equity issue.”

JAAPA | Jackson, Toni MMS, PA-C; Watkins, Elyse DHSc, PA-C, DFAAPA

Previously called spontaneous abortion, early pregnancy loss (EPL) is the preferred term encompassing threatened abortion, incomplete abortion, complete abortion, and anembryonic pregnancy. EPL has many causes, including chromosomal abnormalities, immunologic and infectious causes, and underlying maternal risk factors. Because many patients present with first-trimester bleeding, clinicians must know the appropriate evaluation and management techniques.

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