PREFACE

This fourth edition of Guidelines for Women’s Health Care: A Resource Manual is a concise reference that encompasses the full spectrum of current policy and management issues relating to women’s health care.

Guidelines for Women’s Health Care provides a digest of clinical infor­mation, with particular emphasis on information not readily found in current textbooks. This volume is not intended to be a comprehensive guide to women’s health, but rather aims to consolidate useful informa­tion from a variety of topics in a single place. The book draws extensively on recommendations from the American College of Obstetricians and Gynecologists’ (the College) Committee Opinions, Practice Bulletins, and Policy Statements as well as guidelines from other governmental and professional organizations. The College will continue to update the guid­ance presented in this edition through these periodic recommendation statements, particularly with regard to rapidly evolving areas of clinical practice. Readers are encouraged to visit www.acog.org for the most up- to-date recommendations from the College. Recommendations and legal considerations are by no means inclusive, and other requirements may apply in certain situations or jurisdictions.

The book’s subtitle A Resource Manual emphasizes the book’s useful­ness as a guide to relevant resources for health care providers and patients from the College as well as other organizations. A topic-specific resource list is included at the end of each section to provide readers with sources of additional information. Referral to resources and web sites is provided for information only and does not imply the endorsement of the College. Resource lists are not meant to be comprehensive; the exclusion of a site or resource does not reflect the quality of that site or resource. Web sites and URLs are subject to change without warning.

Guidelines for Women’s Health Care is a companion volume to Guidelines for Perinatal Care, which is a joint publication with the American Academy of Pediatrics that provides information on obstetric and neonatal care. As a set, Guidelines for Women’s Health Care and Guidelines for Perinatal Care provide a thorough overview of all aspects of women’s health care.

There are significant changes in this fourth edition, including new and updated clinical guidance and resources and the addition of many new boxes, tables, and illustrations designed for quick reference. Also, the organization of the book has been changed; it now includes four parts: 1) Governance and Administration, 2) Organization of Services, 3) Well­Woman Care, and 4) Gynecologic Care. Each part is divided into sections with their own Bibliography and Resources list. Additional information and resources can be found in the book’s 12 appendixes.

Part 1, “Governance and Administration,” provides updated and expanded guidance for the establishment of systems of governance, credentialing, quality improvement, patient safety, risk management, regulatory compli­ance, human resources, and ethics.

Part 2, “Organization of Services,” provides guidance on the physical environment—ambulatory and inpatient—in which women’s health care is provided. This part contains practical information about facili­ties and equipment, ancillary services, and practice management issues.

“Information Management” section has been expanded with updated guid­ance on the use of electronic health records as well as electronic communi­cation media, including social media, for exchanging medical information among patients and health care providers.

Part 3, “Well-Woman Care,” focuses on routine screening and preven­tive care. In addition, there are individual sections that address adolescent health care and pediatric gynecologic care. A wealth of new information is provided, including new sections on health care access and complemen­tary and alternative medicine; updated clinical guidance on cardiovascu­lar disease, diabetes, and osteoporosis; revised breast cancer and cervical cancer screening guidelines; expanded information on preconception care, including new information on interconception care; and expanded infor­mation on family planning, including the Centers for Disease Control and Prevention’s Medical Eligibility Criteria for Contraceptive Use, 2010 and the U.S. Selected Practice Recommendations for Contraceptive Use, 2013.

Part 4, “Gynecologic Care,” deals with selected women’s health topics that may go beyond the depth of cases seen by the typical generalist. This part includes updated guidelines on the diagnosis and management of abnormal uterine bleeding, abnormal cervical cytology, and common can­cers in women; new sections on vulvar skin disorders and chronic gyneco­logic pain; and new information on premenstrual dysphoric disorder, with diagnostic criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Guidelines for Women’s Health Care is the result of the efforts of many individuals who contributed their time and expertise. The Editorial Committee and the College wish to extend their thanks to the following individuals for their review and revision of particular sections:

David L. Eisenberg, MD, MPH (“Sexually Transmitted Infections” in Part 3)

Tessa Madden, MD, MPH (“Transgender Individuals” in Part 3)

Laura Meints, MD, MBA (“Abuse” in Part 3)

Joyce M. Peipert, MMSc, RDN, LD (“Fitness” in Part 3)

Zevidah Vickery, MD (“Sexual Function and Dysfunction” in Part 4)

Members of the Editorial Committee for Guidelines for Women’s Health Care include Abraham Lichtmacher, MD, Chair; Monica G. Adams, MS, PA-C; Sarah L. Berga, MD; Ann J. Davis, MD; Mitchell I. Edelson, MD; Roxanne M. Jamshidi, MD; Jeffrey F. Peipert, MD, PhD; Johanna F. Perlmutter, MD; Holly E. Richter, MD, PhD; and Catherine T. Witkop, MD, MPH. Special thanks are extended to past members, Rebecca A. Lehman, PA-C, and Mark D. Walters, MD, for their contributions to this edition.