This review explores transitioning toward a multidisciplinary, biopsychosocial framework for evaluating chronic pelvic pain (CPP), considered a global epidemic. The manuscript introduces the updated FIGO-IPPS CPP definition, which lowers the diagnostic threshold to pain typically lasting 3 months or more and prioritizes functional impairment. Central to this definition is the R U MOVVING SOMe classification system, enabling systematic identification of overlapping pain generators and central sensitization. The authors advocate for a cutting-edge methodology integrating trauma-informed care (TIC), specialized musculoskeletal and neurological examinations, and validated Patient-Reported Outcomes (PROs). This framework provides clinicians a standardized pathway to optimize diagnostic accuracy and treatment.

Maternal-fetal medicine (MFM) specialists are highly trained subspecialists whose expertise lies in managing complex pregnancies. This paper argues against the routine involvement of MFMs in low-risk labor and delivery, focusing on cost inefficiencies, workforce shortages, maternity care deserts, equity concerns, and comparisons to other subspecialists providing primary care. It also highlights the benefits of obstetric hospitalist frameworks and collaborative care models with midwives as sustainable alternatives.

Vulvovaginal pain disorders can manifest with varying symptomology and can take years to diagnose and even longer to treat. Given the nature and location of the pain, these disorders can significantly affect interpersonal relationships and quality of life. Therapy options range from behavioral interventions to medications and minimally invasive procedures, and in rare cases surgery. The following review covers common etiologies of vulvovaginal pain, evaluation strategies, currently used treatments and promising future therapies.

The advent of massively parallel ("next-generation") DNA sequencing has enabled prenatal testing for any and all diseases at reasonable cost, resulting in the widespread adoption of highly expanded carrier screening. While the size and constitution of these gene panels may be critiqued on various grounds, at least all the diseases selected represent potential risks to the newborn or older child if affected. Thus, the rationale behind the effort falls within ACOG's definition of prenatal care as a preventive health service "designed to improve the health and well-being of pregnant and birthing individuals and their infants through evidence-based services." Nowhere does it promise to improve the health of offspring when they reach adulthood. Here, we argue that testing for adult-onset diseases in the prenatal setting (in the absence of a positive family history) is neither justified nor desirable, based on considerations of equity, scope of practice, downstream burden on the health care system, and psychosocial repercussions.

Chronic pelvic pain (CPP) severely impacts quality of life, presenting distinct perioperative management challenges. Patients face heightened anxiety, severe postoperative pain, prolonged recovery from fear of movement, and persistent pain amplified by concurrent chronic overlapping pain conditions (COPCs). While data on preoperative pain's precise impact remains limited, surgery often triggers severe flares. Consequently, comprehensive preoperative screening is crucial. Evaluating risk factors-including central sensitization, substance use, smoking, COPCs, specific pain generators, and psychological comorbidities-allows clinicians to manage expectations effectively. Ultimately, this targeted risk assessment equips patients with the necessary strategies and tools to optimize their surgical recovery.

Large, randomized control trials have shown the efficacy of low-dose aspirin (ldASA) in reducing rates of clinically significant severe preterm pre-eclampsia in high-risk populations. Multiple societies have recommended varying risk-stratifying criteria over the last decade. Unfortunately, current approaches to risk-based administration have failed to improve outcomes in an overall high-risk population in the US. Increasing evidence has shown universal ldASA prescription as a practical approach to bridging known gaps in health care for the highest risk patients. This review addresses the benefits of implementing a universal protocol for the administration of ldASA in pregnancy to reduce maternal morbidity and mortality.

Endometriosis is a chronic inflammatory condition that can result in chronic pain through complex nociceptive, neuropathic, and nociplastic pathways. This article provides a comprehensive background on endometriosis as well as future directions in diagnosis and management. The diagnosis of endometriosis is explored, including novel imaging techniques, biomarkers, and the integration of artificial intelligence. The medical management of endometriosis is reviewed, including a focus on new nonhormonal treatment options. Surgical treatments are reviewed along with surgical outcomes. We discuss nonpharmaceutical and behavioral interventions with growing interest. Finally, this article reviews future directions in endometriosis care, including precision medicine and AI.

As increasing numbers of individuals with cognitive disabilities have become integrated into society and have reached reproductive age, the number of patients with cognitive disabilities who desire pregnancy has also risen. This review highlights the disparities in pregnancy outcomes for patients with cognitive disabilities, addresses issues of capacity and consent, and identifies common challenges during the preconception, prenatal, intrapartum, and postpartum courses to provide tailored and comprehensive care for this patient population.

The American Disabilities Act of 1990 (ADA) was established to protect individuals with disabilities from discrimination against access to health care and public services and to ensure they have equitable resources. It is imperative that obstetric providers understand the applications of the ADA requirements when caring for pregnant patients with disabilities ensuring they are able to physically access outpatient care and effectively communicate with their care team.

Disabilities are highly prevalent in the population, and people with disabilities have faced stigma for millennia. Despite federal mandates, persistent disparities in care remain for patients with disabilities seeking obstetric and gynecologic care. Lack of adequate clinician training, clinician stigma and biases, inaccessible clinical spaces, and suboptimal communication all contribute to care inequities. Updated regulations under federal disability rights statutes will require clinic spaces to have equipment that is accessible for patients of all abilities. Understanding these recommendations and mandated changes is the next step in improving care for disabled patients.

Visual impairment affects millions of reproductive-aged individuals worldwide, yet obstetric care for this population remains underrepresented in clinical guidelines and medical education. Patients with visual impairment face unique barriers throughout the reproductive continuum. This review provides a comprehensive, obstetrician-gynecologist-focused framework for the care of the visually impaired. Key topics include communication, optimization, screening for coercion and violence, prenatal care, labor and delivery, postpartum care, breast/chest feeding, and contraception. Emphasis is placed on patient autonomy, consent, trauma-informed care, and compliance with legal/ethical standards. Integrating disability-competent practices into obstetric care is essential to improving outcomes and advancing equity in reproductive health.

Menstrual management and access to reliable contraception are integral components of equitable reproductive health care for patients with disabilities. Concerns surrounding impending periods are common among caregivers of patients with physical and cognitive disabilities, even before menarche. There are several considerations in the approach to options for management of both periods and contraception in this patient population, and this article details the available options with a lens toward the unique needs of patients with disabilities.