By Laura Freeman

Alabama has one of the best OB/GYN facilities in the nation at UAB, which is ranked number five in U.S. News and World Report’s best hospitals for its excellence in obstetrics and gynecology. But it’s a sad irony that even the best hospitals alone can’t counter the economic, social and health-access issues that have led to our state having one of the worst infant and maternal mortality records in a country that ranks significantly lower than most first-world nations. In 2020, Alabama had the third highest maternal death rate in the U.S. In 2021, the U.S. had ten times the rate of maternal deaths as a number of comparable countries including Australia, Japan, Israel and Spain.

“Having a baby today is much safer than it once was. People forget that dying in childbirth or shortly after was not uncommon before modern obstetric and gynecological care,” said Warner Huh, MD, FACOG, FACS, professor and chair of the UAB Department of OB/GYN. “We’ve turned that around so that women now tend to live longer than men.

“However, we’re seeing a disturbing uptick in maternal and infant mortality, and that needs to be addressed. As a state and a country, we’re also nowhere near where we should be compared to our global peers.”

The recognition the UAB has received can reassure Alabama women that quality OB/GYN care is available here. “What sets UAB apart is a culture of commitment and excellence,” Huh said. “Our exceptionally talented and highly trained teams are focused on advancing women’s health and offering our patients the very best in everything we do. High-risk pregnancies including the sickest women and babies from across the state and region are referred here because physicians know we will put every effort into helping patients achieve the best possible outcome. Working with difficult cases every day also gives us the depth of expertise to deal with rare and challenging situations.”

UAB also has pockets of excellence in research and clinical care that expand the department’s capabilities in finding and developing innovative solutions. It is one of the few OB/GYN departments doing cutting edge research that changes the standard of care and incorporates it into clinical practice.

“We offer the only uterine transplant program in the south—and perhaps the only truly active program in the nation, as well as an excellent egg and fertility preservation program that can be particularly comforting to young cancer patients who want to become parents,” Huh said. “We are one of a handful of pediatric gynecology clinical programs in the US with an associated fellowship – ours is the only one in the Southeast region. Our researchers are making tremendous advances in reproductive cancers and understanding the role of HPV in cervical cancer. What we have learned is being translated into screening and treatment advances that are saving lives.”

Also highly ranked in best doctors, staff and patient satisfaction surveys, the department’s outstanding fellowship training and medical education programs, the medical center is also working to address some of the factors behind Alabama’s poor maternal and infants health scores.

“Poor outcomes are disproportionately found in patients of color and those who live in medically underserved areas,” Huh said. “We work with larger numbers of patients from those populations than most medical centers, and we have extensive research going on to investigate the reasons for health disparities and address them. Teamed with the School of Public Health, we’re looking into some of the root causes of poor outcomes and strategies for addressing them. One of our research programs is investigating the possible role of cardiovascular diseases in maternal mortality.

“We’re also working on the healthcare access problem. There are numerous, significant obstetric deserts in the state where patients may have to travel more than a hundred miles for care and may not have transportation. We’re hoping the new certified nurse midwife program we’re launching in cooperation with the School of Nursing will help to ease that situation.”

UAB Ob/Gyn offers the complete spectrum of care for women at every age and stage of life. In addition to the department’s number five ranking, it received a top score of “excellent” in numerous areas, including advanced technologies, patient services, and nurse staffing. It also received a score of “high performing” in the area of ovarian cancer surgery.

“I’m incredibly proud of our department and the high level of quality health care that we offer all women in Alabama,” Huh said.

Despite being an island of excellence in a region that is lagging behind in maternal and neonatal health, Huh points out that health care providers can’t solve the problem of high maternal and neonatal deaths alone. So many of the factors that lead to crisis situations occur long before patients reach a hospital.

“It’s going to take everyone working together to change policies, economic factors, social and lifestyle influences, access to care and the stress that people in difficult circumstances have to live with on a daily basis,” he said. “We can come together and change things for the better.”