Improving Patient-Centered Care Through OB/GYN Research

Investigators in Massachusetts General Hospital's Deborah Kelly Center for Clinical Research within the Department of Obstetrics and Gynecology are improving outcomes across the lifespan through clinical trials as well as database and medical record based research studies. Mass General established the Deborah Kelly Center to create an infrastructure for OB/GYN clinical research designed to better understand and improve current treatments and support clinicians to make evidence-based, patient-centered recommendations. They use both prospective clinical research and database-oriented research to explore questions of treatment efficacy and methodology across different populations.

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"The Deborah Kelly Center has given our researchers more infrastructure for collaboration with researchers across fields that include endocrinology, cardiology, psychiatry, and anesthesia. It also provides resources for Mass General clinicians who primarily focus on clinical care and teaching to contribute to the literature, which is important because so often the best insights come from patient care," says Anjali Kaimal, MD, MAS, director of the Deborah Kelly Center from 2015-2022.

Challenges to Patient-centered OB/GYN Care

"In obstetrics, our goal is both a good outcome for mother and baby as well as a good experience for the family. Sometimes that means supporting a family through the experience of an uncomplicated pregnancy and delivery, and in other cases it involves caring for women who are at increased risk for complications," says Dr. Kaimal. "It also means understanding that those complications don't have to erase all the hopes and dreams a patient has for her pregnancy and delivery. When there are elements of care that are uncomplicated and more usual, we should make sure they are a part of the experience."

The unpredictable nature of some pregnancy complications is challenging and can lead to doctor-patient misunderstandings. Research has also shown that race and racism also affect risk.

"The medical field is in no way immune to the racial injustice in our society," says Dr. Kaimal. "We need to work to understand what drives the way providers and systems interact with and provide care to different patient populations and how that leads to disparities in outcome so we can work to address those inequities."

Obstetrics and Gynecology Research at the Deborah Kelly Center

While the first mission of the OB/GYN Department is clinical care, the Deborah Kelly Center is comprised of a core group of dedicated researchers in:

• Epidemiology
• Gynecologic Oncology
• Maternal-Fetal Medicine
• Reproductive Endocrinology
• Female Pelvic Medicine and Reconstructive Surgery
• Medical Education

"We're bringing researchers together from different clinical and research backgrounds," says Dr. Kaimal. "When a fertility doctor is doing research, part of what they're interested in is what happens to a woman after birth. Putting together that researcher with someone who's looking at pregnancy outcomes helps them find the synergies in their ideas and ask more robust research questions. And as we identify the important questions, together we can create data sets to answer them."

Unique Opportunities in OB/GYN Research

Dr. Kaimal says Mass General offers unique opportunities for obstetric and gynecological research. "Patients can have all their care throughout their life at Mass General. Their children can do the same. The addition of the obstetric service in 1994 allowed us to provide care across the lifespan and increases opportunities for collaboration to answer challenging health questions."

Deborah Kelly Center researchers are also redoubling research efforts that focus on equity and racial justice.

"Racism isn't biology. Environmental, social and genetic factors and structural inequities all impact outcomes in ways that may be addressable through thoughtful, equitable implementation of medical treatments. We're still in the early stages of figuring that out, but we have some of the tools to do it, including diverse populations, detailed data sets and people who are willing to work on it. We also have engaged providers who are willing to think about the way that they interact with patients and try to do better," says Dr. Kaimal. "We have the same responsibility we always have—to listen and tell people their voices are important. Facilitating women to be empowered and engaged in their care is beneficial for everyone."

Learn more about the Deborah Kelly Center for Clinical Research

Refer a patient to the Department of Obstetrics and Gynecology