New OB/GYN Chair: Reflections and Vision for Future

On October 1, 2020, Nawal M. Nour, MD, MPH, became the chair of the Department of Obstetrics and Gynecology at Brigham and Women’s Hospital. Upon assuming her role, Dr. Nour became the first African-American department chair at the Brigham, the first department chair of Sudanese descent and the third woman to be named to a chair role. Dr. Nour succeeded Robert L. Barbieri, MD, who served in the role for 27 years and helped establish the department as a world leader in compassionate clinical care, teaching, research, innovation and discovery.

A board-certified obstetrician and gynecologist, Dr. Nour joined the Obstetrics and Gynecology faculty at the Brigham in 1999 following her residency at the hospital. Over the past 20 years, Dr. Nour has held various leadership roles at the Brigham, including the director of the Ambulatory Obstetrics Practice. Last year, Dr. Nour assumed leadership of the Ambulatory Gynecology Division.

“It has long been my mission to advance the health and human rights of all women while educating the next generation of smart, strong and compassionate leaders who will have lasting impact on all facets of women’s health—from clinical care and teaching to research and health equity,” said Dr. Nour. “As chair of the Department of Obstetrics and Gynecology at the Brigham, I hope to accomplish these goals by building on our existing strengths and identifying areas of growth, while maintaining excellence in all aspects of the care we provide.”

Establishing Equitable Care for All Patients

Dr. Nour has exhibited a lifelong commitment to establishing equitable care for all patients and to ensuring the next generation of health care providers reflects the diverse population the Brigham serves. In 2018, she was named the chief diversity and inclusion officer for faculty, trainees and students, unifying the community and providing support to help women and underrepresented minorities in medicine.

Dr. Nour has been at the forefront of some of the most pressing issues facing underserved communities in the Greater Boston Area. In 1999, seeing the influx of African immigrants and refugees to the U.S., Dr. Nour founded the African Women’s Health Center at the Brigham. It was the first practice of its kind in the U.S., which improves access and services for women who have undergone female genital cutting.

“In line with my personal values, I’m deeply committed to providing value-based care, based on equitable access, attention and treatment for all women,” said Dr. Nour. “This must be true across the continuum, from community-based care to our academic medical centers and must be iteratively reconfirmed, especially as we innovate in the pursuit of efficiency and economy.”

Health Equity and Innovations During COVID-19

During the COVID-19 pandemic, upon recognizing that the virus disproportionately affected Black and Latinx communities in Boston, the OB/GYN Department deployed testing sites to address these disparities. Members of the OB/GYN department also provided donated food, hand hygiene products, face masks and infection-prevention educational materials written in the various languages spoken in those underserved communities.

“The COVID-19 pandemic is taking place in the context of systemic racism, income inequality, police violence and a partisan national government, amplifying the magnitude of societal disruption,” said Dr. Nour. “Our best hope for a just society involves people working together to understand the history of our society. We have to admit our personal biases, discuss our current challenges and create plans for future communities that are fair and supportive of all people.”

In addition to expanding access to health services in the community, Dr. Nour and others have helped ensure that the OB/GYN Department remains agile in a rapidly changing environment. This involves inventing digital health solutions and reducing the use of low-value interventions while improving patient and staff experience.

Early in the pandemic, the department implemented high-capacity nucleic acid testing for the coronavirus. This permitted all women admitted to Labor and Delivery, and those scheduled for surgical procedures involving an anesthetic, to be tested before their appointment. It also allowed Brigham providers to focus their highest intensity infection-control practices on the few asymptomatic individuals who tested positive for the virus, greatly reducing uncertainty.

A team of providers led efforts to integrate telemedicine into its outpatient prenatal care program to ensure that pregnant patients were safely monitored during the pandemic. The department also collaborated with multidisciplinary teams across the hospital to develop new guidelines for managing critically ill pregnant patients with COVID-19. These protocols are available to providers in the obstetrics section of the Brigham’s COVID Clinical Guidelines.

Supporting the OB/GYN Department’s Core Mission of Research

Throughout her career, Dr. Nour’s research has focused on diseases that affect women in resource-poor settings. In 2009, she established the Brigham’s Global Obstetrics and Gynecology Division, which makes motherhood safer for women in resource-poor nations. In 2015, Dr. Nour developed a Global OB/GYN Fellowship at the Brigham to further support these efforts.

As chair, Dr. Nour will support the OB/GYN Department’s core mission of research and innovation. To advance all aspects of OB/GYN care, a number of investigators across the Brigham are conducting basic and clinical research on a wide range of OB/GYN conditions. The department’s primary areas of research include: reproductive medicine, perinatal research, uterine fibroids, epidemiology, cytogenetics, gynecological oncology, maternal-fetal medicine, and reproductive biology.

Dr. Nour highlights the groundbreaking research of Raina N. Fichorova, MD, PhD, AMHC, a reproductive immunologist and director of the Brigham’s Genital Tract Biology Lab. Dr. Fichorova’s work aims to prevent and cure inflammatory conditions in the female reproductive tract and improve reproductive and sexual health. Dr. Fichorova oversees more than 50 funded research projects. Currently, she’s leading the scientific community in the study of Trichomonas vaginalis, a sexually transmitted infection with serious consequences.

“Dr. Fichorova’s innovations will improve women’s health throughout the life cycle, while also representing viable commercial enterprises, including patents and the monetization of intellectual property,” said Dr. Nour. “Her diverse work is an excellent example of ‘intrapreneurship’ within an academic setting like the Brigham, offering a source of financial stability to support further cutting-edge research in a fast-changing funding landscape.”

Enhancing the OB/GYN Residency Training Program

Under Dr. Nour’s leadership, the department will continue to nurture the Brigham’s OB/GYN residency training programs, ranked first in the U.S. by Doximity. These programs help attract and retain talented young physicians for clinical and research faculty positions at the Brigham.

“We’re expanding CME courses for practicing OB/GYN specialists and trainees to improve awareness of OB/GYN issues, to enhance the reputation of the department and faculty and to increase referrals,” said Dr. Nour. “I’m also committed to diversity and inclusivity in training and mentorship. We can’t expect diverse new generations of caregivers without it.”

A New Generation of Advances in Women’s Health

To create a cohesive OB/GYN department, Dr. Nour is bringing together faculty from various disciplines, from maternal-fetal medicine and gynecology, to oncology and reproductive endocrinology. In line with her long-held values, Dr. Nour remains deeply committed to building a healthy equity and inclusion lens into research, medical education and clinical care.

“I’m honored to lead the respected OB/GYN Department at the Brigham,” said Dr. Nour. “I look forward to collaborating with my colleagues to further build upon an already strong foundation and work toward creating a new generation of advances in women’s health.”

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