ACOG's Defiant Stand Against Trump's 'Guerrilla War on Science'
When Dr Steven Fleischman assumed the presidency of the American College of Obstetricians and Gynecologists in 2025, he anticipated professional challenges but never foresaw the organisation becoming a frontline defender against what he describes as a systematic assault on medical evidence. As the premier membership body for over 62,000 US-based OB-GYNs, ACOG has transformed from a clinical guidance provider into a formidable political force, directly confronting the Trump administration's healthcare policies.
Confronting Medical Misinformation Head-On
The nonpartisan organisation has emerged as a leading voice challenging what it perceives as dangerous medical misinformation promoted by government agencies. Fleischman has publicly criticised several administration positions, including:
- Trump's unsupported suggestion linking Tylenol use during pregnancy to autism risks
- The FDA's "alarmingly unbalanced" panel examining antidepressant use in pregnancy
- The CDC's decision to stop recommending Covid vaccines for pregnant women
This unprecedented situation has forced ACOG to advise patients to question CDC recommendations for the first time in its 75-year history, creating what Fleischman calls "a terrible situation for patients" who must navigate conflicting medical advice.
Financial Independence and Political Advocacy
In a bold move last summer, ACOG became the first national medical society to reject federal funding from the Trump administration. This decision stemmed from concerns that executive orders restricting diversity, equity and inclusion initiatives would compromise research integrity and undermine health equity efforts. Dr Kristin Lyerly, a Wisconsin-based OB-GYN and ACOG member, praised the organisation's stance, noting that many other medical and legal groups have capitulated to administration pressure.
Preparing for Healthcare Disruption
The organisation is now preparing members for potentially devastating changes through the One Big Beautiful Bill Act, which could leave an estimated 10 million Americans without insurance and threaten hundreds of hospitals with service reductions, staff layoffs, or complete closure. ACOG plans to lobby state legislators to protect pregnant and postpartum patients from losing Medicaid coverage while supporting congressional bills to expand rural emergency labour and delivery services.
Expanding Political Engagement
ACOG's political activism has intensified significantly since the Supreme Court's 2022 decision overturning Roe v Wade. The organisation has:
- Doubled its state-level political donations during the 2024 election cycle
- Increased participation in legislative lobby days from 75 to over 800 attendees
- Allocated resources to hire lobbyists in every state
- Filed legal briefs supporting medical organisations challenging administration policies
Combatting Declining Trust in Medicine
This advocacy occurs against a backdrop of declining public trust in medical institutions. Research indicates trust in doctors and hospitals has fallen by approximately 30% between 2020 and 2024, with those distrusting physicians less likely to receive Covid vaccinations. Daniel Treisman, a UCLA political scientist, describes the situation as a "guerrilla war against science in the public sphere," where scientific statements are increasingly viewed as mere opinion.
Direct Patient Engagement Strategy
ACOG's Combatting Misinformation initiative has become a priority, producing plain-language papers addressing unfounded claims about hormonal birth control, abortion, sex education and vaccines. Fleischman emphasises that the solution lies in personal relationships, urging members to leverage the trust they maintain with individual patients despite broader institutional distrust. "People don't trust healthcare right now, but they love their own physician," he observes, highlighting the importance of one-on-one patient education.
Rachel Gandell Tetlow, ACOG's vice-president of government and political affairs, acknowledges the "very scary time for many people" but emphasises the organisation's commitment to being "an unwavering voice in support of medical evidence" despite facing opposition from conservative groups like the Heritage Foundation and Alliance Defending Freedom.
