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Neel Shah, MD Profile picture
Neel Shah, MD
@neel_shah
chief medical officer @mavenclinic, founder @marchformoms @costsofcare // building a world where every person can choose to grow their family with dignity
Jan 29 • 7 tweets • 3 min read
1/ My longtime collaborator @BirthNumbers and I dig into U.S. birth trends from the latest @NCHStats data:

Fertility rates plummeted, medical interventions skyrocketed, racial disparities persisted and people giving birth are more wary of hospitals than ever 2/ 2023 is almost certain to be the first year that the majority of births will be to non-white individuals

(This poses a moment of reckoning for a system that, by all measurements, fails at producing equitable outcomes by race) mavenpreprint.substack.com/p/three-digita…
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Dec 30, 2022 • 6 tweets • 3 min read
1/ Last year I was contemplating a professional identity shift from academic physician to tech executive. Atul Gawande offered me sage advice:

Be intentional about what you set aside, what you bring with you and what you newly adopt… 2/ The purpose of a startup should be to meet unmet needs, sustainably and at scale.

By adopting a business interest I set aside academic neutrality. But I aimed to bring a commitment to scientific rigor and health equity with me

wsj.com/articles/obste…
Oct 29, 2021 • 7 tweets • 3 min read
1/ Only 1 in 4 pregnant people in the U.S. are vaccinated against #COVID19

Rather than jump to conclusions, we surveyed 500 pregnant people across the country to ask them why they are hesitant...

Quick 🧵on what the data showed and what it means 2/ Public health messages are clearly not translating

61% of pregnant people do not know that the @CDCgov strongly recommends vaccination during pregnancy against COVID-19

AND

70% of pregnant people have been told by someone close to them not to get the vaccine
Oct 20, 2020 • 15 tweets • 8 min read
1/ A few thoughts on how disruptions to our health systems are impacting birthing people 🤱🏾

(taken from today's public @NIH_ORWH committee meeting)

VIDEO: orwh.od.nih.gov/about/newsroom… NIH Presentation Title Slide: System Disruptions to Childbir 2/ So far, it is unclear whether pregnant people are more likely to be severely INFECTED by COVID-19

Regardless, pregnant people are definitely more likely to be severely AFFECTED by COVID-19
Mar 28, 2020 • 10 tweets • 2 min read
My favorite thing about being an obstetrician is watching families meet their baby for the first time

Doulas are among my greatest professional mentors

I’ve published evidence on how labor support improves safety and dignity

...and I worry this policy may be ill-considered My heart breaks for everyone impacted by visitation policies (and all mitigation measures), including cancer patients, those at the end of life...

I understand these policies have a disproportionate impact on the most vulnerable
Jan 10, 2020 • 24 tweets • 90 min read
1/ Each year nearly 4 million of Americans give birth in bed: on their backs, with their knees up, legs spread, feet in the air...

I attended the deliveries of thousands of babies before I ever wondered why

theconversation.com/im-an-ob-gyn-w… 2/ But approximately 20,000 Americans choose to give birth out of bed, which usually requires giving birth out of hospitals – an 83% increase over the last decade
nytimes.com/2018/09/25/wel…
Dec 30, 2018 • 14 tweets • 11 min read
THIS is the cover story of latest @HarvardChanSPH magazine

TLDR version 👉🏽 the scientific explanation based on decades of research (following even more decades of black mothers calling it out) is racism

hsph.harvard.edu/magazine/magaz… .@mclemoremr & team found that three quarters of pregnant black women experience racial discrimination just living their lives...

nearly half on the street or in a "public setting"...

more than a fifth (ONE in FIVE) while receiving medical care

ajog.org/article/S0002-…
Aug 22, 2018 • 12 tweets • 5 min read
1/ Public image of maternal death is a woman who, in dramatic moments immediately surrounding birth, suffers terrible tragedy

latest @CDCgov data tells different story...rather than waiting to publish academic paper, decided to share analysis right away

2/ first of all, > 80% maternal death does not occur on the day of delivery... >60% does not even occur within a week of delivery

The great majority of these deaths are at home or in the community...NOT in the hospital

(slide by @BirthNumbers)
Apr 25, 2018 • 10 tweets • 3 min read
ok, can of worms...

no quarrel with any of the ideas in this publication

BIG concern with decision to formulate the consensus statement as a "bundle" rather than committee opinion, a KEY difference that risks compromising rather than bolstering improvement efforts --> THREAD 1/ among American hospitals working to improve care, it's common to see good ideas get embedded into bad tools