Early this year, I attended a symposium at the VCU Medical Center where I had the best experience with an attending physician leading a workshop. This was a workshop I hadn’t actually signed up for, but I sneaked into the extra seat in the room and sat down, captivated by the set up of three mannequins ready to give birth.
Leading the workshop was Dr. Fidelma Rigby, a Maternal Fetal Medicine Obstetrics and Gynecology Women’s Health at VCU Medical Center. She specializes in high risk pregnancy.
As an aspiring physician, I wanted to know how the team at VCU mediates her experience as a provider. Her words motivated me; she was focused on empowering women through interdisciplinary teams. For example, she shared the story of a patient who was 35 weeks pregnant who came for preconception counseling. She had many comorbidities, including chronic hypertension, a high body mass index (linked with more complications in pregnancy), a connective tissue disorder that predisposes her to fistulas (abnormal connection between body parts), and even interstitial lung disease. However, Dr. Rigby worked with her pulmonologist, learned how to mitigate her inflammatory response process through rheumatology, and was able to successfully deliver her baby. In other cases, she has discouraged pregnancy due to factors that could increase the risk of complications.
Situations such as these show how the complex histories of patients coupled with the persistence of healthcare providers are key players in determining the level of care. However, we still have a long way to go in terms of making aspiring mothers more comfortable with pregnancy, especially as pregnancies are becoming more common in older individuals. The insurance billing codes that allow for genetic screens (such as NIPT) of older moms are listed in derogatory terms like ICD10 codes for “advanced maternal age/elderly pregnancy.” We need to start changing our language and our perspectives to make all individuals feel like they are supported and have access to high quality care.
As a member of Her Campus, I wanted to also ask about how healthcare providers are better addressing the fluidity of the terms of gender and sexuality. I asked Dr. Rigby her thoughts on how her practice has changed to better accept the LGBTQ+ community. She described her practice of always asking pronouns through the following phrase: “How would you like to be addressed?” Just this simple question can increase respect and strengthen bonds in these interactions. Another important introductory question would be, “And how are you two related?” because some moms bring sisters and brothers to OB appointments, not just their partners.
I loved that Dr. Rigby also breached the Diversity, Equity, and Inclusion issues in the medical field during our conversation. Women of color have poorer outcomes even when stratifying for income level. We need to advocate for more of these diverse communities to be in clinical trials and have access to new care through things like minimally invasive and robotic surgery.
Dr. Rigby also shared her views on abortion. She tends to lean more conservative than her colleagues, but “wishes we could all move toward more common ground on making abortion safe, legal and rare.” However, she wants to decrease unwanted pregnancy through straightforward, accessible means. Dr. Rigby’s twin sister is a lawyer, so she has a unique perspective on how pregnancy is an example of how people are using positive rights and divisive rhetoric to intervene in something that continues to transition from an ethical to legal issue.
Moving more into her personal history, I loved hearing about her experiences that led her to pursuing OB/GYN. Dr. Rigby is an Irish immigrant who lived in Culpeper, VA, completed her undergraduate education at Princeton, finished medical school at UVA, and then completed her residency and fellowship in New Orleans at LSU. Her career was greatly impacted by Hurricane Katrina which prompted her to move to VCU Medical Center. She found that MCV was very similar to LSU. (For all the people thinking about medical school in Virginia, she said UVA is better known academically, but MCV is more of a “roll up your sleeves” school where you see a really diverse patient base.” Surprisingly, OB/GYN was her last option for third year. She really liked surgery and continuity of care in medicine, but the much longer, slow-paced rounds on internal medicine were not her cup of tea. Dr. Rigby’s journey is a testament to how there is no clear path towards being a good physician, only the ability to pivot and vigilance.
She now focuses a lot on trauma-informed care and is involved with research about human trafficking and a fourth year elective at the medical school to treat incarcerated populations. In treating vulnerable patients, she recommends “slowing down as much as you can” and preserving autonomy despite the more rapid, efficiency-driven mindset in Western medicine. Specifically, when encountering domestic partner violence and human trafficking, the key thing is to let them know that you can recognize something is going on and not forcing them to disclose, making this a safe place, giving them the information to empower themselves.
Overall, I loved hearing more about how Dr. Rigby’s practice empowers other women and builds families. As a member of Her Campus, a pre-medical student at VCU, and an immigrant, her story resonates with me and I hope you also find time to reach out to someone inspirational in your community to share their stories.