Meet the Board: Laura E. Riley on her career in high-risk obstetrics, the HIV epidemic, and more

Laura E. Riley, MD
Laura E. Riley, MD

Chair of Obstetrics and Gynecology
Weill Cornell Medicine
Obstetrician and Gynecologist-in-Chief
New York Presbyterian Hospital
NEW YORK CITY, NY

,
Lindsey Carr

Associate Editor for Contemporary OB/GYN

Introducing Contemporary OB/GYN® Editorial Advisory Board member, Laura E. Riley, MD.

Contemporary OB/GYN®'s Associate Editor Lindsey Carr sat down with Laura E. Riley, MD, to discuss her interest in the editorial board, obstetric infectious disease, and more. Plus, check out Riley's full interview for Contemporary OB/GYN®'s Meet the Board series.

Q: When did your interest in Contemporary OB/GYN® begin?

Riley: I would have to say it began very early in my career, probably junior faculty, maybe. It's been a lot of years. And one of the things that I've always liked about it is that it's always relevant, so that's what makes it successful.

Q: How would you describe your role as a board member to our readers?

Riley: I'm new to the board and have attended just one meeting, which is great. The role that I would like to play is that I'd like to be giving new ideas on helping figure out what topics are important to people who are practicing now. I'm also wondering if there's ways we can sort of spice it up a little bit and present the information differently, so that it's appealing to even more people than the ones who are reading now.

Q: What made you decide to pursue ob/gyn, specifically high-risk obstetrics?

Riley: That's a long meandering answer. There's a long meandering answer to that. I would say, by the time I got to medical school and in the last couple years of medical school, I started to think about, 'What's the population of people that I can see myself working with for a really long career?' Although I liked medicine, and I liked surgery, I didn't particularly like psychiatry. I thought I was going to be a pediatrician, and then I realized, 'I'm not so sure I like that either.'

Women's health really turned out to be the perfect area in the perfect patient population. In general, I kind of liked the young and healthy good things [that] happen [and the happy outcomes]. Of course, I ended up going into all of the areas that would be not as happy. Nonetheless, that was the original draw to it: the ability to deliver babies, and help women and their families, and all those sort of happy outcomes. And then I fell into high-risk obstetrics, where it's not always happy, but you know, what, 99.9% of the time, it is happy. It just might be bumpy getting there. That I find challenging,and even more rewarding.

[As for] the infectious disease part of it, I just literally fell into because of the timing of when I finished my fellowship. It was the beginning of the HIV epidemic in Boston, so I really got in there. That sort of changed everything. I left Brigham and Women's after my fellowship in high-risk obstetrics, then I got my first job, which was then at Boston City, which is now Boston University. That's where I did my infectious disease fellowship, and [where] we started the first HIV clinic for women.

Q: In addition to your experience at the HIV clinic, your infectious disease expertise has led you to become a member of the American College of Obstetricians and Gynecologists (ACOG) COVID-19 Task Force. How do those intersect for you in your practice?

Riley: When I told my then chair that I wanted to work in HIV, the infectious disease specialists, they are both pediatrics and adult infectious disease said, 'No, you need more training.' I [thought,' 'I just want to get out and practice,' and they convinced me to do an infectious disease fellowship--which at the time--there wasn't one that was really focused on Reproductive Medicine. You either did pediatrics or internal medicine, so I ended up doing the internal medicine and about six months of Pediatrics. Once I did that, it really became a super-specialty in a way. And so, all along with my career, I've either been doing HIV or group B strep, or recently, things like Ebola [and] Zika, and now COVID-19. Having a specialty that is within a specialty is mostly what's driven my career.

Pregnancy has different physiology. [As] infectious diseases are pretty common, how you treat them, how they impact pregnant women, and things like that can be very different. Having that expertise has been sort of what's gotten me into all these different areas and different collaborations, like the CDC and ACOG.

Q: What do you and your colleagues on the task force expect to see as people start getting vaccinated and come together again?

Riley: What we're hoping to see is that the numbers of new COVID cases continue to go down. I think that we've been reasonably successful at being very transparent with the public. Pregnant women have gone ahead and gotten vaccinated, which I think is incredibly reasonable, given an ongoing pandemic, and...the information suggesting that COVID-19 really is worse in pregnancy and is associated with worse pregnancy outcomes.

I think women heard that, and also heard the fact that the vaccine has been very successful in decreasing cases. So that's been the reason to go ahead and essentially avail themselves with the only preventive strategy that exists. Now, I think a lot of it is just keeping track of the safety data. So far, it seems like there haven't been any things that we should be worried about., but obviously, we need to continue to monitor that.

Q: Does the task force have a plan for updating the information, which is coming out so frequently? How does the task force manage that?

Riley: The COVID task force actually meets every week, that's how much information there is [and] that's how rapidly it changes. The people at ACOG who have been knee-deep in this are great at keeping up with the literature as well. The literature is coming out fast and furiously. I think that that's what's challenging for practitioners is the information comes out so quickly. It's our responsibility to be able to put that information together, and present it to our patients, and answer the patient's questions.

The hope has been that ACOG's COVID Taskforce efforts are helping other physicians do exactly that. We take in the information, and as soon as we get it, try and understand whether it's published, real, or not real? And then, put that into Frequently-Asked-Questions and Practice Advisories and things that are easy for people to access.

Q: How do you juggle such a busy schedule taking care of other people and making time for yourself? What advice would you give younger folks just starting out that are looking to incorporate health and wellness into the daily routine?

Riley: What I say to residents and junior faculty is pace yourself, right? I think when you start your career, you're like, 'I have so much to do,' because you finally have the knowledge you've been practicing, and studying forever. Now, you are actually going to get out there and do something. Depending on [...] your aspirations--I want to be a chair, I want to be, you know, this, whatever--you just have to pace yourself because, you know, life is gonna happen. You don't want to be looking so far ahead that you miss what's happening today.

Also, you know, medicine is stressful, right? You have so much responsibility for other people's lives as well as your own family. I think that that's the other reason that you have to really take your time. COVID was just...a disastrous 14 months, but I would say, the thing that kept my sanity was a Peloton.

You just need to do something mindless. Some people I know [...] were really into it and worried about their time. I'm like, 'Whatever.' I just get on there and let the music blast and just sweat. And then I feel better. I'm convinced that exercise is important, and that spending time with your family is important, and all those other things that we all know.