When Phyllis Leppert was a nursing student in the late 1950s, she learned that infant and maternal mortality rates were a bellwether indicator of a nation’s health. More than half a century later, the United States appears to be on life support, with the highest maternal death rate of any developed country. Between 2019 and 2021, there was a nearly 60% increase in maternal mortality rates and those numbers continue to climb, with Black women more than twice as likely to die as white women.
Leppert has worked tirelessly throughout her career, first as a nurse-midwife and later as chief of the Reproductive Services Branch of the National Institute of Child Health and Human Development (NICHD), before joining Duke’s OB-GYN faculty in 2006. Now a Duke professor emeritus, Leppert continues to sound the charge for more funding for basic science research and education around reproductive health. The Ph.D. she earned from Columbia University was important to her research on the extracellular matrix of the uterine cervix and how it functions in pregnancy and birth, and to her studies (conducted at NICHD and then at Duke) on uterine fibroid biology. She continues to be a member of a Duke team working on a new approach to the treatment of uterine fibroids.
“People don’t realize that reproductive biology is so much more than birth control; it encompasses things like endometriosis, uterine fibroids, pelvic pain, and postpartum depression,” Leppert says. “One study at the Mayo Clinic found that women who had hysterectomies were at higher risk of stroke and heart disease. But without basic science research, we can’t develop effective prevention, interventions, and treatments.”
Given that the National Institutes of Health didn’t mandate until 1993 that women and minorities be included in clinical trials, it’s perhaps not surprising that basic science research lags so far behind. And with the highly politicized conversations around women’s bodies and agency, a broken health care system, and an acute lack of resources for the more than 8 million women of reproductive age who are uninsured, it’s no wonder that women continue to die of preventable conditions.
To accelerate needed research, Leppert and her geneticist brother formed the Phyllis and Mark Leppert Foundation for Fertility Research, known as the Campion Fund, to promote basic biomedical research on diseases that affect the human reproductive system. The foundation has three goals:
- Provide peer-reviewed grants to research universities and qualified scientists.
- Host an annual conference for the scientific community, most recently in February 2023 co-hosted with NIEHS a meeting on the Basic Science of Gestation and Parturition.
- Provide education about fertility to the public.
Additionally, Leppert says that reducing maternal mortality rates hinges on implementing policies that allow all women to have access to free or affordable primary care before, during, and after pregnancy; creating a maternal healthcare workforce consisting mainly of midwives for routine births with physicians for high-risk situations, all paid for by insurance; and comprehensive postpartum support, including doulas.
“Eighty-nine percent of maternal deaths are preventable. We need basic research, better education of doctors, patients, and researchers, and legislation and politicians that support women’s health.”