American College of Obstetricians and Gynecologists (ACOG)

The audit

Who controls it

ACOG guidance is developed by clinical committees, volunteer clinicians, staff, and, for some documents, methodologists and outside experts. The reviewed editorial records named no political appointee or industry representative, but this was not a review of every author or document.

Money

ACOG's return for the year ending December 2024 reports $63,505,977 in revenue and $13,263,216 in contributions. The return does not identify donor sectors; the College's advertising, newsletter promotion, and mailing-list income was not separately verified, and the ACOG Foundation is a separate entity.

Conflict rules

ACOG publicly refers to a conflict-of-interest disclosure policy, and its Ethics Committee says statement authors filed disclosures and potential conflicts were managed under policy. The full Clinical Consensus methods page did not render, so detailed rules and author-by-author records were not verified.

Method

ACOG Clinical Practice Guideline No. 8 used a planned protocol, a broad librarian search, study-quality review, and GRADE, a system for rating evidence and recommendations. These details apply to that guideline example, not automatically to every ACOG document; the Clinical Consensus method details were not accessible.

Dates on its pages

ACOG says originating committees review clinical guidance every 24 to 36 months, but that does not show each item was updated on time; its HIV FAQ displayed a June 2026 update date and an April 2025 review date.

Political exposure

In September 2025, after FDA began an acetaminophen label-change process, ACOG reaffirmed judicious use and said the evidence did not support a causal link with neurodevelopmental disorders. The reviewed record showed no official order to rewrite ACOG guidance, but the historical scan was not exhaustive.

Money exposure

By the October 14, 2026 audit cutoff, ACOG offered advertising, newsletter promotions, and mailing-list rental, with an advertising policy separating ads from editorial content and barring implied endorsement. No public dollar amount for College advertising, sponsorship, or company support was verified, and no specific recommendation was shown to have changed because of a sponsor.

Track record

In five backtests, ACOG's 2020 antiseizure-medicine opinion gave broad class-level risk information, not a valproate-specific absolute risk or a topiramate-specific assessment. Its 2021 postpartum pain guidance allowed selected short-term codeine use and was reaffirmed in 2025; its nausea FAQ acknowledged uncertainty without effect estimates. The 2025 acetaminophen advisory was first captured three days after FDA's announcement, but its exact publication lag is unknown; no source-specific evidence of financial or political control was found in the tests.

Where this comes from

• ACOG College 2024 tax return record
• ACOG Clinical Practice Guideline No. 8
• ACOG relationships with industry statement
• ACOG advertising policy and opportunities
• ACOG September 2025 acetaminophen advisory