Objectives: Unintended pregnancy is common in the United States, yet scant research has evaluated women’s preferences on pregnancy options counseling. This study explores pregnant women’s preferences for pregnancy options counseling from health care providers. Methods: We conducted semistructured interviews with pregnant women at a prenatal clinic and an abortion clinic. We asked women about recent ...Read more >

Justification for the project Long-acting reversible contraceptive (LARC) methods such as etonogestrel contraceptive implants and intrauterine devices (IUDs) have low failure rates and are effective at preventing teen pregnancy. High upfront cost limits use of these methods, but acceptability and initiation are high among adolescents when these methods are offered for free. While continuation rates ...Read more >

Although blood loss during modern dilation and evacuation procedures is well tolerated by most patients, one of the most common complications is heavy bleeding if the uterus doesn’t contract appropriately after the procedure.  As physicians, we prevent and treat heavy bleeding with a range of different “uterotonic” medications given in a wide variety of different ...Read more >

Levonorgestrel (LNG) and ulipristal acetate (UPA) emergency contraceptive (EC) efficacy trials suggest more EC failure among women with greater body mass index (BMI); this relationship appears much stronger for LNG-EC than for UPA-EC. Differences in systemic exposure by BMI might explain differences in failures. Thus, the primary objective of this study was to compare the ...Read more >

Background: Over 1 million induced abortions are performed each year in the US. The majority of first trimester abortions are performed using vacuum aspiration. There are two methods of vacuum aspiration available; manual vacuum aspiration (MVA) and electric vacuum aspiration (EVA). In studies performed prior to 11 weeks’ gestation, no differences between the methods have ...Read more >

Background: Reproductive coercion (RC) refers to explicit attempts to impregnate a partner against her will, control outcomes of a pregnancy, coerce a partner to have unprotected sex, and/or interfere with contraceptive methods. Recent research from the CDC, family planning clinics in California, and a family medicine residency site in the Bronx, NY, report prevalence of ...Read more >

Background: Placement of long-acting reversible contraception (LARC) immediately postpartum is becoming increasingly popular. This practice provides highly effective contraception, which may be especially beneficial for women with barriers to contraceptive use such as lack of insurance coverage outside of pregnancy or loss to follow-up postpartum. While increasing access to LARC is an important goal, it ...Read more >

Contraception is a critical component of healthcare for HIV-infected women as it is key to both promoting maternal health and preventing perinatal transmission, yet evidence to direct contraceptive choices in HIV-positive women remains limited. Particular concern exists about potential effects of protease inhibitors, especially ritonavir, on the efficacy of combined oral contraceptives. However, these concerns ...Read more >

In 1951 India became the first country to launch a national family planning program focused on promoting reversible and permanent contraception including financial incentives for both method acceptors and providers. Despite governmental provision of the copper intrauterine device (IUD), oral contraceptive pills (OCP) and condoms at no cost, most Indian women choose permanent sterilization after ...Read more >

Background:  Although post-abortion contraception is known to be acceptable, safe, and effective, many women leave abortion clinics without contraception and are therefore at risk for repeat unintended pregnancy.1-11    Abortion clinic staff and providers often cite cost as a barrier to women receiving immediate post-abortion contraception.12,13  Insurance copayments and out-of-pocket costs have been shown to affect ...Read more >