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 >

Short birth intervals increase risk of low birth weight, preterm birth, neonatal and infant mortality, as well as maternal complications, including third trimester bleeding, postpartum infection, and anemia. To date, research has not reached a consensus on the optimal timing and method to discuss postpartum contraception with patients. Most studies have focused on the postpartum ...Read more >

Pain control is a significant concern for women undergoing surgical abortions with the most of women experiencing at least moderate levels of pain. Intravenous sedation has been shown to significantly reduce pain during these procedures, but the majority of abortion providers use only local anesthesia for pain control. Heat is an effective modality used for ...Read more >