Background: Hemorrhage, the most common complication of dilation and evacuations is estimated to occur in 0.8% to 2.1% of procedures. The rate of hemorrhage increases with gestational age, affecting up to 6.3% of dilation and evacuations performed above 18-weeks gestation. Many practitioners report the use of prophylactic uterotonics, like oxytocin, with dilation and evacuation to ...Read more >

Background Nearly all of the 3 million unintended pregnancies in the United States each year result from inconsistent or non-use of contraception. Increasing use of the most effective methods of contraception will reduce unintended pregnancies and their social, medical and economic consequences. The contraceptive etonogestrel implant (ENG implant) is 20 times more effective at pregnancy ...Read more >

Background: Hysteroscopic sterilization with Essure is increasingly performed in the outpatient setting. No studied interventions including paracervical block, intravenous or oral sedation, or intrauterine lidocaine, have successfully reduced pain during in-office procedures. Inhaled nitrous oxide with oxygen (NOS) has proven effective for short painful procedures in the outpatient and Emergency Room setting. NOS has analgesic, ...Read more >

Background: The immediate postpartum period is an ideal time to initiate contraception, however many women leave the hospital without an effective birth control plan. Intrauterine devices (IUDs) are highly effective at preventing pregnancy and can be placed immediately after delivery (post-placental insertion). Despite the safety and effectiveness of placing an IUD after delivery, this practice ...Read more >

Background: Cervical preparation before second-trimester dilation and evacuation reduces surgical risk. Same-day cervical preparation in early second trimester is safe and effective with osmotic cervical dilators and prostaglandin analogues but few studies have examined cervical preparation methods for same-day dilation and evacuation in the second trimester. Administration of misoprostol as an adjunct to osmotic dilators ...Read more >

HIV specialists are the main primary care providers for women with HIV; this care often includes gynecologic care. Specific drug interactions between contraceptives and antiretroviral therapy may alter contraceptive efficacy for HIV+ women of reproductive age. There are limited data on what women with HIV are using for contraception and it is unclear what HIV ...Read more >

Background: The use of long-acting, highly effective forms of contraception such as the intrauterine device (IUD) or subdermal implant is associated with lower pregnancy and repeat abortion rates.  Immediate post-abortal insertions are safe and effective, yet many abortion facilities in the United States do not offer immediate placement. Previous research has identified patient and provider ...Read more >

Background: The United States has one of the highest teen birth rate in the entire developed world, despite a decline in rates over the last two decades. Declining teen pregnancy rates have been due in part to increasing knowledge, access, and utilization of contraception. Teen birth rates of American Indian and Alaska Native (AI/AN) women ...Read more >

Background: With less than 5% adolescents using IUDs, there is limited information on young women’s contraceptive decision making around choosing IUDs and their experiences with IUDs.  Prior qualitative studies have largely utilized in-depth interviews and centered around the time of pregnancy.  The purpose of this qualitative study is to explore why adolescents who were enrolled ...Read more >