Background: The interpregnancy interval (IPI) is defined as the time between a live birth or stillbirth and the onset of a subsequent pregnancy. Short IPIs (60 months) have been associated with congenital anomalies, labor dystocia, and pre-eclampsia. While patients receive a great deal of counseling regarding contraception, it is unclear if they receive counseling about ...Read more >

Short interval pregnancies, defined as pregnancies conceived within 18 months of a previous birth, are associated with adverse pregnancy outcomes, such as preterm birth and low birth weight. Postpartum use of long acting reversible contraception (LARC), which includes intrauterine devices (IUDs) and contraceptive implants, has been shown to decrease the risk of short interval pregnancies ...Read more >

Objective: Unplanned pregnancy remains a nationwide problem. Within the active duty military population, the age-adjusted unintended pregnancy rate is higher than the national average.  Unplanned pregnancy provides additional challenges for female service members.  When the pregnancy is unplanned, the female service member is unexpectedly removed from the team, and unit readiness is compromised.  Additionally, access ...Read more >

Background: Half of all pregnancies in the United Stated are unintended. The traditional postpartum visit is scheduled at six-weeks following delivery. This time period may be too late as women can already be pregnant by that visit. Additionally, as many as 50% of women on Medicaid never attend a postpartum visit, and one reason for ...Read more >

Obesity is a critical public health issue in the United States.  Overweight and obese women are at risk of excessive gestational weight gain and postpartum weight retention.  Research shows that poor postpartum weight loss correlates with long-term obesity and associated comorbidities.  Contraceptive use in the postpartum period prevents unintended pregnancy and short inter-pregnancy intervals.  Women ...Read more >

Women with sickle cell disease (SCD) have unmet contraceptive needs.   A 2011 study of Medicaid claims in women with SCD found higher rates of pregnancy than encounters for contraception. Because of their known pregnancy risks, this is problematic.  Gaps in patient and provider knowledge and unanswered questions regarding contraceptive safety persist.  SCD pain significantly impacts ...Read more >

Background: Dilation and evacuation is the most common method of second trimester abortion procedures. Adequate cervical preparation is required prior to second-trimester dilation and evacuation procedures to minimize the risk of uterine and cervical trauma. Studies have reported a strong preference by women for same-day dilation and evacuation procedures and for a pharmacological method (misoprostol) ...Read more >

Background: Obstetrician-gynecologists are rarely an adolescent’s first contact with the health care system. Most adolescent visits are with pediatricians and family practitioners. A large number of uninsured adolescents have no primary care provider and rely on emergency departments for routine care. These providers, termed “frontline adolescent providers”, who have routine contact with adolescent patients have ...Read more >

Modern contraceptive use by HIV-infected women prevents maternal morbidity, economic disparity, and perinatal HIV infection. Despite the clear benefits of hormonal contraceptives, there continues to be significant unanswered questions about contraceptive safety in women living with HIV on anti-retroviral therapy (ART). Specifically, hormonal contraceptives are metabolized in the liver by cytochrome P450 (CYP) enzymes and ...Read more >

Background: Women with cystic fibrosis (CF) now have a median age of survival of 38.3 years, and for the first time in history, may require contraception on a population-based level. Additionally, it appears that female CF patients are prone to a more severe disease course than their male counterparts. This CF “gender gap” may be ...Read more >