In the United States, there is an ever-increasing burden of state-level legislation that interferes with the patient-physician relationship. A focus on forwarding a political agenda while ignoring established and evidence-based guidelines for care are hallmarks of this type of legislation. Major US medical organizations have raised serious concerns about laws that prohibit physicians from discussing with ...Read more >

Background: Medication abortion accounts for more than a third of abortions in the US prior to nine weeks gestation. It is very effective, with ongoing pregnancies occurring in less than 1% of cases. Patients must return to the clinic to confirm that the procedure was complete because symptoms alone are not very accurate in identifying ...Read more >

Medical students can carry strong preexisting personal beliefs about pregnancy options through their training. Medical school curricula often do not allow students the opportunity to understand these complex beliefs.  Narrative Medicine (NM), the practice of engaging with illness through artistic dimensions, can be used to address the “difficult to teach” clinical competencies such as empathy, ...Read more >

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 >