Purpose: Adolescent girls who use emergency departments for non-emergent complaints have risk factors for unintended pregnancy and are difficult to reach in outpatient settings. This pilot study examined the feasibility of comprehensive contraceptive counseling in a novel outreach setting, a pediatric emergency department (PED).  Methods: This prospective cohort pilot study enrolled girls ages 13-18 presenting ...Read more >

Background:  The copper intrauterine device (Cu T380A IUD) is highly effective, hormone free, and the most effective form of emergency contraception (EC).  Women seeking EC often report multiple episodes of unprotected intercourse (UPI). Currently, the Centers for Disease Control and Prevention’s Selected Practice Recommendations limit placement of the Cu T380A IUD to the first five days ...Read more >

Abortion remains one of the most common surgical procedures in the world. In the United States, at least half of all women will experience an unintended pregnancy by age 45, and one third of all women will have had an abortion by this same age. Despite universal efforts to increase the comfort of these procedures, ...Read more >

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 >

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 >