Background: For many adolescents the Emergency department (ED) may be their first or only contact with the health care system for sexual and reproductive health yet many ED providers rarely discuss EC outside cases of sexual assault. Clinical guidelines, or recommendations for effective and uniform clinical practice, have been shown to improve clinical care. There ...Read more >

Background: The history of reproductive injustice in the United States against women and girls of color is well-documented. As a result, women of color mistrust and are suspicious of medical professionals in reproductive health care. The conditions of mistrust and suspicion are further worsened by the disparity that affects women of color in family planning. ...Read more >

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 >

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 >