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 >

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 >

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 >

Background: In 2011, Texas cut its family planning budget, resulting in a patchwork system of access to family planning services, and increased contraception costs for many patients. Although much of this budget was restored in 2013, multiple barriers to care still exist, including a decreased number of clinics providing contraceptive services and the exclusion of ...Read more >

An intrauterine device placed immediately following a delivery can serve as an effective and safe contraceptive strategy in the postpartum period. There is limited evidence that the levonorgestrel intrauterine system may have a higher rate of expulsion compared to the copper intrauterine device; however, rates of expulsion for these 2 intrauterine device types have not ...Read more >

Background Highly effective, long-acting reversible contraceptive (LARC) methods have the potential to decrease unintended pregnancies and reduce health disparities. These include the copper-containing intrauterine device (Cu-IUD) and the levonorgestrel-containing IUD (LNG-IUD). The LUCID Study (long-term utilization and continuation of intrauterine devices) sought to describe long-term continuation of the LNG- and Cu-IUD at 48 and 60 ...Read more >

This pilot study will evaluate the ability to recruit and retain participants for a larger, planned cohort to examine clinical contraceptive failure (positive pregnancy test) after quick start LNG IUD insertion when a woman reports unprotected sex 6-14 days prior to insertion with a negative pregnancy test. If this study demonstrates recruitment and high retention ...Read more >