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 >

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: Every year tens of thousands of refugees arrive in the United States. In contrast to other immigrant populations, refugees have often fled war, violence and/or natural disaster. Many refugee women from Somalia and the Democratic Republic of the Congo (DRC) are designated as ‘women-at-risk’ by the United Nations High Commission on Refugees (UNHCR) meaning ...Read more >

Oral contraceptive pills are the most commonly utilized form of contraception in the United States. However, there are fears about the safety of combined oral contraceptive (COC) pills, particularly regarding the risks of venous thromboembolic events (VTE) among users. Progestin only pills (POP) have relatively few contraindications and are not associated with risk for VTE. ...Read more >