Background: In Texas, abortion is legal through 20 weeks; exceptions past this gestational age include “severe fetal abnormalities.” Abortion counseling in the setting of lethal or severely morbid fetal anomalies may be performed by Maternal-Fetal Medicine specialists (MFMs) in settings without Family Planning specialists (FPs), as is the case in many places in Texas. MFMs ...Read more >

Ketamine is commonly used for procedural sedation and analgesia. It is widely used for trauma cases in the emergency department and is considered a superior agent in the outpatient setting due to its lack of respiratory and cardiovascular depression. In chronic opioid users, ketamine decreases acute pain and reduces postoperative opioid consumption. Few studies have ...Read more >

Eighteen million reproductive aged women living in rural America experience marked access limitations to contraceptive services. Rural U.S. counties also lack abortion clinics, and patients must travel to larger communities for care. Provision of affordable post-abortion contraception, particularly LARC methods, may fill a crucial service gap for rural patients but is challenging to implement due ...Read more >

Medical education relies on patient consent to provide trainees with the experiences to become competent doctors and ensure future access to healthcare. Abortion care in the United States is uniquely stigmatized, politicized, and has ongoing barriers to access, including a lack of new providers in training. Obtaining consent for trainee participation in a patient-centered manner ...Read more >

Ultrasound use in the assessment of medical abortion eligibility varies by practice site. The National Abortion Federation (NAF), the Society of Family Planning (SFP), and the World Health Organization (WHO) guidelines do not recommend the routine use of ultrasonography; however, many institutions and practices still require this as part of clinic protocol. Furthermore, many clinicians ...Read more >

We conducted a multisite, double blind, randomized clinical trial to assess the utility of nitrous oxide for pain relief in early second trimester abortion. This study randomized participants to receive either inhaled nitrous oxide or intravenous (IV) sedation with fentanyl and midazolam. We included women desiring abortion at gestational ages between 12 weeks 0 days ...Read more >

Mifepristone followed by misoprostol is a safe, highly effective (> 95%) method for medical termination of early pregnancy. New data reveals that administering mifepristone prior to misoprostol also has superior efficacy than misoprostol alone in the treatment of miscarriage, and practice recommendations have been updated to reflect this practice. Despite its safety and efficacy, few ...Read more >

Background: Quality assurance and improvement in healthcare relies on performance measurement. Up until recently, there were no performance measures related to reproductive health and contraceptive provision. The Office of Population Affairs (OPA) developed and validated claims-based performance measures for contraceptive care, aimed at addressing unintended pregnancy. In 2016, the National Quality Forum (NQF) endorsed these ...Read more >

Rationale: The Los Angeles (LA) homelessness crisis continues to worsen with the current estimate of 60,000 homeless individuals expected to rise annually and women make up one-third of this population. Homeless women live in a unique sociocultural context that warrants in-depth exploration of sexual and reproductive (SRH) behaviors and needs, focusing on the variations in ...Read more >

This study will consist of in-depth interviews with adolescents with chronic disease (ACD) and their parents. It will explore the ACD-parent dyad and how contraception is currently addressed within context of both the functioning dyad and overall disease management. It aims to identify if there are factors influencing knowledge, use of, and attitudes toward contraception ...Read more >