Background: Unintended pregnancy among teenagers remains a significant problem. It is particularly important to consider unintended pregnancy in African American communities as African American teenagers are at increased risk of unplanned pregnancy and are more likely to seek abortion when pregnancy occurs. Women’s decision making about pregnancy and contraception is often influenced by their male ...Read more >
Aparna Sridhar, MD, University of California, Los Angeles
Due to time constraints that limit physician’s ability to deliver detailed contraception counseling, patients increasingly require supplemental education opportunities. Applications for smartphones and tablets are being designed to educate patients about contraceptive methods and simplify communication between patient and provider. We designed a mobile application entitled Plan A Birth Control to provide targeted information about ...Read more >
Objective: The objective was to investigate mifepristone as a potential adjunct to cervical preparation for surgical abortion after 19 weeks of gestation, with the aim of improving procedure access, convenience and comfort. Methods: This is a site-stratified, block-randomized, noninferiority trial of 50 women undergoing surgical abortion between 19 and 23 6/7 weeks of gestation randomized to receive ...Read more >
African American adolescent women in the Southern United States carry a disproportionately high burden of Chlamydia and gonorrhea infections when compared to women of the same age but of different race/ethnicity or geographic location. Additionally, Chlamydia and gonorrhea re-infection rates are 1.7 times higher in adolescents than in older women. Successfully reducing re-infection rates may ...Read more >
Background: Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester dilation and evacuation training. Objective: ...Read more >
Maureen Baldwin, MD, MPH, Oregon Health and Sciences University
Objective: To investigate whether early interval placement of a postpartum intrauterine device (IUD) at 3 weeks after delivery, compared to the usual placement timing of 6 weeks, is associated with greater IUD uptake by 3 months after delivery. Uterine measurements via ultrasound and uterine sounding were compared. Pain with insertion, six month continuation, subject acceptability, ...Read more >
Research Design:We propose a prospective randomized-controlled trial in which postpartum adolescents (age 14-19) will be randomized to receive either a brief standardized contraceptive counseling intervention or routine postpartum care. The primary outcome is repeat pregnancy rates at 6 and 12 months postpartum. Secondary outcomes include evaluating the subjects’ contraceptive choice, use and continuation rates postpartum ...Read more >
Erika Levi, MD, University of North Carolina at Chapel Hill
Background: Delaying the initiation of effective contraception until the postpartum visit puts some women at risk for rapid, repeat, and unintended pregnancy. Women who intend to use an intrauterine device (IUD) for postpartum contraception are often unable to return for a postpartum visit, and never receive an IUD. These women are more likely to be ...Read more >
Background: Second trimester uterine evacuation can be accomplished safely and effectively with dilation and evacuation. The Accreditation Council for Graduate Medical Education mandates routine abortion training in obstetrics and gynecology residency, but few graduate competent to perform dilation and evacuation due to limited clinical volume and lack of access to skilled teachers. Simulation-based education offers ...Read more >
Objectives: To assess whether a targeted educational intervention, with skills training in cervical dilation and paracervical anesthesia, will increase IUD insertion success rates. Study Design: This was a prospective study of an intervention aimed at improving IUD insertion success among a group of advanced practice clinicians (APCs) at family planning clinics in Utah. Data were ...Read more >
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