The training and research activities proposed in this Junior Investigator Career Development Award will expand my research program in reproductive health for incarcerated women and set the stage for future grants. I will survey a representative sample of prison and jail systems across the US to prospectively report the aggregate number of pregnant women, abortions, ...Read more >

I seek a Midcareer Mentoring Award to achieve my long-term career objectives: (1) reduce unintended pregnancy through interventions that enhance safe contraceptive health care delivery and improve access for disparate populations and (2) foster a cadre of research-scientists working to enhance family planning services in primary care settings. Since 2006, I have mentored 37 trainees. ...Read more >

Objectives: To assess late presentation for care, gestational age, and disparities in traveling for care in Mexico City’s public abortion program, called ILE. To replicate a recent publication (Koch et al) purporting to show that restrictive abortion laws are associated with reduced maternal mortality in Mexico. Methods: We extracted data from clinical charts and used ...Read more >

The recommended treatment for ongoing pregnancy following medical abortion is usually suction curettage. Limited published data demonstrate that additional misoprostol can successfully terminate ongoing pregnancy, but there is no published literature on the repeat use of a combined mifepristone-misoprostol regimen. This randomized placebo-controlled trial seeks to assess the effectiveness of a repeat course of 200 ...Read more >

Objectives: To date, there has been no research on the abortion experiences of Punjabi women in Canada. Based on registry data, available research focuses solely on sex-selective abortion in immigrant populations. Our study aimed to explore and give voice to Punjabi women’s abortion experience in Ontario (ON) and British Columbia (BC). Methods: We conducted four ...Read more >

Objective: Carbamazepine, a known cytochrome P-450 enzyme inducer, significantly reduces serum hormone levels from oral contraceptives. Despite case reports of contraceptive failure with concomitant use of the etonogestrel contraceptive implant and carbamazepine, no studies have explored the pharmacologic relationship between carbamazepine and non-oral contraceptives. We set out to investigate the pharmacokinetic and pharmacodynamic effects of ...Read more >

Persistently high rates of unintended pregnancy in the US suggest a need for new patient-centered approaches to contraceptive acceptability and promotion. A critically understudied aspect of contraceptives are their sexual acceptability, or how methods influence women’s sexual experiences, which can in turn influence family planning clients’ preferences and practices. Moreover, despite professional enthusiasm about long-acting ...Read more >

Catholic health networks have expanded substantially in recent years. These facilities follow the Ethical and Religious Directives for Catholic Healthcare Services, which prohibit abortion, contraception, sterilization, and certain treatment for obstetrical complications or miscarriage. Yet, little is known about patients’ awareness of religious restrictions on care. Defenders of institutionally-based conscience rights assert women can simply ...Read more >

The objective of this study was to explore the challenges that abortion providers in conservative or “red” states are experiencing in this period of intense regulation and restriction, and to document what have been their responses to these challenges. (“Providers” in this case refers to administrators and various levels of staff of independent clinics, and ...Read more >

The etonogestrel (ENG) contraceptive implant (Implanon/Nexplanon) is one of the most effective forms of contraception available. Continuation rates in published studies of Implanon range from 55%-90%; one of the most common reasons for discontinuation is the complaint of “bleeding problems” such as prolonged and frequent bleeding patterns. There is limited evidence supporting ways to improve ...Read more >