Provision of Contraception: Key Recommendations from the CDC
TLDR
All patients-including adolescents; those who identify as lesbian, gay, bisexual, or transgender; and patients with disabilities or limited English proficiency-should receive high-quality care in an accommodating, nonjudgmental environment.Abstract:
The Centers for Disease Control and Prevention has released comprehensive recommendations for provision of family planning services. Contraceptive services may be addressed in five steps and counseling may be provided in a tiered approach whereby the most effective options are presented before less effective options. Clinicians should discuss all contraceptive methods that can be used safely by the patient regardless of whether a method is available on site and even if the patient is an adolescent or a nulliparous woman. Physical assessment is usually limited to blood pressure evaluation before starting hormonal contraceptives or pelvic examination before placing an intrauterine device. Monitoring the patients weight also may be helpful. If it is reasonably certain that the patient is not pregnant any contraceptive may be started immediately. When hormonal contraceptives are selected one years supply should be prescribed to reduce barriers to use. Condoms should be made readily available. Documentation of visits for contraception should include patient understanding of use benefits and risks plus an individualized follow-up plan. Bleeding irregularities generally are not harmful and may resolve with continued use of the contraceptive method. All patients-including adolescents; those who identify as lesbian gay bisexual or transgender; and patients with disabilities or limited English proficiency-should receive high-quality care in an accommodating nonjudgmental environment. The Centers for Disease Control and Prevention supports advance provision of emergency contraceptives. Because no test reliably verifies cessation of fertility it is prudent to consider contraceptive use until menopause or at least until 50 to 55 years of age.read more
Citations
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Contraception for adolescents.
Mary A. Ott,Gina S. Sucato +1 more
TL;DR: This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: sexual history taking, confidentiality, and counseling; adolescent data on the use and side effects of newer contraceptive methods; new data on older contraceptives methods; and evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.
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Commercial sexual exploitation and sex trafficking of children in the United States
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Global PrEP roll-out: recommendations for programmatic success.
K. Rivet Amico,Linda-Gail Bekker +1 more
TL;DR: It is proposed that the sell should focus on protection or wellness framing, the branding should convey PrEP as appropriate for anyone in need, and the provision of PrEP should be placed in the context of other relevant and valued health services.
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The history of tiered-effectiveness contraceptive counseling and the importance of patient-centered family planning care.
Kristyn Brandi,Liza Fuentes +1 more
TL;DR: The development of tiered-effectiveness contraceptive counseling is examined, how its rise mirrored the focus on promoting LARCs to decrease the unintended pregnancy rate, and key considerations and the potential conflicts of a LARC-first model with patient-centered care are discussed.
References
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Medical-eligibility criteria for contraceptive use.
TL;DR: The revised version of the WHO document on medical eligibility criteria for contraceptive use aims to ensure that contraceptive counseling is based on the best available evidence and to simplify the criteria for eligibility to include only those essential for screening to ensure the safe provision of contraceptive services.
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Contraceptive failure in the United States
TL;DR: This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States and reflects new research on contraceptive failure both during perfect use and during typical use.
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Physician-Patient Communication: The Relationship With Malpractice Claims Among Primary Care Physicians and Surgeons
TL;DR: The study identifies specific and teachable communication behaviors associated with fewer malpractice claims for primary care physicians and surgeons and can use these findings as they seek to improve communication and decrease malpractice risk.
Journal ArticleDOI
The variability of female reproductive ageing
TL;DR: Age at last birth in natural fertility populations, which marks the end of female fertility, shows an identically wide variation as age at menopause, but occurs on average 10 years earlier than this, given the high heritability for age atMenopause.
Journal ArticleDOI
Effectiveness of long-acting reversible contraception.
B. Winner,Jeffrey F. Peipert,Qiuhong Zhao,Christina Buckel,Tessa Madden,Jenifer E. Allsworth,Gina M. Secura +6 more
TL;DR: The effectiveness of long-acting reversible contraception is superior to that of contraceptive pills, patch, or ring and is not altered in adolescents and young women.