Dr. Amy Whitaker joins panel discussion on abortion care

Dr. Amy Whitaker joined IL Congresswoman Jan Schakowsky on Monday, September 21 at Personal PAC for a panel discussion about issues surrounding choice. Illinois appellate judge Laura Liu moderated the panel.

Dr. Whitaker spoke about her passion for abortion care. She also described the situations our patients are in as well as the barriers that doctors face in providing abortion care.

To learn more about PersonalPAC, check out the hashtag #‎GetPersonalWithPersonalPAC‬ on Facebook and Twitter.

Congresswoman Jan Schakwosky and Dr. Amy Whitaker

Appellate Judge Laura Liu moderates the panel

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Liletta: New IUD approved by the FDA

The U.S. Food and Drug Administration (FDA) recently approved Liletta™, a new hormonal intrauterine device (IUD). This levonorgestrel-releasing IUD inhibits uterine lining from thickening and has been FDA approved for up to three years to prevent pregnancy. Liletta, found to be more than 99 percent effective, is already available in Europe and should arrive in the USA within the next few months.

Liletta was developed by Actavis and the non-profit Medicines360. Given the current high cost of IUDs, Medicines360 has focused on making Liletta affordable and accessible to all women. FDA approval was based on results from the largest hormonal IUD trial conducted in the U.S. The Section of Family Planning has been proud to participate in this study since 2010, as part of our broader commitment to research that improves contraceptive access for women.

Our previous research revealed various barriers in accessing the most effective methods, including cost. One recent study, conducted with support from the Office of Population Affairs, explored systems-level barriers to IUD provision. This research led to the development of a toolkit for clinical staff and health care providers to use in identifying and addressing barriers in their own clinics. We are also currently researching the feasibility and effectiveness of using mobile applications for contraceptive counseling in clinic waiting rooms. Our current studies follow previous research on an initial application, available here as an iOS app.

The Section supports the FDA’s approval of Liletta given its effectiveness at preventing pregnancy and ease of use for most women.

“Increasing the array of available and affordable contraceptive methods helps women find a method that best helps them achieve their reproductive health goals”, said Dr. Melissa Gilliam, Chief of the Section of Family Planning and lead investigator for the Section’s study site.

 

Dr. Melissa Gilliam at Discover UChicago San Francisco – Feb. 3

Dr. Gilliam Inquiry Impact Seattle

Dr. Melissa Gilliam presents on games and learning at Discover UChicago Seattle. Photo courtesy of UChicago Alumni.

Section of Family Planning Chief and Ci3 Founder and Director Dr. Melissa Gilliam will present as part of Discover UChicago San Francisco on Tuesday, February 3.

The event is part of the University of Chicago Campaign: Inquiry and Impact. According to the campaign website, Inquiry and Impact is the most ambitious campaign in UChicago history, aiming to support faculty and research, practitioners and patients, and students and programs across the University. Over the next several months, the campaign will hold events in Los Angeles, Chicago, Hong Kong, New York and London. Watch the campaign video.

Dr. Gilliam previously participated in Discover UChicago Seattle on January 13.

RSVP to Discover UChicago San Francisco.

Ci3’s Lee Hasselbacher Quoted in “Guardian” Article

Lee Hasselbacher

Image courtesy of Lee Hasselbacher

Lee Hasselbacher, JD, policy coordinator for Ci3 and the University of Chicago Section of Family Planning & Contraceptive Research, was quoted in a January 15 article on abortion rights, published in The Guardian. 

In the article, entitled “Restricting abortion high on the agenda for Republican-controlled Congress,” Hasselbacher expressed concern that individuals think of abortion as separate from women’s reproductive healthcare, and optimism that this attitude is changing.

Read the full article.

Dr. Melissa Gilliam to Present at Discover UChicago Seattle

Dr. Melissa Gilliam. Photo: Associated Press

Dr. Melissa Gilliam. Photo: Associated Press

Dr. Melissa Gilliam will present as part of Discover UChicago Seattle on Tuesday, January 13. The event will take place at the Four Seasons Hotel in Seattle from 6:30-8:30 p.m., and is part of the University of Chicago Campaign: Inquiry and Impact.

Click here for details and to RSVP.

Dr. Gilliam is Chief of the University of Chicago Section of Family Planning & Contraceptive Research, Founder and Director of Ci3, and Co-founder of Game Changer Chicago Design Lab.

Inquiry and Impact is the most ambitious and comprehensive campaign in the University of Chicago’s history. The Campaign will raise $4.5 billion to support faculty and researchers, practitioners and patients, and students and programs across the University. Over the next several months, the campaign will hold events in San Francisco, Los Angeles, Chicago, Hong Kong, New York and London.

New Section publication discusses reproductive counseling and weight-loss surgery

Women of reproductive age often pursue weight-loss surgery; in fact, they account for nearly half of all bariatric surgery patients. The relationship between reproduction and rapid weight loss has been well documented and includes an increased risk of infertility, menstrual irregularities, and changing sexual function. Women who receive bariatric surgery are also more likely to have an unplanned pregnancy. Because of these reproductive risks, the American Society for Metabolic and Bariatric Surgery recommends using effective birth control methods when experiencing rapid weight loss and the American College of Obstetricians and Gynecologists recommends delaying pregnancy one to two years after bariatric surgery.

Yet, according to one survey, 31 percent of female bariatric surgery patients planned to become pregnant after obtaining surgery, and nearly one-third planned to do so within two years. These intentions, as well as contraceptive efficacy following weight loss, warrant close collaboration between bariatric surgeons and women’s health providers.

Section faculty Dr. Julie Chor conducted a national survey of bariatric surgeons to assess perioperative reproductive counseling and contraceptive provision. Her findings were published in Surgery for Obesity and Related Diseases.

http://www.soard.org/

Image courtesy of http://www.soard.org

The study found that 74% of bariatric surgeons preoperatively screen patients regarding contraceptive use more than 50% of the time. The most common method prescribed, however, were oral contraceptive pills, which may have decreased efficacy in the obese and in the postoperative state, depending on the type of surgery.

Most respondents (90 percent) recommended delaying pregnancy 12 to 24 months, yet 84% did not require a gynecologic consultation for female patients of reproductive age and 35% further stated that they did not know how their patients obtained contraception.

One-fifth of respondents did not assess their patients’ pregnancy intentions. This disparity suggests that practitioners should counsel patients preoperatively about reproductive changes that can occur after weight loss from bariatric surgery as well as discuss contraception with all women of reproductive age, whether or not they desire a future pregnancy.

Dr. Chor’s findings suggest implementing a routine gynecology consultation for female bariatric surgery patients prior to an operation. These women would greatly benefit from increased education on fertility changes associated with weight loss and on highly effective methods of contraception, such as intrauterine devices and contraceptive implants.

Read the full article here.

New Section research promotes parent–daughter communication about abortion before pregnancy occurs

parent_daughters

Press Release

Published: 13 October 2014

 

Discussing sexuality and reproductive health is a complex issue for parents and their daughters. Parents often feel ill-prepared to initiate these talks, and their daughters often fear a negative reaction or perceive judgment for their sexual activity. Yet, numerous studies have shown that, in general, parent-daughter communication leads to positive sexual health outcomes with regards to pregnancy and STI/HIV prevention.

New Section research, published online ahead of print in the Journal of Adolescent Health, discusses the role and potential impact of parent-daughter communication about abortion among non-pregnant adolescents. These conversations, the authors suggest, may decrease pregnancies and abortion and obviate the need for forced communication.

Currently, 38 states legislate communication between abortion-seeking minors and their parents via Parental Involvement (PI) laws, which require minors 18 years old and under to notify or obtain consent from a parent(s) or guardian before obtaining an abortion. PI supporters argue that these laws promote communication and provide young women with family support. PI opponents maintain that forced communication during the time of crisis can harm young women and delay treatment, increasing the medical risk of a procedure. Furthermore, studies show that most adolescents voluntarily involve parents in their decisions about pregnancy resolution, especially when they anticipate support.

Our qualitative study found that only 43 percent of nonpregnant African-American adolescent females had ever discussed abortion with a parent. Almost half were sexually active, and the vast majority stated they would voluntarily tell a parent of an abortion decision “as soon as possible” or “within one to two weeks.” However, nearly 20 percent acknowledged risk and expressed fears of hurt, punishment, and eviction if their parent learned about an abortion.

The study identified several correlates of parent-daughter communication about abortion. Parents who had had talked about other sexual health topics (e.g. birth control and STIs) were more likely to have discussed abortion with their daughter. If daughters perceived parental acceptance of sexual activity, they were more likely to have an abortion communication. A mother’s experience with teenage pregnancy was positively associated with abortion communication, although the study did not assess the positive or negative quality of the communication. Of concern, sexually active adolescents were less likely to communicate about abortion.

Ultimately, this study found that rather than mandating communication at the time of abortion, policies should focus on general parent-daughter communication about sexual health. Policies that force communication at the time of abortion appear misplaced.

Read the full article here.

Reference

Sisco K, Martins S, Kavanaugh E, Gilliam M. Parent-Daughter Communication About Abortion Among Nonpregnant African-American Adolescent Females. Journal of Adolescent Health. Published online ahead of print September 27, 2014: DOI: 10.1016/j.jadohealth.2014.07.010

 

JOB OPENING: Clinical Trials Coordinator

The University of Chicago Section of Family Planning and Contraceptive Research is now accepting applications for a Clinical Trials Coordinator.

A partial description is as follows:

Works under the general direction of a Clinical Trials Manager and the Director of Clinical Research. Works closely with Principal Investigators (PI) and sponsoring agents. Interacts with regulatory agents, Institutional Review Board (IRB) personnel, patients, department staff, and hospital staff. Manages all aspects of conducting clinical trials including: screening, enrollment, subject follow-up, completion of the case report form, and adverse event reports. Maintains accurate and complete documentation of signed informed consent, relevant IRB approvals, source documentation, Case Report Forms (CRF’s), drug dispensing logs, and study related communication. Plans and coordinates patient schedule for study procedures, return visits, and study treatment schedules. Ensures Standard Operating Procedures (SOP) are implemented and documented in accordance to study sponsor, primary investigator, and regulatory agency specifications. Prepares and maintains protocol submissions and revisions. Educates patients about study procedures to be performed, visit schedule, what to report between and during visits, and potential side effects. Performs assessments at visits and monitors for adverse events. Organizes and attends site visits from sponsors and other relevant study meetings. May recruit and interview potential study patients. May obtain, possess, and transport specimens to appropriate laboratory according to established aseptic techniques. 

For a full job description, click here and enter Requisition Number 097025.

New study recommends doula support during abortion procedures

image from exhaleprovoice.orgMany women choose to have a doula–a lay support person–present during their labor process. A doula’s support has been connected to maternal and child health benefits such as pain control, shorter labor, decreased rates of cesarean delivery, and breastfeeding assistance. In full-spectrum reproductive health care, doulas can provide support for women during not only labor and delivery, but also for a variety of reproductive experiences, including miscarriage, adoption, and abortion.

While each of these reproductive experiences has unique physical and emotional challenges, a doula’s role is consistent: be a source of emotional, physical, and social support.

Section faculty Dr. Julie Chor researches the effect and role of doulas in abortion care. Her most recent publication, co-authored with Dr. Melissa Gilliam and Dr. Brandon Hill, appeared in the June 2014 online edition of the American Journal of Obstetrics and Gynecology.

In this study, Dr. Chor hypothesized that women having a first trimester abortion with doula support would have significantly less pain than women randomized to usual care.

She found that the although the majority of women who had an abortion were satisfied with the procedure, doula support did not statistically impact recalled pain. However, 96.2% of women who received doula support recommended that doula support be routinely used during procedures and 60.4% expressed interest in training to become a doula. Additionally, more than 70% of women who did not receive doula support said they would have wanted someone present to provide support during their procedure.

Furthermore, women receiving doula support were less likely to require additional clinic support resources. Doula support, Chor suggests, may address patient psychosocial needs.

Dr. Chor’s findings are relevant and timely, as volunteer abortion doula groups are organizing across the country and increasingly being used in clinics.

Click here to read more of Dr. Chor’s research on expanding the role of doulas into abortion care.

Clear communication during appointment scheduling can increase LARC uptake

Portrait of a female doctor using a computer while being on the phone

UPDATE: the final version of this article is now online. Read the abstract and download the full article in PDF format.

A new study from Dr. Melissa Gilliam and former Section staff discusses why some scheduled IUD appointments do not result in placement.

“Impact of a revised appointment scheduling script on IUD service delivery in three Title X family planning clinics” was published in the June 2014 online issue of Contraception.

This study began by reviewing clinic administrative data, which showed that women did not receive a desired IUD because of cancellations, no-shows, the need for an IUD-specific appointment, lack of awareness of clinic guidelines, and unknown pregnancy status.

With these systems-level barriers in mind, the researchers created a simple and scalable intervention: revising the appointment scheduling call script. The revised script used by telephone schedulers at a call center addressed these common mishaps and met national Title X guidelines. Along with the revised script, visual tools reminded schedulers to explain behavior prerequisites such as “Do not have unprotected sex at least two weeks prior to an appointment” and “Continue to use pills, patches, or rings up until the appointment”. The script also prompted schedulers to communicate logistical requirements such as bringing an ID, proof of insurance or cash to pay for the procedure, and instructions to call and cancel an appointment if necessary.

Before the new script was instituted, only 47 percent of patients at these sites successfully received an IUD at their scheduled appointment. After implementation of the revised script, 60 percent of scheduled appointments resulted in the desired IUD insertion. Additionally, the no-show rates decreased from 40 to 23 percent, and in particular, young women were more likely to keep their scheduled appointment.

This study shows that a simple IUD appointment scheduling script with clear communication improves LARC uptake. Additionally, as many clinics in the US move forward to computerized and centralized call centers, improving patient communication during the scheduling process may have a broad impact on clinical efficiency.

Related: Development and testing of an iOS waiting room “app” for contraceptive counseling in a Title X family planning clinic