Reproductive Health In The ED
Published on Nov 20, 2015
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MORE DECKS TO EXPLORE
PRESENTATION OUTLINE
THE ISSUE
- >50% pregnancies are unplanned in the US
- Difficult to obtain IUDs in Illinois under Medicaid
- ED is a main healthcare access point for under-served women
- Past studies suggested need and patient interest
- But - most studies in teens or on emergency contraception
References:
- Fine, L.C. & Mollen, C.J. A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population. Pediatr Emerg Care 26, 413-416 (2010).
- Merchant, R.C., et al. Contraceptive usage, knowledge and correlates of usage among female emergency department patients. Contraception 74, 201-207 (2006).
- Miller, M.K., Pickett, M., Leisner, K., Sherman, A.K. & Humiston, S.G. Sexual health behaviors, preferences for care, and use of health services among adolescents in pediatric emergency departments. Pediatr Emerg Care 29, 907-911 (2013).
- Fine, L.C. & Mollen, C.J. A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population. Pediatr Emerg Care 26, 413-416 (2010).
- Merchant, R.C., et al. Contraceptive usage, knowledge and correlates of usage among female emergency department patients. Contraception 74, 201-207 (2006).
- Miller, M.K., Pickett, M., Leisner, K., Sherman, A.K. & Humiston, S.G. Sexual health behaviors, preferences for care, and use of health services among adolescents in pediatric emergency departments. Pediatr Emerg Care 29, 907-911 (2013).
Photo by AG Toine
STUDY GOALS
- Determine gaps in reproductive health coverage
- Assess attitudes towards reproductive health care in the ED
- Examine beliefs about long acting contraceptives (LARCs)
PROJECT DEVELOPMENT
- Obtained ED and Family Planning faculty buy-in
- Reviewed literature on reproductive health in the ED
- Submitted IRB Protocol
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INITIAL RESULTS: DEMOGRAPHICS
Additional demographics:
- age range 18-40
- 60% had some college education or higher
- 88% had health insurance
- 59% had been pregnant before
- age range 18-40
- 60% had some college education or higher
- 88% had health insurance
- 59% had been pregnant before
BIRTH CONTROL USE
Most patients had heard of IUDs and Depo Provera. 35% had used Depo provera before but stopped due to side effects. About 20% overall were interested in trying IUDs and Depo.
Though many patients (10) noted that the Depo shot was effected, many (6) also noted that they were not effective. The most common concern about Depo though was the risk of making periods worse and other side effects (9).
Many patients (12) also noted that IUDs were effective and fewer (2) noted that they were not always effective. The most common reason for not wanting to get it was discomfort and worry about side effects.
Fewer women had heard of then explain on., only about 36% of respondents. The most common concern was also side effects.
Though many patients (10) noted that the Depo shot was effected, many (6) also noted that they were not effective. The most common concern about Depo though was the risk of making periods worse and other side effects (9).
Many patients (12) also noted that IUDs were effective and fewer (2) noted that they were not always effective. The most common reason for not wanting to get it was discomfort and worry about side effects.
Fewer women had heard of then explain on., only about 36% of respondents. The most common concern was also side effects.
BIRTH CONTROL READINESS
Most common reason for not wanting to start birth control: side effects
BIRTH CONTROL IN THE ED
Other stats
- 21% feel it would be easier to get birth control in the emergency department
- 24% would want to get birth control in the emergency department
- 54% would be interested in getting a referral to another doctor that could provide me with birth control
- 21% feel it would be easier to get birth control in the emergency department
- 24% would want to get birth control in the emergency department
- 54% would be interested in getting a referral to another doctor that could provide me with birth control
INITIAL CONCLUSIONS
- Good access to primary reproductive care
- Desire to prevent pregnancy (contemplation stage),
- But most using less effective birth control methods
- Most worried about side effects of birth control
- Comfortable talking to ED docs about reproductive health
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LESSONS LEARNED
- Need for education before intervention
- Primary care access less of a problem
- Every step of a research study is time consuming
- Important to establish continuity plan early
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NEXT STEPS
- Continue collecting data
- Share data at conferences and to local leadership
- Conduct provider needs assessment
- Continuity: transition to EM intern & MS1 students
Photo by Todd Baker << technowannabe
