Reconsidering the use of urine drug testing in reproductive settings.

The urine drug test is ubiquitous within reproductive healthcare settings. Although the test can have evidence-based use for a patient and clinician, in practice, it is often applied in ways that are driven by bias and stigma, do not correctly inform decisions about clinical aspects of patient care, and cause devastating ripple effects through social and legal systems. This paper proposes a framework of guiding questions to prompt reflection on (1) the question the clinical team is trying to answer, (2) whether a urine drug test answers the question at hand, (3) how testing benefits compare with the associated risks, (4) a more effective tool for clinical decision-making if the urine drug test does not meet the standards for use, and (5) individual and institutional biases affecting decision-making.

Contraception.

Contraception counseling and provision are vital components of comprehensive health care. An unplanned pregnancy can be particularly challenging for patients with chronic illness. Internal medicine physicians are uniquely positioned to assess pregnancy readiness and provide contraception, as they often intersect with pregnancy-capable patients at the moment of a new diagnosis or when providing ongoing care for a chronic medical condition.

Oral Contraceptive Pills Are an Effective Method of Preventing Pregnancy in Women With Crohn's Disease.

Background: Oral contraceptive pill (OCP) use in the general population is associated with a failure rate as low as 0.3% with perfect use but as high as 9% with typical use. Women with Crohn's disease (CD) may have malabsorption in the setting of small bowel disease or resection, which could affect absorption of OCPs.

Understanding Barriers to Contraception Screening and Referral in Female Adolescents and Young Adults with Cancer.

Contraception screening and referral occur infrequently in cancer care for young women of reproductive age. Barriers to contraception screening and referral in this setting have not been thoroughly identified. We sought to understand oncology clinicians' current practices and perceptions of barriers to screening and referring young women for adequate contraception during cancer treatment.

Contraception.

Contraception counseling and provision are vital components of comprehensive health care. Unplanned pregnancy can be devastating to any woman but is particularly dangerous for those with chronic illness. Internal medicine providers are in a unique position to provide contraception, as they often intersect with women at the moment of a new medical diagnosis or throughout care for a chronic problem.

Patient Education About the Affordable Care Act Contraceptive Coverage Requirement Increases Interest in Using Long-Acting Reversible Contraception.

Background: The Patient Protection and Affordable Care Act (ACA) requires health insurance to cover all Food and Drug Administration-approved contraceptives at no cost to patients, including highly effective long-acting reversible contraception (LARC). Our objective was to determine whether a brief educational intervention about these provisions would increase interest in LARC use.

Methods: This is a cross-sectional survey of women seeking contraceptive care in an urban outpatient obstetrics/gynecology clinic.

Describing abortion attitudes among young, African American men.

Objectives: This paper describes African American teenaged males' attitudes and perspectives on abortion.

Methods: Data were derived from a larger cross-sectional survey of African American males aged 14-19, living in the south side of Chicago.

Results: Acceptability of abortion varied by partner type, such that 60% of teenagers felt abortion was acceptable with a casual partner while 37% found it acceptable with committed partners (p<.