Overnight pain and opioid use after osmotic cervical dilator placement for second trimester dilation and evacuation.

Objective: The aim of the study was to evaluate pain following overnight osmotic cervical dilator placement for second trimester dilation and evacuation (D&E).

Methods: A retrospective cohort study surveyed pain and quantified prescription opioid use among 100 women who underwent overnight osmotic cervical dilator placement for D&E. Participants were given opioid and non-steroidal anti-inflammatory (NSAID) prescriptions and were asked to rate their level of pain on a Likert scale (1-10).

"It's a horrible assignment": A qualitative study of labor and delivery nurses' experience caring for patients undergoing labor induction for fetal anomalies or fetal demise.

Objectives: This study sought to explore labor and delivery (L&D) nurses' experiences caring for women undergoing induction for intrauterine fetal demise (IUFD) or termination for fetal anomalies, and to characterize reluctance towards participation in abortion care or - conversely - the commitment to provide services.

Study Design: Researchers conducted a qualitative study that consisted of open-ended, semistructured interviews with 15 registered nurses who care for women on L&D at a large metropolitan hospital. We analyzed these data for content and themes.

Vaginal metastasis of gestational trophoblastic neoplasia resulting in hemorrhage: A case report.

Complete molar pregnancies complicate approximately 1 in 1500 pregnancies in the United States and result in gestational trophoblastic neoplasia in about 15-20% of these cases. Vaginal metastasis is the second most common site of metastasis and may present with vaginal bleeding and hemorrhage. This report describes a case of a 19-year-old Hispanic primigravida who presented with hemorrhage from an anterior vaginal wall metastasis two weeks after dilation and curettage for complete molar pregnancy.

Contraceptive use among women with medical conditions: Factors that influence method choice.

Objective: To identify factors that influence contraceptive initiation among women with medical conditions.

Study Design: We conducted an exploratory cross-sectional survey of women 18-45 years old with medical conditions who received contraception consultation from complex family planning specialists at five University of California Medical Centers from June 2014-June 2015. We asked survey participants about factors that influence their decision of choosing and initiating a contraceptive method, how they accessed family planning specialists and the impact of this consultation on their contraceptive method choice.

Controversies in family planning: intrauterine device placement in solid organ transplant patients.

With an ever-increasing number of reproductive-aged women undergoing solid organ transplant and fertility improving after transplant, knowledge of the safety and efficacy of various contraceptive methods is essential to guide patient selection. We present the case of a 22-year-old patient desiring an intrauterine device (IUD) for contraception with a history of liver transplant as a child. The Centers for Disease Control and Prevention (CDC) and American Society for Transplantation (AST) offer conflicting recommendations on the use of IUDs in transplant patients.

Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.

Objectives: The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned.

Methods: We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center.

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

Background: Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior.

Case: We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation.

"Sometimes they used to whisper in our ears": health care workers' perceptions of the effects of abortion legalization in Nepal.

Background: Unsafe abortion has been a significant cause of maternal morbidity and mortality in Nepal. Since legalization in 2002, more than 1,200 providers have been trained and 487 sites have been certified for the provision of safe abortion services. Little is known about health care workers' views on abortion legalization, such as their perceptions of women seeking abortion and the implications of legalization for abortion-related health care.

Sex-selective abortion in Nepal: a qualitative study of health workers' perspectives.

Background: Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests that it occurs nevertheless. Providers' perspectives on sex-selective abortion were examined as part of a larger study on legal abortion in the public sector in Nepal.

Methods: In-depth interviews were conducted with health care providers and administrators providing abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas.

Efficacy, acceptability and safety of medication abortion in low-income, urban Latina women.

Background: Health care providers may be reluctant to offer medication abortion to low-income, non-English-speaking populations. Concerns include lack of patient interest, incorrect use of misoprostol at home, missing mandatory follow-up visits and inappropriate use of emergency services. We describe the appeal, acceptability, safety and follow-up rates of medication abortion in a low-income Latina population in New York City.