Family Planning Curriculum

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1 Family Planning Curriculum University of Alabama at Birmingham Department of Obstetrics and Gynecology

2 Module 1: Introduction Incidence of unintended pregnancy and abortion Safety of abortion, morbidity and mortality Abortion access and restrictions to abortion Abortion and contraception decision-making Introductory 1. Reason U.S. Women Have Abortions: Quantitative and Qualitative Perspectives. Finer et al, Perspectives on Sexual and Reproductive Health Sept;37(3): An Overview of Abortion in the United States. Guttmacher Institute, October 2009; html 3. Facts on Induced Abortion in the United States. Guttmacher Institute, July 2008; Module 2: Surgical Abortion Characteristics and protocol of early abortion methods (Medication vs. Aspiration abortion) Principles of surgical technique Pre-procedure preparation, including cervical preparation Setup and equipment: room setup, instruments and supplies, ultrasound Pain control, including anesthesia/analgesia protocol Post-procedure care First-Trimester 1. Chapter 10: First-trimester aspiration abortion. Meckstroth K and Paul M. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009: Early Surgical Abortion: An alternative to and backup for medical abortion. MacIsaac et al, American Journal of Obstetrics and Gynecology Aug;183(2):S Second-Trimester 1. Chapter 11: Dilation and evacuation. Hammond C and Chasen S. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009:

3 Module 3: Medication Abortion and Labor Induction Understanding medication abortion agents (mifepristone, methotrexate, misoprostol): pharmacokinetics, efficacy and cost Medication abortion regimens and protocol Techniques for induction abortion Patient eligibility, counseling, preparation, pain management, side effects and complications for medication abortion and induction Post-procedure care and contraception 1. Chapter 9: Medical abortion in early pregnancy. Creinin MD and Danielsson KG. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009: Chapter 12: Medical methods to induce abortion in the second trimester. Kapp N and von Hertzen H. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009: NAF Protocol for Mifepristone/Misoprostol in Early Abortion. National Abortion Federation, January dical_abortion/protocol_mife_miso.pdf Module 4: Miscarriage Management Management of first- and second-trimester pregnancy loss: surgical, expectant and medical management Safety and effectiveness of treatment for early pregnancy loss (anembryonic pregnancy, embryonic demise, fetal demise, incomplete miscarriage, inevitable miscarriage) 1. Medical management of early pregnancy failure: efficacy. Chen B and Creinin MD, Seminars in Reproductive Medicine Sep;26(5): Expectant care versus surgical treatment for miscarriage. Nanada K. et al, Cochrane Database of Systematic Reviews Apr 19;(2).

4 Module 5: Contraception Contraceptive efficacy, medical eligibility criteria, and contraindications to the use of contraceptives. Mechanisms of action of contraception. Contraceptive counseling, including post-partum and post-abortion contraception. Overview 1. Contraceptive Efficacy. Hatcher RA, Trussell J et al. Contraceptive Technology: Nineteenth Revised Edition. New York NY: Ardent Media, Available at 2. Pearl Index. Speroff et al, A Clinical Guide for Contraception. 2005:4 3. Hormonal Contraception. Blumenthal et al, Obstetrics and Gynecology Sept;112(3): Summary Chart of the U.S. Medical Eligibility Criteria for Contraceptive Use. Centers for Disease Control, March Available at: Combined Hormonal Contraception 1. Oral Contraception. Speroff et al, Clinical Guide for Contraception. 2005: Vaginal and Transdermal Combined Contraception. Speroff et al, Clinical Guide for Contraception. 2005: Progestin-Only 1. WHO Statement on hormonal contraception and bone health. World Health Organization, July Available at Non-Hormonal & IUC 1. Intrauterine and Barrier Contraception. A practical review of recent developments. Masters et al, Current Obstetrics and Gynecology. Feb 2005;15(1): Intrauterine Device. ACOG Practice Bulletin Jan;105(1): Use of Copper Intrauterine Devices and the Risk of Tubal Infertility Among Nulligravid Women. Hubacher et al, New England Journal of Medicine Aug;345(8): Benefits and Risks of Sterilization. Pollack. ACOG Practice Bulletin Sept;102(3):647-58

5 5. Ambulatory Gynaecological Surgery: Transcervical Sterilization. Abbot et al, Best Practice & Research Clinical Obstetrics & Gynecology. Oct 2005; 19(5): Contraception in the Postpartum Period 1. IMAP Statement on postpartum contraception and breast-feeding. IPPF Medical Bulletin Sept;42(3):1-5. Available at: Emergency Contraception 1. Emergency Contraception. ACOG Practice Bulletin Dec;106(6):

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