Family Planning Curriculum University of Alabama at Birmingham Department of Obstetrics and Gynecology
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. 2005 Sept;37(3):110-18. 2. An Overview of Abortion in the United States. Guttmacher Institute, October 2009; http://guttmacher.org/presentations/ab_slides. html 3. Facts on Induced Abortion in the United States. Guttmacher Institute, July 2008; http://guttmacher.org/pubs/fb_induced_abortion.html 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; 2009:135-156. 2. Early Surgical Abortion: An alternative to and backup for medical abortion. MacIsaac et al, American Journal of Obstetrics and Gynecology. 2000 Aug;183(2):S76-83. 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; 2009:157-177.
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; 2009:111-134. 2. 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; 2009:178-192. 3. NAF Protocol for Mifepristone/Misoprostol in Early Abortion. National Abortion Federation, January 2008. http://www.prochoice.org/pubs_research/publications/downloads/professional_education/me 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. 2008 Sep;26(5):411-22. 2. Expectant care versus surgical treatment for miscarriage. Nanada K. et al, Cochrane Database of Systematic Reviews. 2006 Apr 19;(2).
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, 2007. Available at http://contraceptivetechnology.org/table.html 2. Pearl Index. Speroff et al, A Clinical Guide for Contraception. 2005:4 3. Hormonal Contraception. Blumenthal et al, Obstetrics and Gynecology. 2008 Sept;112(3):670-84. 4. Summary Chart of the U.S. Medical Eligibility Criteria for Contraceptive Use. Centers for Disease Control, March 2011. Available at: http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usmec.htm Combined Hormonal Contraception 1. Oral Contraception. Speroff et al, Clinical Guide for Contraception. 2005:677-80 2. Vaginal and Transdermal Combined Contraception. Speroff et al, Clinical Guide for Contraception. 2005:153-162. Progestin-Only 1. WHO Statement on hormonal contraception and bone health. World Health Organization, July 2005. Available at http://whqlibdoc.who.int/wer/who_wer_2005/80_297-304(no35).pdf 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):31-37 2. Intrauterine Device. ACOG Practice Bulletin 59. 2005 Jan;105(1):223-232 3. Use of Copper Intrauterine Devices and the Risk of Tubal Infertility Among Nulligravid Women. Hubacher et al, New England Journal of Medicine. 2001 Aug;345(8):561-7 4. Benefits and Risks of Sterilization. Pollack. ACOG Practice Bulletin 46. 2003 Sept;102(3):647-58
5. Ambulatory Gynaecological Surgery: Transcervical Sterilization. Abbot et al, Best Practice & Research Clinical Obstetrics & Gynecology. Oct 2005; 19(5):743-756. Contraception in the Postpartum Period 1. IMAP Statement on postpartum contraception and breast-feeding. IPPF Medical Bulletin. 2008 Sept;42(3):1-5. Available at: http://www.ippf.org/en/resources/medical/medical+bulletin+september+2008.htm Emergency Contraception 1. Emergency Contraception. ACOG Practice Bulletin 69. 2005 Dec;106(6):1443-52