Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.

Background: Family planning (FP) methods have been found as an efficient approach of reducing fertility and are therefore widely supported in order to decrease population growth, particularly in poor nations. Promoting contraception availability among women (15 – 49) age has also been shown to be an efficient public health strategy for improving maternal and newborn health outcomes. This paper aimed at exploring the pooled prevalence of contraceptive uptake and its contextual determinants among women of childbearing age in The Gambia. Methods: The Gambia Demographic and Health Survey (GDHS) in both 2013 and 2019-20 was used for this study. Data were obtained from a pooled 22,098 women aged 15-49 (10,233 for 2013 and 11,865 for 2019-20) through a stratified two-stage cluster sampling approach. Percentages and chi-square tests were used and variables with p-value <0.05 were included into the model. A multivariable logistic regression model was used to assess the predictors of contraceptive usage at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). All the study data were analyzed using Stata version 15. Results: The weighted pooled prevalence of modern contraceptive utilization in The Gambia was 10.1%. Younger age, compared with women aged 25-29; 30-34; 35-39; 40-44; primary education (aOR=1.25, 95% CI=1.05-1.49); secondary education (aOR=1.57, 95% CI= 1.32-1.85); Higher education (aOR=1.90, 95% CI=1.34-12.69); living in urban areas (aOR=1.49, 95% CI= 1.25-1.79); parity 2-4 (aOR=1.21, 95% CI= 1.01-1.47); told about FP at health facility (aOR=2.97, 95% CI= 2.61-3.38), and no desire for many children (aOR=1.96, 95% CI= 1.62-2.37) were more like to use modern contraceptives among Gambian women. Conclusion: The programme certainly needs to consider improvements in the quality of care being offered to acceptors. Government agencies should target these programs and campaigns on regional FP demands and provide suitable culturally sensitive and regionally adaptive services to the communities' contexts. The programme should intensify its efforts in rural and urban settings to improve accessibility to and availability of FP services.

Trends in abortion care in the United States are changing quickly, affected by many epidemiological factors as well as a varying political climate. Surgical abortions are the more common method of conducting abortion care. Recent CDC National Surveillance Data has shown an increase in second-trimester abortion, correlating to an increased need for providers experienced in surgical abortions and cervical preparation agents, such as misoprostol, mifepristone, and laminaria. Furthermore, recent studies have shown an increase in long-acting reversible contraceptive options including post-abortion contraceptive use. We hoped to compare the trends in abortion of pregnancy in our low-resource urban environment against the national trends to better understand what demographic factors might influence decision-making. We identified a need for studies on trends in abortions of pregnancy in a low-resource urban setting which can become applicable across similar neighborhoods, some of which might not participate in CDC abortion surveillance reports. Our study shows an increase in dilation and evacuation procedures, correlating with an increase in the use of misoprostol and laminaria for cervical preparation as well as digoxin for induction of fetal demise, both of which would occur at higher frequency in the second trimester. We also found a preference towards no contraception after abortion, which slightly differs from national trends in recent years. Our study aims to evaluate these trends and identify the need for further quality assurance and improvement in this care.

Introduction: One Key Question® is a patient-centered tool that seeks to understand patient pregnancy intention and counseling. This pilot study aimed to assess implementation of OKQ at an urban healthcare facility and improve understanding of short interpregnancy intervals (IPI). Methods: We describe the implementation of OKQ in our setting using the Diffusion of Innovation Theory as a framework. We broke this up into two phases – the first to assess provider acceptance of the OKQ integration into the clinic workflow and the second to assess how well documentation of OKQ answers occurred in our EMR. Results: Most providers in the first phase reported awareness of the inclusion of OKQ in the EHR, yet most physician providers reported only using OKQ at “some visits” (n=5) compared to the MAs, who reported using OKQ at “every visit” (n=8). Most providers felt that OKQ was an effective method of providing preconception and contraception care for women of reproductive age (n=10). Sixty-four patients completed a survey on OKQ after their visit who identified as young (mean age 28.7), either Black (46.9%) or Hispanic (51.6%) and pregnant (61%). Of those, 83% reported that they were not asked OKQ and 42% reported receiving counseling on optimal IPI. In those patients, 78% had documentation of usage of OKQ in the medical record. Discussion: The implementation of OKQ provided an opportunity to provide standardized preconception and contraception care to our patient population and improve information regarding short IPI. However, challenges existed in implementation which much be overcome to benefit from OKQ. Significance: OKQ has been used successfully in primary care and other settings to assess pregnancy intentions. This article adds to the literature by investigating the implementation of OKQ in a low-resource setting during prenatal and gynecology care. It shares struggles of implementing OKQ in an electronic medical record and how to roll out this program in a setting where pregnancy intention already is including in various forms by our providers.