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APHA Scientific Session and Event Listing

Recorded presentation

Ruth Lesnewski, MD¹, Linda Prine, MD², and Lisa M. Maldonado, MPH¹. (1) Reproductive Health Access Project, P. O. Box 21191, New York, NY 10025, 917 586-3260, rlesnewski@institute2000.org, (2) The Center for Reproductive Health Education in Family Medicine, 126 Fifth Avenue, Suite 805, New York, NY 10011

Despite recent increased contraceptive options, New York City's unintended pregnancy rate has held steady at 60% for the past ten years. The most recent data for NYC estimates that in 2003 there were more than 100,000 unintended pregnancies in NYC, 75% of which ended in induced abortion.

Though proactive contraceptive prescribing practices and ready access to EC could drastically reduce rates of unintended pregnancy, clinical practices and healthcare systems often create barriers to women's timely access to birth control. For example, despite the fact that hormones do not increase the risk of cervical cancer, many physicians require Pap smears before prescribing contraception. A recent survey of NYC primary care providers found that only 57% of primary care providers say they provide contraceptive counseling to their patients. Our recent survey found that fewer than 20% of patients calling community health centers requesting EC were actually were able to get a prescription.

This session will describe a project to increase access to contraception by “re-engineering” NYC community health centers. The strategy focuses on providing education and technical assistance to community health centers to change the way reproductive health care is delivered. Outcome data comparing contraceptive prescribing practices of participating and non-participating health centers will be presented to illustrate the effectiveness of this approach.

Learning Objectives:

• 1. Identify at least two ways that traditional medical care creates barriers to timely access to contraception.
• 2. Describe two methods to assess clinical barriers to contraceptive access.
• 3. Describe at least two strategies to remove barriers to contraceptive access within community health centers.
• 4. Describe two ways to assess changes in contraceptive access in a community health center

Keywords: Reproductive Health, Access

Related Web page: www.reproductiveaccess.org

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation