A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
This document discusses pharmacotherapy for pediatric HIV infection. It covers antiretroviral therapy (ART) used during pregnancy and delivery to prevent mother-to-child transmission of HIV. ART regimens aim to achieve high drug levels in the fetus to prevent transmission. Short-term neonatal ART prophylaxis is also used. While ART has significantly reduced pediatric HIV infections, challenges remain due to limited access in developing countries, where most new pediatric HIV cases occur. Ongoing research monitors potential long-term effects of in utero ART exposure on children.
Breastfeeding in Women with Covid19 infection-Expert group meeting for develo...Niranjan Chavan
Breastfeeding in Women with Covid19 infection-Expert group meeting for development of standard treatment protocols for clinical management of covid- 19 complicating pregnancy at New Delhi 8th December 2021
The presentation will discuss; Increasing trend for fertility at midlife; Reasons; Problems; Advantages; Challenges; Chances of success naturally or with IUI or with IVF, role of PGT A; Delphi consensus Posieden criteria; Newer techniques with ovarian rejuvenation and CRISPR and ASRM recommendations and conclusions. We are seeing celebrities with millions of followers having babies at an older age. Aishwarya rai at 37 Rani mukherjee 37 Neha Dhupia 38 Kareen Kapoor 36 Farah Khan triplets at 40 yrs of age. An excellent publication from 2013 titled: Age shock: mis perceptions of the impact of age on fertility before and after IVF in women who conceived after age 40 K. Mac Dougall, Hum Reprod. 2013 Feb has put forth reasons for a mistaken belief in robust fertility
Since no study has claimed the relationship between the corona vaccine and menstrual cycle, there is no certain cause for the same. However, some experts suggest the following possible causes.
This document discusses barriers to contraceptive use globally and in Sudan specifically. It begins with an introduction on family planning and contraceptive use trends globally. It then discusses the large unmet need for contraception worldwide, particularly in Africa and benefits of family planning. Barriers to use discussed globally include socioeconomic factors, limited access, side effects, and cultural/religious opposition. Barriers in Sudan specifically include shortage of facilities, staff turnover, socioeconomic factors, low awareness, and lack of dedicated funding. Figures show contraceptive use in Sudan is only 7.7% with 28.9% unmet need, among the lowest rates in Africa.
The document discusses a conference on South Asia Day that focused on improving quality of care in obstetrics and gynecology through sessions on topics like patient safety, violence against women, menopause, and cancer. It also provides details on a session about the rising rate of cesarean sections and its consequences, including increased rates of morbidly adherent placenta. Current approaches to the conservative management of morbidly adherent placenta are discussed.
A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
This document discusses pharmacotherapy for pediatric HIV infection. It covers antiretroviral therapy (ART) used during pregnancy and delivery to prevent mother-to-child transmission of HIV. ART regimens aim to achieve high drug levels in the fetus to prevent transmission. Short-term neonatal ART prophylaxis is also used. While ART has significantly reduced pediatric HIV infections, challenges remain due to limited access in developing countries, where most new pediatric HIV cases occur. Ongoing research monitors potential long-term effects of in utero ART exposure on children.
Breastfeeding in Women with Covid19 infection-Expert group meeting for develo...Niranjan Chavan
Breastfeeding in Women with Covid19 infection-Expert group meeting for development of standard treatment protocols for clinical management of covid- 19 complicating pregnancy at New Delhi 8th December 2021
The presentation will discuss; Increasing trend for fertility at midlife; Reasons; Problems; Advantages; Challenges; Chances of success naturally or with IUI or with IVF, role of PGT A; Delphi consensus Posieden criteria; Newer techniques with ovarian rejuvenation and CRISPR and ASRM recommendations and conclusions. We are seeing celebrities with millions of followers having babies at an older age. Aishwarya rai at 37 Rani mukherjee 37 Neha Dhupia 38 Kareen Kapoor 36 Farah Khan triplets at 40 yrs of age. An excellent publication from 2013 titled: Age shock: mis perceptions of the impact of age on fertility before and after IVF in women who conceived after age 40 K. Mac Dougall, Hum Reprod. 2013 Feb has put forth reasons for a mistaken belief in robust fertility
Since no study has claimed the relationship between the corona vaccine and menstrual cycle, there is no certain cause for the same. However, some experts suggest the following possible causes.
This document discusses barriers to contraceptive use globally and in Sudan specifically. It begins with an introduction on family planning and contraceptive use trends globally. It then discusses the large unmet need for contraception worldwide, particularly in Africa and benefits of family planning. Barriers to use discussed globally include socioeconomic factors, limited access, side effects, and cultural/religious opposition. Barriers in Sudan specifically include shortage of facilities, staff turnover, socioeconomic factors, low awareness, and lack of dedicated funding. Figures show contraceptive use in Sudan is only 7.7% with 28.9% unmet need, among the lowest rates in Africa.
The document discusses a conference on South Asia Day that focused on improving quality of care in obstetrics and gynecology through sessions on topics like patient safety, violence against women, menopause, and cancer. It also provides details on a session about the rising rate of cesarean sections and its consequences, including increased rates of morbidly adherent placenta. Current approaches to the conservative management of morbidly adherent placenta are discussed.
Barriers to Adoption of Family Planning among Women in Eastern Democratic Rep...MEASURE Evaluation
This study assessed barriers to family planning among women in Butembo, Eastern Democratic Republic of Congo. The researchers surveyed 572 women and found high knowledge of family planning methods but low usage of modern contraceptives. Only 36% used modern methods such as male condoms, pills, injectables, and implants while 64% relied on traditional methods like calendar-based family planning and withdrawal. Major barriers included lack of knowledge, fear of side effects, religious views, and husband opposition. The researchers recommend improving access to family planning in health facilities, advocating for modern methods, training health workers, and promoting family planning to women at health encounters.
The document provides statistics and information about abortion worldwide and in the United States. Some key points include:
- Approximately 42 million abortions occur worldwide each year, with 115,000 occurring daily.
- In the US, there are about 1.37 million abortions annually, with 3,700 occurring daily.
- The vast majority (93%) of abortions in the US are done for social or economic reasons rather than health reasons.
- Over half of abortions in the US occur before 9 weeks of pregnancy.
The document discusses newborn screening (NBS), which tests newborns for certain disorders and conditions that can compromise development if undetected. While NBS successfully lowers infant mortality, it has not addressed the increase in disabilities. The document advocates beginning NBS programs in India to detect conditions like congenital hypothyroidism and prevent associated morbidities and financial burdens. NBS programs require epidemiological data, ethical and economical consideration, and availability of screening tests, treatment, and intervention timelines. The document encourages starting regional NBS centers in India to prevent childhood disabilities and mortality from treatable metabolic diseases.
Born too soon the global action report on preterm birthPaul Mark Pilar
The report Born Too Soon analyzes the global problem of preterm birth. It features the first estimates of preterm birth rates by country and is authored by over 45 international experts. The report finds that about 15 million babies are born prematurely each year, which is more than 1 in 10 babies worldwide. Prematurity is the leading cause of newborn death and the second leading cause of death in children under 5 years of age. Many preterm babies who survive face lifelong disabilities. The report highlights proven solutions to save lives of preterm babies and reduce rates of death and disability.
The document provides statistics and information about abortion worldwide and in the United States. Some key points include:
- Approximately 42 million abortions occur worldwide each year, with 115,000 occurring daily.
- In the US, there are about 1.37 million abortions annually, or 3,700 daily.
- 93% of abortions in the US occur for social reasons rather than health concerns.
- Abortions have been linked to increased risks of depression, PTSD, substance abuse and elevated suicide rates in women.
- The vast majority of abortions, over 88%, occur during the first trimester.
The FIGO recommends that gestational diabetes mellitus (GDM) be considered a global health priority. GDM is associated with higher rates of maternal and neonatal morbidity and mortality as well as long term consequences for both mother and child. The FIGO proposes universal testing for GDM during pregnancy, providing the best possible management given available resources in each country, and using the postpartum period to improve health and reduce future risks for both mother and child.
1) Unsafe abortions are a major reproductive health challenge, accounting for 24 million procedures and over 360,000 deaths annually.
2) Lack of access to contraception and family planning services, as well as social factors like poverty, early marriage, and gender inequality contribute to high rates of unwanted pregnancy and unsafe abortion.
3) Improving access to contraception, comprehensive sexuality education, and safe abortion and post-abortion care services can help reduce maternal mortality from unsafe abortion and advance progress on Millennium Development Goal 5 of improving maternal health.
This document discusses barriers to access to progesterone to prevent preterm birth among Medicaid managed care organizations (MCOs). A 2016 survey of 18 Medicaid MCOs found barriers to providing all forms of progesterone, including cost differences between branded and compounded progesterone, clinician lack of knowledge, and unclear coverage and billing policies. While progesterone has been shown to reduce preterm birth risks by a third, scientific evidence is still needed on the effectiveness and optimal use of different progesterone formulations to inform clinical guidelines and policy.
A US district judge recently overturned an FDA decision and ruled that Plan B emergency contraceptive pills must be available without a prescription to women of all ages. This was seen as a major victory for women's health and rights advocates. However, some parents were concerned that easier access could promote irresponsible sexual behavior among teenage girls. While this contraceptive is considered very safe when used correctly, its effectiveness declines the longer a woman waits after unprotected sex to take it. Usage has been rising in recent years, with 14% of users being girls ages 15 to 19.
Newborn Screening and Severe Combined Immune DeficiencyDr. Allen Cherer
The document discusses newborn screening for Severe Combined Immune Deficiency (SCID), the most serious form of primary immunodeficiency. It describes how SCID is present at birth and results in life-threatening infections if not treated early. The use of the T cell receptor excision circle assay in newborn screening programs allows for early diagnosis of SCID before infections develop. Studies have shown that stem cell transplants before 3.5 months of age can cure 94% of infants with SCID if detected through newborn screening. Nearly all states now screen newborns for SCID given the life-saving benefits of early detection and treatment.
Developing normal placental growth curves using 2 d ultrasound in a zimbabwe ...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Contraceptive use in sub saharan africa -the sociocultural contextJake Odunga
This document provides an outline on contraceptive use in sub-Saharan Africa. It begins with an introduction on the importance of family planning for improving maternal and child health. It then discusses targets under MDG5 on improving maternal health and reproductive health. It notes that while contraceptive prevalence is increasing in parts of sub-Saharan Africa, rates remain low overall and unmet need for family planning remains high. Key factors influencing contraceptive use include levels of education, cultural and religious barriers, and access to family planning services. The document recommends multi-sectoral approaches including improving access to education and reproductive healthcare to increase contraceptive use in the region beyond 2015.
1) ART pregnancies have some differences from natural pregnancies that require special care and monitoring, such as progesterone and estrogen supplementation due to the absence of a corpus luteum in some cases.
2) Multiple pregnancies are a major risk factor for ART pregnancies and require close monitoring due to higher risks of preterm birth and low birth weight.
3) While antenatal care is largely the same for ART and natural pregnancies, ART pregnancies have slightly higher risks of complications like preterm birth and birth defects, so careful screening and management is important.
The document provides information on COVID-19 vaccination for postpartum lactating women. It discusses the vaccines available in India and their effectiveness. Studies have shown that the mRNA vaccines generate robust immunity in pregnant and lactating women similar to non-pregnant women. Vaccine-induced antibodies were found in breastmilk, allowing for immune transfer to infants. Preliminary findings did not reveal any obvious safety signals among vaccinated pregnant individuals. International organizations recommend vaccination for pregnant and lactating individuals when the benefits outweigh the risks.
Maternal Health Innovations_Graves_5.13.11CORE Group
Misoprostol is effective for preventing postpartum hemorrhage (PPH) in low-resource settings without skilled birth attendants when administered by community health workers during antenatal care visits or by women themselves at home births. A study in Tanzania found integrating misoprostol distribution into existing antenatal care services was feasible, safe, and effective. Over 12,000 women received misoprostol during antenatal visits, with 88% receiving and using it correctly for home births. This demonstrated misoprostol can successfully be distributed during antenatal care to protect women from PPH where skilled attendance is unavailable.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
This document summarizes literature on vaginal birth after caesarean (VBAC). It finds that evidence comparing outcomes of VBAC versus elective repeat caesarean section is poor quality. VBAC has a low risk of uterine rupture but increased risks compared to repeat c-section. Successful VBAC rates vary greatly based on individual risk factors. The document emphasizes informing women of their options and risks in an unbiased manner to empower their decision. It provides guidance on care for a planned VBAC, including continuous support, monitoring for rupture signs, and collaboration with obstetric specialists.
Post partum period an excellent opportunity for hpv vaccinationLifecare Centre
1) A study in Brazil found that HPV prevalence in young primiparous women was 58.5%, with 17.3% and 13.3% positive for the two high-risk HPV types 16 and 18. This suggests that postpartum vaccination could provide protection against cervical cancer for many women.
2) A US study found high acceptance of postpartum HPV vaccination, with 97% of women satisfied with the choice and 98% finding it convenient. However, only 30.7% completed the full three-dose vaccination series.
3) The presenter's experience vaccinating over 200 women in India postpartum found 99% compliance, with women reporting it was convenient and recommending it to friends
Benzathine penicillin is the only recommended treatment for syphilis during pregnancy to prevent mother-to-child transmission. However, global supplies of benzathine penicillin have been inadequate in recent years due to shortages. An estimated 5.6 million doses are needed annually to treat all syphilis cases, with 930,000 doses needed during pregnancy to prevent congenital syphilis. WHO is conducting analyses of benzathine penicillin production, demand, supply and procurement practices to address shortages and ensure availability for eliminating mother-to-child transmission of syphilis.
This document summarizes a study on contraceptive use dynamics using data from 60 Demographic and Health Surveys conducted between 1990-2009 in 25 countries. It analyzes 422,478 episodes of contraceptive use reported by women who were married or in unions. Key indicators presented include discontinuation rates by reason and method, duration of use by method, switching after discontinuation, and reproductive outcomes after discontinuation or failure. Discontinuation is high, ranging from 13% for IUD to 50% for condoms at 12 months. Method-related reasons are the main cause of discontinuation. Consequences can be serious, with 5-20% of accidental pregnancies ending in miscarriage, stillbirth or abortion. The results stress the need
Barriers to Adoption of Family Planning among Women in Eastern Democratic Rep...MEASURE Evaluation
This study assessed barriers to family planning among women in Butembo, Eastern Democratic Republic of Congo. The researchers surveyed 572 women and found high knowledge of family planning methods but low usage of modern contraceptives. Only 36% used modern methods such as male condoms, pills, injectables, and implants while 64% relied on traditional methods like calendar-based family planning and withdrawal. Major barriers included lack of knowledge, fear of side effects, religious views, and husband opposition. The researchers recommend improving access to family planning in health facilities, advocating for modern methods, training health workers, and promoting family planning to women at health encounters.
The document provides statistics and information about abortion worldwide and in the United States. Some key points include:
- Approximately 42 million abortions occur worldwide each year, with 115,000 occurring daily.
- In the US, there are about 1.37 million abortions annually, with 3,700 occurring daily.
- The vast majority (93%) of abortions in the US are done for social or economic reasons rather than health reasons.
- Over half of abortions in the US occur before 9 weeks of pregnancy.
The document discusses newborn screening (NBS), which tests newborns for certain disorders and conditions that can compromise development if undetected. While NBS successfully lowers infant mortality, it has not addressed the increase in disabilities. The document advocates beginning NBS programs in India to detect conditions like congenital hypothyroidism and prevent associated morbidities and financial burdens. NBS programs require epidemiological data, ethical and economical consideration, and availability of screening tests, treatment, and intervention timelines. The document encourages starting regional NBS centers in India to prevent childhood disabilities and mortality from treatable metabolic diseases.
Born too soon the global action report on preterm birthPaul Mark Pilar
The report Born Too Soon analyzes the global problem of preterm birth. It features the first estimates of preterm birth rates by country and is authored by over 45 international experts. The report finds that about 15 million babies are born prematurely each year, which is more than 1 in 10 babies worldwide. Prematurity is the leading cause of newborn death and the second leading cause of death in children under 5 years of age. Many preterm babies who survive face lifelong disabilities. The report highlights proven solutions to save lives of preterm babies and reduce rates of death and disability.
The document provides statistics and information about abortion worldwide and in the United States. Some key points include:
- Approximately 42 million abortions occur worldwide each year, with 115,000 occurring daily.
- In the US, there are about 1.37 million abortions annually, or 3,700 daily.
- 93% of abortions in the US occur for social reasons rather than health concerns.
- Abortions have been linked to increased risks of depression, PTSD, substance abuse and elevated suicide rates in women.
- The vast majority of abortions, over 88%, occur during the first trimester.
The FIGO recommends that gestational diabetes mellitus (GDM) be considered a global health priority. GDM is associated with higher rates of maternal and neonatal morbidity and mortality as well as long term consequences for both mother and child. The FIGO proposes universal testing for GDM during pregnancy, providing the best possible management given available resources in each country, and using the postpartum period to improve health and reduce future risks for both mother and child.
1) Unsafe abortions are a major reproductive health challenge, accounting for 24 million procedures and over 360,000 deaths annually.
2) Lack of access to contraception and family planning services, as well as social factors like poverty, early marriage, and gender inequality contribute to high rates of unwanted pregnancy and unsafe abortion.
3) Improving access to contraception, comprehensive sexuality education, and safe abortion and post-abortion care services can help reduce maternal mortality from unsafe abortion and advance progress on Millennium Development Goal 5 of improving maternal health.
This document discusses barriers to access to progesterone to prevent preterm birth among Medicaid managed care organizations (MCOs). A 2016 survey of 18 Medicaid MCOs found barriers to providing all forms of progesterone, including cost differences between branded and compounded progesterone, clinician lack of knowledge, and unclear coverage and billing policies. While progesterone has been shown to reduce preterm birth risks by a third, scientific evidence is still needed on the effectiveness and optimal use of different progesterone formulations to inform clinical guidelines and policy.
A US district judge recently overturned an FDA decision and ruled that Plan B emergency contraceptive pills must be available without a prescription to women of all ages. This was seen as a major victory for women's health and rights advocates. However, some parents were concerned that easier access could promote irresponsible sexual behavior among teenage girls. While this contraceptive is considered very safe when used correctly, its effectiveness declines the longer a woman waits after unprotected sex to take it. Usage has been rising in recent years, with 14% of users being girls ages 15 to 19.
Newborn Screening and Severe Combined Immune DeficiencyDr. Allen Cherer
The document discusses newborn screening for Severe Combined Immune Deficiency (SCID), the most serious form of primary immunodeficiency. It describes how SCID is present at birth and results in life-threatening infections if not treated early. The use of the T cell receptor excision circle assay in newborn screening programs allows for early diagnosis of SCID before infections develop. Studies have shown that stem cell transplants before 3.5 months of age can cure 94% of infants with SCID if detected through newborn screening. Nearly all states now screen newborns for SCID given the life-saving benefits of early detection and treatment.
Developing normal placental growth curves using 2 d ultrasound in a zimbabwe ...TÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Contraceptive use in sub saharan africa -the sociocultural contextJake Odunga
This document provides an outline on contraceptive use in sub-Saharan Africa. It begins with an introduction on the importance of family planning for improving maternal and child health. It then discusses targets under MDG5 on improving maternal health and reproductive health. It notes that while contraceptive prevalence is increasing in parts of sub-Saharan Africa, rates remain low overall and unmet need for family planning remains high. Key factors influencing contraceptive use include levels of education, cultural and religious barriers, and access to family planning services. The document recommends multi-sectoral approaches including improving access to education and reproductive healthcare to increase contraceptive use in the region beyond 2015.
1) ART pregnancies have some differences from natural pregnancies that require special care and monitoring, such as progesterone and estrogen supplementation due to the absence of a corpus luteum in some cases.
2) Multiple pregnancies are a major risk factor for ART pregnancies and require close monitoring due to higher risks of preterm birth and low birth weight.
3) While antenatal care is largely the same for ART and natural pregnancies, ART pregnancies have slightly higher risks of complications like preterm birth and birth defects, so careful screening and management is important.
The document provides information on COVID-19 vaccination for postpartum lactating women. It discusses the vaccines available in India and their effectiveness. Studies have shown that the mRNA vaccines generate robust immunity in pregnant and lactating women similar to non-pregnant women. Vaccine-induced antibodies were found in breastmilk, allowing for immune transfer to infants. Preliminary findings did not reveal any obvious safety signals among vaccinated pregnant individuals. International organizations recommend vaccination for pregnant and lactating individuals when the benefits outweigh the risks.
Maternal Health Innovations_Graves_5.13.11CORE Group
Misoprostol is effective for preventing postpartum hemorrhage (PPH) in low-resource settings without skilled birth attendants when administered by community health workers during antenatal care visits or by women themselves at home births. A study in Tanzania found integrating misoprostol distribution into existing antenatal care services was feasible, safe, and effective. Over 12,000 women received misoprostol during antenatal visits, with 88% receiving and using it correctly for home births. This demonstrated misoprostol can successfully be distributed during antenatal care to protect women from PPH where skilled attendance is unavailable.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
This document summarizes literature on vaginal birth after caesarean (VBAC). It finds that evidence comparing outcomes of VBAC versus elective repeat caesarean section is poor quality. VBAC has a low risk of uterine rupture but increased risks compared to repeat c-section. Successful VBAC rates vary greatly based on individual risk factors. The document emphasizes informing women of their options and risks in an unbiased manner to empower their decision. It provides guidance on care for a planned VBAC, including continuous support, monitoring for rupture signs, and collaboration with obstetric specialists.
Post partum period an excellent opportunity for hpv vaccinationLifecare Centre
1) A study in Brazil found that HPV prevalence in young primiparous women was 58.5%, with 17.3% and 13.3% positive for the two high-risk HPV types 16 and 18. This suggests that postpartum vaccination could provide protection against cervical cancer for many women.
2) A US study found high acceptance of postpartum HPV vaccination, with 97% of women satisfied with the choice and 98% finding it convenient. However, only 30.7% completed the full three-dose vaccination series.
3) The presenter's experience vaccinating over 200 women in India postpartum found 99% compliance, with women reporting it was convenient and recommending it to friends
Benzathine penicillin is the only recommended treatment for syphilis during pregnancy to prevent mother-to-child transmission. However, global supplies of benzathine penicillin have been inadequate in recent years due to shortages. An estimated 5.6 million doses are needed annually to treat all syphilis cases, with 930,000 doses needed during pregnancy to prevent congenital syphilis. WHO is conducting analyses of benzathine penicillin production, demand, supply and procurement practices to address shortages and ensure availability for eliminating mother-to-child transmission of syphilis.
This document summarizes a study on contraceptive use dynamics using data from 60 Demographic and Health Surveys conducted between 1990-2009 in 25 countries. It analyzes 422,478 episodes of contraceptive use reported by women who were married or in unions. Key indicators presented include discontinuation rates by reason and method, duration of use by method, switching after discontinuation, and reproductive outcomes after discontinuation or failure. Discontinuation is high, ranging from 13% for IUD to 50% for condoms at 12 months. Method-related reasons are the main cause of discontinuation. Consequences can be serious, with 5-20% of accidental pregnancies ending in miscarriage, stillbirth or abortion. The results stress the need
The Indo-American Journal of Pharma and Bio Sciences plays a crucial role in the scientific community by providing a platform for the exchange and dissemination of research findings in the fields of Pharmacy and Bio Sciences is the scope and journal of the best science journals.
This was a fictional health communications campaign plan to bring awareness of birth control options for women over the age of 40. Even at 40, many women are still at risk for unintended, naturally occurring pregnancies. However, what worked in our younger years may not necessarily work as we get older.
This document discusses the potential for noninvasive prenatal DNA testing (NIDT) to become the standard screening test for Down syndrome in all pregnant women. It presents perspectives both for and against this proposition. Those in favor argue that NIDT has higher accuracy and lower risk than current invasive screening tests, so it respects patient autonomy and informed choice better. However, others are more cautious and want more data on costs and outcomes before widely implementing NIDT as the standard of care for all pregnancies. Overall the debate centers on whether NIDT should replace current screening paradigms or be offered as an additional option based on its advantages over existing tests.
This document proposes a policy to expand preventative prenatal care coverage in the United States. It finds that the U.S. has high rates of infant and pregnancy-related mortality compared to other developed nations. This is partly due to many women not receiving adequate prenatal care due to costs. The document evaluates three potential policy options and recommends expanding coverage of preventative prenatal care services to include no cost-sharing for patients. This option would encourage earlier and more frequent prenatal care, reducing mortality rates and healthcare costs over the long run.
This document summarizes a study that assessed knowledge of contraceptive methods and the impact of health education among married women in India. The study used a pre-test post-test design and surveyed 1200 married women between the ages of 18-45 before and after a health education intervention. The results showed that before the intervention, knowledge of female sterilization was highest at 93.6%, while knowledge of other methods like oral contraceptives and condoms was lower. After the health education, knowledge increased to nearly 100% for all discussed methods. The study concluded that health education significantly improved knowledge of contraceptive methods and that sociodemographic factors like education level were associated with existing knowledge.
The document provides an overview of abortion worldwide, including definitions, types, and legal status of abortion. It discusses methods for measuring abortion incidence, conditions under which women have abortions, and the impact of unsafe abortion on maternal health. Unsafe abortion remains a major public health issue, and reducing unintended pregnancies through access to contraception is key to also reducing abortions.
Community Wellness Through Improved Maternity Practices By Drs Jose Gorrin and Ana Parilla. Given at the Puerto Rican Cultural Center in September of 2003
This document summarizes the key findings of a survey conducted by the Working Mother Research Institute on women's knowledge and attitudes around breast cancer screening and breast health. Some of the main findings include:
- 9 out of 10 women consider mammograms an important part of health management and 80% have had at least one mammogram, with 70% getting screened annually.
- However, many women lack knowledge about breast density and its health implications, and options for screening technologies. Nearly half did not know if they had dense breasts.
- Of women who had a mammogram, 5 out of 10 were called back for additional testing, with most finding nothing suspicious but some receiving cancer diagnoses.
- The document reviews
USAID supports expanding contraceptive options for couples in developing countries. In addition to modern methods, USAID has promoted natural family planning methods since 1985 to broaden options and meet the needs of couples preferring natural methods. Three natural methods promoted are the Standard Days Method using CycleBeads, Lactational Amenorrhea Method for breastfeeding women, and the Two-Day Method based on cervical secretions. Studies show these methods can be over 95% effective when used correctly. USAID programs have expanded access to these methods in over 25 countries through public sector programs and partnerships.
Glob Health Sci Pract-2016-Samuel-S60-72Melaku Samuel
The document summarizes an intervention in Ethiopia that aimed to strengthen postabortion family planning (PAFP) services by expanding contraceptive choice and improving access to long-acting reversible contraceptives (LARCs). The intervention was implemented in 101 public health facilities in Southern Nations, Nationalities, and People’s Region from 2010 to 2014. It significantly improved PAFP uptake and increased the proportion of abortion clients receiving LARCs over the period. Specifically, the share of the method mix for LARCs rose from 2% in 2010 to 55% in 2014, while use of implants increased from 2% to 43% and IUDs from 0.1% to 12%. The broader method mix allowed more clients
The Board of Governors held a special teleconference to discuss two potential funding announcements (PFAs). For the first, they voted to approve developing a PFA on treatment options for uterine fibroids that would fund a national disease registry and observational studies using the registry data. They also discussed a PFA on improving treatment for uncontrolled asthma in African Americans and Hispanics/Latinos through comparative effectiveness research testing interventions to increase adherence to guidelines.
This document provides information on postpartum family planning methods. It discusses the Lactational Amenorrhea Method (LAM) which uses exclusive breastfeeding as a contraceptive for up to 6 months if specific criteria are met. It also discusses various hormonal methods including progestin-only pills and injectables that can be used by breastfeeding and non-breastfeeding women starting at 6 weeks postpartum. The single rod subdermal implant is also described as a long-acting reversible contraceptive option effective for 3 years. Guidance is provided on when each method can be initiated in the postpartum period as well as effectiveness, advantages, disadvantages and who should not use each method.
Vaccines: Linking Awareness, Access, and ActionRx EDGE
This presentation was delivered at the PEPP (DTC Perspective’s “Patient Engagement through Physicians and Pharmacists” event).
The presentation dicusses the current landscape and the tactics and strategies currently being undertaken in this critical public health area. It also shares insights from pharmacy programs in the Tdap, flu, and shingles categories.
New product dedisions provide a dear path to the business. New product development
astep by step process. A Complete idea is required behind new product.
1 1deal Generation: The development of a product starts with the concept and idea.
The remaining process is depending on that idea.
2 Screening of Idea: This step is cruial to ensure that unsuitable ideas, for whatever
reason, are rejected as soon as possible. Ideas need to be considered objectively,
ideally by a group or committee.
3. Concept Development and Testing: After having an idea, next is the sreening
stage. The idea should now convert into concept. It has depth information which can
be visualizing by the consumer.
4. Anaysis of business: After finalization of concept, a business case needs to be kept
algTStogether to consider whether the new service /product will be gainful.
2665.Product Development If the nev product is approved, it will be approved to the
2marketing and technical development step.
6. Test Marketing: Market testing (test marketing or) is different to consumer testing.
in that it introduces the product that follows proposed plan of marketing.
od7. Commercialization: When the concept has been tested and developed, final
0decisions are required to move the product to its introduction into the market.
8. Launch: A detailed plan of launch is required for this step. This is the important
stage for success of a product
New Drug Development
So In present business atmosphere, it is more important to take smart decisions for
business. Innovative approaches and new products can put an organization on proper
pathway and to make a big success if appropriately analyzed and executed. Make it simpler
(Fig.2.1).0
Following parameters should keep in mind for a better decision:
Analyzing existing service and product portfolio frequently.
Knowing the position of functions of business, projects of departments and
initiatives.
Understanding the distribution of funds and assessing efficiency.
Having understanding of market for new opportunities and possible competition.
2.B PRODUCT BRANDING, PACKAGING AND LABELLING DECİSIONs
2.8.1 Branding
Branding has its existence from ancient era. According to Nilson (2000), the first example
of branding is found in the oil lamps' manufacture on the Greek islands thousands of years
back. Brand elements are name, sign, term, symbol, design or distinguishing characteristics.
Brand is not only a graphical design or a logo; it is the unique identity of the product.
By American Marketing Association, Brand can be defined as name, term, sign, symbol
or design, or a combination of them intended to identijy the goods and services of one seller or
group of sellers and to diferentiate them from those of other sellersa54
Branding is a process, where a company generates loyalty among consumers in the
market. Brands are designed with a motive to communicate customers the reason for the
existence of their product. Brand should have a strong connection with customers;
Dr. j melgar family planning and developmentrigelsuarez
Family planning provides significant benefits by improving health outcomes and empowering individuals and families. It saves lives by reducing maternal and infant mortality, improves social and economic development, and eases pressure on scarce resources. While initially controversial, most major medical organizations now recognize modern contraception as very safe and support access to family planning as a basic health right and smart investment.
Similar to Telehealth: The next frontier in abortion care (20)
This document summarizes self-care initiatives for sexual and reproductive health. It discusses the WHO definition of self-care, and examples like the Caya diaphragm introduced in Niger through the EECO project. Over 600 diaphragm kits were sold or distributed there from 2019-2020. The DOT app was marketed in India to help women track their periods and fertility. Looking ahead, more evidence is still needed on specific self-care interventions and how to evaluate them, while building advocacy and addressing regulatory questions. COVID-19 also impacts future self-care work.
- The SASS Project aimed to assess how well California high schools complied with the California Healthy Youth Act (CHYA) standards for comprehensive sex education, from the perspective of students.
- Students at 13 LAUSD high schools completed an anonymous online survey assessing their sex ed classes' coverage of CHYA standards and classroom environment.
- Results showed a range of compliance across schools, with strongest coverage of HIV topics and weakest coverage of gender/sexuality and contraception. Classroom environment also varied, with teachers generally comfortable but time limited.
- The findings could help identify areas of improvement, but LAUSD had not yet decided to formally incorporate the student surveys or provide feedback to schools.
This document discusses the persistence of electronic fetal monitoring (EFM) despite evidence that it does not improve neonatal outcomes for low-risk pregnancies compared to intermittent auscultation. While EFM was introduced to screen for fetal distress and reduce cerebral palsy rates, multiple studies have found it does not achieve these goals. However, EFM continues to be used in 85% of deliveries and has led to increased cesarean rates and costs without clear benefits. The document examines possible explanations for EFM's persistence, including the influence of law and economics, and calls for more randomized trials before new medical technologies are widely adopted.
This document provides information about the Durbar intervention for HIV prevention among sex workers in Kolkata, India. It summarizes the evolution of the intervention over time from community mapping and advocacy in 1991 to establishing community organizations and microfinance opportunities for sex workers in 1995. Key aspects of the intervention included community mobilization, empowerment training, peer health workers, and addressing structural barriers faced by sex workers. The document also summarizes a replication study conducted by UCLA which found that the Durbar intervention was successful in increasing condom use and empowerment outcomes among sex workers compared to standard STI clinic care alone. Factors like education level, employment status, and age predicted which sex workers benefited most from the additional community structural intervention components.
This document provides an overview of challenges in implementing sexual and reproductive health rights in Southern Africa, using examples from Botswana, South Africa, and Eswatini. It discusses how international law establishes these rights but they still face challenges in practice. Key issues include lack of legal protections, socio-cultural norms that discriminate against women, and lack of resources. While countries have laws incorporating international standards, discrimination and harmful practices still undermine equal access to healthcare and decision making. Ensuring sexual and reproductive rights requires addressing both legal frameworks and social attitudes.
Justice Oagile Key Dingake, who has had a distinguished career as a judge in Botswana and is now a judge in Papua New Guinea and Sierra Leone, will be giving a lecture at UCLA on gender discrimination in sexual and reproductive health rights. Justice Dingake received his LLB from the University of Botswana and LLM and PhD from universities in the UK and South Africa. He is recognized as a leading scholar in sexual and reproductive rights and has held prominent roles in judicial organizations in Africa focused on health, HIV/AIDS, and social justice. The introduction praised Justice Dingake for his progressive opinions on gender equality that have made him equivalent to U.S. Supreme Court Justice Ruth Bader
UCLA, Bixby Center Lecture
"From horror to humor: Abortion on American television"
Gretchen Sisson, PhD
Advancing New Standards in Reproductive Health (ANSIRH)
UCSF Bixby Center for Global Reproductive Health
Bixby Center Lecture
"Homeless and Vulnerable Youth in Los Angeles: Sexual and Reproductive Helth Challenges"
November 29, 2017
by Carrie Mounier, LCSW
This document discusses transformative approaches to sex education and violence prevention programs for youth. It outlines effective programs that seek to reduce risks and promote healthy relationships through gender transformative approaches. One such program is Program H, which uses a socio-ecological model to help boys and young men critically examine masculinity and promote gender equality, empathy, sexual health, and reduce dating violence. The document notes challenges in measuring the impact of such programs and how policies and funding can undermine social justice goals.
This document summarizes the Creating Space lactation accommodation project at UCLA. The project aims to improve support for breastfeeding mothers on campus by investing in lactation rooms, education, and support services. A needs assessment found few appropriate lactation spaces and a lack of support services. The project works to map and improve existing rooms, train lactation educators, and provide counseling services on campus.
KIHEFO is a local non-profit organization in Kabale District, Uganda dedicated to community development. It operates a medical clinic, HIV/AIDS clinic, nutrition center, and other projects focused on healthcare services and community development. Adolescent reproductive health is a major issue in Uganda, as 25% of the population is between 10-19 years old. Issues include lack of awareness, peer pressure, poverty, and cultural norms. Sexual activity begins early, and coercion, unwanted pregnancies, and STIs are problems. KIHEFO aims to address the integrated problems of disease, poverty, and lack of education through an integrated approach of healthcare services and community development projects.
This document outlines Caroline Maposhere's work advocating for LGBTI rights in Southern Africa. It discusses the legal criminalization of same-sex relations in many countries, which creates barriers to healthcare access and stigma. Community dialogues and human sexuality education sessions were used to raise awareness and address misconceptions. Key topics included the impact of criminalization on health, barriers like discrimination from providers, and training journalists, leaders, and LGBTI communities themselves. The conclusion recognizes that LGBTI people have always existed in Africa but are often denied and overlooked, and that advocacy must be conducted sensitively using appropriate approaches.
More from The Bixby Center on Population and Reproductive Health (20)
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
1. University of California, San Francisco | Bixby Center for Global Reproductive Health
Telehealth
The next frontier in abortion care
Ushma Upadhyay, PhD, MPH
January 9, 2019
University of California, Los Angeles
Los Angeles, CA
3. Telehealth
Slide 3January 2019
tel·e·health
/ˈteləˌhelTH/
noun
◼ The provision of healthcare remotely by means of
telecommunications technology.
◼ Telehealth is different from telemedicine because it
refers to a broader scope of remote healthcare
services than telemedicine. While telemedicine refers
specifically to remote clinical services, telehealth can
refer to remote non-clinical services.
4. Medication abortion
◼ Two types of pills
◼ Mifepristone
◼ 1 pill taken orally/swallowed
◼ Misoprostol
◼ 4 pills put between gums and cheek until they
are dissolved
◼ Taken 24-48 hours after mifepristone
◼ Cramping and bleeding then usually
starts 1-4 hours after taking
misoprostol and can last for several
hours
Slide 4January 2019
5. Medication Abortion is highly effective
95%
Intervention needed for
completion: 5%
Slide 5January 2019
Data from ~11,000 medication
abortions covered by Medi-Cal,
(Upadhyay et al. 2015)
95%
Effectiveness
6. Medication Abortion is extremely safe
99.7%
Serious adverse event: 0.3%
Slide 6January 2019
Data from ~11,000 medication
abortions covered by Medi-Cal,
(Upadhyay et al. 2015)
7. Medication Abortion is extremely safe
Slide 7Month YEAR
3 Million
Women Have
Used Mifeprex
Between 2000-2017
19 deaths have
been reported
Mortality rate of
0.00063%
This is much lower than the mortality rate for childbirth
in the U.S. (0.009%)
Medication abortion is safer than many common drugs
in the U.S., including Tylenol or Viagra
=
8. Medication Abortion in California
◼ In 2014, estimated 157,350 abortions in California
◼ 2014 Medi-Cal data indicates 46% were
medication abortions
46.0%
8.2%
45.6%
0.2%
FFS Medi-Cal funded abortions, 2014
First trimester aspiration
2nd trimester or later
Medication Abortion
Other
Source: DHCS
~78,000/year
Slide 8January 2019
9. Self-Managed Abortion
Slide 9Month YEAR
How do women obtain pills?
◼ Websites such as Plan C, SASS (Self-Managed Abortion; Safe
and Supported), Women on Web, and safe2choose provide
information to women on how to get pills and how to use them.
◼ plancpills.org
◼ abortionpillinfo.org
◼ womenonweb.org
◼ safe2choose.org
◼ An online search will bring up numerous results of places to buy
the pills via the Internet.
◼ There is evidence that most, if not all, pills purchased online from
these websites are real medications, with active ingredients.
10. Substantial demand for getting abortion pills online
◼ 2015: 700,000+ Google searches using terms related to
self-induced abortion in the U.S.
◼ Online sites report many U.S. consultation requests for
pills initiated each year:
◼ Safe2choose: 120,000;
◼ Women on Web: 36,000
◼ AID ACCESS reports substantial traffic:
600 requests in 6 months from the U.S.
◼ Over 4000/year are denied an abortion and carry to term
because they can’t access abortion
Slide 10January 2019
11. State Laws
REMS
Hurdles to telehealth abortion
Slide 11
◼ State laws regulating use of medication abortion
◼ Physical presence laws (telemedicine bans)
◼ Criminalization of self-managed abortion
◼ U.S. FDA REMS
◼ Makes it illegal to send abortion pills by mail
January 2019
14. Risk Evaluation and Mitigation Strategies (REMS)
◼“To mitigate a specific, serious risk listed in the labeling of the drug”
◼atypical infection
◼prolonged heavy vaginal bleeding
◼REMS not applied to other conditions/procedures with similar risks
◼In February 2017, Mifeprex REMS Study Group called for withdrawal
of REMS in the NEJM
Slide 14January 2019
15. Elements to Assure Safe Use
1. Prescribers must be certified with the program by completing the
Prescriber Agreement Form
2. Patients must sign a Patient Agreement Form.
3. MIFEPREX must be dispensed to patients only in certain
healthcare settings, specifically clinics, medical offices and
hospitals by or under the supervision of a certified prescriber
Slide 15January 2019
16. Impact of the REMS
Slide 16
Keeping the REMS in place limits its use.
◼ Prevents primary care providers from providing
occasionally
◼ Requires burdensome requirements for registration,
storage, and reporting
◼ Limits the ability for generics to be developed
Largest limitation:
◼ Prohibits the mailing of abortion pills
January 2019
17. 3 Telemedicine models: Clinic Model
◼ Iowa (Grossman et al., 2011)
◼ PPFA – Expanding throughout the United States (Alaska, etc)
◼ Maine Family Planning
Ultrasound and any tests
completed onsite
Telemedicine consult
with off-site physician
who can “dispense”
mifepristone.
Patient presents to facility
Slide 17January 2019
18. 3 Telemedicine models: Tests Model
◼ Tabbot Foundation in Australia
◼ Gynuity Health Projects in the U.S.
Initial consultation at home
Patient obtains
ultrasound and
other tests from
a local health
care provider
Results sent to
telemedicine
provider
If eligible,
medications and
instructions
mailed to patient
Slide 18January 2019
19. 3 Telemedicine models: No-Tests Model
Person completes
screening form online
Medical history
is reviewed by a
telemedicine
provider
If eligible,
medications and
instructions
mailed to patient
◼ Ireland: Similar safety rates to in-clinic models
(Aiken et al. 2017)
Slide 19January 2019
21. 1. Do we really need ultrasounds for gestational
dating?
Slide 21January 2019
◼Small risk of underestimation of pregnancy
◼Pills may not work delayed abortion, emergency room or
unwanted baby
◼However a study of 3041 U.S. women over 99%
correctly estimated their gestational age was
within the eligibility window of 10 weeks
(Bracken et al.2010)
22. 2. What are the efficacy rates of telehealth abortion
in the United States?
Slide 22
◼ Study of 400 women provided medication
abortion without ultrasound, 99% had complete
abortions without major adverse events
(Raymond et al. 2018)
◼ In Ireland, Women on Web found 95% (CI:93%-
96%) reported successfully ending their
pregnancy without aspiration. (Aiken et al. 2017)
23. 3. Does telehealth abortion enable people to have
their abortions at earlier gestations?
Slide 23
◼ What is the average time to abortion care and how
does time differ for those who choose referrals?
◼ In Iowa after clinic-based telemedicine was
introduced, women were less likely to have a second-
trimester abortion (Grossman et al 2013)
24. 4. Do we really need ultrasounds to diagnose
ectopic pregnancy?
Slide 24January 2019
◼ Small risk of missed ectopic pregnancy (~1%)
◼ Delayed diagnosis call the on-call clinician emergency room
◼ However, abortion pills do not increase risk of ectopic
pregnancy
◼ Patients would be at the same risk of ectopic pregnancy had
they not sought an abortion at all.
25. 5. Is Rhogam needed for Rh negative people?
Slide 25
◼ An Rh-positive baby born to an Rh-negative woman who did not
receive immune globulin is at risk of developing hemolytic disease
◼ In abortion care: Routine test to assess negative blood type
◼ About 15% of people are Rh-negative
◼ In abortion and early miscarriage Rh immune globulin is used to
protect a future pregnancy, but is only theoretical.
◼ No studies demonstrate subsequent maternal sensitization or
development of hemolytic disease in the fetus after an early
medication abortion
◼ What are people’s preferences for Rhogam after having this
information?
26. 6. What is our appetite/tolerance for risk?
Slide 26
◼ Small risk of underestimation of pregnancy
◼ Pills may not work delayed abortion, emergency room or unwanted baby
◼ Small risk of missed ectopic pregnancy
◼ Delayed diagnosis still same as wanted pregnancy emergency room
◼ Unknown risk of not getting Rhogam
◼ Many people know their rh status/blood type from previous pregnancies, some may not want
future children
◼ Large legal risk if seeking treatment at a rural or restrictive ED
◼ Who should decide what level of risk is acceptable?
◼ Legislatures?
◼ U.S. FDA?
◼ Physicians?
◼ People who get pregnant?
27. 7. What information do individuals need to make an
informed choice between in-clinic and telehealth
abortion?
Slide 27
◼ How can we support individuals who are choosing
between having an in-clinic abortion and having a
telehealth abortion?
◼ How much do they want to know on these issues?
◼ Costs/Insurance/Medicaid coverage
◼ Legal risks
◼ Pain control
◼ Ectopic pregnancy
◼ Rh status
28. University of California, San Francisco | Bixby Center for Global Reproductive Health
Thank you!
Ushma Upadhyay
Ushma.Upadhyay@ucsf.edu