Contraception An Issue Of Obstetrics And Gynecology Clinics

There have been exciting new developments and research related to currently available contraceptives. In addition, in the last seven years, emergency contraception has gone from behind the counter to being FDA-approved for use. This issue addresses the most important clinical leaps in contraception and family planning in the last decade, with emphasis on new options for long-term, reversible contraception and emergency contraception. Information is also included to address the impact of Affordable Health Care and legal aspects of sterilization.

Consulting Editor, Dr. William Rayburn, is serving as Guest Editor for this special issue of Obstetrics and Gynecology Clinics devoted to Interprofessional Collaboration for Select Women’s Health Issues. Articles deal with the spectrum of disciplines in response to failures of interprofessional collaboration that resulted in compromises to patient quality and safety. Systematic reviews have shown that this type of learning has led to positive outcomes in relation to participant’s reactions, attitudes, knowledge/skill, behaviors, and practice, as well as patient benefits. Articles in this issue are specifically devoted to the following topics: Reproductive Rights and Women’s Mental Health: Essential Information for the Ob/Gyn; Goals for Collaborative Management of Obstetric Hemorrhage; Role of Lipid Management in women's Health Preventative Care; Stroke in Pregnancy: An Update; Treatment of Viral Infections During Pregnancy; Benign Uterine Disease: The Added Role of Imaging; Racial Differences in Pregnancy-Related Morbidity and Mortality; Psychiatric Medication Use in Pregnancy and Breastfeeding; Neuroimaging During Pregnancy and the Postpartum Period; The Midlife Transition, Depression and Its Clinical Management; and Burnout in Obstetricians-Gynecologists: Its Prevalence, Identification, Prevention, and Reversal. Readers will come away with the information needed to improve patient outcomes while aiming toward goals like interprofessional faculty development that result in reducing feelings of isolation, developing a more collaborative approach, and providing opportunities to share knowledge, experiences, and ideas.

Gynecology is a procedure-related field that, like other specialties, has moved toward minimally invasive procedures that can be performed in the office setting. This issue of the Obstetrics and Gynecology Clinics covers the most commonly performed gynecologic procedures performed in the office setting. Colposcopy, Cryosurgery, LEEP, sterilization, D and C, and Urogynecologic procedures are all covered, along with articles on surgically implanted contraceptives and surgical abortion.

In this issue of Obstetrics and Gynecology Clinics of North America, guest editors Drs. Jean R. Anderson and Grace Chen bring their considerable expertise to the topic of Global Women’s Health. The goal of this unique issue is to explore some of the challenging health problems that affect women worldwide and to make a positive impact on the global health of women. Multinational authors provide up-to-date reviews that address key clinical issues and critical topics in the field. Contains 13 practice-oriented topics including contraception and preconception care; interpersonal violence; quality care for women; interprofessional care in obstetrics and gynecology; surgical burden of disease in women; nonmedical factors that impact women’s health; and more. Provides in-depth clinical reviews on global women’s health, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The acquisition and implementation of new findings for clinical care in obstetrics and gynecology is at a more rapid pace than ever before. More understanding of the pathophysiology of disease coupled with improved screening technology and genetic information requires physicians to constantly update their knowledge-base and familiarize themselves with guidelines and advances in techniques as well as question old euphemisms. Medical specialties, including obstetrics and gynecology have moved from board certification as a solitary achievement to maintaining current knowledge- a continuous lifelong learning process. This issue of Obstetrics and Gynecology Clinics is dedicated to clinical care for patients with evidence-based recommendations: “state of the art advice and updates. Articles are specifically devoted to Contraception: menarche to menopause; Vaginitis: beyond symptoms; Abnormal uterine bleeding; Recognition and therapeutic options for malignancy of the cervix and uterus; Gestational diabetes: Diagnosis, classification and clinical care; Hypertensive disorders in pregnancy; Obstetric emergencies: Shoulder dystocia and postpartum hemorrhage; Prenatal diagnosis: tools and tests for screening; Clinical recognition and screening for common breast disorders and malignancy; and Recognizing and managing common urogynecologic disorders.

This issue of Clinics will focus on innovations in contraception as well as medical and public health barriers to reducing unintended pregnancy. Described in this issue are a number of contraceptive innovations developed over the last few years, including the contraceptive patch and ring as well as the hormonal intrauterine system and hormonal implants. The very effective options, including the IUD and hormonal implants, have appealed to women who previously did not use contraception or used less effective methods. Other contraceptive innovations described include novel approaches to contraception: Treating the need for contraception as an emergency, using "quick start" methods of initiating contraceptives, expanding the profile of women considered good candidates for IUDs, and using extended dosing regimens for hormonal contraceptives. At the systems level, this issue will examine legislation, regulations and funding of contraception, factors that have a major impact on access and use. The last decade has seen both improvements in contraceptive usage and continued barriers to improved access. We suggest ways to improve contraceptive use and access over the years to come.

Dr. Nicholson's issue is devoted to providing health care to the underserved woman. Leading experts in the area have written reviews to address the leading thinking and management of patient outcomes in the following areas: Racial/ethnic Disparities in Health and Healthcare; Perinatal Quality Indicators and Achieving Birth Equity among Underserved Women; Reducing Disparities in Unintended Pregnancy; Family planning American style: Why it’s so hard to control birth in the United States; Breaking the Cycle of Obesity in Women in Underserved Communities; Addressing Healthcare Disparities Among Sexual and Gender Minorities with Community Initiatives; Comparing Options for Patient-Centered Treatment for Uterine Fibroids: Addressing Patient-Centered Fibroid Management in Underserved Women of Childbearing Age; Aiding Underserved Women with Substance Use Disorders before and after Pregnancy; The Role of Qualitative Research in Gynecologic and Reproductive Care; and Using the Electronic Health Record to Conduct Reserch in Population Health. Readers will come away with state-of-the-art information that they can immediately integrate into patient care.

These four papers supplement the book Contraception and Reproduction: Health Consequences for Women and Children in the Developing World by bringing together data and analyses that would otherwise be difficult to obtain in a single source. The topics addressed are an analysis of the relationship between maternal mortality and changing reproductive patterns; the risks and benefits of contraception; the effects of changing reproductive patterns on infant health; and the psychosocial consequences to women of controlled fertility and contraceptive use.