| Pelvic examinations and access to oral hormonal contraception. | |
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MedLine Citation:
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PMID: 21099589 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Requiring a pelvic examination before prescribing oral contraception poses an unnecessary barrier to contraceptive access. Medical guidelines have outlined the safety of oral contraception provision without a pelvic examination, yet little is known about the practices of clinicians providing reproductive health care. Our purpose was to investigate clinicians' requirements for pelvic examination and what may account for practice differences. METHODS: We administered a mailed survey to a national probability sample of obstetrician-gynecologists (ob-gyns), family medicine physicians, and advanced practice nurses specializing in obstetrics and gynecology and women's health or family medicine in 2008-2009 (N=1,196), with a response rate of 65.3%. RESULTS: Nearly one third of ob-gyns and family medicine physicians reported always requiring a pelvic examination when prescribing oral contraception (ob-gyns 29%; family medicine 33%). A higher proportion of advanced practice nurses in primary care (45%) and a markedly lower percentage of advanced practice nurses in reproductive health (17%) reported always requiring the examination. In adjusted analyses, older clinicians were more likely to require the pelvic examination (odds ratio [OR] 1.03, P<.01) and clinicians serving a higher proportion of Medicaid patients more likely (OR 1.62, P<.05). Providers in private practice were more than twice as likely as those working in family-planning or community clinics to require pelvic examinations (OR 2.30, P<.01). CONCLUSION: One third of clinicians we surveyed require pelvic examinations before provision of oral contraceptives, despite guidelines indicating they are unnecessary and research suggesting they can pose a barrier to contraceptive access. |
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Authors:
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Jillian T Henderson; George F Sawaya; Maya Blum; Laura Stratton; Cynthia C Harper |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 116 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-04 Revised Date: 2012-01-18 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1257-64 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California, USA. HendersonJ@obgyn.ucsf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Advanced Practice Nursing Contraceptives, Oral, Hormonal* Data Collection Family Practice Female Gynecological Examination* Gynecology Humans Male Middle Aged Obstetrics Physician's Practice Patterns* |
| Grant Support | |
ID/Acronym/Agency:
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K01 HD054495-05/HD/NICHD NIH HHS; K01HD054495/HD/NICHD NIH HHS; KL2 RR024130/RR/NCRR NIH HHS; R01 HD046027/HD/NICHD NIH HHS; R01 HD046027-01/HD/NICHD NIH HHS; R01 HD046027-02/HD/NICHD NIH HHS; R01 HD046027-03/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Contraceptives, Oral, Hormonal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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