Family Planning Curriculum

Program Goal

To develop the OBGYN resident's knowledge and skills to effectively counsel and provide the most appropriate contraceptive and pregnancy options.

Faculty Contact

  • Sarah Prager, MD (University of Washington)

The family planning clinic, based at UW Roosevelt Women's Health Clinic, provides the PGY-1 and PGY-3 with education on the most up-to-date contraceptive methods, pregnancy options counseling, and termination methods including medical/D&C/D&Es, management of abortion complications, miscarriage management and counseling and contraceptive counseling, particularly for those with challenging contraceptive needs. This clinic experience provides a solid medical and surgical abortion experience early in residency training so that the resident will be able to continue to provide these services as part of routine gynecologic services and care. Residents gain additional experience in pregnancy options counseling, cervical preparation, and termination procedures on the antepartum obstetric service as a PGY-2 and PGY-3.

Educational Focus

Residents exercising their right to not perform elective abortions will still participate in the clinic and didactic experience without physically performing elective abortions. All FDA-approved contraceptive methods will be taught and made available to clients and even off label use of some methods such as continuous OCP regimens for menstrual suppression. There will be a weekly review of Modules which contain assigned materials from current abortion and contraception texts, articles, and on-line resources. At the beginning of each academic year, a hands-on simulation workshop is held to train residents on the various family planning procedures.

The PGY-1 and PGY-3 are expected to learn to demonstrate competency in the following skills:

  • Unbiased counseling: Contraceptive and pregnancy options
  • Determination as to the most appropriate route of termination:  Medical abortion, office D&C, surgical D&C and management of complications of each.
  • Proficient in performing intrauterine device insertion, Implanon insertion, Essure placement, tubal sterilization.

Residents who "Opt-out" are expected to counsel, evaluate, and manage the patient in an unbiased fashion. They may opt-out only on the termination procedure portion. Specific clinical responsibilities are clearly delineated in MedHub.

Family Planning Educational Resources: (Articles available on MedHub; paper copies will be made available upon request).

Modules

Module 1

Module 2

First-trimester

  • Chapter 10: First-trimester aspiration abortion. Meckstroth K and Paul M. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009:135-156.
  • Early Surgical Abortion: An alternative to and backup for medical abortion. MacIsaac et al, American Journal of Obstetrics and Gynecology. 2000 Aug;183(2):S76-83.

Second-trimester

  • Chapter 11: Dilation and evacuation. Hammond C and Chasen S. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009:157-177.

Module 3

  • Chapter 9: Medical abortion in early pregnancy. Creinin MD and Danielsson KG. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009:111-134.
  • Chapter 12: Medical methods to induce abortion in the second trimester. Kapp N and von Hertzen H. In: Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Blackwell Publishing Ltd; 2009:178-192.
  • NAF Protocol For Mifepristone/Misoprostol In Early Abortion. National Abortion Federation, January 2008

Module 4

  • Medical management of early pregnancy failure: efficacy. Chen B and Creinin MD, Seminars in Reproductive Medicine. 2008 Sep;26(5):411-22.
  • Expectant care versus surgical treatment for miscarriage. Nanada K. et al, Cochrane Database of Systematic Reviews. 2006 Apr 19;(2).

Module 5

Overview

Combined Hormonal Contraception

  • Oral Contraception. Speroff et al, Clinical Guide for Contraception. 2005:677-80.
  • Vaginal and Transdermal Combined Contraception. Speroff et al, Clinical Guide for Contraception. 2005:153-162.

Progestin-only

Non-hormonal & IUC

  • Intrauterine and Barrier Contraception. A practical review of recent developments. Masters et al, Current Obstetrics and Gynecology. Feb 2005;15(1):31-37.
  • Intrauterine Device. ACOG Practice Bulletin 59. 2005 Jan;105(1):223-232.
  • Use of Copper Intrauterine Devices and the Risk of Tubal Infertility Among Nulligravid Women. Hubacher et al, New England Journal of Medicine. 2001 Aug;345(8):561-7.
  • Benefits and Risks of Sterilization. Pollack. ACOG Practice Bulletin 46. 2003 Sept;102(3):647-58.
  • Ambulatory Gynaecological Surgery: Transcervical sterilization. Abbot et al, Best Practice & Research Clinical Obstetrics & Gynecology. Oct 2005;19(5): 743-756.

Contraception in the Postpartum Period

Emergency Contraception

  • Emergency Contraception. ACOG Practice Bulletin 69. 2005 Dec;106(6):1443-52.