Visiting professor highlights ‘educated choice’ in reproductive health

An easy-to-understand algorithm for incorporating family planning into primary care can help women to choose the best method of contraception for their stage of life and prevent unintended pregnancies, said Ashlesha Patel, M.D., MPH, 11th Annual Visiting Professor at Christiana Care Health System.

Dr. Patel, a gynecologist, is system director of Family Planning Services and director of Ambulatory Services in the Department of Obstetrics and Gynecology at the John H. Stroger Jr. Hospital of Cook County in Chicago, Illinois.

She spoke at two grand rounds, as well as a panel discussion on May 5, hosted by the Christiana Care Community Center of Excellence in Women’s Health.

“Reproductive health is all about choice,” she said. “We need to reframe it so that it is an educated choice.”

Dr. Patel developed the Family Planning Quotient (FPQ), which evaluates the number of children a woman desires, if any, versus the number of children she has. If a woman doesn’t want to have children for a number of years or already has completed her family, she can prevent unintended pregnancies with long-acting reversible contraception (LARC), typically an IUD or a contraceptive implant.

“It’s a platform to talk to women about planning, to be proactive,” she said, noting that she envisions the FPQ becoming an integral measure in family planning, much the way Body Mass Index (BMI) is used in evaluating obesity.

A panel discussion moderated by Elizabeth Zadzielski, M.D., MBA, associate physician leader, Women and Children’s Service Line, and medical director of Christiana Care’s Women’s Health Ambulatory Services, Division of Education, featured Dr. Patel and experts from Christiana Care, Delaware Health and Social Services, Nemours and Westside Family Healthcare.

16. women's health grand rounds OBGYN_GR-0022
Panelists Krishna White, M.D., MPH, Ashlesha Patel, M.D., MPH, Karen J. Antell, M.D., MPH, Tom Stephens, M.D., Elizabeth Zadzielski, M.D., MBA (moderator), and Leah Jones Woodall, MPA.

Karen Antell, M.D., MPH, Department of Family & Community Medicine, Women’s Health Faculty, talked about efforts to reduce unintended pregnancies through Delaware CAN (Contraceptive Access Now) and Upstream USA, a public/private partnership to improve health outcomes for women and children that ensures all Delaware women of reproductive age have same-day access to the full range of contraceptive methods at low or no cost.

Dr. Antell said that women delivering at Christiana Care now have the option to receive an IUD immediately after the placenta is delivered or a contraceptive implant the day after delivery. She said it’s important for women to learn about these options well before they give birth.

“It’s not a conversation you want to have between contractions,” she said.

Krishna White, M.D., MPH, director of Adolescent Medicine at Nemours, recalled that three of her classmates got pregnant when they were in high school. Today, both teens and parents are becoming more proactive in preventing unintended pregnancies.

“They are asking for LARC,” she said.

Tom Stephens, M.D., chief medical officer at Westside Family Healthcare, said family planning empowers women to lead more productive lives.

“When people do not have unintended pregnancies, it expands their opportunities for work and school,” he said.

Leah Jones Woodall, MPA, chief of the Family Health Systems section of the state Division of Public Health, said Delaware has ranked first in the nation in the percentage of unintended pregnancies and is working hard to change that by supporting reproductive life planning and making contraception acceptable, accessible and affordable.

“We are reaching out to women with messages that resonate with women,” she said.

In addition to her grand rounds on primary care and reproductive life plans, Dr. Patel also gave a presentation on the impact of cancer treatments on sexuality and fertility.

“If fertility preservation is an issue, it’s time sensitive, something that needs to be addressed ASAP,” she said.