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The 2024 CDC MEC and SPR included a number of significant changes that clinicians should be aware of. In addition to new recommendations regarding people with chronic kidney disease, the 2024 MEC includes revised risk categories for some people using depot-medroxyprogesterone acetate (DMPA). The SPR has an expanded section of pain management for IUD placement and bleeding problems with implant use. The QFP Guidelines are an update of the 2014 QFP and contain state-of-the-art contraceptive counseling guidelines. The changes will be discussed in detail, as well as a review of the MEC/SPR app and job aids available from the CDC.
Learning Objectives:
List the contraceptives that are considered to be Category 3 or 4 in people with chronic kidney disease.
For people using DMPA, list three medical conditions that had changes in their U.S. MEC safety category.
Describe two changes in the section of the SPR on bleeding irregularities during implant use.
Speakers:
Jennifer Karlin, MD, PhD Associate Professor, Department of Family & Community Medicine, University of California, San Francisco School of Medicine Project Principal Investigator, National Clinician Consultation Center, Medical Consultant for the CA Family PACT Program, California Prevention Training Center Associate Editor, Annals of Family Medicine
Michael Policar, MD, MPH Professor Emeritus, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco School of Medicine Clinical Fellow, National Family Planning and Reproductive Health Association (NFPRHA)
Transgender and gender diverse (TGD) people represent a growing subset of patient populations, yet many continue to report a lack of provider knowledge when it comes to TGD health. This session will build on TGD health terminology and competency essentials presented in Part 1, Chosen Family: Contraception for Transgender and Gender Diverse People, by reviewing evidence-based recommendations for contraception, fertility, and family-building counseling.
Learning Objectives:
Describe three new pieces of data that providers can incorporate into their counseling for patients initiating testosterone gender-affirming hormone therapy.
Identify two aspects of contraceptive counseling that providers can incorporate into the care of patients initiating estrogen gender-affirming hormone therapy.
Explain existing data on fertility and gender-affirming hormone therapy and how this data can inform their decision-making for patients and families.
Speakers:
Chance Krempasky FNP-BC, WHNP-BC, AAHIVS Director of Medicine and Director of Education at the Community Healthcare Network in New York City. Providing care for the LGBTQIA+ communities for the past 15 years. Lead author of “Chapter 22: Contraception for Lesbian, Gay, Bisexual, Transgender, Gender Diverse, Queer/Questioning, Intersex, and Asexual Individuals” in the 22nd Edition of Contraceptive Technology.
Miles Harris FNP-BC, AAHIVS Trans and nonbinary-identified family nurse practitioner and the Director of Gender-Affirming Care for UC Davis Health. Assistant Clinical Professor at the UC Davis Betty Irene Moore School of Nursing. Published in The American Journal of Obstetrics and Gynecology and The Nurse Practitioner, as well as textbooks including Pharmacotherapeutics for Advanced Practice Nurse Prescribers and the 22nd Edition of Contraceptive Technology.
This webinar explains why contraception is a vital component of health care for clients and their families. Learn how to proactively address contraception stigma and misinformation and how to advocate for contraceptive access among your colleagues, clients, and community.
Learning Objectives:
Reproductive life planning in the United States
Person-centered counseling
Benefits versus risks of contraception
Responding to patient concerns
Speaker:
Carrie Cwiak, MD, MPH, FACOG Chief of the Obstetrics and Gynecology Inpatient Service Line for Emory Healthcare and Vice Chair of Quality for the Department of Gynecology and Obstetrics. Director of the Complex Family Planning Fellowship. Active in training, speaking, and writing to educate trainees and providers; advocating for the people of Georgia; and collaborating in research.
Transgender and gender diverse (TGD) people represent a growing subset of patient populations, yet many continue to report a lack of provider knowledge when it comes to TGD health. This session will build on TGD health terminology and competency essentials by reviewing evidence-based recommendations for contraceptive counseling.
Learning Objectives:
List 5 terms related to gender-inclusive sexual and reproductive health.
Describe barriers faced by TGD people seeking contraception.
Give examples of contraceptive considerations for TGD people.
Discuss available contraceptives for TGD people.
Speakers:
Chance Krempasky FNP-BC, WHNP-BC, AAHIVS Associate Director of Medicine- Education at Callen Lorde Community Health Center in New York City. Professor of Clinical Nursing at Columbia University School of Nursing, in the Certificate in Professional Achievement in TGNB Health Care Program. Lead author of “Chapter 22: Contraception for Lesbian, Gay, Bisexual, Transgender, Gender Diverse, Queer/Questioning, Intersex, and Asexual Individuals” in the 22nd Edition of Contraceptive Technology.
Miles Harris FNP-BC, AAHIVS Trans and nonbinary-identified family nurse practitioner and the Director of Gender-Affirming Care for UC Davis Health. Assistant Clinical Professor at the UC Davis Betty Irene Moore School of Nursing. Published in The American Journal of Obstetrics and Gynecology and The Nurse Practitioner, as well as textbooks including Pharmacotherapeutics for Advanced Practice Nurse Prescribers and 22nd Edition of Contraceptive Technology.
Many patients report that their intrauterine device (IUD) placement was uneventful and relatively comfortable. Others describe the experience as the worst pain of their life. We can’t predict which patients will experience severe anxiety, pain, or trauma from IUD placement or removal. However, what we can do is universally address the potential for pain and anxiety with counseling and diverse management strategies. Data now confirms the effectiveness of cervical blocks and a variety of pharmacologic and non-pharmacologic management strategies to mitigate against potential pain and anxiety with IUD placement and removal.
Learning Objectives:
List 3 non-pharmacologic interventions designed to prevent pain with IUD placement.
Demonstrate anticipatory guidance for vasovagal prevention.
Describe the evidence for providing a cervical block to reduce pain with IUD placement.
Speakers:
Joely Pritzker, MS, FNP-C Nurse Practitioner at Vista Community Clinic National Trainer for Envision SRH & the PATH Framework Sexual and Reproductive Health Trainer and Consultant Contributing author for the 22nd Edition of Contraceptive Technology
Patty Cason, RN, MS, FNP-BC Assistant Clinical Professor UCLA School of Nursing President, Envision SRH
Trauma, including Adverse Childhood Experiences (ACEs), interpersonal violence (IPV), and sexual assault have significant impacts on health outcomes, and are common among people seeking family planning services. Trauma affects sexual and reproductive health, pregnancy, and mental health, making it important for clinicians to address trauma when providing family planning services. In this webinar, we will discuss the Trauma and Resilience-informed Inquiry for Adversity, Distress, and Strengths (TRIADS) framework and ways this may be useful to family planning clinicians. Using case studies, we will describe how the TRIADS framework establishes a foundation of empathy, respect, and compassion; thereby increasing engagement in care and improving health outcomes in patients seeking family planning services.
Learning Objectives
Describe the TRIADS framework and the importance of highlighting resiliency and strengths when discussing trauma, adversity, and distress
Apply the TRIADS framework to a family planning clinical case
Screen for and respond to trauma in family planning settings
Speakers:
Megha Shankar, MD Assistant Professor of Medicine, UC San Diego Clinical and academic work focusing on elevating the health of women and gender diverse individuals through trauma-informed care, promoting reproductive and racial justice, and addressing gender-based violence Practices primary care in San Diego, serving patients seeking asylum at the US-Mexico border
Kelsey Loeliger, MD, PhD Complex Family Planning Fellow, UC San Diego Goals in research and advocacy include addressing healthcare, substance use disorders, incarceration, mental health, and interpersonal violence and trauma Seeks to better understand the impact of contraception use on gender dysphoria in gender-diverse individuals
This presentation will provide an overview of the laws that impact minors and their access to confidential sexual health and family planning services in California. It will review important exceptions to confidentiality, including mandated child abuse reporting, and share some examples of best practices for implementation in difficult situations. Participants will learn about resources to support implementation of minor consent laws and be given an opportunity to test their own knowledge through case studies.
Learning Objectives:
Identify when minors in California may consent to their own sexual health care under federal and state law
Determine the confidentiality and information sharing obligations that apply when minors seek sexual health care services
Describe approaches to implement the basic tenets of inclusive, respectful, and empowering health care provision in line with consent and confidentiality
Identify resources for keeping up-to-date with law and best practices related to consent and confidentiality for adolescent health services in California
Speaker:
Rebecca Gudeman, J.D., M.P.A. Attorney and Senior Director of Health at the National Center for Youth Law Leading national expert in multiple areas with over 30 years experience Launched Reproductive Health Equity Project for Foster Youth in 2016
Exposure to abuse, neglect, discrimination, violence, and other adverse experiences can greatly impact a person’s health for the long term and the way they interact with the healthcare system especially when it comes to family planning services. Because of the potentially long-lasting negative impact of trauma on physical and mental health, it’s important for providers to understand and incorporate trauma-informed approaches to care into their practice.
Trauma-informed care acknowledges the need to understand a client’s life experiences to deliver effective care and has the potential to improve patient engagement, treatment adherence, and health outcomes. This webinar will go over strategies for integrating trauma-informed practices into reproductive health services.
Learning Objectives:
Define various types of traumas frequently experienced by people accessing reproductive health services
Identify trauma-informed practices that can be used in clinical settings
Describe the role of self-care and team-based care in providing trauma-informed services
Speaker:
Dominika Seidman, MD, MAS OBGYN and associate professor at San Francisco General Hospital Co-founded Team Lily, a trauma-informed, multidisciplinary care team providing wrap-around services to pregnant people Provides reproductive health services at the San Francisco County Jail
According to the National Survey of Family Growth, approximately 12% of “women of childbearing age” have a disability, and yet our educational and training programs devote little to no time in preparing us to provide accessible, appropriate, quality services to these populations. This webinar will define the population, identify the sexual and reproductive health needs, barriers to health care and health care disparities for people with disabilities, and present best practices for providing accessible, equitable sexual and reproductive health care for people with disabilities. This webinar will also discuss actionable items providers can immediately implement in their practices to make them disability accessible.
Learning Objectives:
Develop an inclusive definition of the populations that comprise people with disabilities
Identify sexual and reproductive health needs, barriers to health care and healthcare disparities for people with disabilities
Outline best practices for providing sexual and reproductive health care for people with disabilities
Identify concrete actions providers can take to improve access to and quality of sexual and reproductive health care for people with disabilities
Become knowledgeable on language, culture, and medical equipment suggestions
Speakers:
Erica Monasterio, MN, FNP-BC-Retired Clinical Professor Emerita at University of California, San Francisco 35 years of clinical experience in primary care for youth and families at UCSF and the San Francisco Department of Public Health Works in collaborations with organizations at the local, state, and national level providing training and technical assistance
Robin Wilson-Beattie, B.A Disability Sexual and Reproductive Health Educator Certified by the American Board of Sexology and City College of San Francisco as a Sexual Health Educator Member of the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the Women of Color Sexual Health Network (WOCSHN), and a graduate of the San Francisco Sexuality Information Training (SFSI) Sex Educator Training Speaker, writer, and advocated for disability and sexuality
This webinar is presented by Gayge Maggio, FNP-BC, AAHIVS and will focus on the reproductive and sexual health needs/considerations of transgender and gender non-conforming people. There will be a focus on learning to approach sexual health in a culturally sensitive, non-judgmental manner and how to deliver family planning needs and contraceptive options for patients who identified as transgender and/or non-binary.
Learning Objectives:
Discuss and perform a culturally sensitive sexual health inventory with transgender patients
Describe how to provide culturally sensitive, trauma-informed cervical cancer screening and the impact of testosterone on testing
Discuss options for contraception in assigned female at birth transgender and gender non-conforming patients
Speaker:
Gayge Maggio (She/They) FNP-BC, AAHIVS Nurse practitioner at Callen-Lorde Community Health Center in New York City She also works in the FlexCare program, providing walk-in primary care to patients
