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Self-managed Medication Abortion in the United States

Jung, Christina; Nippita, Siripanth
Self-managed abortion (SMA) is ending a pregnancy without medical supervision, either by obtaining medications (known as self-managed medication abortion) or through other means. Many factors influence a person's decision to pursue self-managed abortion, such as time constraints, financial considerations, and local availability of abortion services. We present on the prevalence, methods and best practices for clinicians in the United States who may interface with individuals undergoing self-managed medication abortion at any point in the process through a harm reduction approach.
PMID: 37750672
ISSN: 1532-5520
CID: 5606592

Abortion Care in the United States — Current Evidence and Future Directions

Jung, Christina; Oviedo, Johana; Nippita, Siripanth
ORIGINAL:0017078
ISSN: 0012-3692
CID: 5573462

Avoiding unintended pregnancy during transition from copper intrauterine device to etonogestrel contraceptive implant: A case report [Case Report]

Sulger, Elisabeth; Jung, Christina; Nippita, Siripanth
We present a patient who experienced an unintended pregnancy after transitioning from the copper intrauterine device to the etonogestrel subdermal implant. When switching from contraceptive methods that do not reliably suppress ovulation, clinicians should consider backup contraception and additional counseling, depending on the specific timing of removal.
PMID: 37257551
ISSN: 1879-0518
CID: 5536632

Abortion Care in the United States - Current Evidence and Future Directions

Jung, Christina; Oviedo, Johana; Nippita, Siripanth
Abortion Care in the United StatesAbortion services are a vital component of reproductive health care. Jung and colleagues review medication abortion and procedural abortion as well as implications of increasing restrictions on access in the United States.
PMID: 38320010
ISSN: 2766-5526
CID: 5632542

Private Conversations, Public Debate [Comment]

Nippita, Siripanth; Jung, Christina; Oviedo, Johana D; Quinn, Gwendolyn P
PMID: 35917426
ISSN: 1536-0075
CID: 5287672

Society of Family Planning Annual Meeting 2021 [Editorial]

Madden, Tessa; Benfield, Nerys; Dempsey, Angela; Gariepy, Aileen; Haider, Sadia; Kavanaugh, Megan; Agbemenu, Kafuli; Anguzu, Ronald; Ariyo, Tosin; Arora, Kavita; Baden, Kelly; Bamberger, Debbie; Bartz, Deborah; Behonick, Dani; Belmonte, Michael; Borgatta, Lynn; Brakman, Anita; Brandi, Kristyn; Bullock, Holly; Cansino, Catherine; Castaño, Paula; Chen, Beatrice; Cook, Elizabeth; Creinin, Mitchell; Diener, Zoe; Dodge, Laura; Dzuba, Ilana; Ellison, Jacqueline; Espey, Eve; Fitzgerald, Kelly; Flink-Bochacki, Rachel; Foster, Angel; Gallo, Maria; Gawron, Lori; Goyal, Vinita; Herold, Steph; Heyrana, Katrina; Jones, Rachel; Kumar, Bhavik; Lampton, Danielle; Lazorwitz, Aaron; Lerma, Klaira; Lindahl, Sarah; Lorange, Ellen; Maldonado, Lisa; Mansbach, Daniela; Mengesha, Biftu; Nattell, Noah; Nelson, Anita; Newcomer, Susan; Nippita, Siripanth; Opper, Neisha; Platt, Catherine; Poitras, Elizabeth; Prager, Sarah; Ramanadhan, Shaalini; Redd, Sara; Rible, Radhika; Rocca, Corinne; Romer, Sarah; Senderowicz, Leigh; Sheeder, Jeanelle; Shorter, Jade; Siddiqui, Ayesha; Skracic, Izidora; Smith, Nicole; Srinivasulu, Silpa; Thompson, Ivana; Vickery, Zevidah; Warsh, Sarah; Wells, Rebecca; Winikoff, Beverly; Ye, Peggy
These scientific abstracts are scheduled for presentation at the 2021 Society of Family Planning Annual Meeting. This year, 225 abstracts were submitted for consideration, of which 12 were selected for oral presentation and 84 were selected for poster presentation. The scientific abstract review was completed by the scientific reviewers and selectors.
PMID: 34289414
ISSN: 1879-0518
CID: 4948352

Funic potassium chloride injection during intact dilation and evacuation

Nippita, Siripanth; Carranza, Ana Sofia Ore; Paul, Maureen E
OBJECTIVE:To describe effectiveness of funic potassium chloride (KCl) injection for fetal demise during intact dilation and evacuation (D&E). STUDY DESIGN/METHODS:We abstracted medical records of patients who underwent standard or intact D&E to identify those who had intact D&E from 20 weeks 0 days through 23 weeks 6 days from February 2016 to August 2017 at one academic center. We extracted data on time to asystole following KCl injection, as well as incidents including hemorrhage, infection, uterine perforation, and unplanned admissions for up to six months following each procedure. RESULTS:Of 57 procedures, 32 (56%) were intact. Median time from KCl injection to fetal asystole was 48 seconds (interquartile range [IQR] 34-100). Median time to asystole at weeks 20 and 21 (46 seconds [IQR 34-60 seconds]) did not differ significantly from weeks 22 and 23 (85 seconds [IQR 34-200 seconds]), p=0.15. Asystole occurred in less than four minutes in all cases but one. No adverse events occurred with either the funic KCl injections or the intact D&E procedures. CONCLUSION/CONCLUSIONS:Funic KCl injection for intact D&E usually causes fetal asystole in less than four minutes.
PMID: 33831443
ISSN: 1879-0518
CID: 4839542

Long-term effects of teamwork training on communication and teamwork climate in ambulatory reproductive health care

Dodge, Laura E; Nippita, Siripanth; Hacker, Michele R; Intondi, Evelyn M; Ozcelik, Guzey; Paul, Maureen E
BACKGROUND:We previously reported an association between team training in the ambulatory setting and improvements in team climate at 6 and 12 months, but it is unknown whether improvements persist at 2 years. STUDY DESIGN/METHODS:Teamwork Perceptions Questionnaire (T-TPQ), and the Patients' Insights and Views of Teamwork (PIVOT) survey. RESULTS:implementation was associated with improved perceptions of teamwork in approximately half (49%) of statements at 2 years. Significant improvements occurred in over half of PIVOT survey statements, and patient satisfaction was significantly greater at 2 years compared to baseline. CONCLUSIONS:implementation in ambulatory reproductive health care centers, demonstrating positive long-term effects of teamwork training.
PMID: 32761729
ISSN: 2040-0861
CID: 4554322

Examining the impact of federal regulations on abortion research in the United States: An exploratory, qualitative study

Verma, Nisha; Nippita, Siripanth; Paul, Maureen E; Dodge, Laura E
OBJECTIVES/OBJECTIVE:We aimed to identify and characterize barriers faced by researchers studying abortion in academic medical centers in the United States (US). We specifically focused on regulatory restrictions on abortion research related to institutional review board (IRB) or research ethics committee interpretations of Subpart B of the 2001 Code of Federal Regulations, which states that researchers cannot take part in decisions involving the timing, method, or procedures used to terminate a pregnancy. We aimed to document investigators' experiences obtaining approval from their IRBs and to identify obstacles that prevent investigators from generating evidence related to abortion care. STUDY DESIGN/METHODS:We conducted semi-structured telephone interviews with family planning researchers at 15 US academic institutions across the country. We coded transcripts using an iterative process, and analyzed the data for content and themes. RESULTS:Interviewees reported significant variations in the way that IRBs at their institutions applied federal regulations to abortion research. At several institutions, the regulations represented barriers to conducting abortion research and discouraged some investigators from conducting such research altogether. At other institutions, interviewees did not face significant barriers related to their IRB's interpretation of Subpart B. Many interviewees discussed creating and maintaining positive professional relationships with members of their IRB as a way to overcome barriers and successfully conduct abortion research. CONCLUSIONS:Our study suggests that IRBs interpret Subpart B in varying ways. At some institutions, this creates barriers to conducting abortion research. However, abortion researchers have also found ways to navigate these challenges successfully.
PMID: 33428905
ISSN: 1879-0518
CID: 4746542

Best practices for collecting repeated measures data using text messages

Shimoni, Noa'a; Nippita, Siripanth; Castaño, Paula M
BACKGROUND:Researchers and clinicians use text messages to collect data with the advantage of real time capture when compared with standard data collection methods. This article reviews project setup and management for successfully collecting patient-reported data through text messages. METHODS:We review our experience enrolling over 2600 participants in six clinical trials that used text messages to relay information or collect data. We also reviewed the literature on text messages used for repeated data collection. We classify recommendations according to common themes: the text message, the data submitted and the phone used. RESULTS:We present lessons learned and discuss how to create text message content, select a data collection platform with practical features, manage the data thoughtfully and consistently, and work with patients, participants and their phones to protect privacy. Researchers and clinicians should design text messages to include short, simple prompts and answer choices. They should decide whether and when to send reminders if participants do not respond and set parameters regarding when and how often to contact patients for missing data. Data collection platforms send, receive, and store messages. They can validate responses and send error messages. Researchers should develop a protocol to append and correct data in order to improve consistency with data handling. At the time of enrollment, researchers should ensure that participants can receive and respond to messages. Researchers should address privacy concerns and plan for service interruptions by obtaining alternate participant contact information and providing participants with a backup data collection method. CONCLUSIONS:Careful planning and execution can reward clinicians and investigators with complete, timely and accurate data sets.
PMID: 31900108
ISSN: 1471-2288
CID: 4252622