veteran

What happens to Veterans who become pregnant when using contraception?

In a study published by the Journal of Women's Health, CONVERGE's Drs. Chang, Callegari, Borrero, and Quinn found that these pregnancies are more likely to end in an abortion than live birth. Given widespread reproductive health restrictions across the US, ensuring Veterans' access to comprehensive health care, including abortion, is critical to supporting reproductive autonomy and whole health.

Dr. Lisa Callegari and her team looked at the variation in provision of long-acting reversible contraceptive (LARC) method across Veteran Affairs facilities. They found substantial variation in LARC provision with less frequency at rural facilities.

Read more about their findings here: https://pubmed.ncbi.nlm.nih.gov/37340270/

National Veteran Affairs guidance recommends regular assessment of reproductive goals at primary care visits. However, Drs. Quinn, Borrero, and Callegari found that fewer than half (44%) of pregnancy capable veterans reported receiving any reproductive health services (i.e., contraceptive services, pre-pregnancy counseling or both) from a VA primary care provider in the last year. In this article the team discusses the femtech tool MyPath as a way to promote patient-centered conversations about reproductive goals and needs for services.

Integration of reproductive health services into primary care is a strategy to address service gaps and improve patient-centered care. This study assessed receipt of contraceptive and pre-pregnancy health counseling among pregnancy-capable Veterans within VA primary care.

Dr. Lisa Callegari and her team looked at uterine weight as a modifier of Black/white racial disparities in minimally invasive hysterectomies among Veterans with fibroids in the VHA. They found that to eliminate disparities in minimally invasive hysterectomies, research focused on experiences of black Veterans, including pathways to treatment and provider-patient interactions, is needed.

Drs. Lisa Callegari and Sonya Borrero are evaluating MyPath in VA primary care to increase the quality and person-centeredness of reproductive health care delivery in primary care.

Drs. Lisa Callegari and Sonya Borrero led a cross sectional study to understand the perceived quality of contraceptive counseling in the VA primary care and assess factors associated with perceived high- and low-quality contraceptive counseling. Based on their findings, more opportunities exist to improve the quality of contraceptive counseling, including more consistent efforts to seek patients' perspectives with respect to contraceptive decisions.

In their recent JAMA article, Lisa Callegari and Sonya Borrero discuss how Veteran Affair’s move to provide abortion in cases of rape, incest, and life/health endangerment, recognizing abortion as an essential health service for Veterans.

Deirdre Quinn, PhD, MSc is one of VHA Shark Tank's finalists! Her promising practice, Contraception on Demand (COD) offers VA facilities the opportunity to expand contraceptive access for Veterans, improve Veteran experiences with reproductive healthcare at VA, and expand VA clinical pharmacists' scope of practice and job satisfaction. The practice is easy to adopt and implement and is achievable at very low cost to the individual facility and an estimated cost savings for the health system at large.

Learn more here: https://marketplace.va.gov/innovations/contraception-on-demand