Now Erika Levi talking about an study of immediate postpartum contraceptive implant placement and breastfeeding outcomes. #SFP2022
The study was a single arm non inferiority design. Inclusion criteria:
- Desire for implant
- >14 years old
- Live birth >24w
- English or Spanish speaking
The primary measure was "Has your milk come in?"

Primary lactation failure define as a patient who answered the primary measure NO for 5 days postpartum.

#SFP2022
For people discharged, they followed them by text or phone in the immediate postpartum period. They also followed up at 3 and 6 months postpartum.

#SFP2022
50% who declined participation did so because they had strong opinions about when they got their implant and did NOT want to be randomized and possibly not receive the implant prior to hospital discharge.

#SFP2022
The study controlled for risk factors for low milk supply including
- Diabetes
- Obesity
- Gestational age at delivery / Premature delivery
- PCOS
- History of difficulty with milk supply

#SFP2022
CONCLUSIONS:
- The primary time to lactogenesis was 68 hours.
- There were 6 primary lactation failures
- There was NO difference between lactogenesis between groups
- Participants were very satisfied with the implant across study groups
#SFP2022
This study came out of competing hospital goals: achieving #BabyFriendly hospital status and implementing access to immediate postpartum LARC. There was conflict between #IBCLC groups and #FamilyPlanning about the earlier mixed data on Nexplanon + lactogenesis

#SFP2022
Audience: Is it ethical to randomize someone to a delayed LARC placement?

Dr. Ralph: Excellent point, which is why the study was transparent & why people for whom outpatient Nexplanon was perceived as high risk declined to participate (& got a LARC prior to discharge)

#SFP2022
I am so impressed that there are several lactation consultants in the audience and attending SFP. I learned so much at #ABM2022 this year and hope for more collaboration between @BFMedicine and @SocietyFP in the future!

#SFP2022

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More from @abbyliberty1

Dec 5
Closing with the session: Collateral Damage: Graduate Medical Education in Post-Dobbs US

#SFP2022
Where you train is where you work. Half of physicians stay in the states where they do their residency, so there is unlikely to be spontaneous sharing of abortion knowledge across communities. Healthcare inequities will continue to rise.

#SFP2022

states.guttmacher.org/policies/
While this panel will focus on medical specialities, including OBGYNS and FM residents who are some of the most diverse subspecialties, there are so many trainees impacted by abortion restrictions including @ACNMmidwives and @GeneticCouns not to mention Pediatric and EM

#SFP2022
Read 38 tweets
Dec 5
Next up: Is less more? A critical appraisal of medication abortion follow up with @VitalaGlobal @uoftobgyn @Stanford @Gynuity @UTAustin and Alamo Women's Health Clinic in Albuquerque

#SFP2022
Mifepristone approval/access has grown in so many ways:
- Globally access improved
- Indications for use expanded
- Methods of delivery expanding (telemedicine, meds by mail)

#SFP2022 Image
In Europe, Germany had the lowest uptake of medication abortion. This might be due to low reimbursement for simple and safe care in Germany and medication abortion is so safe!

#SFP2022
Read 26 tweets
Dec 4
Patient Confidentiality as a Reproductive Justice Issue session by @prhdocs and @ifwhenhow

#SFP2022
Speaker Alejandra Pablos shares her story #KeepAleFree and encourages others to do so too through @AbortionStories. She says her story of fighting deportation, being detained and says that fighting for abortion rights are an intuitive extension of her goals and values.

#SFP2022 Image
Dr. Perritt @Reprorightsdoc encourages the audience to center on their own positionality. We focus on disclosures in medicine, but positionality - where we grew up, who we are, how the world sees us - are probably more important in framing our actions.

#SFP2022
Read 31 tweets
Dec 3
Today's closing session is entitled Hablamos Español: Why Language & Culture Matters in Family Planning

#SFP2022
Speakers are from @PPFA where they lead the strategy and content that aims to to increase inclusivity and culturally appropriate care among Spanish speaking populations

#SFP2022
They recognize that this is a HUGE task because of the immense diversity among Latinx populations. However, they report that language can be unifying across these cultural differences.

#SFP2022
Read 24 tweets
Dec 3
Kyle Latack, MD from @UMichOBGYN_Res speaking about Copper v Hormonal IUD breakage reporting with the @US_FDA Adverse Event Registry

#SFP2022
@UMichOBGYN_Res @US_FDA Reports of IUD breakage is increasingly common in the media.

#SFP2022
They found 170,215 events of which 6,284 represented mechanical breakdown or breakage reports.

These were more frequent among copper IUD with an OR 6.19.

#SFP2022
Read 18 tweets
Dec 3
Now Ci'erra Larsen of @EmoryRollins speaking on Barriers to Abortion Access for Young Southerns: A Qualitative Analysis of @ARC_Southeast

#SFP2022
**TRIGGER WARNING FOR UPCOMING CONTENT**

Young people reported financial barriers and overcame these with:
- Selling possessions
- Formal and informal loans
- Short term employment

#SFP2022
Young people also reported
- Exhausted social networks for support
- Privacy concerns
- Threats to personal safety

They also reported fear of family separation secondary to their pursuit of healthcare triggering ICE involvement.

#SFP2022
Read 6 tweets

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