Contraceptive Use and Pregnancy Risk_Elizabeth Feldman Elizabeth Feldman, MD Kathleen Talamayan, MD, MPH Cermak Health Services of Cook County

Elizabeth Feldman, MD Kathleen Talamayan, MD, MPH Cermak Health Services of Cook County Linda Forst, MD, MPH University of Illinois at Chicago Acknowledgments ● Adina Goldberger, MS2, Miranda Hart, MD, and Rose Kiken, BSN served as research assistants ● Carolyn Sufrin, MD for her 2010 NCCHC presentation and willingness to permit us to adapt her survey instrument Cook County Department of Corrections Case ● 37 yo G4P2002 c/o opioid withdrawal ● Multiple arrests for retail theft, PCS, prostitution ● Unprotected vaginal intercourse in previous 5 days ● Never used hormonal contraception ●+GC dx last incarceration ●+ regular tobacco use, + 3-4 bags intranasal heroin/d ● Urine HCG negative Background ● Women represent the fastest growing prison population (Greenfield and Snell,1999, Staton et al, 2003) ● Incarcerated women are underserved and socioeconomically disadvantaged (Covington,2007) ● This population has reduced access to and utilization of family planning services (US DHHS) Background ● In the US, 39m women are at risk for unplanned pregnancy (Clark et al, 2006a) ● Of those women at risk for unplanned pregnancy, 67% report inconsistent use of birth control (Clark et al, 2006a) ● Despite OTC availability, emergency contraception (EC) is underutilized (Devine,2012) ● Only 4% of women ages 15-44 who have ever had sexual intercourse have used EC (CDC, 2005) ...............................................continued......................................................