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Latebreakers

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm

Ambivalence

Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative

Applying the “New” Cervical Cytology Guidelines in Your Practice

Acute Excessive Uterine Bleeding: New Management Strategies

Medical indications for IUD use in teens

Whatever happened to PID?

Update on Emergency Contraception

Contraceptivetechnology.com New and Improved

Zika: Updated guidance for providers
October 2016

 

Our empirical understanding of Zika virus is rapidly evolving. This can present challenges for us as clinicians: to stay abreast of the changes and facilitate understanding and clarify implications for our patients.

Zika virus was discovered over 50 years ago, and there have been outbreaks before. However, the current global epidemic is the largest and most far-reaching to date. Currently, there are approximately 60 countries with Zika activity.  Most affected countries are in the Americas; Oceana has the next highest number of countries with current local transmission.

Certainly, the implications for pregnant women are most concerning and can result in severe fetal birth defects.  Our counseling for pregnant women is very clear: avoid travel to areas with local transmission of Zika, avoid sexual exposure from partners who may have traveled and take steps to avoid mosquito bites. However, most women aren’t currently pregnant. The message to we give to them must be as clear, and this is where family planning takes a central role. These messages are particularly important when we consider that still nearly half of pregnancies are unintended. The office of population affairs, OPA, has created a toolkit for providers that provides guidance about contraceptive counseling using the principles outlined in QFP modified for the local Zika context (https://www.hhs.gov/opa/pdfs/zikatoolkit.pdf).  Recommendations include first assessing a woman’s reproductive goals, then assessing her risk of Zika exposure, and finally working collaboratively with the knowledge of her goals and potential risks to determine a plan that will work best for her.  Ultimately, our goal as family planners is similar to what it has always been: to provide women with the tools they need to reach their reproductive health goals.  The difference is that now the threat for additional negative outcomes in the face of an unintended pregnancy are amplified.

Though cooler months are approaching and our local mosquito transmission may be slowing here in the US.  However, the mosquito that transmits the virus lives in tropical and sub-tropical climates and is still at threat around the globe. We do not know how long this epidemic will last in the US and abroad, so this conversation must continue. Providers should connect to their local health departments to be aware of risk of local transmission. The CDC has a Zika widget (http://www.cdc.gov/widgets/zika/index.html) that can be downloaded to office desktops or practice websites that will provide the up-to-date information on the epidemic. ACOG also has a Zika page that has current recommendations for evaluation and management in pregnancy as well as prevention through family planning (http://www.acog.org/About-ACOG/ACOG-Departments/Zika-Virus).

Feel free to reproduce the following two infographics for patients developed by the CDC, also available through these links: Zika: Plan Your Pregnancy and Zika: What We Know and What We Don’t.

Zika-thinking-about-having-a-baby Zika-what-we-know

Melissa Kottke, MD, MPH, MBA, Director, Jane Fonda Center Associate Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta GA