Inaction Despite Motivation: Assessing Systemic and Personal Barriers to Pediatricians' Post-Dobbs Emergency Contraception Utilization. J Pediatr Adolesc Gynecol 2025 Aug;38(4):504-508
Date
03/20/2025Pubmed ID
40107408DOI
10.1016/j.jpag.2025.03.006Scopus ID
2-s2.0-105005651273 (requires institutional sign-in at Scopus site) 1 CitationAbstract
PURPOSE: Following the US Supreme Court's Dobbs vs Jackson Women's Health (Dobbs) decision and subsequent changes to abortion access, increasing emergency contraception (EC) access for adolescents is vital. The first step is understanding providers' knowledge, attitude and practices regarding EC post-Dobbs.
METHODS: This cross-sectional internet-based survey was sent to providers within 3 general pediatric primary care systems from November 2023 to January 2024. Questions addressed EC knowledge, attitudes (perceived barriers and desired support to increase EC prescription) and practices post-Dobbs.
RESULTS: There were 51 participants. Most (81%) providers felt adolescent EC prescription was more important post-Dobbs, but very few (7%) had increased their own prescribing practices. Overall, providers had a mean knowledge score of 71%. Providers closer to training had a higher EC knowledge score (77% vs 68%, P = .02), as did providers who were generally willing to provide EC (72% vs 58%, P = .004). Providers in urban and rural areas were more likely to have prescribed EC than suburban counterparts (54% urban, 40% rural, 16% suburban, P = .04). Various barriers were elicited, most commonly relating to lack of awareness and knowledge about EC. Over half of respondents noted they would be more likely to prescribe EC with clinical decision support built into the EMR (69%), an order set in the electronic medical record (57%), and education sessions (55%).
DISCUSSION: This study highlights a strong need to bolster provider EC education in pediatrics and address systems factors that will facilitate easier, more confident EC prescription.
Author List
Hovel E, Pickett M, Visotcky A, Porada K, Ehrman W, Thew M, McFadden VAuthors
Elizabeth Hovel MD Assistant Professor in the Pediatrics department at Medical College of WisconsinVanessa Mcfadden MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michelle L. Pickett MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Alexis M. Visotcky Program Director I in the Center for International Blood and Marrow Transplant Research department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Attitude of Health Personnel
Contraception, Postcoital
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Male
Motivation
Pediatricians
Practice Patterns, Physicians'
Surveys and Questionnaires
United States
