Description 

Supporting reproductive health needs of our patients is crucial in the light of the recent overturn of Roe v. Wade. Half of pregnancies in the US are unintended and ‘The most effective way to reduce abortion rates is to prevent unintended pregnancy by improving access to consistent, effective, and affordable contraception’. Patients with mental health, substance use or intellectual/developmental disorders have high rates of unintended pregnancies, higher pregnancy complication risk, and greater maternal morbidity/mortality, making prevention of unwanted pregnancies of paramount importance. Access concerns prevent our more vulnerable patients from connecting to expedient care with Ob-gyn or family practice/internal medicine to address their contraceptive and reproductive health needs. Scope of practice concerns have been raised about psychiatrist prescribing of contraception and many feel inadequately trained in this area. However, in recent years, pharmacists have expanded their scope of practice to include prescribing oral contraceptives without medical oversight in 20 jurisdictions. Psychiatric residency training on adequate contraception, reproductive life plans and reproductive justice is limited. This presentation reviews One Key Question® (OKQ), a standardized screen to open the conversation around reproductive health, to systematically identify reproductive health needs in clinical practice settings. With an affirmative answer, a psychiatrist would be encouraged to provide preconceptual counseling on various aspects of health, medication review, review of substance use and mental health concerns that may impact a fetus or pregnant person and should trigger a referral to Ob-Gyn or other primary care physicians for preconceptual counseling. A negative answer should trigger conversations around contraceptive planning/options, and possible initial prescription of contraceptive vs. deferral to PCP/Ob-Gyn for initiation, when appropriate.   Psychiatrists in practice should have adequate education and information on best practices in contraception counseling/prescribing and reproductive rights. This presentation includes education of audience members by an Ob-gyn on initiating appropriate contraception when indicated, to help improve skills/confidence of psychiatrists. Given limitations for many of our patient on primary care or Ob-gyn access, providing these patients with contraceptive care in a psychiatric setting follows ethical principles of equity in broadening access to a potentially life-saving treatment. Subsequent participant training can be supported with use of portable/online curricula such as UCSF’s Beyond the Pill or the CDC mobile phone app MEC (Medical Eligibility Criteria), both of which will be introduced to audience members. Right now is the time to ensure that we, as psychiatrists, are fully prepared to engage in discussion, planning and supports for our patients as they navigate their reproductive health needs.

Format 

Recorded webinar.

This content was recorded during the APA 2023 Annual Meeting.

Learning Objectives 

1. Identify and describe most common oral and long-acting contraceptives, medical eligibility considerations for different contraceptive options
2. Demonstrate use of ‘One Key Question’ in patient engagement with patients with behavioral health or substance use conditions in conversations about their reproductive life plans
3. Initiate suitable contraception when applicable and provide patients' education related to adherence and efficacy, as well as develop a plan for referral for continued contract
4. Discuss educational options for integration of reproductive health curriculum into psychiatry resident training
5. Describe basics of reproductive rights/reproductive justice and the role of psychiatrists in reproductive needs of patients

Target Audience 

Residents/Fellows, Psychiatrists, Psychologists

Estimate Time to Complete 

Estimated Duration: 1.5 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028

How to Earn Credit 

Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit  

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

The APA designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity. 

Instructors 

• S. Therese Garrett, MD, FAPA
• Camila Arnaudo, MD
• Mary Morreale, MD, FAPA
• Katheryn Gunnison, MD, FACOG

Planners  

• Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 
• Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 
• Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance