Semin Reprod Med 2019; 37(01): 024-031
DOI: 10.1055/s-0039-1692201
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contraceptive Care in the Veterans Health Administration

Emmanuelle B. Yecies
1  Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2  VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
,
Colleen P. Judge-Golden
3  University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Lisa Callegari
4  Seattle-Denver Center of Innovation for Veteran-Centered and Value-Drive Care, VA Health Services Research and Development, Seattle, Washington
5  Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington
6  Department of Health Services, University of Washington School of Public Health, Seattle, Washington
,
Sonya Borrero
1  Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2  VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
7  Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
11 June 2019 (online)

Abstract

In recent years, the number of women Veterans obtaining care in the Veterans Affairs (VA) Healthcare System has grown, expanding the need for provision of contraceptive care. Women Veterans are a diverse group of women with complex sociodemographic and medical backgrounds, and meeting their needs presents a unique challenge for VA. Efforts including the establishment of comprehensive women's health clinics and training practitioners in women's health have greatly improved healthcare services for women Veterans over the last few decades. Recent data from a large cross-sectional survey study suggest that contraceptive use in VA is similar to the general population and that rates of unintended pregnancy, while still significant, are not higher than that in the general population. Subgroup analyses of this survey data, however, suggest that ongoing efforts are needed to improve outcomes in vulnerable subpopulations of women Veterans, particularly ethnic/racial minorities and Veterans with complex medical backgrounds. Policy changes such as the elimination of copayments for contraceptive prescriptions and the dispensing of more months of contraceptive supply are evidence-based starting points for improvements, in addition to leveraging VA's integrated system and research infrastructure to improve patient-centered counseling and contraceptive access.

Note

The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the VA.


Disclosure

C.J-G. is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR001858 (PI: Wishwa Kapoor). L.C. is supported by the VA Health Services Research and Development (HSR&D) Career Development Award (CDA-14–412). Dr. Borrero was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, VA Merit Award IIR 12-124 (PI: Dr. Borrero).