Public Health in Unintended Pregnancy Prevention and Care
Many women experience barriers to accessing family planning and preconception care. Cost of services and lack of insurance may be a barrier. The Affordable Care has addressed the cost barrier for insured women by mandating insurance coverage of contraceptives, and federal and state family planning programs provide low cost services, which specifically target the uninsured or underinsured. Other barriers to accessing reproductive health services include a lack of transportation, or cost of transportation, clinic hours and scheduling restrictions (e.g. lack of same day appointments), clinic policies that create barriers (e.g. unavailability of same day insertions for IUDs and implants). In addition, seeking care to prevent pregnancy may not be a priority for some women.
This module explores five public health problems: insecure housing, substance use, inadequate sex education, intimate partner violence, and cultural differences in the context of unintended pregnancy prevention and care. Three of the scenarios are designed for student self-directed learning; two additional scenarios are designed for classroom discussion with faculty facilitation points included. While unintended pregnancy is a public health concern in and of itself, other public health issues complicate women’s control of their reproductive lives. Using social psychology theory that people are more likely to engage with an individual’s story than with a global concept, the modules begin with patient story, then discuss public health concepts.
How to Use This Module
This Nursing Education Curriculum is designed for a flipped classroom model to incorporate unintended pregnancy prevention and care into existing curricula.
Students—Click the student tab and complete the pre-assessment. You may have received a site code from your instructor which you may enter within the pre-assessment. Definitions and Orienting Facts provide context for the Patient Situations, which are clinical scenarios designed to raise critical issues and questions to put unintended pregnancy prevention and care in the context of public health. Students should complete the Required Reading at any time while going through the Patient Situations. Please complete the post-assessment after finishing the module.
Faculty—Open the faculty tab below to access teaching tips, exercises, and handouts for incorporating module content into the classroom, and to learn more about obtaining a “site code” to download and access students’ pre- and post-assessment data.
- Understand concepts of population health and integrate into the care of the individual patient.
- Understand the unique challenges of providing sexual health information to people from different backgrounds.
- Analyze systemic barriers to family planning/pregnancy prevention for vulnerable populations.
- Develop skills in providing effective referrals for unintended pregnancy prevention and care health services.
Relevant UPPC Essential Competencies
Through a national Delphi study, Essential Competencies in Unintended Pregnancy Prevention and Care for Nursing Education (Hewitt, C. and Cappiello, J., 2015) 85 nursing experts in unintended pregnancy prevention and care reached consensus on 27 core educational competencies for nursing education which provide a framework for curricular development in an important area of nursing education. The following competencies are relevant to this nursing education module.
- Demonstrate knowledge of the nurse’s professional responsibilities in providing health care to clients in need of unintended pregnancy prevention and care.
- Demonstrate ability to recognize unique reproductive health needs of women from vulnerable and special populations (e.g. adolescents, women with mental or physical disabilities, survivors of violence) affected by many factors (e.g. relationship status, sexual orientation).
- Demonstrate knowledge of current state-specific laws regulating minors’ access to reproductive care for the state(s) in which nurse practices (including contraceptive access and abortion care).
- Demonstrate basic understanding of female and male anatomy and physiology related to conception and reproduction” (no quotes) in numerical order using the same format as the others.
- Demonstrate knowledge of confidentiality regulations specific to unintended pregnancy prevention and care.
- Demonstrate knowledge of state and local adoption options and resources and applicable regulatory laws and statutes.
- Demonstrate proficiency in promoting sexual-health self-care practices.
- Demonstrate proficiency in providing patient-centered risk reduction counseling specific to unintended pregnancy prevention.
- Demonstrate proficiency in identifying preconception health risks.
- Demonstrate ability to make appropriate referrals to community-based prenatal care providers and resources.
- Demonstrate proficiency in assessing risk for intimate partner violence including sexual violence and coercion).
- Demonstrate proficiency in referring clients with unintended pregnancy to area providers and support services.
Pre- and Post-Assessments
Definitions and Orienting Facts
Patient Situation 1
Patient Situation 2
Patient Situation 3
This module looks at unintended pregnancy prevention and care in the context of five public health problems: insecure housing, cultural differences, inadequate sex education, substance use, and intimate partner violence. Three of these issues are addressed in the online patient scenarios and two patient scenarios are described in a class handout in the Classroom Exercises section below.
These modules are designed to use with a flipped classroom model in which students are directed to complete the module as homework, including the Pre- and Post-Assessments. Once students have completed the module in its entirety, including the recommended reading, faculty can use the Teaching Tips document and materials from the Classroom Exercises section below to integrate concepts from the module into the classroom or group setting.
- Public Health Intimate Partner Violence Scenario
This handout from Provide includes definitions, orienting facts, and a clinical case on intimate partner violence in the context of unintended pregnancy prevention for students to consider in a classroom setting. The Teaching Tips document for this module provides guidance on facilitating classroom discussion related to the scenario described in this handout.
- Public Health Cultural Humility Scenario
This handout from Provide includes definitions, orienting facts, and a clinical case on cultural competency in the context of unintended pregnancy prevention for students to consider in a classroom setting. The Teaching Tips document for this module provides guidance on facilitating classroom discussion related to the scenario described in this handout.
- The Abortion Option: A Values Clarification Guide for Health Care Professionals
These exercises from the National Abortion Federation include tools that can be used in class for clarifying values related to abortion and discussing the role of health care providers.
- HOW to Refer
Use materials in Module 2 of Referrals for Unintended Pregnancy: A Curriculum for Health and Social Service Providers from Provide to present referrals as part of services provision, identify general barriers to accessing abortion care, and demonstrate best practices for referrals.
- Patient Education and Risk Reduction Messages
This exercise from CORE (Curricula Organizer for Reproductive Health Education) is designed for nursing faculty to use in class. The activity uses interactive case studies, role play with scenarios, and group discussion questions are provided.
Accessing Student Pre- and Post-Assessment Data
Pre- and post-assessments are designed to measure students’ satisfaction with the module as well as what they have learned. To be able to complete the assessments students will need to enter a “site code” prior to working through the online module. Faculty will use this site code to download and review students’ pre- and post-assessment data. To obtain a site code your institution must e-mail AmyLevi@salud.unm.edu. In the text of the email, please include your name (as instructor), the name of the institution, and the module(s) for which you would like to access data. RhN will send you 1) a site code for your students to enter at the beginning of the assessment, 2) a web link to access the results from each module, and 3) an “answer key” to help grade your students’ responses. You may also assign a unique student code to each student that you would like to assess on an individual basis. Students must enter the correct site code for faculty to be able to access their data.