De-funding abortion providers: where we stand and what you can do

who receive and women who are denied wanted abortions, will be presented.The reported physical health consequences of abortion and birth followingunwanted pregnancy will be discussed. Also, data on women's emotionalresponses to clinic protesters, ultrasound viewing and receiving or beingdenied a wanted abortion will be presented.

O17

THE CLINICIAN/HEALTH EDUCATOR TEAM ANDCOUNSELING FOR LONG-ACTING,REVERSIBLE CONTRACEPTION

Thompson Kirstena, Gelt Marshab, Stern LisacaUCSF Bixby Center for Global Reproductive Health, San Francisco,CA, USAbCardea Services, Oakland, CA, USAcPlanned Parenthood Federation of America Medical Affairs,New York, NY, USA

Speidel J Joseph, Harper Cynthia

The popularity of long-acting reversible contraception (LARC) is increasingin the USA, but national surveys show that women at highest risk forunintended pregnancy still face barriers to access. This session will presentfindings on provider LARC knowledge and practice, and tools and resourcesfor patient counseling on LARC from the University of California, SanFrancisco and Planned Parenthood National Trial of Contraceptive Accept-ability. This cluster randomized trial tested the impact of a clinic-wide trainingat 40 Planned Parenthood health centers across the US. This study is the firstto examine the role of health educators in the provision of LARC. The impactof the clinic-wide training on LARC knowledge and practice, including theuse of evidence-based criteria for determining client eligibility will beexamined. Also, concordance of knowledge between health educators andclinicians, and how it impacts overall clinic practices will be explored. Finally,the presenters will facilitate an interactive session on skills and tools forcounseling that is tailored to the concerns of the audience, including selectedtools for overcoming clinic flow, billing and counseling barriers.

O18

DE-FUNDING ABORTION PROVIDERS: WHERE WE STANDAND WHAT YOU CAN DO

Beck AndrewAmerican Civil Liberties Union, New York, NY, USA

Camp Talcott

This will be an interactive presentation that covers both the categories ofstate policies that have de-funded providers of abortion care since 2011,and the track record of challenges to those policies. Attendees willunderstand and be able to differentiate among the different strategies stateshave used to render those who provide abortion care ineligible for publiccontracts and grants to provide non-abortion care, such as contraceptivecounseling and services. They will also be able to summarize the status ofcourt challenges to block these de-funding provisions. Finally, they willleave with a sense of how they can join the effort to make funding forproviders of abortion more available.

O19

EARLY IDENTIFICATION OF HUMANTRAFFICKING VICTIMS

Poppema Suzanne TInternational Medical Consulting, Seattle, WA, USA

Human trafficking is a human rights violation that disproportionately affectswomen and children. It is not only an international problem, but one that ishappening right here in the USA, especially in the border states. Healthcareproviders are one of the only groups of professionals who see humantrafficking victims before they have even been identified as such. Healthcareproviders have a unique opportunity to identify and help these patients whilethey are still under the control of the criminals who enslave them. Theprocess is very simple and straightforward and does not add significant timeor effort to a busy care provider's day. Identifying and helping humantrafficking victims is the next logical step in treating victims of sexualviolence and domestic violence.

O20

EVIDENCE-BASED CHANGES IN MEDICALABORTION PRACTICE

Fjerstad MaryWomanCare Global, San Diego, CA, USA

Since the introduction of mifepristone, medical abortion has been the subjectof intense research. The provision of medical abortion is evolving,influenced by new evidence. Recent evidence which has the potential tomake medical abortion more accessible to women and improve follow-upare: provision of medical abortion by advanced practice clinicians, medicalabortion with home use of misoprostol up to 70 days LMP and methods offollow-up other than a clinic visit, for instance use of a multi-level (semi-quantitative) pregnancy test. The World Health Organization now stronglyrecommends that highly effective hormonal contraception such ascontraceptive implants or injectable contraception may be administered onthe day of mifepristone; the session will review the scant evidence thatsupports this recommendation, some of which has not been published. Theevidence of the ability of women themselves to determine whether medicalabortion was successful based on symptoms alone will also be reviewed.

O21

INCREASING LONG-ACTING REVERSIBLE CONTRACEPTIONUPTAKE THROUGH THE DELIVERY OF TITLE X SERVICESAT FEDERALLY QUALIFIED HEALTH CENTERS

Hathaway MarkUnity Health Care, Washington DC, USA

Klauss Karen, Vollett-Krech Jennifer, Dixon Camille

The District of Columbia (DC) has one of the highest unintended pregnancyrates in the country. In 2006, 59% of all pregnancies in DC were unintended,compared with 49% nationally. Intrauterine devices (IUDs) and contraceptiveimplants, also known as long-acting reversible contraception (LARCs), are themost effective of all reversible methods at preventing unintended pregnancy.As the District's Title X grantee and its largest federally qualified primary careprovider, Unity Health Care (Unity) is working to reduce unintendedpregnancy rates and increase LARC uptake among urban, underservedcommunities. In 2012, Unity saw approximately 20% of the femalepopulation of reproductive age in DC with over 46,000 family planningencounters. Unity has more than doubled the number of female familyplanning users (120% increase) and LARC users (117% increase) over the last5 years. During 2012, 9.2% of all female patients of reproductive age at riskfor unplanned pregnancy were using a LARC method, up from 6.4% in 2009.As an FQHC, Unity embeds Title X services within its primary care services at17 health centers in DC, including three in high schools. System changes, staffdevelopment and patient education are three areas of strategic focus that haveincreased LARC uptake. System changes include availability of IUDs andimplants at all 17 sites at all times, on-demand/walk-in family planning,standardized insertion set-up and advocacy for improved insurance

301Abstracts / Contraception 88 (2013) 297–318