(Research Hub Theater) Promoting Reproductive Health Equity After Spinal Cord Injury: Identifying Needs in Physiatry Training and Continuing Education

Objective: Accurate, timely, and comprehensive information regarding contraception is critical to the reproductive health of women with spinal cord injury. We aimed to evaluate contemporary references commonly used by physiatrists in training and practice for the scope, depth, and accuracy of such information and identify areas that may need improvement.

Design: We conducted a search using PubMed, Web of Science, and MEDLINE and reviewed eight contemporary textbooks used frequently in physical medicine and rehabilitation residency and spinal cord injury medicine fellowship training for comprehensive information on contraception methods for women with spinal cord injury and compared the breadth and detail of information with that available for able-bodied women through the Reproductive Health National Training Center and Centers for Disease Control and Prevention.

Setting: We focused on articles published in English and major textbooks used by physical medicine and rehabilitation graduate medical education trainees and spinal cord injury medicine fellows.

Participants: Three reviewers consisting of two spinal cord injury medicine fellows and a dual-boarded physiatrist with fellowship training in spinal cord injury medicine. We focused on educational materials used by over 10,000 board-certified physiatrists in the U.S. and hundreds of graduate medical trainees.

Interventions: Not applicable

Main Outcome Measures: We viewed inclusion of accurate, up-to-date information on contraceptive methods, including reversible long-acting contraception, oral hormonal contraception, barrier methods, and emergency contraception as comprehensive coverage of contraception.

Results: Our search results returned 134 articles, only 17 of which were deemed relevant. No articles or major textbooks included comprehensive information on contraception and specific and accurate details of why particular methods may be preferred or avoided in specific populations.

Conclusions: Providing essential health care for women with spinal cord injury requires physiatrists to provide accurate and reliable information concerning reproductive health, including options for contraception. Professional organizations and authors of physiatry textbooks must strive to improve the quality of evidence and information presented.