A long-term evaluation of a required reproductive health training rotation with opt-out provisions for family medicine residents

G iven the high US prevalence of unintended pregnancy, early pregnancy loss, and abortion, the vast majority of family physicians care for patients that face these issues. More than half of US pregnancies are unintended,1 up to 20% of recognized pregnancies end in miscarriage,2 and 22% of pregnancies end in abortion.3 Family physicians also have an important role in provision of contraception4 and addressing the underutilization of effective contraceptive methods, including intrauterine device (IUD) and contraceptive implant,5 which is an important contributor to the high rate of unintended pregnancy. The importance of family physicians in the provision of reproductive health services is augmented by the fact that they practice in diverse and underserved areas,6 are procedurally trained, and provide care for women throughout the lifecycle.