Availability of Inpatient Sexual and Reproductive Health Services at U.S. Children's Hospitals.

Abstract

Objective: To understand the scope of sexual and reproductive health (SRH) services provided to adolescents assigned female at birth in pediatric hospitals in the United States.

Methods: Data were collected via an electronic survey of inpatient clinical leaders at freestanding and nested children's hospitals in the United States. Survey domains included availability of trained clinicians, equipment to perform pelvic exams, contraceptive methods offered, and facilitators and barriers in providing SRH services. Descriptive statistics were used for analysis.

Results: Of 160 invited hospitals, 52 (33%) responded with 25 (48%) surveys completed by Pediatric Hospital Medicine and 23 (44%) Adolescent Medicine specialists. Twenty-two (42%) worked in free-standing and 30 (58%) in nested children's hospitals with 42 (81%) reporting academic- or university-affiliations. Only 3 (6%) reported having the equipment needed to perform pelvic exams on the inpatient unit. Eleven (21%) reported providing some form of long-acting reversible contraception, of which all provided implants; only 5 (10%) institutions offered intrauterine device insertion. A common facilitator was having clinicians with required skills (65%) and a common barrier was SRH not being considered an inpatient problem (83%).

Conclusion: While clinicians identify SRH services at children's hospitals as important, many lack the basic equipment needed and institutional support to provide comprehensive SRH care. This study suggests that the integration of clinicians appropriately trained in SRH care may be one of the greatest facilitators to providing inpatient SRH care in children's hospitals.