Healthcare providers with questions about reproductive and sexual health topics have a new resource at their disposal: an anonymous, confidential, and free physician-staffed hotline.
Reproductive Health Hotline, or ReproHH, launched earlier this summer and is staffed by clinicians at the University of California San Francisco (UCSF) with expertise in sexual and reproductive health.
The comprehensive reproductive and sexual health hotline is equipped to answer questions about complex contraceptive counseling; abortion, where legal; post-abortion and miscarriage care; early pregnancy management; sexually transmitted diseases; urinary tract infections and vaginitis; and pain management for gynecological procedures.
Jennifer Karlin, MD, PhD, an associate professor at UCSF who developed the hotline, told MedPage Today that ReproHH was partially inspired by the patient-facing M+A (Miscarriage and Abortion) Hotline and the National Clinician Consultation Center, another UCSF project that runs various clinician-to-clinician HIV, hepatitis C, and substance use hotlines.
"A bunch of us started realizing that there was a need to have a clinician-facing hotline that could support clinicians with sexual and reproductive health nationally," she said. "When we talk to physicians across the country about [ReproHH], people say, 'Oh my God, we've needed this for a decade!'"
The Dobbs v. Jackson Women's Health Organization Supreme Court decision that overturned Roe v. Wade and upended federal abortion rights further magnified the need for a resource like ReproHH, Karlin noted.
So far, ReproHH has received a couple dozen calls, but the team said the word is only starting to get out. About half of calls have come from physicians, mostly in primary care. The rest of calls have been from community health workers, health educators, and advanced care providers, like nurse practitioners and physician assistants.
When a healthcare provider calls the hotline, they must first acknowledge ReproHH's terms of service. Next comes a live triage where a hotline worker checks if the caller is a healthcare provider and asks if they are located in or outside of California. If the caller is a community health worker, they don't ask any additional questions, including whether or not they are from California. Patients who call ReproHH are given the contact information for the M+A Hotline.
California-based clinicians are given the opportunity to provide some demographic data about themselves if they choose, like their specialty, how many years they've been practicing, the setting they work in, if they have access to reproductive healthcare specialists, and broad demographic questions about the communities in which they operate. This voluntary information will help inform potential trainings and capacity building initiatives in the state. ReproHH does not collect information on the specifics of queries from states other than California, nor does the project know if a non-California caller is dialing in from New York, Florida, or Louisiana.
"We ask that people not provide PHI [personal health information] or any specific information about any of the cases that any of the clinicians are calling about, so that we can provide clinical information based on best practices in the literature and evidence-based practice and the licensure of our state," Karlin explained.
Additionally, if a clinician is inquiring about how to obtain abortion pills or how to do an abortion, ReproHH asks whether the caller is in a state where abortion, to the best of their knowledge, is legal. In order for the hotline to provide information about procuring an abortion, that person must say yes. However, if the patient has already had a miscarriage, received abortion pills, or had an abortion, clinicians can still get information about how to manage those situations.
Nikki Zite, MD, MPH, of the University of Tennessee Graduate School of Medicine in Knoxville, who is not involved in ReproHH, said that the hotline "has the potential to support healthcare workers that don't have easy access to a more experienced provider or clinical information."
Zite said she's seen fellow physicians seek clinical guidance on other platforms where evidence-based answers are not a guarantee.
"As we see the number of maternity and healthcare deserts expand, I am grateful that they plan to focus on reducing misinformation, promoting equitable access to quality healthcare, and ensuring providers in any setting are able to confidently provide care," Zite said. "As outlets like UpToDate get more expensive, some providers may not have access to these sources and knowing a reliable institution like UCSF is working to make evidence-based information easily accessible should be reassuring."
David Hackney, MD, a maternal-fetal medicine physician at Case Western Reserve University in Cleveland, who also is not involved in ReproHH, noted that as reproductive healthcare access contracts, patients are seeking care wherever they can.
"Unfortunately patients often now find themselves in emergency departments, urgent cares, and primary care offices in which healthcare workers provide the best care they can, though may not be specifically trained in obstetrics and gynecology, particularly for nuanced or complicated issues," he said. "Although the optimal solution would be to have regional providers with reproductive expertise, services such as ReproHH will likely become critical over the years to come and until our access situations are improved."
Even before the proliferation of abortion bans post-Dobbs, Hackney noted that rural labor and delivery units had been closing under financial pressure, and impending Medicaid cuts and other legislation further threaten access to comprehensive reproductive care.
Before launching ReproHH, the team conducted a needs assessment to prepare for common queries. So far, the top reason for calling has been complex contraception issues, which the team predicted. One surprising topic has been syphilis, though Karlin said it lines up with the rise in cases and complicated disease management.
To access ReproHH, healthcare providers can call 1-844-ReproHH (1-844-737-7644).
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