Data are % (n/N) unless otherwise specifi ed. n=those with children. N=total participants. *n not provided in study.Table: Sex workers who are mothers and their children

BackgroundTo reach global and national goals for maternal and child mortality, countries must identify vulnerable populations, which includes sex workers and their children. The objective of this study was to identify and describe maternal deaths of female sex workers in Cambodia and causes of death among their children.MethodsA convenience sample of female sex workers were recruited by local NGOs that provide support to sex workers. We modified the maternal mortality section of the 2010 Cambodia Demographic and Health Survey and collected reports of all deaths of female sex workers. For each death we ask the ‘sisterhood’ methodology questions to identify maternal deaths. For child deaths we asked each mother who reported the death of a child about the cause of death. We also asked all participants about the cause of deaths of children of other female sex workers.ResultsWe interviewed 271 female sex workers in the four largest Cambodian cities between May and September 2013. Participants reported 32 deaths of other female sex workers that met criteria for maternal death. The most common reported causes of maternal deaths were abortion (n = 13;40%) and HIV (n = 5;16%). Participants report deaths of 8 of their children and 50 deaths of children of other female sex workers. HIV was the reported cause of death for 13 (36%) children under age five.ConclusionThis is the first report of maternal deaths of sex workers in Cambodia or any other country. This modification of the sisterhood methodology has not been validated and did not allow us to calculate maternal mortality rates so the results are not generalizable, however these deaths may represent unrecognized maternal deaths in Cambodia. The results also indicate that children of sex workers in Cambodia are at risk of HIV and may not be accessing treatment. These issues require additional studies but in the meantime we must assure that sex workers in Cambodia and their children have access to quality health services.

INTRODUCTION: ACOG supports immediate postpartum LARC provision as a means to reduce unintended and short interval pregnancies. Immediate postpartum contraception became routinely available at Bridgeport Hospital in 2016. The aim is to determine uptake, choice, and continued use of postpartum contraception at our institution. METHODS: Using an EPIC-generated list of all deliveries at Bridgeport Hospital for calendar years 2015 and 2017. Institutional IRB waiver was obtained. After sorting for only clinic service deliveries we performed a systematic chart review of each patient looking at demographic data, pregnancy and delivery information, contraceptive choice antepartum and postpartum, and pregnancies within one year of delivery. Data collection for 2017 in still ongoing. RESULTS: In 2015 and 2017, there were 326 and 202 Bridgeport Hospital OB/GYN Clinic deliveries, respectively. The demographic characteristics were similar for both cohorts. 92% in 2015 of patients had antepartum counseling on contraception compared to 97% in 2017. In 2015, 44% desired a LARC and 59% received one. Comparatively, in 2017, 53% desired a LARC and 92% received one. Over 80% of patients returned for a postpartum visit. Among patients who had their IUD or implant removed, 75% were for side effects. The percentage of short interval pregnancies in 2015 was 12% and 13% in 2017. CONCLUSION: LARCs were the most often requested contraception, and antepartum counseling has improved. Our hospital policy allowing immediate postpartum LARCs led to the majority of patients receiving their desired method. Whether this has led to a reduction in short interval pregnancies requires further investigation.