# Improving Contraceptive Care for Pregnancy-Capable Veterans with Autoimmune Conditions > **NIH NIH F31** · UNIVERSITY OF WASHINGTON · 2024 · $48,974 ## Abstract PROJECT SUMMARY/ABSTRACT Pregnancy-capable Veterans experience an elevated risk of adverse reproductive health outcomes relative to the general population due to a high prevalence of comorbid mental, physical, and psychosocial conditions influenced by trauma, combat exposure, and other experiences. Veterans' unique trauma and stress experiences may influence the development or severity of other health conditions that pose issues for reproductive health outcomes and care access, such as autoimmune conditions. Pregnancy, in particular, can introduce elevated risks for people with autoimmune conditions because many are managed with teratogenic medications, and pregnancy may exacerbate disease activity. Access to ongoing contraceptive care is especially vital for people with autoimmune conditions because it allows them to mitigate the potential health risks of pregnancy and control when they want to achieve pregnancy. These conditions often require regular, ongoing care from multiple providers, which may lead to gaps in access and quality of wanted contraceptive care. Subspecialists, who often provide most care for this population, may have limited expertise in contraception and fear the possible implications of pregnancy for their patients. The underlying elevated risk of adverse reproductive health outcomes coupled with the unique challenges of autoimmune conditions may be further compounded by provider and facility-level characteristics for Veterans who use Veterans Health Administration (VA), where pregnancy-capable Veterans remain a minority and availability and quality of contraceptive care are variable. The VA is an ideal setting for studying contraceptive care delivery for this population due to the system’s size, comprehensive electronic health record (EHR), and diverse patient population. The proposed mixed methods study aims to examine the potential multi-level quality and access barriers to contraceptive care delivery to Veterans with autoimmune conditions using three different data sources. First, differences in documented procedural or prescription contraception will be investigated for Veterans with the most prevalent autoimmune conditions compared to those without these conditions using structured EHR. Hierarchical modeling will identify facility, provider, and patient-level factors associated with the documentation of a method. Second, novel natural language processing software and qualitative analytical methods will be applied to unstructured EHR clinical notes to characterize contraceptive care for Veterans without a documented method to explore contributors to the lack of documentation, such as poor care quality or lack of need. Third, the findings from the first aims of the project will be further contextualized by conducting qualitative interviews with Veterans with autoimmune conditions with and without documentation of contraception to characterize access and quality barriers to receiving desired contraceptive care. The result... ## Key facts - **NIH application ID:** 10821973 - **Project number:** 1F31HD114364-01 - **Recipient organization:** UNIVERSITY OF WASHINGTON - **Principal Investigator:** Zoe Hypatia Pleasure - **Activity code:** F31 (R01, R21, SBIR, etc.) - **Funding institute:** NIH - **Fiscal year:** 2024 - **Award amount:** $48,974 - **Award type:** 1 - **Project period:** 2024-07-15 → 2027-07-14 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10821973 ## Citation > US National Institutes of Health, RePORTER application 10821973, Improving Contraceptive Care for Pregnancy-Capable Veterans with Autoimmune Conditions (1F31HD114364-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10821973. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*