Emily M. Godfrey

Emily M. Godfrey
University of Washington Seattle | UW · Department of Family Medicine

MD, MPH, FAAFP

About

81
Publications
6,207
Reads
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1,094
Citations
Introduction
Check out our latest article: Josephy T, Sanan S, Thayer E, Godfrey EM*. Comparison of completeness and timeliness of paper, text and smartphone app bleeding diaries. Matern Child Hlth J , Jan 23 2022. Doi: 10.1007/s10995-021-03362-6 You can access the published article here: https://rdcu.be/cFwA9
Additional affiliations
October 2012 - present
University of Washington Seattle
Position
  • Professor (Associate)
September 2010 - present
Centers for Disease Control and Prevention
Position
  • Guest Researcher
Description
  • Work on U.S. Based contraceptive guidelines for women with medical conditions.
September 2010 - August 2012
University of North Carolina at Chapel Hill
Position
  • Professor (Assistant)
Education
August 2000 - June 2003
University of Rochester
Field of study
  • Public Health
August 1992 - June 1997
Medical College of Wisconsin
Field of study
  • Medicine
September 1987 - June 1991
University of Wisconsin–Madison
Field of study
  • English Literature

Publications

Publications (81)
Experiment Findings
Full-text available
Within the RE-AI(M) framework, we seek to answer the following five research questions: B1. REACH: What is the level of interest for the Toolkit and where are interested persons in seeing the toolkit located? We will describe how many people visited the website where the toolkit is housed and simple demographics of persons who downloaded the toolk...
Article
Full-text available
Objective: More people with cystic fibrosis (pwCF) are reaching adulthood and considering their reproductive futures. Unfortunately, many pwCF report gaps in their reproductive healthcare. We describe measures of stakeholder engagement in developing a reproductive goals decision aid for women with CF called MyVoice:CF. Methods: Stakeholders reviewe...
Article
Objectives: Most researchers who study the effects of hormonal contraception on menstrual bleeding rely on self-reported data via paper diaries, for which completeness and timeliness have been shown to be poor. The purpose of this exploratory study was to compare the completeness and timeliness of bleeding data collected via paper diaries, text me...
Article
Full-text available
Background Patient-centered outcomes research (PCOR) emphasizes patient-generated research priorities and outcomes, and engages patients throughout every stage of the research process. In the cystic fibrosis (CF) community, patients frequently provide input into research studies, but rarely are integrated onto research teams. Therefore, we develope...
Article
Data on the safety and effectiveness of contraception among women with rare diseases are critical and sorely lacking. To fill this gap, we propose a national, patient-driven database that tracks contraceptive safety and effectiveness among women with rare diseases. We built a pilot database focusing on women with cystic fibrosis in 3 phases: (1) da...
Article
Objective: To examine provision of direct-to-patient medication abortion during COVID-19 by US family physicians through a clinician-supported, asynchronous online service, Aid Access. Study design: We analyzed data from US residents in New Jersey, New York, and Washington who requested medication abortion from three family physicians using the...
Article
Full-text available
Objective : To overcome obstacles to delivering medication abortion services during the COVID-19 pandemic, clinics and providers implemented new medication abortion service models not requiring in-person care. This study identifies organizational factors that promoted successful implementation of telehealth and adoption of “no test” medication abor...
Article
Full-text available
Although rare, pelvic phleboliths may confound the diagnosis of an intraperitoneal or malpositioned intrauterine device (IUD). Pelvic phleboliths are focal calcifications in pelvic veins, often in multiples near the ureters, occurring in about 40% of adult patients. We treated a 35-year-old woman requesting removal of her copper-containing IUD (TCu...
Preprint
BACKGROUND Patient-Centered Outcomes Research (PCOR) engages patients as partners in research and focuses on questions and outcomes that are important to patients. Traditionally done in person, COVID-19 has forced PCOR teams to engage via online platforms. Similarly, virtual engagement is the only safe choice for members of the cystic fibrosis (CF)...
Article
Full-text available
Background: Patient-Centered Outcomes Research (PCOR) engages patients as partners in research and focuses on questions and outcomes that are important to patients. Traditionally conducted in-person, COVID-19 has forced PCOR teams to engage via online platforms. Similarly, virtual engagement is the only safe choice for members of the cystic fibros...
Preprint
BACKGROUND Cystic fibrosis (CF) is a rare, life-shortening, multi-organ disease that has seen significant increases in life expectancy. Many advances in CF care are due to the active participation of people with CF as research subjects. Yet, most CF research teams do not yet fully partner with people with CF or their caregivers on the research team...
Article
Full-text available
Background Cystic fibrosis (CF) is a rare, life-shortening, multiorgan disease, the treatment of which has seen significant increases in the life expectancy of those with CF. Many advances in CF care are thanks to the dedicated and active participation of people with CF as research participants. Unfortunately, most CF research teams still do not fu...
Preprint
Full-text available
Background: The most common reason women report discontinued use of the Copper T 380A (TCu380A) IUD is because of bleeding irregularities after method initiation. The objective of this study was to determine whether an over-the-counter NSAID, naproxen sodium, reduces the number of bleeding and spotting days and heavy or prolonged bleeding episodes...
Article
Full-text available
The purpose of our study was to explore the knowledge, attitudes, and experiences of Somali refugee women with family planning in the U.S. We conducted focus groups of Somali refugee women and used grounded theory methodology to identify emergent themes. Fifty-three women, aged 18–49 years, participated. Somali refugee women’s cultural and religiou...
Article
Objectives To examine contraceptive use, pregnancy intention and the association of hormonal contraceptive type with adverse health outcomes among women with cystic fibrosis (CF). Study Design We recruited 150 women with CF, ages 18-49 from three adult CF programs to complete an online survey regarding their pregnancy and contraceptive use history...
Article
Patients commonly present with unintended pregnancy in the primary care setting, and 1 in 4 women has an abortion in her lifetime. Early abortion services can be safely provided in the primary care setting. Abortion options provided in primary care settings include both medication abortion and early uterine aspiration abortion. Medication abortion,...
Article
Objective: To assess the impact of contraceptive counseling on the uptake of long-acting reversible contraception (LARC), namely, intrauterine devices and the contraceptive implant, by 3 months postpartum among women with a recent preterm birth. Design: We enrolled patients in a single-blinded, one-to-one, randomized, controlled trial to assess...
Article
Background The levonorgestrel intrauterine system (LNG-IUS) is a contraceptive method that can cause irregular bleeding and cramping during the first 6 months of use. Expected side effects are common reasons given for LNG-IUS device discontinuation within 12 months of use. Anticipatory counselling regarding expected LNG-IUS side effects may reduce...
Article
Objective: To evaluate the ability of electronic health record (EHR) data extracted into a data-sharing system to accurately identify contraceptive use. Study design: We compared rates of contraceptive use from electronic extraction of EHR data via a data-sharing system and manual abstraction of the EHR among 142 female patients ages 15-49years...
Article
As women approach menopause, fertility declines but pregnancy can still occur. Maternal and infant risks are increased among women of older reproductive age compared with younger women. A high proportion of pregnancies among women of older reproductive age are unintended and these pregnancies can also be associated with negative maternal and infant...
Article
The US Medical Eligibility Criteria for Contraceptive Use (US MEC) and US Selected Practice Recommendations for Contraceptive Use (US SPR) provide evidence-based guidance to safely provide contraception counseling and services. Both documents were updated in 2016 and are endorsed by the North American Society for Pediatric and Adolescent Gynecology...
Article
Background: Little is known about how new therapies that partially correct the basic cystic fibrosis (CF) defect (ivacaftor and lumacaftor) might alter hormonal contraceptive effectiveness, impact pregnancy outcomes, or affect pregnancy timing. Examination of pregnancy rates among CF women during periods of CFTR modulator therapy initiation will p...
Article
Background: Little is known about unintended pregnancy (UIP) risk and current contraceptive use among women aged 45 years and over in the United States (US). Objectives: To describe the prevalence of women aged 45-50 years at risk for UIP and their current contraceptive use and to compare these findings to those of women in younger age groups....
Article
The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including sp...
Article
The primary study aim was to describe patient satisfaction regarding abortion experiences in urban academic family medicine centers (FMCs). We conducted a cross-sectional survey of 210 women obtaining a first trimester medication or aspiration abortion at four FMCs. The 32-item written survey consisted of multiple choice, open-ended questions and L...
Article
The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent tee...
Article
Full-text available
This report provides recommendations developed collaboratively by CDC and the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS). The recommendations outline how to provide quality family planning services, which include contraceptive services, pregnancy testing and counseling, helping clients achieve pregn...
Article
Full-text available
Recent evidence-based guidelines expanded the definition of appropriate candidates for the levonorgestrel-releasing intrauterine system (LNG-IUS). We investigated correlates of evidence-based selection of candidates for the LNG-IUS by physicians who offer insertion. We conducted a mixed-mode (online and mail) survey of practicing family physicians...
Article
Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with...
Article
Full-text available
Does the efficacy of placing a copper intrauterine device (IUD) for emergency contraception (EC) to prevent pregnancy depend on menstrual cycle timing and timing of unprotected intercourse (UPI)? If the urine pregnancy test is negative prior to IUD placement, the copper IUD is highly effective for EC at any point in the menstrual cycle. The use of...
Chapter
Barrier contraceptive methods act by preventing spermatozoa from reaching the upper female genital tract or, in combination with spermicides, killing them. These methods include the male and female condom, diaphragm, contraceptive sponge, Lea's shield, and cervical cap. They have no systemic side effects and are safe to use in most instances, but a...
Article
Background: Bleeding irregularities, such as intermenstrual spotting or heavy or prolonged menstrual bleeding, are common among copper-containing intrauterine device (Cu-IUD) users and are one of the leading reasons for method discontinuation. This review evaluates the evidence for effective therapeutic and preventive treatments for bleeding irreg...
Article
Full-text available
This paper seeks to address the gaps in research regarding recommendations for contraceptive use. There are three primary questions to be answered question the patient and provider understanding of adherence instructions to contraceptives prevention of bleeding irregularities among women using hormonal and intrauterine contraception and the long te...
Article
Background: Unscheduled uterine bleeding is common among women who choose extended or continuous combined hormonal contraception and may subsequently lead to method discontinuation. This systematic review evaluates the evidence on treatments for unscheduled bleeding for women using continuous or extended combined hormonal contraception. Study des...
Article
Full-text available
Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Female patients presenting f...
Article
Full-text available
More than 30% of the pregnancies in women aged 35 and over are unintended. This paper compares perceptions about contraceptive methods and use among women with and without an unintended pregnancy after turning age 35. Semi-structured, in-depth interviews were conducted with 17 women. They were all 35 to 49 years old, regularly menstruating, sexuall...
Article
To determine the contraceptive needs [including emergency contraception (EC)] of women seeking care from a publicly funded sexually transmitted infection (STI) clinic and to better understand women's knowledge of and attitudes towards EC. An anonymous survey was administered to 197 women seeking services at one Chicago Department of Public Health S...
Article
Full-text available
Between July and December 2006, 209 women at a university-based primary care center and a freestanding abortion clinic completed a verbally administered questionnaire in which they were asked their preference for the location of early abortion services. Sixty women seeking primary care services at the university-based clinic and 149 women seeking f...
Article
Full-text available
Unplanned pregnancies are common in Nigeria. Much of the unplanned pregnancies is due to low contraceptive prevalence and high contraceptive user failure rates. High user failure rates suggest the important role of emergency contraception to prevent unplanned pregnancy. Randomized, controlled, double-blind, multicenter, noninferiority trial compari...
Article
To determine the effectiveness of the Copper T380A (CuT380A) intrauterine device (IUD) as an emergency contraceptive in women. Prospective, multicentre, cohort clinical trial. Eighteen family planning clinics in China. A cohort of 1963 women, aged 18-44 years, requesting emergency contraception within 120 hours of unprotected sexual intercourse. Wo...
Article
This editorial discusses the event of family planning guidance arriving as an initiative of national importance at the Centers for Disease Control and Prevention (CDC) and the national recommendations on the best contraceptive practices in the United States issued by the CDC. It describes the next task as integrating these critical recommendations...
Article
To compare the efficacy of gestrinone with that of mifepristone for emergency contraception. A randomized double-blind trial was conducted in five family-planning clinics in China. We randomly assigned 998 healthy women with regular menstrual cycles and negative urine pregnancy tests who were requesting emergency contraception up to 72 hours after...
Article
Full-text available
To compare satisfaction with and adherence to the contraceptive vaginal ring and a daily low-dose oral contraceptive pill (OCP) among college and graduate students using a novel method of electronic data collection. We randomly assigned 273 women to the contraceptive vaginal ring (n=136) or OCP (n=137) for three consecutive menstrual cycles. Partic...
Article
Intrauterine contraception can provide adolescents with effective, long-term contraception as well as with other health benefits. In adult populations, intrauterine contraception rates highly in patient satisfaction and safety. It is rarely prescribed to adolescents because of limited data. Multicenter, randomized, controlled, participant-blinded p...
Article
Cervical priming prior to uterine suction evacuation softens the cervix and lessens the force needed for dilation, thereby potentially reducing the probability of procedural complications. The use of buccal misoprostol has been shown to be an adequate cervical primer in second trimester surgical procedures, but its use in first trimester aspiration...
Article
Abortion is increasingly being incorporated into primary care training programs. It remains unclear if women, given the option, would accept and access these services with their primary care provider. An anonymous survey was administered to 299 women at two abortion clinics in New York and Chicago. One hundred seventy-four (58.2%) respondents theor...
Article
Induced abortion is common in the US, yet there is a lack of providers. We surveyed female patients asking why they would or would not (a) accept early abortion offered by their family physician (FP) in their family medicine clinic (FMC) and (b) prefer to access abortion services in the FMC. An anonymous survey with open- and closed-ended questions...
Article
Emergency contraception, otherwise known as post-coital contraception, is part of the continuum of contraceptive methods that women and couples can use for pregnancy prevention. Although emergency contraception should not be used as a regular, plan-ahead contraceptive method, it gives a woman one last-ditch effort to prevent unwanted pregnancy. Thi...
Article
This study was conducted to assess the prevalence of lower genital tract infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae among women seeking first-trimester pregnancy termination in a same-day abortion clinic in a public hospital. We reviewed CT and N. gonorrhoeae test results of 1974 women who underwent a first-trimester abort...
Article
Full-text available
To examine urban, inner-city female patients' acceptability of the provision of early abortion services by their family physician in the family medicine clinic (FMC). We administered a survey with open- and closed-ended questions to a convenience sample of English- or Spanish-speaking female patients aged 18 to 45 recruited from a FMC in the Bronx,...
Conference Paper
Current rates show that 1 in 3 women will have at least one abortion by the age of 45. The majority of these occur in the first trimester, a safe procedure that is often learned in most OB/GYN and some family medicine residencies. Nonetheless, most women must seek this service at a free-standing abortion clinic. To our knowledge, there are no studi...
Article
Determining medical abortion outcome commonly includes a costly evaluation such as ultrasonography or serial serum hCG testing. Urine pregnancy testing may represent a less costly alternative. This prospective diagnostic test evaluation study was part of a multisite randomized trial of 1080 women undergoing medical abortion up to 63 days' gestation...
Article
As health care providers, we are committed to the bestpossible patient care. The ability to provide that level of careto our patients is based in no small part on the availability ofaccurate clinical information about drug and device usagethat reflects actual clinical issues of importance to theclinical decision-making process. The dissemination of...
Article
In this randomized pilot study, we compared the contraceptive efficacy, safety and side effect profiles of weekly versus planned postcoital regimens of low-dose mifepristone. Forty participants were randomized to receive mifepristone 10 mg weekly or planned postcoitally (to be used no more frequently than once every 5 days), for 12 consecutive mont...