BACKGROUND:Sexual health in the postpartum period contributes to a patient's overall well-being, highlighting the importance of addressing concerns that may arise related to sexual dysfunction. The comprehensive postpartum visit should include providing guidance on sexuality, management of dyspareunia, and resumption of intercourse. There is little literature examining the incidence of such counseling. METHODS:Patients who attended their postpartum visit at a large, urban academic medical center were invited to complete a web-based survey at their postpartum visit as part of a quality initiative. The survey consisted of a total of 34 questions evaluating frequency and quality of sexual health counseling, as well as sexual experience after delivery. Descriptive statistics, chi-squared tests, and multivariable logistic regression were used to analyze our findings. RESULTS:Our survey study had a 41.5% response rate (277/668). A total of 91% of participants reported receiving some sexual health counseling at their postpartum visit but only half of participants reported the counseling as helpful. Providers were statistically more likely to discuss sexual health with primiparous over multiparous participants (94.9% vs 87.9%; P = 0.037) and patients who had not yet resumed intercourse (93.5% vs 85.7%; P = 0.039). Providers had longer conversations with patients who delivered vaginally versus via cesarean (P = 0.039). CONCLUSIONS:Providers at this institution are almost universally offering some sexual health counseling to patients. However, we found that parity, delivery mode, and resumption of intercourse may impact providers' likelihood of discussing sexual health with postpartum patients.

Menopause care in the United States is limited by inadequate access, insufficient clinician training, and the absence of scalable care models. Despite increasing awareness and intolerance of menopause symptoms, few health systems offer coordinated menopause services, and no published frameworks exist to guide program development. We present a practical, evidence-informed flexible nine-step blueprint for designing, implementing, and sustaining comprehensive menopause programs, including a structured needs assessment and a resource-tiered implementation framework for program development. Drawing on implementation science, multidisciplinary care models, and the authors' real-world experience from large academic health systems, we describe each of the essential steps. This approach provides practical strategies for developing standardized clinical workflows, scalable care pathways, and workforce capacity. Case examples demonstrate stepwise adoption across diverse settings, beginning with foundational activities and expanding as resources grow. This blueprint offers a scalable approach to addressing persistent gaps in women's health for midlife and beyond.

Vasomotor symptoms (VMS) related to the menopausal transition affect the majority of women and contribute to significant quality of life burden. Incidence, length, severity and report of symptoms vary by race, ethnicity, and coexisting health conditions. The pathophysiology of VMS is not fully understood and is likely multifactorial, involving changes in the hypothalamicpituitary-ovarian axis during the menopausal transition. Treatment approaches include lifestyle modifications, hormonal and non-hormonal therapies, including integrative and complementary medicine approaches. Systemic hormone therapy with estrogen is the most effective treatment. Emerging evidence suggests that treatment with SSRIs, SNRIs, and gabapentin is effective for many women who want to avoid hormone therapy. A shared decision approach to treatment decisions involves consideration of risks with treatment options and discussion of patient priorities.

INTRODUCTION:Endometrial cancer is the most common gynecologic cancer in the United States, and endometrial cancer staging historically has included lymph node assessment to inform prognosis and guide recommendations for adjuvant treatment. This study sought to determine the incidence of lymph node involvement in patients undergoing hysterectomy with sentinel lymph node dissection for a preoperative diagnosis of endometrial intraepithelial neoplasia (EIN) to allow for risk stratification and management by general gynecology and gynecologic oncology. METHODS:We performed a retrospective chart review of patients diagnosed with EIN who underwent hysterectomy from January 2018 through July 2021. We collected and analyzed patient characteristics, perioperative metrics, and postoperative data. Incidence of lymph node positivity on final pathology was the primary outcome of interest. We analyzed clinical and histologic risk factors for correlation with a final diagnosis of endometrial carcinoma. Chi-square, Fisher exact, and t tests were used for comparisons. RESULTS:One hundred patients met inclusion criteria, 40 of whom had an underlying endometrial cancer. The majority were stage IA grade 1 endometrioid carcinomas (95%). Per institutional protocol, all patients were recommended sentinel lymph node dissection, of which 84 (84%) patients ultimately underwent lymph node dissection. One patient was found to have a positive sentinel lymph node on final pathology (1.2%). Increasing endometrial stripe thickness was positively associated with risk of endometrial carcinoma on final pathology (22.39 mm ± 31.87 vs 11.78 mm ± 5.17, P = 0.023). CONCLUSIONS:The incidence of lymph node involvement in patients with a preoperative diagnosis of EIN is low. Sentinel lymph node dissection is unlikely to affect adjuvant treatment recommendations following surgical staging. Standardized risk assessment methods are warranted for patients with a preoperative diagnosis of EIN to delineate the utility of lymph node assessment in this population.

The experience of menopause is not “one size fits all.” Instead, biologic, physiologic, and sociocultural factors strongly affect women's experiences of menopause symptoms and the ways in which they would like to manage their care. By providing culturally sensitive and patient-centered care, clinicians may be able to improve menopause experiences for all of their patients. However, a literature review revealed a lack of information about culturally responsive care for menopause. The first objective of this review is to discuss the ways in which sociocultural identity influences menopause care-seeking and management. The second objective is to introduce a framework of culturally responsive care for menopause.

From the Washington University School of Medicine in St. Louis, Madison, MO. Received March 21, 2024; revised and accepted March 21, 2024. Funding/support: None reported. Financial disclosure/conflicts of interest: Dr. Williams is an advisor for Astellas. Address correspondence to: Makeba Williams, MD, FACOG, MSCP, Washington University School of Medicine in St. Louis, Madison, MO. E-mail: [email protected]

Introduction The COVID-19 pandemic has presented an unprecedented global health issue. The World Health Organization estimates 773 million confirmed cases and 7 million deaths. Vaccination continues to be the most effective way to prevent COVID-19 and has demonstrated safety and efficacy in all age groups. Though a lot of studies have looked at COVID-19 vaccination acceptance and hesitancy in adults, there is scarce research addressing adolescent vaccination readiness. COVID-19 infection in this age group may result in lost school days, school and community transmission, and loss of productivity for parents. Aim This study aims to determine COVID-19 vaccination rates and factors influencing its acceptance and hesitancy in adolescents in a community setting. Methods A voluntary survey was conducted at a local high school in May 2023. Information was collected about the demographics of adolescents and the educational background of parents/guardians. The survey assessed the COVID vaccine rate, reasons for COVID-19 vaccine acceptance or refusal, number of doses of COVID-19 vaccine and boosters received, prior history of COVID-19 infection, source of information on COVID-19 vaccine, flu vaccine acceptance by the students, and whether they would be willing to take a COVID-19 vaccine booster. Results Four hundred participants, ranging in age from 13 to 19, were surveyed. The vaccination rate in boys was comparable to that in girls. 72% received at least one COVID-19 vaccine, and 66% were considered completely vaccinated. Of those completely vaccinated, 80% had undergone further updated COVID-19 booster vaccinations. Adolescents whose parents/guardians were college graduates had a higher vaccination rate than those whose parents/guardians were not. Caucasians and Asians had a higher vaccination rate compared to African Americans and mixed races. The vaccination rate was not statistically different in adolescents with prior COVID-19 infection versus no prior infection. Flu vaccination was associated with higher COVID-19 vaccination rates. Lack of trust was an important reason for vaccine hesitancy, along with questions about efficacy, concerns about side effects, parent/guardian decisions, and religious reasons. Protecting oneself, family/friends, and community were the major reasons to take the vaccine. Parents/guardians, physicians, peers, television, social media, flyers, and schools were the primary sources that adolescents relied on for information about the COVID-19 vaccination. Conclusion Lower education attainment among parents/guardians, African Americans, and mixed races was associated with lower vaccination rates. Lack of trust in the vaccine, questions about efficacy, and fear of side effects were the most frequently cited reasons for vaccine hesitancy. Parent/guardian influence and religious reasons were other significant reasons for vaccine hesitancy. Flu vaccination was associated with higher COVID-19 vaccination rates. Understanding factors influencing COVID-19 vaccination will allow us to address barriers to COVID-19 vaccination and other vaccinations appropriate for this age group. Educating adolescents in schools, involving local and state health departments to increase awareness about the vaccine, and educating parents and guardians along with the teenagers can help increase the acceptance of the vaccine. These interventions will also positively affect the acceptance of the booster and prepare us for any future pandemics.

Objectives: This study aimed to characterize African American women's experiences of menopause and their interactions with the health care system related to menopausal symptoms. Study design: We conducted four focus groups with community-dwelling midlife African American women. Main outcomes measures: Women who consented to participate completed demographic surveys. Transcripts of the four focus groups (n = 26) were analyzed and themes were elucidated. Results: In total, 26 midlife African American women participated in the four focus groups. Participants revealed unmet needs regarding obtaining menopause information from their clinicians. Clinician discussions about menopause tended to be initiated by patients based on their symptoms. Some women reported feeling ignored and/or dismissed by the clinician when they initiated discussions of menopause. Women wanted their clinicians to provide information on menopause, which included receiving information prior to the menopause transition to help them know what to expect. Conclusion: Women wanted their clinicians to initiate discussions of menopause rather than wait for women to mention symptoms. Prioritizing menopause training for clinicians taking care of midlife African American women may help to improve discussions of menopause.

OBJECTIVE:To compare the cost effectiveness of opportunistic salpingectomy and bilateral tubal ligation for sterilization immediately after vaginal delivery.METHODS:A cost-effectiveness analytic decision model was used to compare opportunistic salpingectomy with bilateral tubal ligation during vaginal delivery admission. Probability and cost inputs were derived from local data and available literature. Salpingectomy was assumed to be performed with a handheld bipolar energy device. The primary outcome was the incremental cost-effectiveness ratio (ICER) in 2019 U.S. dollars per quality-adjusted life-year (QALY) at a cost-effectiveness threshold of $100,000/QALY. Sensitivity analyses were performed to determine the proportion of simulations in which salpingectomy would be cost effective.RESULTS:Opportunistic salpingectomy was more cost effective than bilateral tubal ligation with an ICER of $26,150/QALY. In 10,000 patients desiring sterilization after vaginal delivery, opportunistic salpingectomy would result in 25 fewer ovarian cancer cases, 19 fewer ovarian cancer deaths, and 116 fewer unintended pregnancies than bilateral tubal ligation. In sensitivity analysis, salpingectomy was cost effective in 89.8% of simulations and cost saving in 13% of simulations.CONCLUSION:In patients undergoing sterilization immediately after vaginal deliveries, opportunistic salpingectomy is more cost effective and may be more cost saving than bilateral tubal ligation for reducing ovarian cancer risk.

Objective The objective of this study is to identify factors associated with receiving surgical menopause counseling in gynecologic cancer patients, as well as patient and provider perspectives, regarding surgical menopause counseling and management. Methods We conducted a single-institution mixed-method study combining retrospective chart review and patient and provider surveys. Patients younger than 51 years who experienced surgical menopause after gynecologic cancer treatment from January 2017 to December 2019 were surveyed in April 2021 about experiences with menopause counseling, barriers to care, and quality of life. We then reviewed charts of only patients who fully completed surveys. All gynecologic oncology providers were surveyed about surgical menopause practices. Logistic regression identified factors associated with receiving counseling. Results Sixty-six of 75 identified met inclusion criteria and received survey invitations. Thirty-five (53%) completed surveys. Sixty percent had documented surgical menopause counseling. Patients who were counseled were younger (43 vs 48.5 years, P = 0.005), more likely to have referrals for menopause care (12 vs 9, P = 0.036), more likely to have menopause providers other than oncology providers (14 vs 8, P = 0.001), and had fewer comorbidities. Decreasing age at surgery increased odds of counseling. Most reported continued menopause symptoms and quality of life disturbances. Half were satisfied with menopause care. Majority preferred counseling from oncology providers. Most providers always counseled on surgical menopause but cited lack of time as the primary obstacle for complete counseling. Conclusions Younger age at surgery increased odds of receiving surgical menopause counseling. Gynecologic cancer patients experienced significant menopause-related disturbances. Improved understanding of patient and provider preferences and greater emphases on surgical menopause and survivorship will improve care for gynecologic oncology patients.

IMPORTANCE AND OBJECTIVE:Little is known and reported about the experiences of African American women as they transition to and experience menopause. Accepted norms are based on the experience of a predominantly White population. The aim of this study is to review available data about the distinct experiences of African American women during the menopause transition and menopause.METHODS:A literature search was developed and executed by the review team in collaboration with a health sciences librarian. The search combined controlled vocabulary and title/abstract terms related to the health status disparities of African Americans in the menopause transition and menopause. The following databases were searched from inception through April 28, 2022: PubMed, Scopus (Elsevier), and Web of Science Core Collection (Clarivate).DISCUSSION AND CONCLUSION:African American women experience distinct differences in physical, psychological, social, and quality of life measures during menopause. Increasing awareness about the unique menopause experiences of African American women is critically important to improve the health of this underserved population.

Hypertension is the leading modifiable risk factor for cardiovascular disease (CVD), the leading cause of death in women.1 Timely referral to primary care from specialty clinics for hypertension occurs infrequently, even among gynecologists.2 BP Connect, a staff protocol for specialty clinics, doubled the odds of timely primary care follow-up for rheumatology patients with hypertension (42% after BP Connect implementation vs 29% before BP Connect implementation).3 Here, we sought to evaluate the feasibility and impact of implementing BP Connect in gynecology clinics.

Objectives: Women at high risk for ovarian cancer are advised to undergo bilateral salpingo-oophorectomy (RRSO) prior to natural menopause. Hormone replacement therapy (HRT) mitigates the negative effects of surgical menopause. We sought to understand how high-risk women are counseled about HRT and use patterns of HRT after RRSO. Methods: We performed a chart review of women seen at a high-risk clinic between 2000-2018 who underwent RRSO. Reviewing patient age, surgical details, pathology, documented HRT counseling, and whether HRT was recommended. We then surveyed by mail, online, and by phone all women alive and meeting study criteria (no surgery for ovarian malignancy, surgery not just for ovarian suppression for breast cancer) to determine what they recalled regarding counseling, use of HRT, cancer diagnoses, and depression (PHQ9), anxiety (GAD7), and cancer worry (CWS) scores. Chi-square test and t-test compared categorical and continuous variables, respectively. Logistic regression examined associations between age, history of cancer, surgeries, and reports of HRT discussions and recommendations. Results: A total of 150 women met the survey criteria, with a 60.1% response rate. The median age at the survey was 57.5 years (range: 37-86). RRSO median age was 46 (range: 27-74). Those surveyed included 76 BRCA’, 50 BRCA2, 3 BRCA1 and BRCA2 mutation carriers, and 22 participants with other mutations or strong family histories. Responders and non-responders were alike in RRSO age and mutation status. About 44.4% of respondents recalled discussion about HRT; eight reported recommendations for HRT, 21 against, and 11 other guidance. Among the respondents, 51.5% reported undergoing hysterectomy; 17 (18.9%) respondents took HRT after surgery (64.7% estrogen alone). Five patients stopped HRT, three because a doctor advised, one because she was afraid, and one because she felt she no longer needed it. HRT recommendations were not associated with mastectomy (prophylactic or otherwise), hysterectomy, or cancer history. Younger age at RRSO was associated with receiving HRT counseling (RRSO age 43 if discussed vs 50 not discussed, p<0.01), but not with recommendations about HRT (RRSO age 41 if recommended vs 44 not recommended, p=0.06). RRSO age remained significant in predicting discussion, though other surgeries and cancer history did not. Starting or continuing HRT after RRSO was not indicative of depression or anxiety scores, but those taking HRT after RRSO had higher CWS (CWS > 10 in 82.4% with HRT vs 52.9% without, p=0.03). Eighteen (43.9%) respondents did not remember receiving counseling documented in the chart, while 15 (37.5%) remembered counseling that was not documented. Conclusions: A majority of patients undergoing RRSO did not receive HRT counseling, and nearly 44% did not remember documented HRT counseling. Surgeries and diagnoses that would impact HRT use were not correlated with recommendations. Younger age was correlated with discussion but not a recommendation for HRT. Before RRSO, we propose discussing HRT regardless of the recommendation for or against the use and providing written summaries to which patients and future healthcare providers can refer. Objectives: Women at high risk for ovarian cancer are advised to undergo bilateral salpingo-oophorectomy (RRSO) prior to natural menopause. Hormone replacement therapy (HRT) mitigates the negative effects of surgical menopause. We sought to understand how high-risk women are counseled about HRT and use patterns of HRT after RRSO. Methods: We performed a chart review of women seen at a high-risk clinic between 2000-2018 who underwent RRSO. Reviewing patient age, surgical details, pathology, documented HRT counseling, and whether HRT was recommended. We then surveyed by mail, online, and by phone all women alive and meeting study criteria (no surgery for ovarian malignancy, surgery not just for ovarian suppression for breast cancer) to determine what they recalled regarding counseling, use of HRT, cancer diagnoses, and depression (PHQ9), anxiety (GAD7), and cancer worry (CWS) scores. Chi-square test and t-test compared categorical and continuous variables, respectively. Logistic regression examined associations between age, history of cancer, surgeries, and reports of HRT discussions and recommendations. Results: A total of 150 women met the survey criteria, with a 60.1% response rate. The median age at the survey was 57.5 years (range: 37-86). RRSO median age was 46 (range: 27-74). Those surveyed included 76 BRCA’, 50 BRCA2, 3 BRCA1 and BRCA2 mutation carriers, and 22 participants with other mutations or strong family histories. Responders and non-responders were alike in RRSO age and mutation status. About 44.4% of respondents recalled discussion about HRT; eight reported recommendations for HRT, 21 against, and 11 other guidance. Among the respondents, 51.5% reported undergoing hysterectomy; 17 (18.9%) respondents took HRT after surgery (64.7% estrogen alone). Five patients stopped HRT, three because a doctor advised, one because she was afraid, and one because she felt she no longer needed it. HRT recommendations were not associated with mastectomy (prophylactic or otherwise), hysterectomy, or cancer history. Younger age at RRSO was associated with receiving HRT counseling (RRSO age 43 if discussed vs 50 not discussed, p<0.01), but not with recommendations about HRT (RRSO age 41 if recommended vs 44 not recommended, p=0.06). RRSO age remained significant in predicting discussion, though other surgeries and cancer history did not. Starting or continuing HRT after RRSO was not indicative of depression or anxiety scores, but those taking HRT after RRSO had higher CWS (CWS > 10 in 82.4% with HRT vs 52.9% without, p=0.03). Eighteen (43.9%) respondents did not remember receiving counseling documented in the chart, while 15 (37.5%) remembered counseling that was not documented. Conclusions: A majority of patients undergoing RRSO did not receive HRT counseling, and nearly 44% did not remember documented HRT counseling. Surgeries and diagnoses that would impact HRT use were not correlated with recommendations. Younger age was correlated with discussion but not a recommendation for HRT. Before RRSO, we propose discussing HRT regardless of the recommendation for or against the use and providing written summaries to which patients and future healthcare providers can refer.

INTRODUCTION: Opportunistic salpingectomy at the time of benign gynecologic surgery and cesarean delivery is a cost-effective strategy for ovarian cancer risk reduction. We sought to evaluate the cost-effectiveness of opportunistic salpingectomy compared to standard tubal ligation in the immediate postpartum period following vaginal deliveries. METHODS: Using two decision analytic models, we simulated a hypothetical cohort of 10,000 women undergoing bilateral salpingectomy or tubal ligation immediately following vaginal delivery. We derived probabilities of ovarian cancer risk reduction following tubal sterilization from published literature. We used institutional charge data to determine cost inputs. The primary outcome was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) at a cost-effectiveness threshold of $100,000/QALY. Institutional review board (IRB) approval was obtained. RESULTS: Opportunistic salpingectomy is more cost-effective than tubal ligation following vaginal delivery in a theoretical cohort, with an ICER of $24,176/QALY. Compared to tubal ligation, opportunistic salpingectomy yields a theoretical total cost savings of $6.48 million. Discounted costs of ovarian cancer were $2.9 million lower for the salpingectomy cohort compared to tubal ligation. Opportunistic salpingectomy avoided 12 fewer ovarian cancer cases and 8 fewer ovarian cancer deaths compared to tubal ligation. CONCLUSION: Our analytic model demonstrates that following vaginal delivery, opportunistic salpingectomy is a cost-effective strategy for reducing risk of ovarian cancer. Compared to tubal ligation, opportunistic salpingectomy reduces ovarian cancer cases and mortality.

OBJECTIVE:To compare operative outcomes of postpartum salpingectomy and tubal ligation after vaginal delivery.METHODS:This retrospective cohort study identified patients who underwent tubal sterilization between January 1, 2009, and December 31, 2019, at a large academic hospital, using the electronic medical record. All patients who delivered vaginally and underwent tubal sterilization during their delivery admissions were included. The primary outcome was total operative time. Secondary outcomes included estimated blood loss, perioperative complications, and readmission within 6 weeks postpartum. Patients who underwent bilateral tubal ligation were compared with those who underwent bilateral salpingectomy using Pearson's χ2 test, Fisher exact, and Student's t test.RESULTS:A total of 317 eligible patients were identified. One hundred and six (94%) salpingectomies were completed using a bipolar electrocautery device. Operative time was 3 minutes shorter in the salpingectomy group, 30 minutes (interquartile range 24-38) compared with 33.5 (26-42) minutes, P=.032. Patients who underwent salpingectomy were more likely to have estimated blood loss of 5 mL or less (our institutional shorthand for minimal blood loss) than women who underwent bilateral tubal ligation (78 [69%] vs 112 [55%], P=.015). There were no significant differences in perioperative complications between the groups.CONCLUSION:When using electrocautery, bilateral salpingectomy can be completed in the immediate postpartum period after vaginal delivery with equivalent operative times to bilateral tubal ligation.

Objectives: The fallopian tube has been implicated as the site of origin in up to 70% of ovarian carcinomas. In November 2013, the Society of Gynecologic Oncology (SGO) advised that women of average risk for ovarian cancer undergo opportunistic salpingectomy at the time of abdominal or pelvic surgery, such as hysterectomy or tubal sterilization, to reduce the risk of ovarian cancer. Opportunistic salpingectomy has previously been incorporated into various surgical procedures including cesarean section, however a paucity of data exists regarding salpingectomy following vaginal deliveries. Our objective was to assess the uptake of opportunistic salpingectomy as a form of postpartum sterilization after vaginal delivery following the 2013 release of the SGO clinical practice statement. Methods: We performed an IRB-approved, retrospective cohort study of all postpartum tubal sterilization procedures performed during delivery admissions between January 2009 and December 2019. All patients undergoing tubal sterilization within 48 hours of vaginal delivery were included. We collected patient demographics, medical history, peripartum and perioperative data. The primary outcome was proportion of sterilization procedures completed as salpingectomies before and after January 1st, 2014. Secondary outcomes included estimated blood loss (EBL), perioperative complications and readmission within 6 weeks postpartum. We used Pearson's c2 test, Fisher's exact and Student's t-test to compare the time periods. We analyzed trends using the Cochran-Mantel-Haenszel test. Results: Conclusions: Postpartum opportunistic salpingectomy rates following vaginal deliveries increased significantly from 2014 to 2019 after the release of the SGO recommendations to consider salpingectomy as an ovarian cancer prevention strategy. This trend in postpartum salpingectomy occurred without an observed increase in complications or readmissions. Opportunistic salpingectomy should be considered a safe and feasible means of potential ovarian cancer risk reduction for patients who undergo vaginal deliveries and desire immediate postpartum sterilization. The fallopian tube has been implicated as the site of origin in up to 70% of ovarian carcinomas. In November 2013, the Society of Gynecologic Oncology (SGO) advised that women of average risk for ovarian cancer undergo opportunistic salpingectomy at the time of abdominal or pelvic surgery, such as hysterectomy or tubal sterilization, to reduce the risk of ovarian cancer. Opportunistic salpingectomy has previously been incorporated into various surgical procedures including cesarean section, however a paucity of data exists regarding salpingectomy following vaginal deliveries. Our objective was to assess the uptake of opportunistic salpingectomy as a form of postpartum sterilization after vaginal delivery following the 2013 release of the SGO clinical practice statement. We performed an IRB-approved, retrospective cohort study of all postpartum tubal sterilization procedures performed during delivery admissions between January 2009 and December 2019. All patients undergoing tubal sterilization within 48 hours of vaginal delivery were included. We collected patient demographics, medical history, peripartum and perioperative data. The primary outcome was proportion of sterilization procedures completed as salpingectomies before and after January 1st, 2014. Secondary outcomes included estimated blood loss (EBL), perioperative complications and readmission within 6 weeks postpartum. We used Pearson's c2 test, Fisher's exact and Student's t-test to compare the time periods. We analyzed trends using the Cochran-Mantel-Haenszel test. Postpartum opportunistic salpingectomy rates following vaginal deliveries increased significantly from 2014 to 2019 after the release of the SGO recommendations to consider salpingectomy as an ovarian cancer prevention strategy. This trend in postpartum salpingectomy occurred without an observed increase in complications or readmissions. Opportunistic salpingectomy should be considered a safe and feasible means of potential ovarian cancer risk reduction for patients who undergo vaginal deliveries and desire immediate postpartum sterilization.