Nurse practitioner education: keeping the academic pipeline open to meet family planning needs in the United States.

According to the Centers for Disease Control and Prevention, family planning is one of the greatest public health achievements of the 20th century. Ample research shows that family planning helps women and men maintain reproductive health, allows women to avoid unintended pregnancies and assists families in determining the number, timing and spacing of their children — all of which contribute to the well-being of individuals, families and the broader society as well [1]. There are 66.4 million women in the United States of reproductive age (13–44 years). More than half (36.2 million) of these women are sexually active, not seeking pregnancies and in need of contraceptive services and supplies. Due primarily to poverty or young age, over 17.5 million of these women do not have insurance or financial resources and need publicly funded contraceptive care [2]. Nurse practitioners (NPs) provide the majority of family planning services in public health departments, community health centers and Planned Parenthood affiliates in the United States. For example, 75% of the 1780 clinicians employed nationally by Planned Parenthood affiliates are NPs [3]. Family planning centers are facing many challenges today such as serving a more diverse population with increasingly complex needs, rising costs, a poor economy and new technologies. Many are also facing a shortage of health care providers. Recruitment and retention of clinicians who provide reproductive care — physicians, NPs, certified nurse midwives and physician assistants — are very costly tasks. The provision of family planning services requires unique skills, knowledge and sensitivity to client needs. Policy makers, public health leaders and other stakeholders are concerned that we are not educating enough new clinicians to provide family planning services to future generations. If NPs are to continue to provide a majority of family planning care, we need to examine the pipeline into NP careers and address issues that could potentially impact future access to care. One of these concerns is that the number of women's health NPs (WHNPs) entering the profession has declined in recent years. As WHNPs retire, the supply will not keep up with the demand. The National