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Dr. Shaw specializes in complex family planning, contraception, abortion, early pregnancy management and general gynecology. As the Chief of Gynecology and Gynecologic Specialties at Stanford, she values inclusive, compassionate, expert clinical care. She is passionate about medical education and shaping future physicians, supporting training programs for students, residents and fellows in her role as the Associate Chair of Education for Obstetrics and Gynecology. She is an active mentor and researcher with her clinical research aimed at improving patient experiences and access to comprehensive reproductive health care. Dr. Shaw is an advocate for her patients and health care locally, nationally and across the globe. She aims to partner with each patient to best provide the individualized care that suits their life and goals.
Contraception and Safe Abortion
My research interests include expanding access to and and improving patient experience with contraception and abortion care both domestically and globally. I am also interested in medical education and resilience among physicians and trainees.
MisOpRostol Effect on Second Trimester Abortion Blood Loss
Although serious complications from second trimester abortion are rare hemorrhage is the most
common cause of procedural abortion related morbidity and mortality. Misoprostol is a
prostaglandin E1 analogue that is used by 75% of clinicians prior to procedural abortion for
the purpose of cervical preparation. Misoprostol is also known to decrease blood loss in
first trimester abortion and is used to treat postpartum hemorrhage, however the effect of
preprocedural misoprostol on procedural blood loss is not well described.
We will conduct a double blinded placebo-controlled gestational age stratified superiority
trial of those undergoing procedural abortion between 18 and 23 weeks gestation at Stanford
Health care. Participants will be randomized to either 400mcg buccal misoprostol or placebo
on the day of the procedure. A quantified blood loss (QBL) will be measured during the
procedure and participants will complete a survey to assess symptoms. Our primary outcome is
quantified blood loss. Secondary outcomes include clinical interventions to manage excess
bleeding, total procedure time, provider reported experience, patient reported experience.
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Cabergoline for Lactation Inhibition After Early Second-Trimester Abortion or Pregnancy Loss
Breast pain following second-trimester abortion is common. Breast engorgement and milk
leakage following second-trimester perinatal loss and abortion can cause both physical pain
and emotional distress. Dopamine agonists have previously been shown to be effective in
lactation inhibition for third-trimester fetal/neonatal loss or contraindications to
breastfeeding. The investigator's prior work demonstrated that compared to placebo, a single
dose of cabergoline was effective in preventing breast symptoms after abortion or loss 18-28
weeks. As lactogenesis starts as early as 16 weeks gestation, the investigators hope to
determine the efficacy of cabergoline earlier in the second trimester,16-20 weeks.
Transcutaneous Electrical Nerve Stimulation for Pain Control During First-trimester Abortion
First-trimester abortion aspiration procedures are painful and sedation is typically
provided. It is unsafe to drive after sedation due to the prolonged motor delay from some
anesthetic agents. Without a known escort, most clinics do not allow patients to use public
transportation, taxis, or rideshare services. Arranging a ride may be harder for those
seeking abortion care than other surgical procedures given privacy concerns and the need to
travel far distances. Additionally, some people have medical reasons that makes sedation in
an outpatient abortion clinic unsafe. As abortion restrictions increase and more people need
to travel far distances to access care, it is important to investigate non-pharmacologic pain
Transcutaneous electrical nerve stimulation (TENS) delivers a low-level electrical current
through the skin. By activating the descending inhibitory systems in the central nervous
system, these pulses of electrical current reduce sensitivity to pain. TENS has been shown to
be effective in decreasing pain with menstrual cramps and during medication abortion, and it
was found to be non-inferior to IV sedation for first-trimester procedural abortion. However,
it remains unclear if TENS is better than ibuprofen and local anesthesia via paracervical
The overarching goal of this research is to identify an inexpensive, non-pharmacologic,
alternative pain control strategy for those with a medical or social contraindication to IV
sedation. The specific aim of this project is to evaluate the efficacy of TENS to prevent
pain during first-trimester procedural abortion. To achieve this objective, a blinded,
randomized superiority trial comparing the use of TENS to sham for management of pain during
first-trimester aspiration abortion is proposed. This research is significant because the
validation of a non-pharmacologic pain management technique would decrease barriers to
accessing abortion care.