A career helping women and girls take control of their reproductive health
By Jan Greene
A woman’s ability to plan if and when she has children is a central pillar of reproductive health — and social and economic progress for both women and their children.
Division of Research Investigator Tina Raine-Bennett, MD, MPH, has been tackling these issues her entire career. She conducts research on contraception and reproductive health and has worked directly with teenage girls in clinical practice.
Before coming to the Division of Research as a senior research scientist, Raine-Bennett was a professor at the University of California, San Francisco (UCSF) and medical director of the New Generation Health Center. She has also been active on the national level with medical journals, the Planned Parenthood Federation of America, and the American College of Obstetrics and Gynecology; she currently serves on the board of the Society of Family Planning. Raine-Bennett continues clinical practice in the obstetrics and gynecology department at Kaiser Permanente’s Oakland Medical Center as a senior physician with The Permanente Medical Group.
Raine-Bennett answered a few of our questions about her work.
How did you get interested in family planning issues?
It was actually back in junior high school, when my best friend had an unintended pregnancy in ninth grade. She had the baby, who the family helped raise, but she was a mother at age 15. Our lives took different paths and I went off to college and medical school. When I became an obstetrician/gynecologist, her story stuck with me, and I decided to specialize in family planning.
I think it’s really important for teenagers and for all women to plan their families when it’s right for them. I’ve done a fair amount of research around increasing access to contraception for teenagers. When I was with UCSF, I was medical director of a teen reproductive health clinic. I still volunteer at that clinic because I appreciate how difficult adolescence is and enjoy making the experience of visiting a gynecologist as positive as possible. At that time the focus of my research was around emergency contraception. I led the actual use study that demonstrated that teens could use emergency contraception without provider supervision; the study supported the Food and Drug Administration’s move to make emergency contraception available to teenagers over the counter.
What kind of research are you focusing on now?
I’ve continued to focus on contraceptive use and understanding the outcomes associated with the use of different methods. For instance, I’m currently collaborating with investigators from 2 other Kaiser Permanente research regions to look at uterine perforation and expulsion rates for IUDs. I’m also working with research colleagues on ectopic pregnancy rates associated with different contraceptive methods. The benefit of being with the Division of Research is our access to data about millions of women who are members of Kaiser Permanente Northern California, and their experience with contraceptives.
I’m also working in a collaboration of the National Cancer Institute to improve cervical cancer screening. We are looking for biomarkers to identify which HPV infections are destined to become cervical cancer. That would allow us to really target diagnostics and potential treatments.
How would you describe the state of contraceptive research?
Access to contraception has improved tremendously in the last two decades, in part because of introduction of new methods and the Affordable Care Act, which considers birth control preventive health to be covered by insurance without copayment. While we have several effective and safe methods, many women have difficulty finding a method that meets their personal preferences and needs, and there are still over 2 million unintended pregnancies each year in the U.S. Most methods contain hormones, which can be associated with side effects including changes in the menstrual cycle, weight, appetite, and mood. Women may need to try different methods to find the one that works best for them.
There is ongoing contraceptive development research of methods that do not contain estrogen or hormones at all, as well as intrauterine devices that do not release hormones. I am part of the Contraceptive Clinical Trials Network, sponsored by the National Institutes of Health, and that is a big focus of its work.
Is there anything people should know about this field that they might not be aware of?
Half of all pregnancies are still unintended – the women weren’t planning or trying to get pregnant. Ensuring optimal timing of pregnancy is as essential as preventing illnesses. It has an important role in helping women and their children thrive and live their best lives.
What do you like to do in your free time?
I enjoy anything that gets me moving and frees my mind. The easiest way to do that is exercising with music. I love indoor cycling at RideOakland or SoulCycle because there’s community and it’s efficient. During the pandemic, I have discovered Peloton and jogging the stairs in my neighborhood in the Oakland hills; the scenery is amazing and I have gotten to meet many of my neighbors.