Woman at the Well Read John 4:7-18, 28-30. Jacob’s well 1900-1920.
Recommendations for Well-Woman Care – A Well …...Recommendations for Well-Woman Care – A...
2
Recommendations for Well-Woman Care – A Well-Woman Chart ©2020, Content owned by the ACOG Foundation, all Marks and Rights Reserved. This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UHOMC29940, Bright Futures for Women’s Health: Standard Practice Guidelines for Well Women Care. This information or content and conclusions are those of the author and should not be construed as the official position nor policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. a Additional Bright Futures recommendations include: Periodic vision and hearing tests for ages 13-21; risk assessment for anemia for ages 13-21; and fluoride supplementation if needed for ages 13-16. b Immunizations should be administered according to the most recent ACIP recommendations (https://www.cdc.gov/vaccines/schedules/index.html). Abbreviations: ACIP = Advisory Committee on Immunization Practices; BRCA = breast cancer susceptibility gene; CRC = colorectal cancer; CVD = cardiovascular disease; HIV = human immunodeficiency virus; HCV = hepatitis C virus; HBV = hepatitis B virus; STI = sexually transmitted infection; USPSTF = U.S. Preventive Services Task Force; WPSI = Women’s Preventive Services Initiative. *Criteria for selective screening 1. Low-dose aspirin to prevent cardiovascular disease and colorectal cancer: Calculated 10-year risk of a CVD event ≥10%; not at increased risk for bleeding; have a life expectancy of at least 10 years; and are willing to take low-dose aspirin daily for at least 10 years. 2. Diabetes screening and management: Overweight or obese for age 40-70 years; previous gestational diabetes but not previously diagnosed with diabetes mellitus when not pregnant for age ≥13 years. 3. Folic acid supplementation: Sexually active and planning or capable of pregnancy. 4. Healthy diet and physical activity counseling: Overweight or obese and have additional CVD risk factors (hypertension, dyslipidemia, abnormal blood glucose levels, diabetes). Specific anticipatory guidance for ages 13-17 may be found in the Bright Futures Guidelines. 5. Lipid screening: Familial dyslipidemia, risk factors, or high-risk conditions for age 13-16 years; universal screening once between age 17-21 years; clinical judgement for age 22-39 years. 6. Osteoporosis screening: 10-year fracture risk equivalent to an average-risk 65-year old woman based on specific risk factors (parental history of hip fracture, smoking, white race, excess alcohol consumption, low body weight). 7. Statin use to prevent CVD: Age 40 to 75 years; one or more CVD risk factors (i.e., dyslipidemia, diabetes, hypertension, or smoking); and calculated 10-year risk of a CVD event ≥10%. 8. Urinary incontinence screening: Screen all women age 18 and older and younger women if postpartum. 9. Gonorrhea and chlamydia screening: New sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI; inconsistent condom use among persons who are not in mutually monogamous relationships; previous or coexisting STI; and exchanging sex for money or drugs. Prevalence is also higher among incarcerated populations, military recruits, and patients receiving care at public STI clinics. 10. Hepatitis B screening: Born in a country with a prevalence of HBV infection ≥2%; lack of vaccination in infancy in U.S.-born persons with parents from a country or region with prevalence ≥8%; HIV-positive persons; injection drug users; and household contacts or sexual partners of persons with HBV infection. 11. Hepatitis C screening: One-time screening for asymptomatic adults age 18-79 without known liver disease. Repeat screening and screen at other ages if increased risk: past or current injection drug use; receipt of a blood transfusion before 1992; long-term hemodialysis; born to an HCV- infected mother; incarceration; intranasal drug use; getting an unregulated tattoo; and other percutaneous exposures (e.g. health care workers). 12. HIV preexposure prophylaxis (PrEP): Candidates for include 1) heterosexually active women with: a serodiscordant sex partner (i.e., in a sexual relationship with a partner living with HIV); or inconsistent use of condoms during sex with a partner whose HIV status is unknown and who is at high risk; or an STI with syphilis or gonorrhea within the past 6 months; 2) uses injection drugs and shared use of drug injection equipment; or has risk of sexual acquisition of HIV based on above; 3) engaged in transactional sex, such as for money, drugs, or other. 13. Sexually transmitted infection prevention counseling: New sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI; inconsistent condom use among persons who are not in mutually monogamous relationships; previous or coexisting STI; and exchanging sex for money or drugs. Prevalence is also higher among incarcerated populations, military recruits, and patients receiving care at public STI clinics. 14. Syphilis screening: Women with HIV; high prevalence communities or populations; history of incarceration; exchanging sex for money or drugs. 15. Latent tuberculosis infection: Persons from countries with increased tuberculosis prevalence; living in high-risk congregate settings (e.g., homeless shelters, correctional facilities); exposure to individuals with active tuberculosis, such as health care workers and workers in high-risk congregate settings; immunosuppressed individuals. 16. Breast cancer screening: No specific criteria, decisions about screening are made on an individual basis through a shared-decision making process. 17. Lung cancer screening: 30 pack-year smoking history and currently smoke or have quit within the past 15 years. 18. Medications to reduce breast cancer risk: Major risk factors for breast cancer include increasing age, family history of breast or ovarian cancer (especially among first-degree relatives and onset before age 50 years), history of atypical hyperplasia or other nonmalignant high-risk breast lesions, previous breast biopsy, and extremely dense breast tissue. Models suggest that women with an estimated 5-year breast cancer risk of 3% or greater are likely to have more benefit than harm, although the balance of benefits and harms depends on age, race or ethnicity, the medication used, and whether the patient has a uterus. 19. Skin cancer counseling: Fair skin, light hair and eye color, freckles, sunburn easily. 20. Perinatal depression interventions: Counseling interventions for women with one or more of the following: a history of depression, current depressive symptoms that may not reach a diagnostic threshold, socioeconomic risk factors such as low income or adolescent or single parenthood, recent intimate partner violence, or mental health–related factors such as elevated anxiety symptoms or a history of significant negative life events. 21. Preeclampsia prevention with low-dose aspirin: History of preeclampsia, especially when accompanied by an adverse outcome; multifetal gestation; chronic hypertension; type 1 or 2 diabetes mellitus; renal disease; autoimmune disease (systemic lupus erythematous, antiphospholipid syndrome). 22. Diabetes screening after pregnancy: Previous gestational diabetes but not previously diagnosed with diabetes mellitus when not pregnant.
Transcript of Recommendations for Well-Woman Care – A Well …...Recommendations for Well-Woman Care – A...
Rec
omm
enda
tion
s fo
r W
ell-W
oman
Car
e –
A W
ell-W
oman
Cha
rt
©20
20, C
onte
nt o
wne
d by
the
ACO
G F
ound
atio
n, a
ll M
arks
and
Rig
hts
Rese
rved
. Thi
s pr
ojec
t was
sup
port
ed b
y th
e H
ealth
Res
ourc
es a
nd S
ervi
ces
Adm
inis
trat
ion
(HRS
A) o
f the
U.S
. Dep
artm
ent o
f Hea
lth a
nd H
uman
Ser
vice
s (H
HS)
und
er g
rant
num
ber U
HO
MC
2994
0, B
righ
t Fut
ures
for W
omen
’s H
ealth
: Sta
ndar
d Pr
actic
e G
uide
lines
for
Wel
l Wom
en C
are.
Thi
s in
form
atio
n or
con
tent
and
con
clus
ions
are
thos
e of
the
auth
or a
nd sh
ould
not
be
cons
true
d as
the
offic
ial p
ositi
on n
or p
olic
y of
, nor
shou
ld a
ny e
ndor
sem
ents
be
infe
rred
by
HRS
A, H
HS,
or t
he U
.S. G
over
nmen
t.
a Addi
tiona
l Bri
ght F
utur
es re
com
men
datio
ns in
clud
e: P
erio
dic
visi
on a
nd h
eari
ng te
sts
for a
ges
13-2
1; ri
sk a
sses
smen
t for
ane
mia
for a
ges
13-2
1; an
d flu
orid
e su
pple
men
tatio
n if
need
ed fo
r age
s 13
-16.
b Im
mun
izat
ions
shou
ld b
e ad
min
iste
red
acco
rdin
g to
the
mos
t rec
ent A
CIP
reco
mm
enda
tions
(htt
ps://
ww
w.c
dc.g
ov/v
acci
nes/
sche
dule
s/in
dex.
htm
l).
Abb
revi
atio
ns:
ACIP
= A
dvis
ory
Com
mitt
ee o
n Im
mun
izat
ion
Prac
tices
; BRC
A =
brea
st c
ance
r sus
cept
ibili
ty g
ene;
CRC
= c
olor
ecta
l can
cer;
CVD
= c
ardi
ovas
cula
r di
seas
e; H
IV =
hum
an im
mun
odefi
cien
cy v
irus
; HC
V =
hepa
titis
C v
irus
; HBV
= h
epat
itis
B vi
rus;
STI
= s
exua
lly tr
ansm
itted
infe
ctio
n; U
SPST
F =
U.S
. Pre
vent
ive
Serv
ices
Tas
k Fo
rce;
WPS
I = W
omen
’s P
reve
ntiv
e Se
rvic
es In
itiat
ive.
*Cri
teri
a fo
r se
lect
ive
scre
enin
g1.
Low
-dos
e as
piri
n to
pre
vent
car
diov
ascu
lar d
isea
se a
nd c
olor
ecta
l can
cer:
Cal
cula
ted
10-y
ear r
isk
of a
CVD
eve
nt ≥
10%
; not
at i
ncre
ased
risk
fo
r ble
edin
g; h
ave
a lif
e ex
pect
ancy
of a
t lea
st 10
yea
rs; a
nd a
re w
illin
g to
take
low
-dos
e as
piri
n da
ily fo
r at l
east
10 y
ears
.2.
Dia
bete
s sc
reen
ing
and
man
agem
ent:
Ove
rwei
ght o
r obe
se fo
r age
40-
70 y
ears
; pre
viou
s ge
stat
iona
l dia
bete
s bu
t not
pre
viou
sly
diag
nose
d w
ith d
iabe
tes
mel
litus
whe
n no
t pre
gnan
t for
age
≥13
yea
rs.
3. F
olic
aci
d su
pple
men
tatio
n: S
exua
lly a
ctiv
e an
d pl
anni
ng o
r cap
able
of p
regn
ancy
.4.
Hea
lthy
diet
and
phy
sica
l act
ivity
cou
nsel
ing:
Ove
rwei
ght o
r obe
se a
nd h
ave
addi
tiona
l CVD
risk
fact
ors
(hyp
erte
nsio
n, d
yslip
idem
ia, a
bnor
mal
bl
ood
gluc
ose
leve
ls, d
iabe
tes)
. Spe
cific
ant
icip
ator
y gu
idan
ce fo
r age
s 13
-17
may
be
foun
d in
the
Brig
ht F
utur
es G
uide
lines
.5.
Lip
id s
cree
ning
: Fam
ilial
dys
lipid
emia
, ris
k fa
ctor
s, o
r hig
h-ri
sk c
ondi
tions
for a
ge 13
-16
year
s; u
nive
rsal
scr
eeni
ng o
nce
betw
een
age
17-2
1 yea
rs;
clin
ical
judg
emen
t for
age
22-
39 y
ears
.6.
Ost
eopo
rosi
s sc
reen
ing:
10-y
ear f
ract
ure
risk
equ
ival
ent t
o an
ave
rage
-ris
k 65
-yea
r old
wom
an b
ased
on
spec
ific
risk
fact
ors
(par
enta
l his
tory
of
hip
frac
ture
, sm
okin
g, w
hite
race
, exc
ess
alco
hol c
onsu
mpt
ion,
low
bod
y w
eigh
t).
7. St
atin
use
to p
reve
nt C
VD:
Age
40 to
75
year
s; o
ne o
r mor
e C
VD ri
sk fa
ctor
s (i
.e.,
dysl
ipid
emia
, dia
bete
s, h
yper
tens
ion,
or s
mok
ing)
; an
d ca
lcul
ated
10-y
ear r
isk
of a
CVD
eve
nt ≥
10%
.8.
Uri
nary
inco
ntin
ence
scr
eeni
ng: S
cree
n al
l wom
en a
ge 18
and
old
er a
nd y
oung
er w
omen
if p
ostp
artu
m.
9. G
onor
rhea
and
chl
amyd
ia s
cree
ning
: New
sex
par
tner
, mor
e th
an o
ne s
ex p
artn
er, a
sex
par
tner
with
con
curr
ent p
artn
ers,
or a
sex
par
tner
w
ho h
as a
n ST
I; in
cons
iste
nt c
ondo
m u
se a
mon
g pe
rson
s w
ho a
re n
ot in
mut
ually
mon
ogam
ous
rela
tions
hips
; pre
viou
s or
coe
xist
ing
STI;
and
exch
angi
ng s
ex fo
r mon
ey o
r dru
gs. P
reva
lenc
e is
als
o hi
gher
am
ong
inca
rcer
ated
pop
ulat
ions
, mili
tary
recr
uits
, and
pat
ient
s re
ceiv
ing
care
at p
ublic
STI
clin
ics.
10
. Hep
atiti
s B
scre
enin
g: B
orn
in a
cou
ntry
with
a p
reva
lenc
e of
HBV
infe
ctio
n ≥2
%; l
ack
of v
acci
natio
n in
infa
ncy
in U
.S.-b
orn
pers
ons
with
pa
rent
s fr
om a
cou
ntry
or r
egio
n w
ith p
reva
lenc
e ≥8
%; H
IV-p
ositi
ve p
erso
ns; i
njec
tion
drug
use
rs; a
nd h
ouse
hold
con
tact
s or s
exua
l par
tner
s of
per
sons
with
HBV
infe
ctio
n.11
. Hep
atiti
s C
scr
eeni
ng: O
ne-t
ime
scre
enin
g fo
r asy
mpt
omat
ic a
dults
age
18-7
9 w
ithou
t kno
wn
liver
dis
ease
. Re
peat
scre
enin
g an
d sc
reen
at o
ther
ag
es if
incr
ease
d ris
k: p
ast o
r cur
rent
inje
ctio
n dr
ug u
se; r
ecei
pt o
f a b
lood
tran
sfus
ion
befo
re 19
92; l
ong-
term
hem
odia
lysi
s; bo
rn to
an
HC
V-in
fect
ed m
othe
r; in
carc
erat
ion;
intr
anas
al d
rug
use;
get
ting
an u
nreg
ulat
ed ta
ttoo
; and
oth
er p
ercu
tane
ous e
xpos
ures
(e.g
. hea
lth c
are
wor
kers
).12
. HIV
pre
expo
sure
pro
phyl
axis
(PrE
P): C
andi
date
s fo
r inc
lude
1) h
eter
osex
ually
act
ive
wom
en w
ith: a
ser
odis
cord
ant s
ex p
artn
er (i
.e.,
in a
sex
ual
rela
tions
hip
with
a p
artn
er li
ving
with
HIV
); or
inco
nsis
tent
use
of c
ondo
ms
duri
ng s
ex w
ith a
par
tner
who
se H
IV s
tatu
s is
unk
now
n an
d w
ho is
at
hig
h ri
sk; o
r an
STI w
ith s
yphi
lis o
r gon
orrh
ea w
ithin
the
past
6 m
onth
s; 2
) use
s in
ject
ion
drug
s an
d sh
ared
use
of d
rug
inje
ctio
n eq
uipm
ent;
or h
as ri
sk o
f sex
ual a
cqui
sitio
n of
HIV
bas
ed o
n ab
ove;
3) e
ngag
ed in
tran
sact
iona
l sex
, suc
h as
for m
oney
, dru
gs, o
r oth
er.
13. S
exua
lly tr
ansm
itted
infe
ctio
n pr
even
tion
coun
selin
g: N
ew s
ex p
artn
er, m
ore
than
one
sex
par
tner
, a s
ex p
artn
er w
ith c
oncu
rren
t par
tner
s,
or a
sex
par
tner
who
has
an
STI;
inco
nsis
tent
con
dom
use
am
ong
pers
ons
who
are
not
in m
utua
lly m
onog
amou
s re
latio
nshi
ps; p
revi
ous
or c
oexi
stin
g ST
I; an
d ex
chan
ging
sex
for m
oney
or d
rugs
. Pre
vale
nce
is a
lso
high
er a
mon
g in
carc
erat
ed p
opul
atio
ns, m
ilita
ry re
crui
ts,
and
patie
nts
rece
ivin
g ca
re a
t pub
lic S
TI c
linic
s.
14. S
yphi
lis s
cree
ning
: Wom
en w
ith H
IV; h
igh
prev
alen
ce c
omm
uniti
es o
r pop
ulat
ions
; his
tory
of i
ncar
cera
tion;
exc
hang
ing
sex
for m
oney
or d
rugs
.15
. Lat
ent t
uber
culo
sis
infe
ctio
n: P
erso
ns fr
om c
ount
ries
with
incr
ease
d tu
berc
ulos
is p
reva
lenc
e; li
ving
in h
igh-
risk
con
greg
ate
sett
ings
(e.g
., ho
mel
ess
shel
ters
, cor
rect
iona
l fac
ilitie
s); e
xpos
ure
to in
divi
dual
s w
ith a
ctiv
e tu
berc
ulos
is, s
uch
as h
ealth
car
e w
orke
rs a
nd w
orke
rs in
hig
h-ri
sk
cong
rega
te s
ettin
gs; i
mm
unos
uppr
esse
d in
divi
dual
s.16
. Bre
ast c
ance
r scr
eeni
ng: N
o sp
ecifi
c cr
iteria
, dec
isio
ns a
bout
scre
enin
g ar
e m
ade
on a
n in
divi
dual
bas
is th
roug
h a
shar
ed-d
ecis
ion
mak
ing
proc
ess.
17. L
ung
canc
er s
cree
ning
: 30
pack
-yea
r sm
okin
g hi
stor
y an
d cu
rren
tly s
mok
e or
hav
e qu
it w
ithin
the
past
15 y
ears
.18
. Med
icat
ions
to re
duce
bre
ast c
ance
r ris
k: M
ajor
risk
fact
ors
for b
reas
t can
cer i
nclu
de in
crea
sing
age
, fam
ily h
isto
ry o
f bre
ast o
r ova
rian
can
cer
(esp
ecia
lly a
mon
g fir
st-d
egre
e re
lativ
es a
nd o
nset
bef
ore
age
50 y
ears
), hi
stor
y of
aty
pica
l hyp
erpl
asia
or o
ther
non
mal
igna
nt h
igh-
risk
bre
ast
lesi
ons,
pre
viou
s br
east
bio
psy,
and
ext
rem
ely
dens
e br
east
tiss
ue. M
odel
s su
gges
t tha
t wom
en w
ith a
n es
timat
ed 5
-yea
r bre
ast c
ance
r ris
k of
3%
or g
reat
er a
re li
kely
to h
ave
mor
e be
nefit
than
har
m, a
lthou
gh th
e ba
lanc
e of
ben
efits
and
har
ms
depe
nds
on a
ge, r
ace
or e
thni
city
, the
m
edic
atio
n us
ed, a
nd w
heth
er th
e pa
tient
has
a u
teru
s.19
. Ski
n ca
ncer
cou
nsel
ing:
Fai
r ski
n, li
ght h
air a
nd e
ye c
olor
, fre
ckle
s, s
unbu
rn e
asily
.20
. Per
inat
al d
epre
ssio
n in
terv
entio
ns: C
ouns
elin
g in
terv
entio
ns fo
r wom
en w
ith o
ne o
r mor
e of
the
follo
win
g: a
his
tory
of d
epre
ssio
n, c
urre
nt
depr
essi
ve sy
mpt
oms t
hat m
ay n
ot re
ach
a di
agno
stic
thre
shol
d, so
cioe
cono
mic
risk
fact
ors s
uch
as lo
w in
com
e or
ado
lesc
ent o
r sin
gle
pare
ntho
od,
rece
nt in
timat
e pa
rtne
r vio
lenc
e, o
r men
tal h
ealth
–rel
ated
fact
ors s
uch
as e
leva
ted
anxi
ety
sym
ptom
s or a
his
tory
of s
igni
fican
t neg
ativ
e lif
e ev
ents
.21
. Pre
ecla
mps
ia p
reve
ntio
n w
ith lo
w-d
ose
aspi
rin: H
isto
ry o
f pre
ecla
mps
ia, e
spec
ially
whe
n ac
com
pani
ed b
y an
adv
erse
out
com
e; m
ultif
etal
ges
tatio
n;
chro
nic
hype
rten
sion
; typ
e 1 o
r 2 d
iabe
tes m
ellit
us; r
enal
dis
ease
; aut
oim
mun
e di
seas
e (s
yste
mic
lupu
s ery
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PREVENTION SERVICESAGE (Years)
13 –17a 18–21a 22–39 40–49 50–64 65–75 >75 GENERAL HEALTH
Alcohol use screening & counseling Anxiety screening
Aspirin to prevent CVD & CRC1 50-59 Blood pressure screening Contraceptive counseling & methods Depression screening Diabetes screening2
Folic acid supplementation3
Healthy diet & activity counseling4
Interpersonal violence screening Lipid screening5
Obesity screening & counseling Osteoporosis screening6
Fall prevention Statin use to prevent CVD7
Substance use assessment Tobacco screening & counseling Urinary incontinence screening8
INFECTIOUS DISEASES
Gonorrhea & chlamydia screening9 ≤24 >24Hepatitis B screening10
Hepatitis C screening (at least once)11 <79HIV preexposure prophylaxis12
HIV risk assessmentHIV screening (at least once) ≥15Immunizationsb
STI prevention counseling13
Syphilis screening14
Tuberculosis screening15
CANCER
Breast cancer screening16
Cervical cancer screening ≥21 ≤65Colorectal cancer screeningLung cancer screening17 55-80 55-80Medications to reduce breast cancer risk18
Risk assessment for BRCA 1/2 testingSkin cancer counseling19 ≤24
PREVENTION SERVICESfor pregnancy provided in addition to age-based services listed above.
PREGNANCYAnxiety screening
Bacteriuria screeningBreastfeeding counseling, services & suppliesContraceptive counseling & methodsDepression and Perinatal Depression Screening20
Folic acid supplementationGestational diabetes screeningGonorrhea & chlamydia screeningHepatitis B screeningHIV screening (each pregnancy)Interpersonal violence screeningPreeclampsia prevention with low-dose aspirin21
Preeclampsia screeningRh(D) blood typingSyphilis screeningTobacco screening & counseling
PREVENTION SERVICESfor postpartum provided in addition to age-based services listed above.
POSTPARTUMAnxiety screening
Breastfeeding counseling, services & suppliesContraceptive counseling & methodsDepression and Perinatal Depression Screening20
Diabetes screening after gestational diabetes22
Folic acid supplementationInterpersonal violence screeningTobacco screening & counseling
KEY: Recommended by the USPSTF (A or B rating), WPSI, or Bright Futures Recommended for selected groups
Preventive care visits provide an excellent opportunity for well-woman care including screening, evaluation of health risks and needs, counseling, and immunizations. Recommendations for Well-Woman Care – A Well-Woman Chart was developed by the Women’s Preventive Services Initiative (WPSI). The Well-Woman Chart outlines preventive services recommended by the WPSI, U.S. Preventive Services Task Force (USPSTF), and Bright Futures based on age, health status, and risk factors. Additional recommendations for immunizations are provided in a separate table from the Advisory Committee on Immunization Practices. Clinical practice considerations, risk assessment methods, and the age and frequency to deliver services are described in the Clinical Summary Tables that accompany the chart.
The Well-Woman Chart provides a framework for incorporating preventive health services for women into clinical practice. These services may be completed at a single visit or as part of a series of visits that take place over time. This information is designed as an educational resource to aid clinicians in providing preventive health services for women, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. While every effort is made to present accurate and reliable information, this publication is provided “as is” without any guarantees or warranties of accuracy, reliability, or otherwise, either express or implied. The Chart and Tables are updated annually. The WPSI website (www.womenspreventivehealth.org) has the most up-to-date version of the Chart and Clinical Summary Tables.
Recommendations from the WPSI and the USPSTF for preventive services for pregnant and postpartum women are also provided in the Well-Woman Chart. Comprehensive recommendations for pregnant and postpartum women can be found in ACOG’s practice guidelines and other educational materials.
2020 RECOMMENDATIONS FOR WELL-WOMAN CARE
MEMBERS OF THE ADVISORY PANEL SUPPORT THE WPSI
Copyright © 2020 by the ACOG Foundation, updated April 2020
