Cynthia Harper, PhD

Professor In Residence
Ob/Gyn, Reproductive Sciences
+1 415 502-4092

Cynthia C. Harper, PhD, is a Professor in Residence in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, and is the Director of the UCSF-Kaiser BIRCWH (Building Interdisciplinary Research Careers in Women's Health) K12 scholar training program. She is a member of the Bixby Center for Global Reproductive Health Executive Committee. Dr. Harper conducts research on contraception with the aim of improving access to care and women's health outcomes through clinical practice and health policy changes.

With a team at UCSF Bixby, she conducted a series of studies over many years and policy contexts that helped to transform emergency contraception from a little known regimen of cut up packets of pills to a product widely available over the counter to everyone, including teens and undocumented populations. The research informed judicial and FDA decisions to ultimately move emergency contraception over-the-counter in the U.S. It also had a wide impact on policy and regulatory decisions in other countries where women can now access emergency contraception.

Dr. Harper and her research team developed a provider contraceptive training curriculum that successfully reduced unintended pregnancy by nearly half among women in family planning clinics. Unintended pregnancy is high in the U.S at almost half of all pregnancies. The clinic intervention, tested in a large, national randomized trial, was a the first one to effectively decrease unintended pregnancy. The intervention also was demonstrated to respect women's autonomy in contraceptive-decision-making.

Based on this effective intervention, Dr. Harper and her national training team, led by Dr. Suzan Goodman, have built a contraceptive training program, Beyond the Pill (beyondthepill.ucsf.edu), that offers a UCSF-Continuing Education-accredited course to physicians, nurses and health educators. They are bringing their intervention to scale reaching practices across the country, including large urban hospital systems, departments of health, FQHCs, family planning clinics, teen clinics, school-based health centers, and community colleges. The Beyond the Pill program has trained over 4,500 providers, reaching more than 1,000,000 female contraceptive patients annually. This year, in response to the Zika public health emergency, they partnered with the CDC Foundation and local stakeholders to train obstetrician-gynecologists in Puerto Rico. During this implementation science phase, the intervention has continued to have a significant impact on clinical practice changes and patient outcomes.

Publications: 

The impact of an IUD and implant intervention on dual method use among young women: Results from a cluster randomized trial.

Preventive medicine

El Ayadi AM, Rocca CH, Kohn JE, Velazquez D, Blum M, Newmann SJ, Harper CC

Long-Acting Reversible Contraception Counseling and Use for Older Adolescents and Nulliparous Women.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Gibbs SE, Rocca CH, Bednarek P, Thompson KM, Darney PD, Harper CC

Public Funding for Contraception, Provider Training, and Use of Highly Effective Contraceptives: A Cluster Randomized Trial.

American journal of public health

Thompson KM, Rocca CH, Kohn JE, Goodman S, Stern L, Blum M, Speidel JJ, Darney PD, Harper CC

Psychosocial factors and pre-abortion psychological health: The significance of stigma.

Social science & medicine (1982)

Steinberg JR, Tschann JM, Furgerson D, Harper CC

Funding policies and postabortion long-acting reversible contraception: results from a cluster randomized trial.

American journal of obstetrics and gynecology

Rocca CH, Thompson KM, Goodman S, Westhoff CL, Harper CC

Provider Opinions Regarding Expanding Access to Hormonal Contraception in Pharmacies.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Rafie S, Kelly S, Gray EK, Wong M, Gibbs S, Harper CC

Obstetrician-gynecologists' beliefs about performing less cervical cancer screening: the pendulum swings.

American journal of obstetrics and gynecology

Schneider A, Henderson JT, Harper CC, Hsu A, Saraiya M, Sawaya GF

Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial.

Lancet (London, England)

Harper CC, Rocca CH, Thompson KM, Morfesis J, Goodman S, Darney PD, Westhoff CL, Speidel JJ

Contraceptive discontinuation and pregnancy postabortion in Nepal: a longitudinal cohort study.

Contraception

Puri M, Henderson JT, Harper CC, Blum M, Joshi D, Rocca CH

Postabortion contraception a decade after legalization of abortion in Nepal.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

Rocca CH, Puri M, Harper CC, Blum M, Dulal B, Henderson JT

Exploring young adults' contraceptive knowledge and attitudes: disparities by race/ethnicity and age.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Craig AD, Dehlendorf C, Borrero S, Harper CC, Rocca CH

Factors influencing the provision of long-acting reversible contraception in California.

Obstetrics and gynecology

Biggs MA, Harper CC, Malvin J, Brindis CD

U.S. clinicians' perspectives on less frequent routine gynecologic examinations.

Preventive medicine

Henderson JT, Yu JM, Harper CC, Sawaya GF

Counseling for IUDs and implants: are health educators and clinicians on the same page?

Perspectives on sexual and reproductive health

Thompson KM, Stern L, Gelt M, Speidel JJ, Harper CC

Counseling and provision of long-acting reversible contraception in the US: national survey of nurse practitioners.

Preventive medicine

Harper CC, Stratton L, Raine TR, Thompson K, Henderson JT, Blum M, Postlethwaite D, Speidel JJ

Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic.

Contraception

Steinberg JR, Tschann JM, Henderson JT, Drey EA, Steinauer JE, Harper CC

The authors reply.

Perspectives on sexual and reproductive health

Rocca CH, Harper CC, Raine-Bennett TR

Effects of abortion legalization in Nepal, 2001-2010.

PloS one

Henderson JT, Puri M, Blum M, Harper CC, Rana A, Gurung G, Pradhan N, Regmi K, Malla K, Sharma S, Grossman D, Bajracharya L, Satyal I, Acharya S, Lamichhane P, Darney PD

Provision of long-acting reversible contraception in HIV-prevalent countries: results from nationally representative surveys in southern Africa.

BJOG : an international journal of obstetrics and gynaecology

Morse J, Chipato T, Blanchard K, Nhemachena T, Ramjee G, McCulloch C, Blum M, Saleeby E, Harper CC

Pregnancy: not a disease but still a health risk.

Contraception

Speidel JJ, Rocca CH, Thompson KM, Harper CC

Unsafe abortion after legalisation in Nepal: a cross-sectional study of women presenting to hospitals.

BJOG : an international journal of obstetrics and gynaecology

Rocca CH, Puri M, Dulal B, Bajracharya L, Harper CC, Blum M, Henderson JT

A nationally representative survey of healthcare provider counselling and provision of the female condom in South Africa and Zimbabwe.

BMJ open

Holt K, Blanchard K, Chipato T, Nhemachena T, Blum M, Stratton L, Morar N, Ramjee G, Harper CC

Access to levonorgestrel emergency contraception: science versus federal politics.

Women's health (London, England)

Thompson KM, Raine TR, Foster DG, Speidel JJ, Darney PD, Brindis CD, Harper CC

Women's reports on postabortion family-planning services provided by the public-sector legal abortion program in Mexico City.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

Becker D, Díaz Olavarrieta C, Garcia SG, Harper CC

Young women's perceptions of the benefits of childbearing: associations with contraceptive use and pregnancy.

Perspectives on sexual and reproductive health

Rocca CH, Harper CC, Raine-Bennett TR

Routine bimanual pelvic examinations: practices and beliefs of US obstetrician-gynecologists.

American journal of obstetrics and gynecology

Henderson JT, Harper CC, Gutin S, Saraiya M, Chapman J, Sawaya GF

Changes to cervical cancer prevention guidelines: effects on screening among U.S. women ages 15-29.

Preventive medicine

Henderson JT, Saraiya M, Martinez G, Harper CC, Sawaya GF

Evidence-based IUD practice: family physicians and obstetrician-gynecologists.

Family medicine

Harper CC, Henderson JT, Raine TR, Goodman S, Darney PD, Thompson KM, Dehlendorf C, Speidel JJ

Willingness of clinicians to integrate microbicides into HIV prevention practices in southern Africa.

AIDS and behavior

Harper CC, Holt K, Nhemachena T, Chipato T, Ramjee G, Stratton L, Blum M, McCulloch CE, Mgweba S, Blanchard K

Male circumcision for HIV prevention: clinical practices and attitudes among healthcare providers in South Africa and Zimbabwe.

Sexually transmitted diseases

Sheldon WR, Nhemachena T, Blanchard K, Chipato T, Ramjee G, Trussell J, McCulloch CE, Blum M, Harper CC

Postabortion contraception: qualitative interviews on counseling and provision of long-acting reversible contraceptive methods.

Perspectives on sexual and reproductive health

Morse J, Freedman L, Speidel JJ, Thompson KM, Stratton L, Harper CC

"Sometimes they used to whisper in our ears": health care workers' perceptions of the effects of abortion legalization in Nepal.

BMC public health

Puri M, Lamichhane P, Harken T, Blum M, Harper CC, Darney PD, Henderson JT

An over-the-counter simulation study of a single-tablet emergency contraceptive in young females.

Obstetrics and gynecology

Raine TR, Ricciotti N, Sokoloff A, Brown BA, Hummel A, Harper CC

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.

Obstetrics and gynecology

Harper CC, Speidel JJ, Drey EA, Trussell J, Blum M, Darney PD

Clients' perceptions of the quality of care in Mexico city's public-sector legal abortion program.

International perspectives on sexual and reproductive health

Becker D, Díaz-Olavarrieta C, Juárez C, García SG, Sanhueza P, Harper CC

The copper IUD for emergency contraception, a neglected option.

Contraception

Belden P, Harper CC, Speidel JJ

Increased use of intrauterine contraception in California, 1997 to 2007.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Thompson KM, Foster DG, Harper CC

Sex-selective abortion in Nepal: a qualitative study of health workers' perspectives.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Lamichhane P, Harken T, Puri M, Darney PD, Blum M, Harper CC, Henderson JT

Sociodemographic factors associated with obstacles to abortion care: findings from a survey of abortion patients in Mexico City.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Becker D, Diaz-Olavarrieta C, Juarez C, Garcia SG, Sanhueza Smith P, Harper CC

One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives.

Obstetrics and gynecology

Raine TR, Foster-Rosales A, Upadhyay UD, Boyer CB, Brown BA, Sokoloff A, Harper CC

Pelvic examinations and access to oral hormonal contraception.

Obstetrics and gynecology

Henderson JT, Sawaya GF, Blum M, Stratton L, Harper CC

Contraceptive policies affect post-abortion provision of long-acting reversible contraception.

Contraception

Thompson KM, Speidel JJ, Saporta V, Waxman NJ, Harper CC

Hormonal contraceptive method choice among young, low-income women: how important is the provider?

Patient education and counseling

Harper CC, Brown BA, Foster-Rosales A, Raine TR

"I wouldn't be this firm if I didn't care": preventive clinical counseling for reproductive health.

Patient education and counseling

Henderson JT, Raine T, Schalet A, Blum M, Harper CC

Abstinence and teenagers: prevention counseling practices of health care providers serving high-risk patients in the United States.

Perspectives on sexual and reproductive health

Harper CC, Henderson JT, Schalet A, Becker D, Stratton L, Raine TR

Contraceptive decision-making in sexual relationships: young men's experiences, attitudes and values.

Culture, health & sexuality

Raine TR, Gard JC, Boyer CB, Haider S, Brown BA, Ramirez Hernandez FA, Harper CC

Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling?

Journal of women's health (2002)

Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B

Attitudes toward the vaginal ring and transdermal patch among adolescents and young women.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Raine TR, Epstein LB, Harper CC, Brown BA, Boyer CB

Challenges in translating evidence to practice: the provision of intrauterine contraception.

Obstetrics and gynecology

Harper CC, Blum M, de Bocanegra HT, Darney PD, Speidel JJ, Policar M, Drey EA

Consistent condom use in married Zimbabwean women after a condom intervention.

Sexually transmitted diseases

Callegari L, Harper CC, van der Straten A, Kamba M, Chipato T, Padian NS

Over-the-counter access to emergency contraception for teens.

Contraception

Harper CC, Weiss DC, Speidel JJ, Raine-Bennett T

Adolescent and young women's experience with the vaginal ring and oral contraceptive pills.

Journal of pediatric and adolescent gynecology

Stewart FH, Brown BA, Raine TR, Weitz TA, Harper CC

Advance provision of emergency contraception for pregnancy prevention: a meta-analysis.

Obstetrics and gynecology

Polis CB, Schaffer K, Blanchard K, Glasier A, Harper CC, Grimes DA

Pharmacy access to emergency contraception: Perspectives of pharmacists at a chain pharmacy in San Francisco.

Journal of the American Pharmacists Association : JAPhA

El-Ibiary SY, Raine T, McIntosh J, Darney PD, Harper CC

Predictors of incident herpes simplex virus type 2 infections in young women at risk for unintended pregnancy in San Francisco.

BMC infectious diseases

Moss NJ, Harper CC, Ahrens K, Scott K, Kao S, Padian N, Raine T, Klausner JD

Reducing maternal mortality due to elective abortion: Potential impact of misoprostol in low-resource settings.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

Harper CC, Blanchard K, Grossman D, Henderson JT, Darney PD

Advance provision of emergency contraception for pregnancy prevention (full review).

The Cochrane database of systematic reviews

Polis CB, Schaffer K, Blanchard K, Glasier A, Harper CC, Grimes DA

Trends in knowledge of emergency contraception among women in California, 1999-2004.

Women's health issues : official publication of the Jacobs Institute of Women's Health

Foster DG, Ralph LJ, Arons A, Brindis CD, Harper CC

Beyond access: acceptability, use and nonuse of emergency contraception among young women.

American journal of obstetrics and gynecology

Rocca CH, Schwarz EB, Stewart FH, Darney PD, Raine TR, Harper CC

Pharmacokinetics of single-dose levonorgestrel in adolescents.

Contraception

Sambol NC, Harper CC, Kim L, Liu CY, Darney P, Raine TR

Safety of mifepristone abortions in clinical use.

Contraception

Henderson JT, Hwang AC, Harper CC, Stewart FH

The effect of increased access to emergency contraception among young adolescents.

Obstetrics and gynecology

Harper CC, Cheong M, Rocca CH, Darney PD, Raine TR

Abortion in the United States.

Annual review of public health

Harper CC, Henderson JT, Darney PD

Tolerability of levonorgestrel emergency contraception in adolescents.

American journal of obstetrics and gynecology

Harper CC, Rocca CH, Darney PD, von Hertzen H, Raine TR

Knowledge of emergency contraception among women aged 18 to 44 in California.

American journal of obstetrics and gynecology

Foster DG, Harper CC, Bley JJ, Mikanda JJ, Induni M, Saviano EC, Stewart FH

Adolescent clinic visits for contraception: support from mothers, male partners and friends.

Perspectives on sexual and reproductive health

Harper C, Callegari L, Raine T, Blum M, Darney P

Sexual partners and use of emergency contraception.

American journal of obstetrics and gynecology

Harper CC, Minnis AM, Padian NS

The other half of the equation: Serving young men in a young women's reproductive health clinic.

Perspectives on sexual and reproductive health

Raine T, Marcell AV, Rocca CH, Harper CC

Race, adolescent contraceptive choice, and pregnancy at presentation to a family planning clinic.

Obstetrics and gynecology

Raine T, Harper C, Paukku M, Darney P

Clinical breast and pelvic examination requirements for hormonal contraception: Current practice vs evidence.

JAMA

Stewart FH, Harper CC, Ellertson CE, Grimes DA, Sawaya GF, Trussell J

Cervical neoplasia risk in women provided hormonal contraception without a Pap smear.

Contraception

Sawaya GF, Harper C, Balistreri E, Boggess J, Darney P

Provision of hormonal contraceptives without a mandatory pelvic examination: the first stop demonstration project.

Family planning perspectives

Harper C, Balistreri E, Boggess J, Leon K, Darney P

Emergency contraception: advance provision in a young, high-risk clinic population.

Obstetrics and gynecology

Raine T, Harper C, Leon K, Darney P

Emergency contraception in Mexico City: what do health care providers and potential users know and think about it?

Contraception

Langer A, Harper C, Garcia-Barrios C, Schiavon R, Heimburger A, Elul B, Renoso Delgado S, Ellertson C

Blood loss with mifepristone--misoprostol abortion: measures from a trial in China, Cuba and India.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

Harper C, Winikoff B, Ellertson C, Coyaji K