About

Arina Chesnokova, MD, MPH, MSHP, is an Assistant Professor of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania. She is trained in general obstetrics and gynecology, with her current practice primarily focused on gynecology, including menopausal care delivery, midlife women's health, and minimally invasive benign gynecologic surgery, such as robotic surgery. Dr. Chesnokova is a Menopause Society Certified Practitioner and practices at the Hospital of the University of Pennsylvania and the Corporal Michael J. Crescenz Philadelphia VA Medical Center. Her research interests include the midlife transition and menopausal care delivery, with a particular emphasis on access to high-quality menopause care for all patients. She is also engaged in studying outpatient care delivery models for underserved patients with obstetrics and gynecology needs, promoting equitable care in low-resource settings, and exploring value-based payment systems in obstetrics and gynecology care. Dr. Chesnokova's work aims to improve healthcare access and quality for women during midlife and beyond.

Research topics

• Medicine
• Demography
• Family medicine
• Environmental planning
• Environmental science

Selected publications

• Postpartum Readmission in People With Intellectual and Developmental Disability

  American Journal of Preventive Medicine · 2025-06-25

  articleOpen access

  INTRODUCTION: Postpartum readmission and severe maternal morbidity have been increasing in recent years in the U.S., but little is known about the risk of either for people with intellectual and developmental disabilities, including the autism spectrum. The purpose of the study is to establish an estimate of postpartum readmission in a nationally representative sample of people with intellectual and developmental disabilities. METHODS: This study used the National Readmission Database to examine the deliveries in people with intellectual and developmental disabilities (n=5,721), people on the autism spectrum (n=1,099), and people without intellectual and developmental disabilities or autism (n=3,890,553) in 2019 and 2020. Log-binomial regression was used to examine person and delivery characteristics associated with postpartum readmission in all deliveries. RESULTS: Postpartum readmission was more common in people with intellectual and developmental disabilities (6.6%) and people on the autism spectrum (3.3%) than in all other deliveries (1.5%). In adjusted analyses, people with intellectual and developmental disabilities (adjusted RR=3.50; 95% CI=3.15, 3.90) and people on the autism spectrum (adjusted RR=2.06; 95% CI=1.42, 2.97) had increased risk of postpartum readmission compared with people without these conditions. Other characteristics were also associated with increased risk of postpartum readmission, including 2.80 times the risk of postpartum readmission in people with severe maternal morbidity compared with that in those without (95% CI=2.66, 2.94). CONCLUSIONS: High rates of postpartum readmission in people with intellectual and developmental disabilities point to the need for a better understanding of the drivers of such high rates in these populations. These drivers could include population differences in co-occurring health and mental health conditions, social and community support, and accessible health care.

  PublisherOA PDFDOI

• Assessing STI and HIV risks among autistic individuals: Implications for healthcare access and intervention

  Disability and health journal · 2025-02-13 · 1 citations

  articleOpen access

  BACKGROUND: Sexually transmitted infections (STIs) are prevalent in the general population. Autistic individuals, both with and without intellectual disability (ID), are potentially at increased risk due to gaps in sexual health education, increased vulnerability to sexual abuse, victimization, and disparities in access to primary and reproductive health care. OBJECTIVE: This study aims to identify the prevalence of STIs and HIV among a national sample of Medicaid-enrolled autistic individuals and their peers, identifying opportunities for intervention. METHODS: Characteristics of autistic Medicaid beneficiaries with and without ID were stratified to compare individuals with and without chlamydia, gonorrhea, syphilis, and HIV. Period prevalence of outcomes among Medicaid enrollees with autism spectrum disorder (ASD) only, ID only, and both (ASD and ID) were compared. RESULTS: Among autistic individuals, the prevalence of STIs and HIV was highest in the 22-30 age group and among Black enrollees, underscoring the importance of prioritizing their care through screening and preventive health measures. CONCLUSIONS: The results emphasize gaps in addressing the sexual and reproductive health needs of autistic individuals. Policymakers should prioritize funding for clinician training and increased healthcare access to address the sexual health needs of this population, especially those from additionally marginalized communities. It is vital to provide inclusive care that addresses the unique challenges faced by autistic individuals in accessing appropriate sexual health resources.

  PublisherDOI

• Integrating Payor-Segregated Outpatient OBGYN Care Models: The Clinician Perspective

  Women s Health Issues · 2025-05-28

  articleOpen access1st authorCorresponding

  PURPOSE: Significant and unacceptable racial disparities in maternal health and gynecologic outcomes exist in the United States, with ambulatory care being a potential contributor. In many academic medical centers (AMCs), publicly insured and uninsured patients receive care in clinics staffed primarily by residents under attending supervision, whereas those with private insurance see attending physicians at a different site. This segregation by payor can translate to de facto racial segregation. This study explores clinician perspectives on payor-segregated care delivery by resident and attending sites in a major AMC and their opinions on integrating these sites. METHODS: We conducted semi-structured interviews with attending physicians and advanced practice providers (APPs) from both sites. The interview guide focused on: 1) perceived value of the current care model, 2) attitudes toward care integration, and 3) barriers and facilitators to integration. Interviews were conducted from October 2022 to January 2023 until thematic saturation was achieved. Data analysis involved an integrated approach with grounded theory, with 20% of transcripts double-coded (k = .90). RESULTS: We interviewed 15 clinicians (10 attendings, five APPs). Although clinicians recognized some value in the existing segregated system, they supported ending it as a moral imperative to combat inequity. They also highlighted challenges and expressed concerns about feasibility of integration. Concerns encompassed maintaining patient-clinician continuity, acceptance of trainees by privately insured patients, potential erosion of mission-driven care, and the risk of racist interactions if a safe space for a vulnerable community is disrupted. Clinicians stressed the need for resources and small-scale trials before full-scale integration. CONCLUSION: Although clinicians expressed unity around the concept of integrating ambulatory care delivery, a path toward implementing an alternative model of care remains unclear. This study provides initial insights into disparities in ambulatory OBGYN care and may guide health systems considering care integration.

  PublisherOA PDFDOI

• Confronting segregation of care in OBGYN: a national survey of program directors

  Journal of Health Equity · 2025-08-26

  articleOpen accessSenior author

  The structure of ambulatory care in teaching hospitals may contribute to disparities in reproductive outcomes, particularly when outpatient care is segregated by insurance status and race. To investigate the prevalence and characteristics of separate faculty and resident practices in obstetrics and gynecology (OBGYN), including payor and racial segregation. Electronic survey administered to OBGYN Residency Program Directors (PDs) from March to September 2023. Ninety-two of 299 PDs responded (31%). Sixty-one programs (66%) reported separate resident and attending practices. Patient assignment was based on appointment availability (77%), patient request (54%), and insurance (37%). Only 30% of programs with separate practices collected data comparing patient demographics, care quality, or outcomes between practices; among these, 72% reported at least one demographic disparity, including differences in race (28%), insurance (67%), and socioeconomic status (61%). A majority reported similar quality of care and patient outcomes between practices, and 64% reported no efforts to integrate. Separate attending and resident ambulatory practices in OBGYN are prevalent and can result in segregated care. National guidance is needed to promote equitable outpatient care while ensuring strong educational experiences. Solutions must be data-driven, locally-tailored, and developed in collaboration with patients, clinicians, educators, and professional organizations.

  PublisherOA PDFDOI

• 570 Birth Morbidity and Readmissions in Autistic People and People With Intellectual and Developmental Disabilities

  American Journal of Obstetrics and Gynecology · 2024-01-01

  articleOpen access
  PublisherOA PDFDOI

• Integrating Payor-Segregated Outpatient Obstetrics and Gynecology Care Models: The Patient Perspective

  American Journal of Perinatology · 2024-12-19 · 1 citations

  article1st authorCorresponding

  Abstract Significant racial and ethnic disparities in maternal morbidity and mortality as well as gynecologic outcomes persist in the United States. The role of ambulatory care in obstetrics and gynecology (OBGYN), particularly in facilities that separate resident and attending care along payor (and de facto racial) lines, remains unclear. This study examines patient perspectives on payor-segregated health care delivery in an academic medical center (AMC) and opinions on possible integration. This is a qualitative study conducted at a single AMC with payor-segregated resident and attending outpatient sites. Interviews focused on patient perception of experience and value in outpatient OBGYN care, perspectives on the segregated care model, and attitudes about integration. Patients participated in a 30-minute semistructured interview with recruitment continuing until thematic saturation was reached (October 2022–August 2023). Interviews were coded using an integrated approach with grounded theory; 12% of transcripts were double-coded (k = 0.86). We interviewed 26 patients (16 from resident, 10 from attending site). Patients prioritized practical aspects such as clinic proximity and quality of clinician interaction. Most were unaware of the payor-segregated clinic system and disapproved upon learning about it. Opinions varied on topics of telehealth and continuity, indicating diverse patient needs. Notably, minoritized patients valued race and class concordance in clinical spaces. Patients generally supported care integration, conditional upon the preservation of aspects of care they valued. Successful OBGYN care integration requires meeting individual needs while ensuring diversity, safety, and community-oriented care, alongside access and convenience. Incorporating patient voices is crucial for aligning services with expectations and improving patient experiences.

  PublisherDOI

• Perinatal and Postpartum Health Among People With Intellectual and Developmental Disabilities

  JAMA Network Open · 2024-08-15 · 15 citations

  articleOpen access

  Importance: Small, geographically limited studies report that people with intellectual and developmental disabilities (IDD) have increased risk for serious pregnancy-related and birth-related challenges, including preeclampsia, preterm birth, and increased anxiety and depression, than their peers. United States-based population-level data among people with IDD are lacking. Objectives: To identify perinatal and postpartum outcomes among a national, longitudinal sample of people with IDD enrolled in public health insurance, compare subgroups of people with IDD, and compare outcomes among people with IDD with those of peers without IDD. Design, Setting, and Participants: This retrospective cohort study used national Medicaid claims from January 1, 2008, to December 31, 2019, for 55 440 birthing people with IDD and a random sample of 438 557 birthing people without IDD. Medicaid funds almost half of all births and is the largest behavioral health insurer in the US, covering a robust array of services for people with IDD. Statistical analysis was performed from July 2023 to June 2024. Exposure: People who had a documented birth in Medicaid during the study years. Main Outcome and Measures: Perinatal outcomes were compared across groups using univariate and multivariate logistic regression. The probability of postpartum anxiety and depression was estimated using Kaplan-Meier and Cox proportional hazards regression. Results: The study sample included 55 440 birthing people with IDD (including 41 854 with intellectual disabilities [ID] and 13 586 with autism; mean [SD] age at first delivery, 24.9 [6.7] years) and a random sample of 438 557 birthing people without IDD (mean [SD] age at first delivery, 26.4 [6.3] years). People with IDD were younger at first observed delivery, had a lower prevalence of live births (66.6% vs 76.7%), and higher rates of obstetric conditions (gestational diabetes, 10.3% vs 9.9%; gestational hypertension, 8.7% vs 6.1%; preeclampsia, 6.1% vs 4.4%) and co-occurring physical conditions (heart failure, 1.4% vs 0.4%; hyperlipidemia, 5.3% vs 1.7%; ischemic heart disease, 1.5% vs 0.4%; obesity, 16.3% vs 7.4%) and mental health conditions (anxiety disorders, 27.9% vs 6.5%; depressive disorders, 32.1% vs 7.5%; posttraumatic stress disorder, 9.5% vs 1.2%) than people without IDD. The probability of postpartum anxiety (adjusted hazard ratio [AHR], 3.2 [95% CI, 2.9-3.4]) and postpartum depression (AHR, 2.4 [95% CI, 2.3-2.6]) was significantly higher among autistic people compared with people with ID only and people without IDD. Conclusions and Relevance: In this retrospective cohort study, people with IDD had a younger mean age at first delivery, had lower prevalence of live births, and had poor obstetric, mental health, and medical outcomes compared with people without IDD, pointing toward a need for clinician training and timely delivery of maternal health care. Results highlight needed reproductive health education, increasing clinician knowledge, and expanding Medicaid to ensure access to care for people with IDD.

  PublisherOA PDFDOI

• Update of the generalized environmental assessment and inertial forecast for the development of a cluster of urban areas of the Bogorodsky urban district of the Moscow region within the framework of the system “Ecology, environment and public health”

  E3S Web of Conferences · 2023-01-01

  articleOpen access

  The article presents an update and a generalized geo-ecological assessment of the Bogorodsky urban district of the Moscow region (the former Noginsky was abolished) at the time of 2021-2022. The indicators of the ecological state of the territories are considered from the standpoint of the realities of the current years. A comparison was made of the geo-ecological situation of the territories of small towns of compact residence in the Noginsk district for 2011-2014 and the current geo-ecological situation of the territory of small towns of the Bogorodsk urban district of the Moscow region (the former Noginsk was abolished) for 2021-2022. Data on the incidence of the population and environmental pollution are analyzed from the standpoint of causal relationships of direct and indirect correlations between diseases of the respiratory, digestive and genitourinary systems. Also, for ecodiagnostics, the dominant concepts of toxicology are used, such as the reaction rate and the response of a particular individual organism to a stimulus. A new municipal specialized subprogram “Ecology and the Environment” for 2023-2027 with the introduction of new indicators aimed at protecting the environment is considered. A look at the scenarios and inertial forecast for the development of environmental sustainability of urbanized territories of small towns in the study area is given.

  PublisherOA PDFDOI

• Trust in provider and stigma during second-trimester abortion

  Sexual & Reproductive Healthcare · 2023-11-25

  article1st author
  PublisherDOI

• Medicaid compared to private insurance is associated with lower rates of sterilization in people with unwanted births

  American Journal of Obstetrics and Gynecology · 2023-10-30 · 4 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

Frequent coauthors

• Stanislav Sergeevich Rodionov

  Togliatti State University

  51 shared

• Anna Suvorova

  Herzen University

  50 shared

• Artem Shevchuk

  50 shared

• Michurina Nadezhda

  Institute of Engineering

  49 shared

• Mikhail Аpanaykin

  Moscow State University of Civil Engineering

  49 shared

• Katherine Yun

  University of Pennsylvania

  19 shared

• David M. Rubin

  Children's Hospital of Philadelphia

  15 shared

• Justine Shults

  Children's Hospital of Philadelphia

  9 shared

Labs

• Arina Chesnokova LabPI

Awards & honors

• Menopause Society Certified Practitioner