Contraception: X最新文献

{"title":"The potential for intramuscular depot medroxyprogesterone acetate as a self-bridging emergency contraceptive","authors":"Robyn Schickler ,&nbsp;Diana Crabtree-Sokol ,&nbsp;Jasmine Patel ,&nbsp;Nicole Bender ,&nbsp;Anita L. Nelson ,&nbsp;Brian T. Nguyen","doi":"10.1016/j.conx.2020.100050","DOIUrl":"10.1016/j.conx.2020.100050","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the rate of ovulatory disruption when intramuscular depot medroxyprogesterone acetate (DMPA) is administered across graded stages of dominant follicle development.</p></div><div><h3>Study design</h3><p>We assigned enrolled participants to one of three preassigned dominant follicle size groups: 12-14 mm, 15–17 mm and ≥<!--> <!-->18 mm. We followed dominant follicles via serial transvaginal ultrasound (TVUS) until the follicles reached their assigned size, at which time we administered DMPA. For 5 consecutive days thereafter, we followed the follicles via TVUS to observe follicle rupture and obtained serum luteinizing hormone (LH), estradiol, and progesterone concentrations. In the following 2 weeks, we collected serum progesterone concentrations twice weekly to detect possible ovulatory delay or dysfunction. We also collected serum medroxyprogesterone acetate (MPA) concentrations at 1 and 24 h after DMPA administration to examine against ovulatory outcomes.</p></div><div><h3>Results</h3><p>Twenty-six of 29 enrolled women completed the study. DMPA suppressed ovulation in 17/26 (65%) and caused ovulatory dysfunction in 1/26 (4%) participants. Larger follicles were more likely to rupture despite DMPA (12–14 mm: 0/10 (0%); 15–17 mm: 3/10 (30%); ≥<!--> <!-->18 mm: 6/6 (100%); p &lt; .01). Pre-DMPA LH concentrations ranged from 13.8 to 93.7 IU/L (mean 49.0 IU/L) in cases of follicle rupture. We observed no cases of follicle rupture when DMPA was administered through cycle day 12. All 24-h MPA concentrations exceeded those needed for ovulation suppression.</p></div><div><h3>Conclusion</h3><p>DMPA suppressed and additionally disrupted ovulation in 65% and 4% of observed cycles, respectively. DMPA may provide effective emergency contraception as well as ongoing contraception if administered prior to an expected ovulation and specifically before the LH surge.</p></div><div><h3>Implications</h3><p>DMPA may be an alternative form of emergency contraception that can also self-bridge to ongoing contraception. As ovulation was not observed among any follicles when DMPA was given through cycle day 12, women who initiate DMPA up through cycle day 12 may not require backup contraception.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38754607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy availability of emergency contraception in southwestern Pennsylvania: A simulated patient study","authors":"Katherine Orr ,&nbsp;Jennifer Chin ,&nbsp;Maris Cuddeback ,&nbsp;Jessica Zimo ,&nbsp;Colleen Judge-Golden ,&nbsp;Marian Jarlenski ,&nbsp;Sonya Borrero","doi":"10.1016/j.conx.2021.100068","DOIUrl":"10.1016/j.conx.2021.100068","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the availability of oral emergency contraception in southwestern Pennsylvania pharmacies.</p></div><div><h3>Study design</h3><p>We conducted a simulated patient study to assess on-the-shelf availability of levonorgestrel emergency contraception and immediate availability of ulipristal acetate emergency contraception.</p></div><div><h3>Results</h3><p>Only 44% of pharmacies stocked levonorgestrel on-the-shelf and only 5% of pharmacies had ulipristal acetate immediately available.</p></div><div><h3>Conclusions</h3><p>We found significant barriers to obtaining timely oral emergency contraception in southwestern Pennsylvania.</p></div><div><h3>Implications statement</h3><p>Timely access to emergency contraception is important for people's ability to determine if, when, how, and under what circumstances to have children. Pharmacies in southwestern Pennsylvania need to expand access to oral emergency contraception.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“When it comes to time of removal, nothing is straightforward”: A qualitative study of experiences with barriers to removal of long-acting reversible contraception in Western Kenya","authors":"Laura E. Britton ,&nbsp;Caitlin R. Williams ,&nbsp;Dickens Onyango ,&nbsp;Debborah Wambua ,&nbsp;Katherine Tumlinson","doi":"10.1016/j.conx.2021.100063","DOIUrl":"10.1016/j.conx.2021.100063","url":null,"abstract":"<div><h3>Objective</h3><p>Barriers to removal of long-acting reversible contraception (LARC) threaten reproductive self-determination, but their influence on contraceptive behaviors is not well understood. We describe perspectives of women in Western Kenya concerning LARC removal barriers.</p></div><div><h3>Study design</h3><p>We used a qualitative descriptive approach with conventional content analysis to analyze transcripts for content and themes from eight focus group discussions (<em>n</em> = 55 participants) and one client journey mapping workshop (<em>n</em> = 9 participants) with women ages 18–49 in Western Kenya who were currently using or had formerly used contraceptives.</p></div><div><h3>Findings</h3><p>Our primary themes concerned women's experience of LARC removal barriers and the impact on their behaviors and attitudes towards contraception. Women described providers being unwilling to remove LARC, regardless of rationale (including expiration, seeking pregnancy, or experiencing intolerable side effects) or demanding unaffordable fees. Women were reluctant to try LARC for fear of having to use the method for its entire lifespan even if they did not like it. Women saw LARC removal barriers as increasing their risk of unintended pregnancy through non-replacement of expired devices and fostering distrust in the health system.</p></div><div><h3>Conclusion</h3><p>Barriers to LARC removal may discourage utilization of LARC and contraceptive services generally, which can undermine women's efforts to achieve reproductive self-determination.</p></div><div><h3>Implications</h3><p>Our findings affirm the importance of timely LARC removal to ensure that family planning programs uphold women's reproductive autonomy.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38919110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suppression of ovulation and pharmacokinetics following subcutaneous administration of various doses of Depo-Provera®: a randomized trial","authors":"Vera Halpern ,&nbsp;Rachael Fuchs ,&nbsp;Vivian Brache ,&nbsp;Luis Bahamondes ,&nbsp;Maria Jose Miranda ,&nbsp;Anja Lendvay ,&nbsp;Leila Cochón ,&nbsp;Douglas Taylor ,&nbsp;Laneta J. Dorflinger","doi":"10.1016/j.conx.2021.100070","DOIUrl":"10.1016/j.conx.2021.100070","url":null,"abstract":"<div><p>Objectives: To identify the lowest dose of Depo-Provera that, when administered off-label subcutaneously, suppressed ovulation and had a pharmacokinetic profile consistent with a 4-month contraceptive effect.</p><p>Study Design: We conducted a randomized, multicenter, parallel-group study to evaluate the pharmacokinetics (PK) and pharmacodynamics (PD) of medroxyprogesterone acetate (MPA) after subcutaneous injection of three different doses of Depo-Provera. We randomized sixty women between 18 and 40 years of age at low risk of pregnancy with confirmed ovulation and body mass index of 18 to 35 kg/m² to receive a single injection of 45, 75 or 105 mg of Depo-Provera, or a single injection of Depo-subQ provera 104 as a reference drug (15 women per group) and followed them for 7.5 months. We evaluated suppression of ovulation as the primary outcome, and MPA concentrations, pharmacokinetic parameters, safety, and local tolerability as secondary outcomes.</p><p>Results: Five women ovulated within four months of treatment initiation (three in the 45 mg group and two in the 75 mg group). MPA levels associated with ovulation were in general low, largely ≤ 0.2 ng/mL (the presumed contraceptive threshold). No women in either the 105 mg group or the Depo-subQ provera 104 group ovulated within four months. The PK parameters including C_max, C₁₁₉, and AUC₀₋₁₁₉ for these 2 groups were similar but not equivalent.</p><p>Conclusion: A dose of 105 mg of Depo-Provera injected subcutaneously was the lowest tested dose that consistently suppressed ovulation and maintained serum MPA levels consistent with contraceptive effect for at least 4 months. The PK and PD results for the 105 mg dose were similar to Depo-subQ provera 104 over this period.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/5b/main.PMC8551587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39687848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-urban residence and emergency contraception use, access, and counseling in the United States, 2006-2017","authors":"Carly M. Milkowski,&nbsp;Erika C. Ziller,&nbsp;Katherine A. Ahrens","doi":"10.1016/j.conx.2021.100061","DOIUrl":"10.1016/j.conx.2021.100061","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate differences in emergency contraception (EC) use, access, and counseling by rural-urban residence among reproductive age women in the United States.</p></div><div><h3>Study design</h3><p>We examined respondent data (2006–2017) from the National Survey of Family Growth for women ages 15-44 (<em>n =</em> 28,448) to estimate EC use, access, and counseling by rural-urban county of residence. Rural-urban prevalence ratios for EC outcome measures were estimated using predicted margins from logistic regression models, which were adjusted for demographic differences and current contraceptive method use. Changes in ever-use of EC over time were estimated for rural and urban respondents, separately, using Chi-square tests and trends were estimated using inverse variance weighted linear regression models.</p></div><div><h3>Results</h3><p>During 2006 to 2017, 10% of rural and 19% of urban women who had ever had sex reported ever using EC pills. Among rural women, ever-use increased from 6% in 2006-2008 to 15% in 2015-2017 (Chi-square <em>p &lt;</em> 0.01; trend <em>p</em>-value &lt; 0.01); among urban women, ever-use increased from 11% to 27% (Chi-square <em>p &lt;</em> 0.01; trend <em>p</em>-value &lt; 0.01). Rural and urban women were similarly likely to have obtained EC without a prescription and from a drug store. Rural women were less likely to have received EC counseling than urban women; however, counseling rates were low among all women.</p></div><div><h3>Conclusion</h3><p>We observed differences in EC ever-use and receipt of EC counseling by rural-urban residence among US women ages 15 to 44, adding to the evidence that rural-urban residence is an important factor in reproductive health. More research is needed to explore factors contributing to rural-urban differences in EC use.</p></div><div><h3>Implications</h3><p>Our key finding that EC use varied by rural-urban county residence offers additional evidence that rural-urban residence should be considered in reproductive health practice and policy. We discuss areas for future research into potential barriers to EC use in rural populations.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25477928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma surrounding contraceptive use and abortion among secondary school teachers: A cross-sectional study in Western Kenya","authors":"Marielle E. Meurice ,&nbsp;Beatrice Otieno ,&nbsp;Jenny J. Chang ,&nbsp;Marlene Makenzius","doi":"10.1016/j.conx.2021.100062","DOIUrl":"10.1016/j.conx.2021.100062","url":null,"abstract":"<div><h3>Objectives</h3><p>Comprehensive sexual education plays an essential role in adolescent sexual and reproductive health and rights (SRHR). The study aim was to investigate Kenyan secondary school teachers’ attitudes toward girls associated with contraceptive use and abortion.</p></div><div><h3>Study design</h3><p>We conducted a cross-sectional study in January 2018 among school teachers (<em>n =</em> 144) at 4 religiously affiliated suburban secondary schools in Kenya and used 2 validated Likert Scales (1–5) to capture contraception and abortion stigma.</p></div><div><h3>Results</h3><p>Overall, 122 teachers responded (85%) (females, 57%; males 43%; age, 21–70 years [mean, 36]). Respondents associated contraceptive use with a promiscuous lifestyle (43%) that will encourage peers to do the same (51%). Respondents indicated that married women were more deserving of contraception than unmarried women (57%), a girl could not herself decide to use contraceptives (50%), and contraceptive use could impair future fertility (57%). Abortion was considered a sin (74%), shameful for the family (48%), a habit (34%), and a behavior that might encourage peers to do the same (51%). Many believed an abortion will lead to worse health (73%). Male and female teachers gave similarly distributed responses. Younger teachers were more likely to find abortion shameful (&lt;29, 64%; 30–39, 39%; ≥40, 39%; <em>p =</em> 0.046). Contraception stigma and abortion stigma were highly correlated (r = 0.355, <em>p &lt;</em> 0.001).</p></div><div><h3>Conclusions</h3><p>Stigmatizing attitudes associated with contraceptive use and/or abortion were common among teachers in Western Kenya.</p></div><div><h3>Implications</h3><p>Stigma may hinder the sexual and reproductive health and rights of students. Contraceptive use and abortion stigma need to be addressed in teacher education to ultimately improve health outcomes among adolescents.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25440878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Using Google Ads to recruit and retain a cohort considering abortion in the United States” [Contraception: X (2) (2020) 100017]","authors":"Ushma D. Upadhyay ,&nbsp;Iris J. Jovel ,&nbsp;Kevin D. McCuaig ,&nbsp;Alice F. Cartwright","doi":"10.1016/j.conx.2021.100056","DOIUrl":"10.1016/j.conx.2021.100056","url":null,"abstract":"","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100056"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25416204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical availability of the copper IUD in rural versus urban settings: A simulated patient study","authors":"Kristen Lilja ,&nbsp;Jennifer Chin ,&nbsp;Lyndsey S. Benson ,&nbsp;Sofia Infante ,&nbsp;Elizabeth Micks","doi":"10.1016/j.conx.2021.100059","DOIUrl":"10.1016/j.conx.2021.100059","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the proportion of Washington state clinics that offer the copper IUD in rural vs urban settings.</p></div><div><h3>Study design</h3><p>We employed a simulated patient model to survey clinics in the Human Health Resources and Services Administration 340B database to primarily assess the availability of the copper IUD.</p></div><div><h3>Results</h3><p>We successfully surveyed 194/212 (92%) clinics. More urban than rural clinics reported copper IUD availability (76/97 [78%] vs 49/97 [51%]; <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Rural clinics are less likely than urban clinics to have the copper IUD available.</p></div><div><h3>Implications</h3><p>The frequency of unintended pregnancies is high in the United States. We should focus our attention on decreasing barriers to the copper IUD as a long-acting reversible contraceptive, particularly for women living in rural settings.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100059"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25416632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of concurrent multiple methods of contraception in the United States, 2008 to 2015","authors":"Megan L. Kavanaugh ,&nbsp;Emma Pliskin ,&nbsp;Jenna Jerman","doi":"10.1016/j.conx.2021.100060","DOIUrl":"10.1016/j.conx.2021.100060","url":null,"abstract":"<div><h3>Objective</h3><p>To identify prevalence of, characteristics associated with, and combinations of, use of more than one method of contraception at last intercourse among US women between 2008 and 2015.</p></div><div><h3>Methods</h3><p>We conducted bivariate and multivariable logistic regression analyses using data on concurrent contraceptive use from 2 nationally representative samples of women ages 15 to 44 who had used some form of contraception at last intercourse in the past 3 months in the 2006–2010 (<em>n</em> = 6601) and 2013–2017 (<em>n</em> = 5562) cycles of the National Survey of Family Growth.</p></div><div><h3>Results</h3><p>Use of more than one method of contraception at last sex increased from 14% in 2008 to 18% in 2015 (<em>p</em>&lt;0.001), with increases in use documented across many population groups. Among multiple method users, the majority combined condoms with other methods (58%), while the rest combined other methods (42%). When compared to single method users, dual method users employing condoms are a more homogeneous group of individuals than are dual method users not employing condoms. As age increases, dual use with condoms decreases, but there is no similar linear relationship between age and dual method use without condoms.</p></div><div><h3>Conclusions</h3><p>A sizable proportion of US women use more than one contraceptive method during sex; current estimates of contraceptive use focused exclusively on single method use may underestimate the extent to which women are protected from unintended pregnancy. The needs and goals of individuals combining contraceptive methods in different ways may change over the life course as pregnancy desires and life circumstances change.</p></div><div><h3>Implications</h3><p>A sizable proportion of US women use more than one contraceptive method during sex; clinicians and health educators in nonclinical settings should assess and acknowledge these more complicated contraceptive strategies in order to help individuals achieve autonomy in method choice and meet their goals around pregnancy and sexually transmitted infection prevention.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25440877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of a values clarification workshop on residents training at Catholic Hospital programs","authors":"Maryam Guiahi ,&nbsp;Carrie Wilson ,&nbsp;Emily Claymore ,&nbsp;Kristin Simonson ,&nbsp;Jody Steinauer","doi":"10.1016/j.conx.2021.100054","DOIUrl":"10.1016/j.conx.2021.100054","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate if a values clarification workshop conducted at Catholic hospital training programs influenced obstetrics and gynecology residents' abortion attitudes.</p></div><div><h3>Study design</h3><p>Between 2018 and 2019, we provided a values clarification workshop focused on abortion care to 47 obstetrics and gynecology residents at five Catholic programs that do not provide abortion training. Participants received a pre-survey eliciting participant characteristics, and training experiences. On pre- and post-surveys, we asked participants to respond to abortion scenarios using a five-point Likert scales (1 = strongly disagree, 2 = somewhat disagree 3 = neither agree nor disagree, 4 = somewhat agree, 5 = strongly agree). We calculated descriptive frequencies, report the proportions agreeing with the statements (Likert ≥<!--> <!-->4) before and after the workshop, and compared median Likert responses using Wilcoxon matched pair test.</p></div><div><h3>Results</h3><p>Forty-one participants (87%) completed both surveys. Twelve (29%) reported Catholic religion, six (15%) reported their personal reproductive care views were in line with their institution, and five (12%) selected their program based on its religious affiliation. Three (9%) had experience with first-trimester abortion for nonmedical reasons, and 20 (49%) planned to provide such care after graduation. Both before and after the workshop, all participants could think of a justification why a patient with an undesired pregnancy would choose abortion. After the workshop, more residents were able to think of a justifiable reason for the following abortion-related scenarios: (1) patients declining post-abortal contraception (51% vs. 78%, p &lt; 0.001), (2) patients presenting for subsequent abortion (93% vs 95%, p = 0.01), and (3) patients presenting for second-trimester abortion (93% vs. 100%, p = 0.001). Many participants increased their Likert score when asked about acceptability of patients declining post-abortal contraception (n = 24, 59%), patients seeking a subsequent abortion (n = 15, 37%), and patients obtaining a second trimester abortion contraception (n = 11, 27%). Emotional and professional reactions to these scenarios were unchanged. After the workshop, residents were more likely to consider either financial inability (73% vs. 83%, p &lt; 0.01) or disruption to career or education (71% vs 80%, p &lt; 0.01) as morally acceptable reasons for requesting an abortion. For abortion for a patient who is financially unable to support their child, 12 (29%) increased their Likert score, 1 (2%) had a lower score and the remaining 28 (68%) had no change. For abortion for a patient whose career or education would be disrupted 13 (32%) increased their Likert score, one (2%) had a lower score and the remaining 27 (66%) had no change.</p></div><div><h3>Conclusion</h3><p>Our values clarification workshop resulted in more residents at Catholic training programs endors","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"3 ","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2021.100054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25383466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}