Contraception: X最新文献

{"title":"Understanding the extent of contraceptive non-use among women at risk of unintended pregnancy, National Survey of Family Growth 2011–2017","authors":"Brittni N. Frederiksen ,&nbsp;Katherine Ahrens","doi":"10.1016/j.conx.2020.100033","DOIUrl":"10.1016/j.conx.2020.100033","url":null,"abstract":"<div><h3>Objective</h3><p>To describe characteristics of U.S. contraceptive non-users to inform tailored contraceptive access initiatives.</p></div><div><h3>Study design</h3><p>We used National Survey of Family Growth data from 2011 to 2017 to identify characteristics of contraceptive non-users compared to other women ages 15–44 at risk for unintended pregnancy. We also examined reasons for not using contraception by when non-users expected their next birth. We calculated unadjusted and adjusted prevalence ratios using two definitions of contraceptive non-use: (1) contraceptive non-use during the interview month, and (2) a more refined definition based on contraception use during the most recent month of sexual intercourse and expectation of timing of next birth. We considered p-values &lt;<!--> <!-->0.05 statistically significant.</p></div><div><h3>Results</h3><p>Approximately 20% (<em>n</em> <!-->=<!--> <!-->2844) of 12,071 women at risk of unintended pregnancy were classified as standard contraceptive non-users. After adjusting for all other variables, non-users were more likely to be low-income, uninsured, never married, expect a birth within 2 years, and have zero or one parity. The top reasons for contraceptive non-use were not minding if they got pregnant (22.6%), worried about contraceptive side effects (21.0%), and not thinking they could get pregnant (17.6%). After applying the more refined non-user definition, we identified 5.7% (<em>n</em> <!-->=<!--> <!-->721) of women as non-users; expecting a birth within 2–5 years and having a parity of one were associated with non-use after adjustment of all other factors.</p></div><div><h3>Conclusion</h3><p>Our more refined definition of non-users could be used in future studies examining the causes of unintended pregnancy and to inform programmatic interventions to reduce unintended pregnancy.</p></div><div><h3>Implications</h3><p>Describing contraceptive non-users and reasons for contraceptive non-use could help us better understand reasons for unintended pregnancy and inform tailored contraceptive access initiatives.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38234074","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":"Out-of-pocket spending for oral contraceptives among women with private insurance coverage after the Affordable Care Act","authors":"Brittni Frederiksen ,&nbsp;Matthew Rae ,&nbsp;Alina Salganicoff","doi":"10.1016/j.conx.2020.100036","DOIUrl":"10.1016/j.conx.2020.100036","url":null,"abstract":"<div><h3>Objectives</h3><p>We aimed to identify which types and brands of oral contraceptive pills have the largest shares of oral contraceptive users in large employer plans with out-of-pocket spending and which oral contraceptives have the highest average annual out-of-pocket costs.</p></div><div><h3>Study design</h3><p>We analyzed a sample of medical claims obtained from the 2003–2018 IBM MarketScan Commercial Claims and Encounters Database (MarketScan), which is a database with claims information provided by large employer plans. We only included claims for women between the ages of 15 and 44 years who were enrolled in a plan for more than half a year as covered workers or dependents. To calculate out-of-pocket spending, we summed copayments, coinsurance and deductibles for the oral contraceptive prescriptions.</p></div><div><h3>Results</h3><p>We found that 10% of oral contraceptive users in large employer plans still had out-of-pocket costs in 2018. Oral contraceptives with the largest share of users with annual out-of-pocket spending are brand-name contraceptives with generic alternatives. The three contraceptives with the highest average annual out-of-pocket spending were brand-name contraceptives without generic alternatives. Three of the 10 contraceptives with the largest shares of users who have annual out-of-pocket spending and 3 of the 10 contraceptives with the highest average annual out-of-pocket spending contain iron.</p></div><div><h3>Conclusions</h3><p>Women with health insurance are still paying out of pocket for oral contraception, and future research should investigate which health plans have fewer fully covered contraceptives and effective modes of educating providers and patients about how to maximize the no-cost coverage benefit that has been extended to women.</p></div><div><h3>Implications</h3><p>The Affordable Care Act eliminated out-of-pockets costs for contraception for most insured women. However, some women still pay out of pocket for certain oral contraceptive brands and types that may have covered alternatives. Providers and patients could benefit from more education on how to maximize the no-cost coverage benefit extended to women.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343921","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":"Using Google Ads to recruit and retain a cohort considering abortion in the United States","authors":"Ushma D. Upadhyay ,&nbsp;Iris J. Jovel ,&nbsp;Kevin D. McCuaig ,&nbsp;Alice F. Cartwright","doi":"10.1016/j.conx.2019.100017","DOIUrl":"10.1016/j.conx.2019.100017","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to develop and test the feasibility of a methodology to recruit and retain individuals in the United States (US) who were considering abortion at the point of searching for an abortion clinic.</p></div><div><h3>Study design</h3><p>We conducted the Google Ads Abortion Access Study, a national cohort study using a novel recruitment method — recruiting people searching for abortion care on Google. Advertisements for the study were displayed in search results. Users who clicked on the advertisement were directed to a landing page explaining the study and then to a screening form. Participants were eligible if they reported being pregnant and considering abortion. They completed an online baseline survey and 4 weeks later were invited by email or text message to complete a follow-up survey.</p></div><div><h3>Results</h3><p>Over the course of 8 months, we recruited a racially/ethnically and geographically diverse cohort considering an abortion using Google Ads. After removing fraudulent cases, we recruited 1706 respondents, and among these, 1464 (86%) provided contact information for follow-up. Among those providing contact information, 1005 completed the follow-up survey, resulting in a 69% follow-up rate. Older age, white race, higher education, difficulty meeting basic needs, being not religious/spiritual and having no previous births were associated with higher follow-up. Total cost of the ads was $31.99 per completed baseline + follow-up survey.</p></div><div><h3>Conclusion</h3><p>Researchers can use online advertising to successfully recruit populations early in their abortion-seeking process to understand the barriers they face and how to improve abortion access. Disadvantages include high cost and a small potential for fraudulent data.</p></div><div><h3>Implications</h3><p>Google Ads is a feasible tool to recruit and follow a diverse sample of individuals who are considering abortion for studies investigating the barriers they face in obtaining a wanted abortion.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100017"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38059126","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":"Transgender abortion patients and the provision of transgender-specific care at non-hospital facilities that provide abortions","authors":"Rachel K. Jones ,&nbsp;Elizabeth Witwer ,&nbsp;Jenna Jerman","doi":"10.1016/j.conx.2020.100019","DOIUrl":"10.1016/j.conx.2020.100019","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the number of transgender and gender non-binary (TGNB) individuals who obtained abortions in the United States and the extent to which abortion facilities offer transgender-specific health services.</p></div><div><h3>Study design</h3><p>We collected survey data from all known health care facilities that provided abortions in 2017. For the first time, the questionnaire included items about TGNB abortion patients and services.</p></div><div><h3>Results</h3><p>We estimate that 462 to 530 TGNB individuals obtained abortions in 2017 and that 23% of clinics provide transgender-specific care.</p></div><div><h3>Conclusion</h3><p>Several hundred abortions were provided to TGNB individuals in 2017, primarily at facilities that did not provide transgender-specific health services.</p></div><div><h3>Implications</h3><p>Findings from this study support efforts to implement and expand gender-inclusive and affirming care at health care facilities that provide abortion.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100019"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38059128","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":"Comparing telemedicine to in-clinic medication abortions induced with mifepristone and misoprostol","authors":"Ellen R Wiebe ,&nbsp;Mackenzie Campbell ,&nbsp;Harani Ramasamy ,&nbsp;Michaela Kelly","doi":"10.1016/j.conx.2020.100023","DOIUrl":"10.1016/j.conx.2020.100023","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to compare the practical aspects of providing medication abortions through telemedicine and in-person clinic visits so that clinics can use this information when planning to add this service.</p></div><div><h3>Study design</h3><p>We conducted a comparative retrospective chart review comparing telemedicine medication abortions to a control group matched for date seen. We extracted and compared demographics, use of dating ultrasound, outcomes and unscheduled visits or communications with staff and physicians.</p></div><div><h3>Results</h3><p>During the study period, we provided 4340 medication abortions, of which 182 (4.2%) were provided through by telemedicine; 199 patients met the criteria to be in the control group. The mean age was 28.7 years for telemedicine patients and 28.1 years for in-person patients (p = .38). The mean gestational ages were also similar, 48.2 days for telemedicine patients and 46.5 days for in-person patients (p = .03). Only 33 (18.1%) of telemedicine patients had dating ultrasounds compared to 199 (100%) of in-clinic patients (p &lt; .001). The proportions of documented completed abortions (164/182, 90.1% and 179/199, 89.9%, p = .76) were similar, as were the proportions of aspirations for completion (6/182, 3.3% and 9/199, 4.5%, p = .54) and the proportions lost to follow-up (5.5% and 6.6%, p = .66). There were 10 complications in each group (5.5% of telemedicine patients and 5.0% of in-clinic patients) (p &gt; 0.5). Unscheduled communications with office assistants were greater in the telemedicine patients than the in-person patients (84/182, 46.2% vs. 43/199, 21.6% in-person, p &lt; .001).</p></div><div><h3>Conclusion</h3><p>We found that telemedicine patients required more unscheduled communications and received ultrasounds far less often compared to in-clinic patients.</p></div><div><h3>Implications</h3><p>We could provide telemedicine without the need for ultrasound to most women. Larger studies without routine ultrasound use are needed to validate our findings. Unscheduled communication with clinic staff was more frequent with telemedicine medication abortion patients. This information may help clinics when planning to add this service.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100023"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38059604","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":"Levonorgestrel release rates measured through analysis of two-rod contraceptive explants","authors":"Rachael Fuchs ,&nbsp;Douglas Taylor ,&nbsp;David W. Jenkins ,&nbsp;Vivian Brache ,&nbsp;Diane Luo ,&nbsp;Laneta J. Dorflinger ,&nbsp;Markus J. Steiner","doi":"10.1016/j.conx.2020.100039","DOIUrl":"10.1016/j.conx.2020.100039","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to characterize and compare in vivo rates of levonorgestrel (LNG) release from Sino-implant (II) and Jadelle® contraceptive implants.</p></div><div><h3>Study design</h3><p>We sampled 48 Sino-implant (II) and 49 Jadelle® explant sets for residual LNG content from participants treated for up to 51 months in a randomized contraceptive efficacy trial in the Dominican Republic (DR). Additional Sino-implant (II) explants were obtained from 8 women who became pregnant in the DR trial and 10 who contributed 3 to 5 years of use in a cohort study in China. Baseline LNG loads were estimated from five unused implant sets per device type. Release profiles were estimated using mixture models that captured initial burst fractions and compared with efficacy and pharmacokinetics data from the DR trial.</p></div><div><h3>Results</h3><p>Estimated baseline LNG loads for Sino-implant (II) and Jadelle® were 142.8 mg and 150.5 mg, respectively (vs. the labeled 150 mg). There was an initial burst release of drug (5.6% and 7.9%, respectively) followed by an exponential decrease in LNG content evident for each device. Release rates were significantly lower for Sino-implant (II) throughout the treatment period, with estimated rates after 3 years of 24.2 mcg/day and 29.0 mcg/day for Sino-implant (II) and Jadelle®, respectively. The estimated Sino-implant (II) rate after 3 years was similar to the predicted rate after 5 years (23.6 mcg/day) for Jadelle® (rate ratio: 1.03; 95% confidence interval: 0.92–1.13).</p></div><div><h3>Conclusions</h3><p>Sino-implant (II) LNG release rates were significantly lower than Jadelle® with Sino-implant (II) rates through year 3 comparable to Jadelle® rates through year 5. These results reinforce the 3-year duration of action for which Sino-implant (II) was prequalified by the World Health Organization.</p></div><div><h3>Implications</h3><p>This analysis confirms the WHO prequalification of Sino-implant (II) for 3 years of use and supports different durations of action for Jadelle® and Sino-implant (II). It provides additional evidence that this approach can complement efficacy trials in determining duration of action of hormonal contraceptives in general.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38439172","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":"Change and stability in contraceptive use patterns among US women over a 12-month period: analysis using the 2013–2015 National Survey of Family Growth life history calendar","authors":"Sean M. Finn,&nbsp;Ayana Douglas-Hall,&nbsp;Rachel K. Jones","doi":"10.1016/j.conx.2020.100028","DOIUrl":"10.1016/j.conx.2020.100028","url":null,"abstract":"<div><h3>Objective</h3><p>To improve understanding of contraceptive use over 1 year among women in the United States.</p></div><div><h3>Study design</h3><p>We used the 2013–2015 National Survey of Family Growth to examine monthly contraceptive use patterns over a 12-month period. We focused on use of contraception during months in which non-sterilized women were sexually active and not pregnant; our outcomes were contraceptive use in every month, some months, and no months. We used simple and multivariate logistic regression to examine socio-demographic and method use characteristics associated with contraceptive use patterns.</p></div><div><h3>Results</h3><p>Some 72% of non-pregnant, non-surgically sterile women used contraception in every sexually active month. After controlling for other demographic and individual characteristics, adolescents had higher odds (aOR<!--> <!-->=<!--> <!-->2.45) of using contraception in each sexually active month compared to women aged 25–29. Other groups more likely to use contraception monthly included those with some college (aOR<!--> <!-->=<!--> <!-->1.58) compared to less than high school and non-cohabiting unmarried women (aOR<!--> <!-->=<!--> <!-->1.49) compared to married women. Those with gaps in insurance coverage during the past year (aOR<!--> <!-->=<!--> <!-->0.70), women who were not sexually active all 12 months (aOR<!--> <!-->=<!--> <!-->0.42), and those with more than two male sexual partners (aOR<!--> <!-->=<!--> <!-->0.49), were less likely to use contraception every sexually active month. Nearly half (46%) of contraceptive users in our sample used more than one type of contraceptive method over the 12-month period.</p></div><div><h3>Conclusions</h3><p>The majority of women use contraception every month they are sexually active, although there is variation between socio-demographic groups. However, over a one-year period, many women used dynamic contraceptive strategies.</p></div><div><h3>Implications</h3><p>Health care providers should recognize that contraceptive use patterns are dynamic and change over a relatively short time period for many women.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38133736","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":"Which contraceptive side effects matter most? Evidence from current and past users of injectables and implants in Western Kenya","authors":"George Odwe ,&nbsp;Francis Obare ,&nbsp;Kazuyo Machiyama ,&nbsp;John Cleland","doi":"10.1016/j.conx.2020.100030","DOIUrl":"10.1016/j.conx.2020.100030","url":null,"abstract":"<div><h3>Objectives</h3><p>The objectives were to assess experiences of menstrual bleeding and nonbleeding side effects among current and past users of injectables and implants and the associations between side effects and method evaluations by women — satisfaction, perceived suitability, the likelihood of future use and intended duration of use.</p></div><div><h3>Study design</h3><p>We used data on past and current users of injectables and implants from a survey of 1866 married or cohabiting women who participated in the third round of a 2-year prospective longitudinal study conducted in Homa Bay County, Western Kenya. Descriptive and bivariate analysis with <em>χ²</em> tests was used to assess statistically significant associations between experience of bleeding/nonbleeding side effects and method-specific attitudes.</p></div><div><h3>Results</h3><p>Self-reported method-related bleeding problems were high among current and past users of injectables (range 69%–79%) and implants (range 55%–60%) and much more common than nonbleeding side effects. For both methods, experience of either bleeding or nonbleeding side effects reduces positive evaluations, but the conjunction of both types had particularly pronounced consequences. Heavy bleeding was more strongly related to method evaluation (satisfaction and the likelihood of future use; p &lt; .001) among past users than other forms of menstrual bleeding disorders. Even among current users, about one third regarded bleeding side effects as very serious. Care-seeking from a healthcare provider for management of contraceptive-related side effects was low among current users (less than 40%) and modest among past users (range 53%–63%).</p></div><div><h3>Conclusions</h3><p>The results underscore the need to strengthen programs on counseling and information on contraceptive side effects including menstrual bleeding disturbances to improve method satisfaction and reduce discontinuation.</p></div><div><h3>Implication</h3><p>The experience of contraceptive-related menstrual bleeding and nonbleeding side effects reduces positive evaluation of the method and deters past users from future use of the method.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38133738","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":"A novel vaginal pH regulator: results from the phase 3 AMPOWER contraception clinical trial","authors":"Michael A. Thomas ,&nbsp;B. Todd Chappell ,&nbsp;Bassem Maximos ,&nbsp;Kelly R. Culwell ,&nbsp;Clint Dart ,&nbsp;Brandon Howard","doi":"10.1016/j.conx.2020.100031","DOIUrl":"10.1016/j.conx.2020.100031","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to evaluate the contraceptive effectiveness, safety, and acceptability of a novel vaginal pH regulator over seven cycles of use.</p></div><div><h3>Study design</h3><p>A single-arm, open-label, phase 3 study was conducted across 112 sites in the United States in sexually active 18–35-year-old women at risk of pregnancy. Women administered the study treatment ≤<!--> <!-->1 h before each episode of intercourse. Women recorded use of study drug, coital information, and any symptoms experienced in electronic diaries. The primary outcome was the seven-cycle cumulative pregnancy rate as calculated using the Kaplan–Meier methodology; secondary outcomes included safety. Overall satisfaction was assessed via written questionnaires.</p></div><div><h3>Results</h3><p>A total of 1384 women were enrolled in the study from July 2017 to November 2018. Mean age was 27.7 ± 4.4 years; most women were white (69.0%). The seven-cycle cumulative pregnancy percentage was 13.7% [95% confidence interval (CI): 10.0%–17.5%], meeting the prespecified primary endpoint of having the upper bound 95% CI ≤<!--> <!-->21%. Most common adverse events (AEs) occurring in ≥<!--> <!-->2% of women were vulvovaginal burning sensation, vulvovaginal pruritus, urinary tract infection, vulvovaginal pain, mycotic infection, bacterial vaginosis, and nasopharyngitis. Of 1330 women who used the study drug at least once, fewer than 2% of women discontinued due to any AEs, and &lt;<!--> <!-->1% of women discontinued due to genitourinary symptoms. Overall, &gt;<!--> <!-->80% of women reported being “very satisfied” or “satisfied” with study treatment.</p></div><div><h3>Conclusions</h3><p>In this phase 3 study, the novel vaginal pH regulator demonstrated 86.3% contraceptive effectiveness, was safe and well tolerated, and was highly acceptable.</p></div><div><h3>Implications</h3><p>This novel vaginal pH regulator is a safe, nonhormonal, woman-controlled method of contraception that expands women's options.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178467","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":"A qualitative exploration of women's experiences discovering pregnancies in the emergency department","authors":"Sarah C.M. Roberts,&nbsp;Erin Wingo,&nbsp;Katrina Kimport","doi":"10.1016/j.conx.2020.100024","DOIUrl":"10.1016/j.conx.2020.100024","url":null,"abstract":"<div><h3>Objectives</h3><p>The few studies examining pregnancy testing in emergency departments (EDs) address pregnancy-related physical risks. Here, we examine experiences of people who discover pregnancies in EDs.</p></div><div><h3>Methods</h3><p>Between 2015 and 2017, as part of a larger study, we conducted interviews with 29 women in Southern Louisiana (<em>n</em> = 13) and Baltimore, MD (<em>n</em> = 16), who reported discussing their pregnancy during an ED visit. We analyzed these interviews for content and themes.</p></div><div><h3>Results</h3><p>Respondents reported diagnosis of pregnancy as a routine and straightforward component of care received in EDs. They reported receiving diagnostic studies and therapeutic interventions to rule out and treat complications of pregnancy and care for what brought them to the ED to begin with, such as treatments for nausea and vomiting; education about physical symptoms and nutrition-related needs during pregnancy; and referrals to prenatal care. However, we find evidence of unmet needs related to patient-centered communication, such as providing emotional care to women discovering pregnancies in EDs and lack of support for transitions to abortion care.</p></div><div><h3>Conclusions</h3><p>While diagnosis of pregnancy in the ED may be routine for ED clinicians, it is not necessarily routine or straightforward for people receiving the diagnosis. ED clinicians should not assume that all people who discover their pregnancies in the ED want to continue their pregnancy. People who discover pregnancies in EDs may benefit from patient-centered communication and support for the range of transitions to care people might need in addition to the routinely provided diagnostic and therapeutic interventions.</p></div><div><h3>Implications</h3><p>ED clinicians may need additional training and support to ensure that they can meet the range of needs of people who discover their pregnancies in the ED.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100024"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38060106","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}