Contraception最新文献

{"title":"REASONS CLINICIANS CONSIDERED LEAVING AND STAYING IN STATES WITH ABORTION BANS","authors":"W Arey,&nbsp;M Heisler,&nbsp;P Shah,&nbsp;L Green,&nbsp;T McHale","doi":"10.1016/j.contraception.2025.111107","DOIUrl":"10.1016/j.contraception.2025.111107","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to examine clinicians’ decisions about whether to leave or continue to practice in states with abortion restrictions.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with clinicians providing care in Louisiana, Idaho, and Florida, after severely restrictive abortion policies went into effect from 2023 to 2024. In this secondary thematic analysis, we examined how these restrictions impacted clinicians’ thoughts about leaving states with bans.</div></div><div><h3>Results</h3><div>The interview sample comprised 57 clinicians and trainees. The majority (n=32) had considered leaving the state, and 12 had plans to leave, including all of the trainees. Twenty-eight said they would more seriously consider leaving if the laws became more restrictive, or would never have moved to the state given the current laws. Cited reasons for leaving included: not being able to use their full range of skills, criminal charges, and moral distress of providing care under laws. However, nine who considered leaving had since committed to staying. Primary cited reasons for staying were: to not abandon patients or concern about what kind of care would be provided if they were not there, to advocate to change the laws, to maintain established family ties in the state, or having moved there intentionally to provide abortions.</div></div><div><h3>Conclusions</h3><div>Participants’ responses highlighted that decision-points like residency or a more restrictive law might be catalysts to decide to leave. Clinicians who worked in practices that experienced fewer impacts from abortion restrictions, had stronger family ties, or had more advocacy-focused goals were more likely to consider staying in states with restrictions.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111107"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABORTION VOLUME IN WESTERN PENNSYLVANIA BEFORE AND AFTER DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION","authors":"RL Shay,&nbsp;BA Chen,&nbsp;KP Himes","doi":"10.1016/j.contraception.2025.111105","DOIUrl":"10.1016/j.contraception.2025.111105","url":null,"abstract":"<div><h3>Objectives</h3><div>We compared the number and characteristics of abortions in two practice settings in western Pennsylvania before and after <em>Dobbs v Jackson Women’s Health Organization</em>.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all abortions performed at an academic medical center (in-hospital) and a freestanding abortion clinic (out-of-hospital) between July 1, 2021 and May 31, 2023. We collected data on total number of abortions, gestational duration, proportion performed in the second trimester, type of abortion, and patient age and state of residence. We compared abortions between July 2021 and May 2022 (pre-<em>Dobbs</em>) with those between July 2022 and May 2023 (post-<em>Dobbs</em>) using t tests, Mann-Whitney U tests, and chi-square tests. We repeated the analysis stratifying by site.</div></div><div><h3>Results</h3><div>The total number of abortions across the two sites was 3,114 pre-<em>Dobbs</em> and 3,153 post-<em>Dobbs</em>. Post-<em>Dobbs</em> in-hospital abortions had a lower median gestational duration than did those pre-<em>Dobbs</em> (9 vs. 12 weeks, p&lt;0.01) and these patients were less likely to be from out-of-state (8.8% vs. 13.1%, p=0.04). In contrast, post-<em>Dobbs</em> out-of-hospital abortion patients had a higher median gestational duration than did those pre-<em>Dobbs</em> (9 vs. 8 weeks, p&lt;0.01) and patients were more likely to be from out-of-state (26.6% vs. 16.3%, p&lt;0.01).</div></div><div><h3>Conclusions</h3><div>Out-of-hospital abortions were more likely to be from out-of-state and occurred at later gestational ages post-<em>Dobbs</em> than pre-<em>Dobbs</em>, while the opposite trends were seen for in-hospital abortion patients. The differences between sites suggest that the burden of increased demand from out-of-state patients was disproportionately absorbed by community abortion providers.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111105"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OPERATIONALIZE REPRODUCTIVE JUSTICE: MODELING COMMUNITY-DRIVEN HEALTHCARE","authors":"CL Irwin,&nbsp;Z Julian,&nbsp;A Robinson,&nbsp;D Rivers,&nbsp;C Drayton,&nbsp;R Archer,&nbsp;N Desta-Bell,&nbsp;S Reyes,&nbsp;S Porter,&nbsp;J Caicedo,&nbsp;L Dary Restrepo","doi":"10.1016/j.contraception.2025.111134","DOIUrl":"10.1016/j.contraception.2025.111134","url":null,"abstract":"<div><h3>Objectives</h3><div>Among the pillars of reproductive justice are the rights to determine the optimal conditions under which one will give birth with dignity in safe, affordable, and sustainable environments. This project aims to utilize community accountable, reproductive justice approaches to ascertain intervention points to address gaps in care and inform our postpartum clinical services, thereby establishing the method our reproductive health organization will use for ongoing community feedback and service evolution.</div></div><div><h3>Methods</h3><div>Focus group interview guides were created by the organization’s team members in collaboration with the Black Mamas Matter Alliance. Cohorts of self-identified 1) transgender individuals, 2) Spanish-speaking Latinx people, 3) persons of color with pregnancy and birth experiences, and 4) birth workers were recruited and provided video links to participate in virtual group discussions with open-ended interview questions. Recorded sessions were qualitatively analyzed for common themes and frequent responses.</div></div><div><h3>Results</h3><div>Four cohorts of 20 people with birth experiences and two cohorts of eight birth workers participated. Focus group participants described their ideal prenatal and postpartum experiences, including high quality, comprehensive, respectful and affordable care that addresses equity and underserved populations. Service needs included extending prenatal visits to discuss other topics like nutrition, creating financial stability for birth workers, and increasing education around postpartum mental health support.</div></div><div><h3>Conclusions</h3><div>Focus group data directly informed the development and implementation of a post-natal services program that will include in-home post-natal visits by advanced practice nurses and referrals for mental health providers and other resources, initiating the community-led model that will be used by the organization moving forward.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111134"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MIFEPRISTONE IN MEXICO: EVIDENCE OF CROSS-BORDER SPILLOVER","authors":"LR Woskie","doi":"10.1016/j.contraception.2025.111092","DOIUrl":"10.1016/j.contraception.2025.111092","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to assess whether restrictive abortion policies in the US — specifically Texas Senate Bill 8 (SB8) and <em>Dobbs v Jackson Women’s Health Organization</em> — affected mifepristone sales within the formal health sector in Mexico, potentially indicating cross-border spillover.</div></div><div><h3>Methods</h3><div>We used a Synthetic Control Model (SCM) to estimate counterfactual trends in mifepristone sales in Mexico following two policy shocks: SB8 (September 2021) and <em>Dobbs</em> (June 2022). “Synthetic Mexico” was constructed using a weighted combination of countries with stable pre-trends and no relevant policy changes. Countries were selected based on data completeness and consistency, and weights were assigned using non-negative least squares.</div></div><div><h3>Results</h3><div>Both US policy interventions were associated with significant increases in mifepristone sales in Mexico. Following SB8, average quarterly sales rose by 123.8 units (95% CI, 72.7–190.8; p&lt;0.01). After <em>Dobbs,</em> sales increased by 94.8 units (95% CI, 23.5–166.1; p&lt;0.01). Although overall volume was low and pre-trend variability limits precision, consistent upward divergence from synthetic controls suggests unique shifts at both policy points. These results are limited to the formal health sector; and SB8 coincides with Mexico’s internal decriminalization ruling, which may explain the larger increase in sales.</div></div><div><h3>Conclusions</h3><div>These data offer empirical evidence that US abortion restrictions displace demand across borders, increasing mifepristone sales in Mexico. Concurrent policy shifts within Mexico make it challenging to attribute causality for SB8, but results underscore the need for a regional perspective on reproductive health access and policy impact.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111092"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“IT WAS SO EASY, IT DIDN’T FEEL REAL”: POSITIVE ABORTION EXPERIENCES POST-DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION","authors":"C Beavin,&nbsp;H Gyuras,&nbsp;J Sinclair,&nbsp;A Kirkendall,&nbsp;D Bessett,&nbsp;ML McGowan","doi":"10.1016/j.contraception.2025.111112","DOIUrl":"10.1016/j.contraception.2025.111112","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-<em>Dobbs</em> research has focused on new and increased barriers to abortion in the US, while less attention has been paid to positive experiences with abortion. This “joy deficit” in US-based abortion research may lead abortion seekers to anticipate abortion as a negative experience.</div></div><div><h3>Methods</h3><div>Between July 2022 and December 2024, we conducted interviews with 74 people from abortion-restrictive states who faced logistic and legal challenges obtaining abortions after <em>Dobbs</em>.</div></div><div><h3>Results</h3><div>Interviews revealed that increased costs and interstate travel can make finding and obtaining abortion care highly burdensome. However, the majority of interviewees also shared positive experiences about the process. Caring and nonjudgmental clinic staff and volunteers at abortion funds and practical support networks helped affirm and destigmatize abortion for participants and made an unnecessarily difficult experience more bearable. These interactions left meaningful impressions, highlighting how quality care and plentiful resources contribute to positive abortion experiences for those living in abortion-restrictive states. Some expressed that despite numerous barriers, their post-<em>Dobbs</em> abortion experience was better and easier than other medical experiences because of strong clinical staff and practical supports they encountered.</div></div><div><h3>Conclusions</h3><div>This study highlights how care providers and support personnel create joy in the abortion-seeking process for those living in restrictive states post-<em>Dobbs</em>. The constellation of actors who care for abortion seekers can counteract the negative effects of barriers to abortion, pointing to the need for shoring up clinics, advocacy groups, and mutual aid collectives in affirming and destigmatizing abortion and contributing to positive outcomes for abortion patients.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111112"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREFERRED SELF-MANAGED ABORTION SUPPORT IN MISSISSIPPI: A DISCRETE CHOICE EXPERIMENT","authors":"HH Leslie,&nbsp;M Griffith,&nbsp;D Nelson,&nbsp;V Robinson,&nbsp;K Holt","doi":"10.1016/j.contraception.2025.111111","DOIUrl":"10.1016/j.contraception.2025.111111","url":null,"abstract":"<div><h3>Objectives</h3><div>Self-managed medication abortion (SMMA) is increasingly common, yet little is known about SMMA decision-making in states with complete bans. We sought to quantify preferences for SMMA support models in Mississippi.</div></div><div><h3>Methods</h3><div>We drew on academic and community input to design a discrete choice experiment with attributes of pill source (levels: online, telehealth, community), cost ($0-$150), information support (handout, hotline, clinic consult, doula) and material support (none, essentials, self-care package). We used community-based convenience sampling to recruit pregnancy-capable Mississippi residents aged 18-45. Respondents selected a hypothetical SMMA model from three alternatives in each of 10 choice tasks. We estimated preferences and willingness to pay with Hierarchical Bayes models.</div></div><div><h3>Results</h3><div>Between August 2024 and February 2025, 163 respondents completed the discrete choice experiment: median age was 30; 84% identified as Black, and 39% could not cover an unexpected $200 medical expense. Half had at least one child and 27% reported a pregnancy ending without live birth; 69% had heard of abortion pills. Cost was the most important consideration in selecting an SMMA model; respondents also valued material support (willing to pay $49 for self-care package vs. no support) and less so information support (willing to pay $25 for an in-person support option vs. hotline). Preferences did not differ based on pregnancy history. Respondents unable to cover unexpected medical expenses strongly preferred lower costs.</div></div><div><h3>Conclusions</h3><div>Source of pills mattered less to Mississippi adults than cost and availability of material support in selecting a hypothetical SMMA model. A focus on access alone may overlook SMMA users’ preferences.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111111"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE IMPACT OF MISINFORMATION AND LEGAL VULNERABILITY ON ABORTION ACTIVISM IN TEXAS","authors":"E Kravitz,&nbsp;H Wurtz,&nbsp;A Mukund,&nbsp;D Johnson,&nbsp;G Cummings,&nbsp;S Sonalkar","doi":"10.1016/j.contraception.2025.111120","DOIUrl":"10.1016/j.contraception.2025.111120","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the impact of fear and legal uncertainty on the work of grassroots abortion activists in Texas, as well as the multi-level strategies of activists to resist the negative impacts of these tactics.</div></div><div><h3>Methods</h3><div>We conducted semi-structured, 60-minute in-depth interviews between November 2023 and April 2024 with 15 grassroots abortion activists serving Texans. We utilized a community based participatory research model to guide our approach to interviews and analysis. Data were coded and analyzed through thematic analysis.</div></div><div><h3>Results</h3><div>Activists describe significant shifts to their approach to providing abortion assistance and support because of widespread fear and legal uncertainty. Meeting clients’ needs for information has been strained by demands of self-censorship and a surge of misinformation promulgated by crisis pregnancy centers. Personnel and partnerships have been altered by uncertainty of the legal ramifications of providing abortion assistance and fear for personal security. In response to fear and legal uncertainty, activists have an expanding role in educating individuals and generating dialogue in the community to destigmatize and legitimize abortions as healthcare. Organizations have prioritized and expanded self-care resources and rely more heavily on coalition support for activists to address rising burnout and personal fear.</div></div><div><h3>Conclusions</h3><div>The anti-abortion movement in Texas has weaponized misinformation and legal ambiguity to elicit fear, stigmatize services, and erode the infrastructure of abortion activist organizations in Texas. Activists have responded with strategies focused on education, resiliency, and collaboration empowering patients and activists.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111120"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DUAL LOYALTY, MEDICAL ETHICS, AND ABORTION BANS","authors":"W Arey,&nbsp;M Heisler,&nbsp;T McHale,&nbsp;H Miller,&nbsp;L Green,&nbsp;P Shah","doi":"10.1016/j.contraception.2025.111106","DOIUrl":"10.1016/j.contraception.2025.111106","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to examine clinicians’ experiences of dual loyalty, defined as conflict between professional duties to a patient and obligations to the interests of a third party such as the state, when providing care under restrictive abortion bans.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with clinicians providing care in Louisiana a year post-<em>Dobbs v Jackson Women’s Health Organization</em> (May to November 2023) and in Florida (July to August 2024) after the six-week abortion ban went into effect. In this secondary thematic analysis, we examined the code for participants’ responses about experiences of dual loyalty.</div></div><div><h3>Results</h3><div>We interviewed 30 healthcare workers and trainees in Louisiana and 25 in Florida; the analytic sample contained 48 participants who described an experience of dual loyalty. Participants described having to deny care to patients that they had the knowledge and skills to care for as a primary example of dual loyalty. Many noted that this was necessary to protect the care that they could offer, by complying with the law to not lose their licenses. Participants also described interference with their medical judgment and having to deviate from the standard of care. Several participants highlighted conflicted thoughts about having to break the law to adhere to their medical ethics. Participants often described feeling moral distress from being unable to adhere to medical ethics.</div></div><div><h3>Conclusions</h3><div>Participants’ experiences of dual loyalty highlight a moral obligation to provide abortion care, which is being negatively impacted by abortion bans. This could be seen as a new form of conscientious objection, where clinicians object to abortion bans as being antithetical to medical ethics.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111106"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE PRICE OF LATER ABORTION CARE IN THE US","authors":"TA Weitz,&nbsp;M Wilson Schwartz","doi":"10.1016/j.contraception.2025.111115","DOIUrl":"10.1016/j.contraception.2025.111115","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to document the price of abortion care after 23 weeks of pregnancy.</div></div><div><h3>Methods</h3><div>We identified 131 healthcare facilities that publicly advertised offering post-23-week abortion care in August 2024. From November 6, 2024 to April 7, 2025, undergraduate research assistants (RAs) posed as mystery clients to inquire about the price of care. They called each facility twice for each two-week pregnancy period at/above 23 weeks (ie, 23-25 weeks; 25-27 weeks). We calculated the range, mean and median price for each two-week difference.</div></div><div><h3>Results</h3><div>RAs made 522 calls, successfully connecting with facility personnel 418 times (80%). RAs successfully obtained information on the service price in 55% of calls (n=228). In response to 189 calls, RAs obtained a specific price and in 39 calls RAs obtained a price range. Specific prices ranged from $1,054-$82,670 (median $3,000) for 23-week abortions (n=131), $1,959-$12,195 (median $6,500) for 25-week abortions (n=23), $5,585-$13,900 (median $9,500) for 27-week abortions (n=17), $9,800-$16,800 (median $11,400) for 29-week abortions (n=7), 14,500-$19,800 (median $19,000) for 31-week abortions (n=7), and $15,500-$19,000 (median $15,500) for 33-week abortions (n=3).</div></div><div><h3>Conclusions</h3><div>One of the most recognized barriers to abortion care is needing to raise the money to pay for the abortion, yet little public data exist on the price of abortion later in pregnancy. This study sought to fill this information gap. We provide information on the range of prices for care over two-week gestational durations. Unfortunately, later abortion care price transparency is still limited as almost half of all calls to facilities that publicly advertised offering this care did not result in price information.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111115"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“LIKE A BUSINESS TRANSACTION”: BLACK WOMEN’S TRUST IN ABORTION HEALTHCARE IN OHIO","authors":"SE Bostic,&nbsp;H Sihra,&nbsp;A Norris Turner,&nbsp;D Bessett,&nbsp;T Odum","doi":"10.1016/j.contraception.2025.111085","DOIUrl":"10.1016/j.contraception.2025.111085","url":null,"abstract":"<div><h3>Objectives</h3><div>Growing research has examined the prevalence of medical mistrust among Black people and its impact on healthcare access, adherence, and outcomes. However, trust in the context of abortion has been seldom studied. These preliminary findings shed light on Black women’s conceptualizations of trust in their experiences with abortion and reproductive healthcare with the emergent theme of abortion as transactional.</div></div><div><h3>Methods</h3><div>We are conducting semi-structured, in-depth interviews with Black women in Ohio, asking them to describe their abortion and reproductive healthcare experiences. We used an iterative, inductive coding approach to analyze interview transcripts, allowing for insights from early interviews to inform ongoing data collection and refinement of codes.</div></div><div><h3>Results</h3><div>Many participants describe their abortion experience as being “like a business transaction,” with providers “just doing their job,” and the clinic “feeling like an assembly line” where “nothing moves without the payment,” highlighting the impersonal, bureaucratic, and commodified aspects of their care. Preliminary findings indicate transactional abortion experiences, with themes of clinical detachment, emotional distance, and perceived commodification of care. However, these experiences were not monolithic; some participants also reported moments of emotional connection and validation within clinical settings, reflecting the negotiation of trust and necessity under constrained circumstances of limited choice for care, resources, and time.</div></div><div><h3>Conclusions</h3><div>These initial findings complicate binary notions of medical trust and mistrust, suggesting that Black women navigate abortion care through nuanced and conditional forms of trust. Understanding these negotiations offers crucial insight into how reproductive healthcare systems can better address the specific needs and experiences of Black women.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111085"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}