Contraception最新文献

{"title":"IMPROVING CARE FOR INDIVIDUALS WITH HIGHER BODY MASS INDEX (BMI) UNDERGOING INDUCTION TERMINATION","authors":"M Fuerst,&nbsp;K Prewitt,&nbsp;B Garg,&nbsp;S Ramanadhan,&nbsp;L Han","doi":"10.1016/j.contraception.2024.110584","DOIUrl":"10.1016/j.contraception.2024.110584","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to examine the association of body mass index (BMI) with time to delivery for those undergoing induction of labor for pregnancy termination in the second or third trimester.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study including all patients with a singleton pregnancy undergoing induction termination at a single academic medical center over a 14-year period (1/2020-2/2024). Our primary outcome was time to fetal expulsion from the first medication given. BMI was categorized into four groups (&lt;18.5, 18.5-25, 25-30, and &gt;30). Kruskal-Wallis tests were used to compare median time to delivery among the BMI groups; and multivariable logistic regression models were used to assess the association of BMI with time to delivery ≥24 hours.</div></div><div><h3>Results</h3><div>Of the 428 charts reviewed, 393 patients met inclusion criteria. Of these, 290 (73.7%) had a BMI greater than 25. The median time to expulsion was significantly different among BMI categories (9 hours for BMI &lt; 18.5, 12 hours for BMI 18.5-25, 14 hours for BMI 25-30, and 20 hours for individuals with BMI &gt;30, p&lt;0.001). After adjusting for maternal age, gestational age, history of cesarean section and prior vaginal deliveries, individuals with a BMI &gt;30 had 6.74 times the odds (95%CI 3.24-14.00) of having a time to expulsion ≥24 hours compared to BMI 18.5-25.</div></div><div><h3>Conclusions</h3><div>We found individuals had a significantly longer time to delivery in second and third trimester induction terminations for patients with BMI &gt;30. Induction protocols may need to be adjusted to provide equitable care for individuals with higher BMI.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110584"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426120","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":"RACE AND ETHNICITY REPORTING AND REPRESENTATION IN US CONTRACEPTIVE CLINICAL TRIALS FROM 2007-2024","authors":"N Fang,&nbsp;J Sheeder","doi":"10.1016/j.contraception.2024.110578","DOIUrl":"10.1016/j.contraception.2024.110578","url":null,"abstract":"<div><h3>Objectives</h3><div>Contraceptive clinical trials inform policy and practice changes, yet participants are often non-representative of the US population. We aimed to characterize race and ethnicity reporting among completed contraceptive trials.</div></div><div><h3>Methods</h3><div>We queried ClinicalTrials.gov for all completed trials (2007–2024) with keywords “contraception” or “contraceptive.” We extracted all race and ethnicity participant data. If this was not reported, we manually reviewed linked publications. We categorized trials as “representative” or “non-representative” of the US population if the proportion of non-White participants were within 30% of the 2020 Census estimates. We described and compared trial characteristics for reporting and representation using chi-squared tests (IBM SPSS Version 29). The study included only publicly available data and was deemed exempt by the Colorado Multiple Institutional Review Board.</div></div><div><h3>Results</h3><div>We reviewed 129 trials meeting initial inclusion criteria; 55 were excluded for including non-US sites or the study was not related to contraception, leaving 74 for the final analysis. Most reported race or ethnicity (85.1%) and occurred in the West region (32.4%); 43.2% evaluated pharmacokinetics, safety, or efficacy. 68.9% were non-representative of the US population. Of those, 82.4% had overrepresentation of non-White participants. Trial phase, funder type, completion year, contraceptive method, and study type did not differ between “representative” and “non-representative” studies.</div></div><div><h3>Conclusions</h3><div>Race and ethnicity of participants in contraceptive trials are not representative of the US. Deliberate and thoughtful recruitment strategies are needed to ensure that contraceptive trials are diverse, inclusive, have adequate representation, and are not unintentionally over-recruiting populations with historical mistreatment within the research community.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110578"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426166","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":"URGENT, EMERGENT, OR JUST MISSED? GEOPOLITICAL VARIATIONS IN THE MANAGEMENT OF EARLY PREGNANCY LOSS IN US EMERGENCY DEPARTMENTS","authors":"ED Lantos,&nbsp;LS Benson,&nbsp;R Sangara,&nbsp;P Garza,&nbsp;M Pearlman Shapiro,&nbsp;BT Nguyen","doi":"10.1016/j.contraception.2024.110626","DOIUrl":"10.1016/j.contraception.2024.110626","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe geopolitical variations in Emergency Medicine (EM) providers’ treatment of early pregnancy loss (EPL) and evaluated their attitudes toward directly managing EPL, with attention to the influence of post-<em>Dobbs v Jackson Women’s Health Organization</em> restrictions.</div></div><div><h3>Methods</h3><div>We distributed a nationwide anonymous survey to emergency medicine clinicians using specialty-specific listservs and social media platforms, exploring experience and comfort with EPL diagnosis and management, as well as relevant institutional and structural barriers, inclusive of state abortion restrictions. We examined associations between state restrictions and emergency medicine resources via bivariate analysis.</div></div><div><h3>Results</h3><div>Most participants (n=203) identified as female (56.6%), non-Hispanic White (69.0%), attendings (73.6%), in urban settings (82.7%) and abortion-permissive states (60.8%). Most reported comfort diagnosing (93.0%) and counseling (86%) about EPL. However, only 39.7% consistently counseled on all management options--expectant, medication, procedural. Participants in abortion-permissive states were significantly more likely to consistently offer comprehensive counseling (44.2% vs. 32.7%, p=0.02) and reported increased access to on-site Ob-Gyn consultation (49.6% vs. 27.5%, p=0.002). Regardless of restrictions, only 16.2% consistently prescribed mifepristone-misoprostol; fewer (3.5%) performed manual uterine aspiration. 49.7% felt stable patients experiencing EPL should not receive treatment in the ED; 48.7% felt Ob-Gyns should manage EPL; 44.0% reported that arranging follow-up was a barrier to management. The majority (78.1%) endorsed the importance of more training on medication management of EPL.</div></div><div><h3>Conclusions</h3><div>Less than 20% of emergency medicine clinicians consistently offer EPL treatment. On-site Ob-Gyn consultations remain an essential resource, though less accessible in abortion-restrictive states. Training emergency medicine providers to treat EPL and improving access to follow-up could improve care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110626"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426172","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":"WHERE’S THE SPACE FOR JOY? A CALL FOR EXPANDED MEASUREMENT OF POSITIVE EMOTIONS AND ATTITUDES ASSOCIATED WITH ABORTION","authors":"A Bell,&nbsp;J Williams,&nbsp;S Banks,&nbsp;K Giles,&nbsp;A Gubrium","doi":"10.1016/j.contraception.2024.110625","DOIUrl":"10.1016/j.contraception.2024.110625","url":null,"abstract":"<div><h3>Objectives</h3><div>The study explored Black women’s abortion experiences and their responses to an existing abortion stigma scale.</div></div><div><h3>Methods</h3><div>Following a six-week virtual digital storytelling workshop that aimed to reduce internalized abortion stigma, 14 self-identified Black women aged 19–66, from California and Indiana participated in a one-hour interview and in four 90-minute focus group discussions (FGDs) conducted via Zoom. During the FGDs, participants completed the Individual Level Abortion Stigma (ILAS) scale and reflected on its contents. The interviews and FGDs were audio-recorded, transcribed, and analyzed thematically using Dedoose.</div></div><div><h3>Results</h3><div>Participants reported that receiving the ILAS scale prior to starting the digital storytelling workshop would have negatively affected their participation. More specifically, participants said that it would have led to feeling unsafe, lack of trust, and emotional guardedness. Respondents described positive emotions related to their abortion that are not captured in the ILAS or other validated measures, including feelings of relief, joy, pride, and gratitude. Participants also reported positive outcomes of terminating the pregnancy, such as finishing post-secondary school, ending harmful romantic relationships, and family planning for the future. Participants noted the need for a measure to better capture these positive aspects. At least one participant believed that the measure should be specific to Black women.</div></div><div><h3>Conclusions</h3><div>Use of scales such as the ILAS, while important, focus on the negative aspects associated with abortion and may actually introduce stigma. Our findings highlight the need for robust measures that are culturally responsive and capture both positive and negative impacts of abortion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110625"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426173","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":"DISTANCE TRAVELED TO OBTAIN ABORTION CARE IN SOUTHERN ILLINOIS BEFORE AND AFTER THE DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION DECISION","authors":"J Trevino,&nbsp;R Paul,&nbsp;E King,&nbsp;J Reeves,&nbsp;D Eisenberg,&nbsp;T Madden","doi":"10.1016/j.contraception.2024.110569","DOIUrl":"10.1016/j.contraception.2024.110569","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to examine changes in one-way driving distance for people seeking abortion care at a single site before and after the <em>Dobbs v Jackson Women’s Health Organization</em> decision, and to identify factors associated with traveling ≥250 miles.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of abortions performed at a single abortion clinic in Southern Illinois for 12 months pre- and post-<em>Dobbs</em> using electronic scheduling data. We compared patient characteristics and one-way driving distance using chi-square. We used a multivariable logistic regression to identify factors associated with a one-way driving distance ≥250 miles.</div></div><div><h3>Results</h3><div>In total, 12,920 abortions occurred from June 2021 to June 2023: 4,666 pre-<em>Dobbs</em> and 8,254 post-<em>Dobbs</em>. The median one-way driving distance increased from 20 miles (IQR 14-118) to 142 miles (IQR 17-312) (<em>p</em>&lt;0.001). Post-<em>Dobbs</em>, a smaller proportion of patients traveled &lt;25 miles, while the absolute number remained stable: 2,617 (56.1%) vs. 2,891 (35.0%). Post-<em>Dobbs</em>, the number of patients traveling ≥250 miles increased by 701% (488 to 3,469). The proportion of out-of-state patients receiving abortions increased from 66.6% to 83.0% (<em>p</em>&lt;0.001). Post-<em>Dobbs</em>, patients traveling≥250 miles for an abortion were more likely to be ≥12 weeks gestational duration (adjusted OR (aOR) 2.94, 95%CI 2.63-3.29), of Hispanic origin (aOR 2.78, 95%CI 2.20-3.51), and self-pay for their procedure (aOR 9.59, 95%CI 8.00-11.48).</div></div><div><h3>Conclusions</h3><div>Post-<em>Dobbs</em>, we observed a seven-fold increase in patients traveling≥250 miles for care at a single independent abortion clinic in Southern Illinois. These findings highlight the increased barriers to abortion access caused by restrictive legislation in the US.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110569"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426182","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":"LIMITS OF PUBLIC POLICY TO CHANGE INDIVIDUALS’ CONSIDERATION OF ABORTION IN THE US SOUTHWEST","authors":"DG Foster,&nbsp;E Gonzalez,&nbsp;LJ Ralph,&nbsp;CH Rocca","doi":"10.1016/j.contraception.2024.110591","DOIUrl":"10.1016/j.contraception.2024.110591","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to understand abortion decision making and the extent to which unsupportive social/economic policies might contribute to people having abortions who might otherwise choose childbearing</div></div><div><h3>Methods</h3><div>As part of a longitudinal cohort study in the US Southwest, we prospectively followed 2,015 participants aged 15-34 years, recruited between 2019-2022 from 23 healthcare facilities, for one year until incident pregnancy (n=382) and through pregnancy decision-making. Participants having abortions reported the circumstances under which they might have decided to continue the pregnancy and raise the child.</div></div><div><h3>Results</h3><div>Among the 95 people who had an abortion, only 15% said nothing would have led them to decide to carry the pregnancy to term. About 71% indicated at least one circumstance related to social/economic status. For instance, 58% might have chosen to give birth if they had more money, of whom 1 in 5 said they would need less than $5,000. Housing was a major consideration, with 47% of women reconsidering abortion if they had their own or a better place to live. However, the vast majority (90%) also indicated circumstances that are immutable to social/economic policy such as if they were older (39%), finished with school (28%), married (27%), in better health (26%), or if their other children did not need their attention (21%). Only one participant exclusively indicated circumstances that could be addressed with economic policies, such as housing, childcare, and financial support.</div></div><div><h3>Conclusions</h3><div>Results suggest that more supportive social/economic policies could help improve reproductive autonomy but would unlikely significantly reduce need for abortion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110591"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426341","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":"ENHANCING CARE FOR LACTATION AFTER A SECOND-TRIMESTER ABORTION OR FETAL LOSS: A QUALITATIVE STUDY","authors":"E Shindo,&nbsp;AE Paris","doi":"10.1016/j.contraception.2024.110597","DOIUrl":"10.1016/j.contraception.2024.110597","url":null,"abstract":"<div><h3>Objectives</h3><div>Encountering breastmilk secretion following abortion or fetal loss in the second trimester can be physically and emotionally challenging. Options for lactation in this setting are to expectantly manage, suppress using behavioral modifications, pharmacologically suppress, and to express and discard or donate milk. Little is known about the lactation preferences among second-trimester abortion and fetal loss patients. This study sought to explore lactation preferences of these patients via the experiences and practices of their healthcare providers, and to enhance support around lactation options counseling for this population.</div></div><div><h3>Methods</h3><div>This was a qualitative study involving semi-structured interviews with a purposively recruited sample of nine providers and community partners who interact with second-trimester abortion/fetal loss patients. Thematic analysis was used to identify and interpret meaningful patterns across the dataset.</div></div><div><h3>Results</h3><div>Three key themes were identified: (1) lactation guidance in the second trimester should be tailored to varying patient situations, (2) more provider education on lactation specific to the second-trimester population is desired, and (3) while milk donation by second trimester patients was rare, stakeholders perceived the experience as being positive for those who chose to donate.</div></div><div><h3>Conclusions</h3><div>Providers are encouraged to seek ways to communicate all lactation options to patients that may be interested. Provision of an informational brochure, enhanced coordination with lactation consultants, and increased educational opportunities for providers around second trimester lactation can help advance such efforts.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110597"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426348","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":"INTIMATE PARTNER VIOLENCE AND DELAYS IN SCHEDULING ABORTION SERVICES","authors":"SS Nayak,&nbsp;AAJ Scoglio,&nbsp;T Sanni-Ojikutu","doi":"10.1016/j.contraception.2024.110600","DOIUrl":"10.1016/j.contraception.2024.110600","url":null,"abstract":"<div><h3>Objectives</h3><div>Intimate partner violence (IPV), the experience of physical and sexual violence, stalking, and/or psychological aggression within an intimate relationship, may influence reproductive autonomy and abortion access. We examined the relationship between IPV victimization and delays in scheduling abortion services for pregnant people in the US.</div></div><div><h3>Methods</h3><div>Data come from the Guttmacher Institute’s Abortion Patient Survey, a nationally representative non-hospital sample of women seeking abortions in 2014 (n=8,380). We estimated complex survey-weighted logistic regression to model the association between IPV victimization and two-week delays in scheduling a desired abortion after the decision to terminate a pregnancy, controlling for sociodemographic variables. We chose two weeks based on the earliest plausible time of pregnancy awareness (four weeks) and the shortest gestation bans (six weeks). A delay of more than two weeks could result in a denied abortion.</div></div><div><h3>Results</h3><div>In bivariate models (n=6,996), experiencing IPV was associated with greater abortion scheduling delays compared to those not experiencing IPV (OR = 1.64, 95% CI 1.27, 2.11, <em>p</em>=0.0002). In multivariable models (n=6,197), experiencing IPV was associated with greater abortion scheduling delays compared to those not experiencing IPV (OR= 1.36, 95% CI 1.01, 1.83, <em>p</em> = 0.0430), controlling for covariates.</div></div><div><h3>Conclusions</h3><div>IPV is associated with delays in scheduling a desired abortion. In the increasingly restrictive US policy climate, IPV-related delays in scheduling services may make abortions functionally inaccessible. Comprehensive IPV screening is critical in obstetrics. Providers working with patients who are seeking abortions and experiencing IPV should provide prompt resources and education to ensure rapid access to abortion services.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110600"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426351","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":"REAL-WORLD CONTRACEPTIVE FAILURE RATES OF MULTIPLE METHODS OVER THREE YEARS: FINDINGS FROM THE HER SALT LAKE CONTRACEPTIVE INITIATIVE — A PROSPECTIVE COHORT STUDY","authors":"JN Sanders,&nbsp;G Carter,&nbsp;B Bullington,&nbsp;A Gero,&nbsp;R Simmons,&nbsp;DK Turok","doi":"10.1016/j.contraception.2024.110560","DOIUrl":"10.1016/j.contraception.2024.110560","url":null,"abstract":"<div><h3>Objectives</h3><div>The HER Salt Lake Contraceptive Initiative provided no-cost contraceptive options for up to three years at four family planning clinics in Salt Lake County, UT. In this analysis, we assess real-world contraceptive failure rates as reported by HER Salt Lake participants.</div></div><div><h3>Methods</h3><div>Survey data were collected at nine time points over 36 months to assess user experiences, including switching, discontinuation, and pregnancy experiences among individuals using the implant, copper IUD, hormonal IUD, pills, ring, injectable, and nonhormonal behavioral methods. We calculated incidence ratios and 95% confidence intervals for contraceptive failures at 1, 2, and 3 years, as well as cumulative incidence failure rates based on reported person-years among continuers for each of these methods.</div></div><div><h3>Results</h3><div>Among 4,278 individuals, there were 91 unintended pregnancies that occurred while contracepting. Hormonal IUDs had the overall lowest cumulative incidence failure rate (incidence rate (IR), 0.006/person-year; 95% CI, 0.004–0.011), followed by the implant (IR, 0.008/person-year; 95% CI, 0.005–0.016), copper IUD (IR, 0.011/person-year; 95% CI, 0.006–0.019), injectable (IR, 0.014/person-year; 95% CI, 0.006–0.025), ring (IR, 0.019/person-year; 95% CI, 0.007–0.044), pills (IR, 0.022/person-year; 95% CI, 0.016–0.031) and nonhormonal behavioral methods (IR, 0.05/person-year; 95% CI, 0.016–0.148).</div></div><div><h3>Conclusions</h3><div>Three-year failure rates in real-world settings are rarely published. The HER participants received their preferred methods and reported lower typical-use failure rates across methods compared to currently published information. While participation in research may influence behaviors, data from contraceptive initiatives that prioritize patient preference add important context when discussing contraceptive effectiveness over time. Our findings provide encouraging data for contraceptive access initiatives committed to offering the full range of contraceptive options and support the effectiveness of all methods.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110560"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426321","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":"BELIEFS ABOUT TRUSTING WOMEN TO MAKE THEIR OWN ABORTION DECISIONS AND PUNISHMENT FOR SELF-MANAGED MEDICATION ABORTION IN A NATIONALLY REPRESENTATIVE SAMPLE","authors":"A Becker,&nbsp;R Schroeder,&nbsp;L Ralph,&nbsp;S Kaller,&nbsp;MA Biggs","doi":"10.1016/j.contraception.2024.110613","DOIUrl":"10.1016/j.contraception.2024.110613","url":null,"abstract":"<div><h3>Objectives</h3><div>Given the anticipated increase in self-managed medication abortion due to decreased access to facility-based abortion in the US after <em>Dobbs v Jackson Women’s Health Organization,</em> we examined lay attitudes regarding trusting pregnant people to make their own abortion decisions and whether trusting women is associated with beliefs about punishment for self-managed medication abortion.</div></div><div><h3>Methods</h3><div>We conducted a nationally representative cross-sectional survey of 7,148 people assigned female at birth (AFAB), aged 15–49 from May to July 2023, using a probability-based panel. Participants were asked to indicate whether they agree or disagree that “Most women are capable of making the best decision on abortion for themselves.” We calculated a mean Trust women score (1–5, 5=higher trust). We conducted multivariable regression to assess factors associated with trusting women and whether trusting women was associated with support for reporting people to Child Protective Services or the police, having them pay a fine, or jailing those who self-managed a medication abortion.</div></div><div><h3>Results</h3><div>The mean Trust Women score was 2.6 (SD= 1.24). Respondents were evenly split between trusting women (50.36% agreed/strongly agreed, 49.64% disagreed, strongly disagreed, or neither agreed nor disagreed). Identifying as a gender or sexual minority, as Democrat, as non-Hispanic Black, and supportive of legal access to in-clinic abortion were associated with higher odds in trusting women to make abortion decisions. Trusting women was associated with decreased support for all forms of punishment for self-managed medication abortion.</div></div><div><h3>Conclusions</h3><div>Beliefs about trusting women are polarized, with only half of AFAB people reporting trusting women to make their own abortion decisions; these attitudes are associated with beliefs about punishing those who self-manage a medication abortion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110613"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426435","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}