Contraception最新文献_第3页

SELF-MANAGED, BUT NOT ALONE: THE HEALTHCARE NEEDS OF SELF-MANAGED MEDICATION ABORTION USERS 自我管理，但并不孤独：自我管理的药物流产使用者的保健需求

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110610

E Sully, I DoCampo, S Cech, A Aiken, J Scott

{"title":"SELF-MANAGED, BUT NOT ALONE: THE HEALTHCARE NEEDS OF SELF-MANAGED MEDICATION ABORTION USERS","authors":"E Sully, I DoCampo, S Cech, A Aiken, J Scott","doi":"10.1016/j.contraception.2024.110610","DOIUrl":"10.1016/j.contraception.2024.110610","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-<em>Dobbs v Jackson Women’s Health Organization</em>, self-managed medication abortion (SMMA) is increasingly common in the US (Aiken et al 2024). This analysis assesses whether, and why, SMMA users seek medical attention post-SMMA. It also explores how user demographics and abortion policy environment influence treatment-seeking post-SMMA.</div></div><div><h3>Methods</h3><div>From July 2023-February 2024, we surveyed SMMA users in Florida, Indiana, and Louisiana about their abortion experiences and treatment-seeking behaviors. An additional round of data will be collected from May-August 2024. We recruited respondents through seven SMMA providers; analyses will also incorporate Aid Access client follow-up data. We examine three dimensions of post-SMMA care: (1) any post-abortion care, (2) care for symptoms requiring medical attention or additional abortive interventions and (3) adverse events requiring treatment. We assess treatment-seeking by user demographics via multivariate regression; we also compare treatment-seeking before and after abortion bans in Indiana and Florida relative to Louisiana, where abortion policy was static throughout the study.</div></div><div><h3>Results</h3><div>Data from 2023 fielding (n=154) indicate high SMMA efficacy (95%) and infrequent complications. 39% of respondents sought medical attention post-SMMA—85% to verify their pregnancy had ended. Black individuals, and parents, were significantly more likely to seek treatment than others. Final findings will incorporate data from Aid Access, May-August 2024 survey data, and estimates of the impact of abortion bans on treatment-seeking.</div></div><div><h3>Conclusions</h3><div>A sizeable proportion of users sought treatment after SMMA, despite high efficacy and low rates of complications. Policymakers, advocates, and providers should ensure that SMMA users can safely access desired medical attention, regardless of state policy environment.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426517","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}

引用次数: 0

ABORTION TRENDS AT A SINGLE CLINIC IN SOUTHERN ILLINOIS BEFORE AND AFTER THE DOBBS V. JACKSON WOMEN’S HEALTH ORGANIZATION DECISION 多布斯诉杰克逊妇女健康组织案判决前后伊利诺伊州南部一家诊所的堕胎趋势

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110611

J Trevino, R Paul, E King, J Reeves, D Eisenberg, T Madden

{"title":"ABORTION TRENDS AT A SINGLE CLINIC IN SOUTHERN ILLINOIS BEFORE AND AFTER THE DOBBS V. JACKSON WOMEN’S HEALTH ORGANIZATION DECISION","authors":"J Trevino, R Paul, E King, J Reeves, D Eisenberg, T Madden","doi":"10.1016/j.contraception.2024.110611","DOIUrl":"10.1016/j.contraception.2024.110611","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe trends in abortion volume and gestational duration at time of abortion 12 months before and after the <em>Dobbs v Jackson Women’s Health Organization</em> decision.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of people obtaining abortions at an independent clinic in Southern Illinois for 12 months pre- and post-<em>Dobbs</em>. We used descriptive statistics to characterize trends and compared mean gestational duration pre- and post-<em>Dobbs</em> using independent sample t-tests.</div></div><div><h3>Results</h3><div>In total, 12,920 abortions occurred in the study period: 4,666 pre-<em>Dobbs</em> and 8,254 post-<em>Dobbs</em> (177% increase). Overall, the mean gestation duration increased from 8.8±4.3 weeks to 9.2±4.4 weeks (<em>p</em><0.001), likely due to the increase in the absolute number of first trimester abortions post-<em>Dobbs</em> (n=2,990). When compared month-by-month, the largest increases in mean gestational duration were in July and August (pre-<em>Dobbs</em>: 8.8 weeks, post-<em>Dobbs</em>: 10.2 weeks). We observed no increase in the proportion of second trimester abortions in the 12 months post-<em>Dobbs</em> (14.3% vs 15.4%, <em>p</em>=0.11); however, we observed an increase in the proportion of second trimester abortions in July (12.0% pre-<em>Dobbs</em>, 16.6% post-<em>Dobbs</em>) and August (15.0% pre-<em>Dobbs</em>, 19.6% post-<em>Dobbs</em>).</div></div><div><h3>Conclusions</h3><div>Post-<em>Dobbs</em>, we observed a nearly two-fold increase in abortion volume. While we found only a slight increase in mean gestational duration and proportion of abortions occurring in the second trimester post-<em>Dobbs</em>, we did see an increase in the two months after <em>Dobbs</em>. These changes may reflect the clinic's dramatic increase in capacity or the impact of abortion funds on maintaining abortion access for people in restrictive states.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426518","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}

引用次数: 0

MATERNAL MORBIDITY AMONG PATIENTS WITH SEVERE OR LIFE-LIMITING FETAL CONDITIONS 严重或危及生命的胎儿疾病患者的孕产妇发病率

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110579

S Yazdani, ME Weiss, AS McLennan, MD Creinin

{"title":"MATERNAL MORBIDITY AMONG PATIENTS WITH SEVERE OR LIFE-LIMITING FETAL CONDITIONS","authors":"S Yazdani, ME Weiss, AS McLennan, MD Creinin","doi":"10.1016/j.contraception.2024.110579","DOIUrl":"10.1016/j.contraception.2024.110579","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare maternal morbidity with pregnancy continuation or abortion in pregnancies with severe or life-limiting fetal conditions.</div></div><div><h3>Methods</h3><div>We extracted data from a de-identified quality database of patients with fetal conditions who received care at our institution to compare maternal outcomes with pregnancy continuation and abortion. We included patients with fetal conditions which would significantly impact future quality of life, require serious intervention to sustain life, or be incompatible with life after delivery. We excluded multiple gestations, previable membrane rupture or fetal demise at time of diagnosis, concern for placenta accreta, and patients that delivered outside of our institution. We considered major morbidity as unplanned intra-abdominal surgery, intensive care unit admission, blood transfusion, venous thromboembolism, readmission within 6 weeks, sepsis, fourth-degree vaginal laceration, uterine rupture, and eclampsia. Minor morbidity included uterine infection requiring intravenous antibiotics, retained products requiring repeat procedure, shoulder dystocia, blood patch post-epidural, cervical lacerations, and third-degree vaginal lacerations.</div></div><div><h3>Results</h3><div>Overall, 387 and 423 individuals chose pregnancy continuation and abortion, respectively. Major morbidity occurred in 23(5.9%) and 7(1.7%), respectively (OR 3.76, 95% CI 1.59-8.85). Minor morbidity occurred in 32(8.3%) and 31(7.3%), respectively (OR 1.20, 95% CI 0.72-2.00). In the continuation group, documented fetal/neonatal demise occurred in 46(11.9%) and cesarean delivery occurred in 180(46.5%) patients. Major abdominal surgery (excluding cesarean delivery) occurred in 2(0.5%) and 2(0.5%), respectively. No mortality occurred in either group.</div></div><div><h3>Conclusions</h3><div>We observed increased maternal morbidity with pregnancy continuation compared to abortion in pregnancies with severe or life-limiting fetal conditions.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426710","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}

引用次数: 0

THE ASSOCIATION OF INSERTION METHODS ON IMMEDIATE POSTPARTUM INTRAUTERINE DEVICE EXPULSION RATES: A RETROSPECTIVE COHORT STUDY 插入方法与产后宫内节育器立即排出率的关系：回顾性队列研究

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110634

EM Perkins, J Federspiel, D Bhattacharya, S de los Reyes

{"title":"THE ASSOCIATION OF INSERTION METHODS ON IMMEDIATE POSTPARTUM INTRAUTERINE DEVICE EXPULSION RATES: A RETROSPECTIVE COHORT STUDY","authors":"EM Perkins, J Federspiel, D Bhattacharya, S de los Reyes","doi":"10.1016/j.contraception.2024.110634","DOIUrl":"10.1016/j.contraception.2024.110634","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within six weeks postpartum.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of patients who had a singleton vaginal delivery and had an immediate ppIUD inserted at Rush University from January 2014 to September 2023. Subjects were excluded if they had a postpartum hemorrhage, no insertion data available, or did not have documentation of postpartum follow up. The primary outcome was rate of expulsion within six weeks postpartum. The rate of expulsion was compared by method of insertion, either using a manual technique versus using ring forceps. Univariable analyses were performed for the association between baseline maternal characteristics and the primary outcome.</div></div><div><h3>Results</h3><div>A total of 219 participants met eligibility with 117 immediate ppIUDs inserted manually and 102 inserted with ring forceps. Baseline maternal demographics were similar across study groups. In unadjusted analysis, expulsion rate in patients who had IUDs placed using ring forceps was significantly higher as compared to manual insertion (30.4% vs 16.2%, p =0.01). After adjusting for factors determined a priori (estimated blood loss, body mass index, GA at delivery, multiparity, type of IUD), ring forceps continued to be significantly more likely to result in expulsion (adjusted OR (aOR) 2.45, CI 1.28-4.90).</div></div><div><h3>Conclusions</h3><div>Insertion of immediate ppIUD with ring forceps was associated with a significantly increased rate of expulsion within six weeks postpartum when compared with manual insertion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426190","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}

引用次数: 0

ASSESSING THE IMPACT OF HEALTH EQUITY-INFORMED QUALITY IMPROVEMENT ON CONTRACEPTIVE CARE SCREENING, COUNSELING, AND PROVISION 评估注重健康公平的质量改进对避孕护理筛查、咨询和提供的影响

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110576

EE Wingo, D Hessler-Jones, L Gibson, S Goetsch-Avila, R Kriz, C Dehlendorf

{"title":"ASSESSING THE IMPACT OF HEALTH EQUITY-INFORMED QUALITY IMPROVEMENT ON CONTRACEPTIVE CARE SCREENING, COUNSELING, AND PROVISION","authors":"EE Wingo, D Hessler-Jones, L Gibson, S Goetsch-Avila, R Kriz, C Dehlendorf","doi":"10.1016/j.contraception.2024.110576","DOIUrl":"10.1016/j.contraception.2024.110576","url":null,"abstract":"<div><h3>Objectives</h3><div>Improving contraceptive care quality is crucial to optimizing people’s reproductive health and achieving reproductive health equity. We assessed the impact of a health equity-focused quality improvement learning collaborative (QILC) on the quality of contraceptive care at community health centers (CHCs) through innovative, person-centered performance measurement.</div></div><div><h3>Methods</h3><div>We developed a nine-month QILC comprising monthly learning sessions on reproductive health equity and person-centered contraceptive care, supporting resources and strategies, peer-learning opportunities, and technical assistance. CHCs collected Person-Centered Contraceptive Counseling (PCCC) measure surveys from patients pre-post QILC to assess contraceptive counseling. CHCs implemented a novel health service needs-based contraception screening question, the Self-Identified Need for Contraception (SINC), into their EHRs. EHR data were extracted to calculate standardized electronic clinical quality measures (eCQMs) of contraceptive use. To assess intervention impact, we compared PCCC scores, percentage of eligible patients screened with SINC, and contraceptive use before and after the QILC.</div></div><div><h3>Results</h3><div>Baseline PCCC scores ranged from 30% to 94%. At endline, 6 of 10 CHCs improved their PCCC score (Δ 2% to 24%) and four of those surpassed the 80% benchmark for high-quality care. At baseline, few patients were screened with SINC (range: <1% - 36%). Across sites, median increase in percentage of eligible patients screened was 10% (range: <1% - 46%). Sites observed an increase in eCQMs for use of most or moderately effective contraceptive methods (mdn change: 2%; range: [<1% -9%).</div></div><div><h3>Conclusions</h3><div>Participation in an equity-focused and performance measures-driven QILC led to increased person-centered screening for contraceptive need and improved contraceptive counseling.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426168","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}

引用次数: 0

DISTANCES TRAVELLED FOR ABORTIONS AND INEQUITIES FOR RURAL RESIDENTS IN OREGON 俄勒冈州农村居民的堕胎路程和不公平现象

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110616

EC Nacev, A Mandelbaum, MF Fuerst, MI Rodriguez

{"title":"DISTANCES TRAVELLED FOR ABORTIONS AND INEQUITIES FOR RURAL RESIDENTS IN OREGON","authors":"EC Nacev, A Mandelbaum, MF Fuerst, MI Rodriguez","doi":"10.1016/j.contraception.2024.110616","DOIUrl":"10.1016/j.contraception.2024.110616","url":null,"abstract":"<div><h3>Objectives</h3><div>Abortion access is dire in most rural areas of the US. Recent studies have shown that most reproductive-aged women live greater than a 30 minute drive from the nearest abortion clinic. True travel distances to abortion care may be even higher, given restrictions in availability by type of abortion and gestational age. This study aims to describe the burden of travel to abortion care for residents of Oregon, a state with no legal restrictions on abortion, by rurality of residence.</div></div><div><h3>Methods</h3><div>We conducted a descriptive study of vital statistics from the Oregon Health Authority of all abortions in Oregon from 2015 to 2021. We calculated distances between county of residence and county of abortion occurrence.</div></div><div><h3>Results</h3><div>Of 57,533 abortions, 90% (n=51,781) were to Oregon residents. Individuals from every county in Oregon needed abortion care during our study period, however abortions were provided in only 25% of counties (n=9). Those that travelled outside their county for abortion care (n=21,808, 37.4%) travelled an average of 56 miles for abortion care. Residents of rural counties (n=4,284) had an average travel distance of 103 miles, with maximum distance travelled of 432 miles.</div></div><div><h3>Conclusions</h3><div>This recent, real-world study describes a high burden of travel for rural residents, even in a state where abortion is legal. This data can support efforts to creatively, strategically, and equitably increase access to abortion, particularly for those with geographic challenges to access.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426438","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}

引用次数: 0

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) FOR PAIN CONTROL DURING FIRST-TRIMESTER PROCEDURAL ABORTION: A BLINDED RANDOMIZED CONTROLLED TRIAL 经皮神经电刺激（Tens）用于控制第一胎程序性流产期间的疼痛：一项盲法随机对照试验

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110617

A Henkel, EP Cahill, S Chavez, JM Shorter, SM Liu, SI Amaya, S Kaur, KA Shaw

{"title":"TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) FOR PAIN CONTROL DURING FIRST-TRIMESTER PROCEDURAL ABORTION: A BLINDED RANDOMIZED CONTROLLED TRIAL","authors":"A Henkel, EP Cahill, S Chavez, JM Shorter, SM Liu, SI Amaya, S Kaur, KA Shaw","doi":"10.1016/j.contraception.2024.110617","DOIUrl":"10.1016/j.contraception.2024.110617","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) to manage pain during first-trimester procedural abortion for those not eligible for or otherwise foregoing sedation.</div></div><div><h3>Methods</h3><div>This is a double-blinded, block-randomized superiority trial (IRB approved, NCT05320432) comparing TENS (placed posteriorly, T10-L1 and S2-S4) to sham for pain management during first-trimester procedural abortion. We enrolled pregnant people less than 12 weeks gestation, English- or Spanish-speaking at two outpatient clinics who were not receiving sedation. The primary outcome was self-reported pain by visual analog scale (VAS, 100 mm) with passage of largest cervical dilator. We planned to enroll 70 patients to show a 15 mm difference in median pain score (80% power, α = 0.05).</div></div><div><h3>Results</h3><div>Between January 2023 and March 2024, we enrolled 70 participants. Baseline demographics were balanced between groups: median (range) gestational duration 6.8 (5.1-11.8) weeks, 35.7% nulliparous. Median (range) reported pain with passage of largest dilator was 44mm (0–88) and 50mm (0–96) in the TENS and sham groups, respectively (p=0.56). We did not find a difference in median pain at any collected time point including placement of tenaculum, paracervical block, aspiration, or recovery. The active TENS group was more likely to say they would recommend this method of pain control to others (94mm vs 73mm, p=0.01). More participants receiving TENS unit correctly identified their group allocation (91.4% vs 63.6%, p<0.001).</div></div><div><h3>Conclusions</h3><div>While we did not demonstrate a difference in pain during the procedure, TENS is a non-pharmacologic alternative that may improve patient experience during uterine aspiration.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426439","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}

引用次数: 0

“IMAGINE A PREGNANCY”: PERSPECTIVES ON PREGNANCY, ABORTION, AND PARENTING OF LATINE EMERGING ADULTS IN AN AGRICULTURAL COMMUNITY IN CALIFORNIA "想象怀孕"：加利福尼亚一个农业社区的拉丁裔新成人对怀孕、堕胎和养育子女的看法

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110585

AE Bryson, PS Nordstrom Miranda, MS Zerofsky, AB Baez De Luna, AM Minnis, M Raymond-Flesch

{"title":"“IMAGINE A PREGNANCY”: PERSPECTIVES ON PREGNANCY, ABORTION, AND PARENTING OF LATINE EMERGING ADULTS IN AN AGRICULTURAL COMMUNITY IN CALIFORNIA","authors":"AE Bryson, PS Nordstrom Miranda, MS Zerofsky, AB Baez De Luna, AM Minnis, M Raymond-Flesch","doi":"10.1016/j.contraception.2024.110585","DOIUrl":"10.1016/j.contraception.2024.110585","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe perspectives on pregnancy, abortion, and parenting among Latine emerging adults.</div></div><div><h3>Methods</h3><div>In a mixed-methods prospective cohort study of emerging adults followed since eighth grade, interviews were conducted (5/2023-1/2024) with a subset selected to achieve variation in current relationship experience. Directed content and inductive analyses of transcripts were completed.</div></div><div><h3>Results</h3><div>Forty-one participants (ages 18-21 years; n=21 female, n=18 male, n=2 non-binary; 12% first generation, 71% second generation, and 17% third generation immigrants) were interviewed. Participant-reported reasons to prevent pregnancy currently included educational goals, maturity, “not ready”, finances, desire not to disappoint parents, and other personal goals. When asked to imagine if they (or their partner) were pregnant now, many reported negative feelings (“…being pregnant would be the worst thing right now”), while few reported positive feelings. Participants were split between preferring abortion (“…I just feel like I would have to abort it just because I can’t even take care of myself”) and parenting (“I think if I had a child, I would really want to raise it and be involved in its life”). Adoption was rarely discussed and arose as a second-tier option if abortion was not available. Family values, support systems, and future goals were critical factors driving imagined pregnancy decisions.</div></div><div><h3>Conclusions</h3><div>We captured perspectives on pregnancy, abortion, and parenting of those typically underrepresented in abortion research, including emerging adults, male and non-binary individuals, and those with immigrant identities. Such research is critical to understanding how these populations are navigating their sexual and reproductive health in an evolving abortion policy landscape.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426707","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}

引用次数: 0

ASSESSING EXPERIENCES OF DISCRIMINATION IN FAMILY PLANNING SETTINGS: AN EXPLORATORY FACTOR ANALYSIS 评估计划生育环境中的歧视经历：探索性因素分析

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110647

AA Luke, M Livingston, AM Gómez, AH Bennett, JM Sales, SK Redd, WS Rice

{"title":"ASSESSING EXPERIENCES OF DISCRIMINATION IN FAMILY PLANNING SETTINGS: AN EXPLORATORY FACTOR ANALYSIS","authors":"AA Luke, M Livingston, AM Gómez, AH Bennett, JM Sales, SK Redd, WS Rice","doi":"10.1016/j.contraception.2024.110647","DOIUrl":"10.1016/j.contraception.2024.110647","url":null,"abstract":"<div><h3>Objectives</h3><div>Given the importance of high-quality, person-centered care, particularly for communities who have experienced reproductive oppression, this study aimed to test the psychometric properties of a nine-item measure of lifetime experiences of discrimination in family planning settings developed by Bird and Bogart (2001).</div></div><div><h3>Methods</h3><div>Data came from the nationally representative Person-Centered Contraceptive Access Metrics survey (unweighted n=3,059). We performed an exploratory factor analysis using principal axis extraction and Promax rotation. We assessed reliability using the coefficient omega. To assess known-groups validity, we employed weighted linear regression with survey sampling weights, using race as the predictor and the discrimination scale score as the outcome variable.</div></div><div><h3>Results</h3><div>The factor analysis resulted in a two-factor solution using 7/9 discrimination items: (1) Interpersonal Discrimination in Family Planning Care, including items reflecting differential treatment and disrespect; and (2) Racial Stereotyping in Family Planning Care, capturing assumptions based on race/ethnicity about welfare status, family size, sexual behavior, and sexually transmitted diseases. The measure demonstrated strong reliability (coefficient omega 0.97) and goodness-of-fit (TLI=0.988, RMSEA=0.066). Known-groups validity testing indicated that people of color experienced higher levels of discrimination in family planning settings compared to White respondents.</div></div><div><h3>Conclusions</h3><div>The validation of this measure assessing experiences of discrimination in family planning settings provides a tool to support research on the prevalence of racial discrimination and its impact on reproductive autonomy, including preferred method use, and access to care. Understanding these impacts can inform interventions promoting access to high-quality, equitable, and just reproductive healthcare.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426892","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}

引用次数: 0

CHANGES IN CONTRACEPTIVE METHOD CHOICES FOLLOWING DOBBS IN A STATEWIDE CONTRACEPTIVE ACCESS INITIATIVE: PATH4YOU 在全州范围内开展的 "避孕药具普及行动：Path4you "中，多布斯之后避孕方法选择的变化情况

IF 2.8 2区医学

Contraception Pub Date : 2024-10-07 DOI: 10.1016/j.contraception.2024.110645

M Ruggles, BT Edmonds, J Peipert, R Evans, M Fernandez, K Wendholt, SS Bhamidipalli, TA Wilkinson, C Bernard

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