Contraception最新文献

{"title":"RESTRICTING RIGHTS: THE CONNECTION BETWEEN VOTING AND ABORTION RESTRICTIONS","authors":"AK Hing,&nbsp;M Mahoney,&nbsp;A Hassan","doi":"10.1016/j.contraception.2025.111101","DOIUrl":"10.1016/j.contraception.2025.111101","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine if an association exists between state-level voting restrictions and abortion restrictions. When barriers to voting increase, it can become more difficult for already marginalized people to access the ballot and make their voices heard. As a consequence, states may move further away from social and health equity rather than toward it. We hypothesize that states with a higher cost of voting will pass more abortion restrictions.</div></div><div><h3>Methods</h3><div>With data from the Guttmacher Institute, we counted the number of abortion restrictions passed from 2012 to 2021 and combined it with the Cost of Voting Index (COVI) 2012, 2016, and 2020, which ranks each state based on the level of difficulty of voting. We then ran a negative binomial regression of the mean COVI rank (1 to 50, with 1 being the state with the fewest barriers) for each state on the total number of abortion restrictions passed.</div></div><div><h3>Results</h3><div>The results of the bivariate negative binomial regression indicate a significant positive relationship between barriers to voting and the number of abortion restrictions. For a one-unit increase in mean COVI rank score, we would expect a 1.046 increase in the rate for abortion restrictions. Thus, we predict 1.72 restrictions in the state where it is easiest to vote and 15.8 restrictions in the state where it is hardest to vote.</div></div><div><h3>Conclusions</h3><div>We observe a higher rate of abortion restrictions passed in states where it is harder to vote, suggesting that attacks on voting rights and reproductive rights are connected.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111101"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277848","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":"STAFF ATTITUDES TOWARD PROVIDING MEDICATION ABORTION IN PRIMARY CARE SETTINGS","authors":"S Srinivasulu,&nbsp;MG Manze,&nbsp;HE Jones","doi":"10.1016/j.contraception.2025.111078","DOIUrl":"10.1016/j.contraception.2025.111078","url":null,"abstract":"<div><h3>Objectives</h3><div>We assessed baseline staff attitudes toward providing medication abortion in 10 primary care clinics participating in a program to adopt medication abortion.</div></div><div><h3>Methods</h3><div>In 2024, staff champions from 10 organizations in eight states administered our online survey to staff at clinics preparing to introduce medication abortion (n=908). Eligibility criteria included non-champion staff who could directly or indirectly be involved in a medication abortion visit. Surveys queried on perspectives related to medication abortion acceptability and belonging in primary care, comfort working in a clinic providing it, and open-ended questions on benefits and concerns. We organized open-ended responses into common themes. We conducted regression analysis using cluster-robust standard errors to explore staff characteristics associated with medication abortion attitudes.</div></div><div><h3>Results</h3><div>Some 721 responded (79.4%); 454 met eligibility criteria. Some 387 (85.2%) believed medication abortion should be available in primary care; only 75 (16.5%) felt uncomfortable working in a clinic that provides it. Significant differences between organizations exist across all outcomes (p&lt;0.04). After we controlled for clustering within organizations, acceptability of medication abortion implementation scores were significantly higher among participants at academic and community health centers than at federally qualified health centers (p&lt;0.01); lower among those working in non-LGBTQ-specific clinics (p&lt;0.001); and lower among patient-facing clinic staff than among providers (p&lt;0.01). Perceived benefits included mitigating access barriers (50.5%), aligning with primary care values (36.8%), and promoting reproductive autonomy (10.6%). Concerns included safety risks (34.2%), training (28.2%), and staff opposition (17.6%). Some 31.3% explicitly stated no concerns.</div></div><div><h3>Conclusions</h3><div>Most staff at these primary care clinics are supportive of providing medication abortion, but have concerns that champions should address during implementation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111078"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277850","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":"EXPERIENCES WITH THE M+A HOTLINE: SUPPORT ALONG THE SPECTRUM OF SELF-MANAGED ABORTION","authors":"E Chew Murphy,&nbsp;J Novaes,&nbsp;J Karlin","doi":"10.1016/j.contraception.2025.111062","DOIUrl":"10.1016/j.contraception.2025.111062","url":null,"abstract":"<div><h3>Objectives</h3><div>The clinician-run Miscarriage and Abortion Hotline (“M+A hotline”) offers evidence-based reproductive health information, including information on self-sourced and self-managed abortion, while maintaining privacy and anonymity. The hotline has supported thousands of individuals experiencing a miscarriage or abortion from across the US, and has seen a continued increase in the number of people seeking support since its inception in 2019. The purpose of this study is to describe the experiences of people who access the M+A hotline and examine the hotline’s impact on their abortion experience.</div></div><div><h3>Methods</h3><div>From June 2024 to January 2025, we recruited 28 individuals from 19 US states who contacted the M+A hotline and completed an online survey. Participants were based throughout the US in states with and without restrictive abortion policies. We conducted anonymous in-depth interviews in English and stopped recruitment when conceptual saturation had been approximated. We analyzed transcripts using inductive and deductive codes and completed thematic analysis.</div></div><div><h3>Results</h3><div>The analysis revealed three key themes: Direct and personalized information from a clinician perspective facilitated participants’ trust in the hotline; by providing and validating information on abortion, the hotline alleviated participants’ concerns about prevalent disinformation; and amidst participants’ fears of the legal repercussions of self-sourced and self-managed abortion, the hotline provided a secure, anonymous way to communicate directly with clinicians for medical information and support.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that abortion experiences exist along a spectrum of informal to formal care utilization, and that the M+A hotline functions within this ecosystem to mitigate abortion stigma and disinformation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111062"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278166","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 ACCESS FOR US SERVICEWOMEN POST-DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION: A QUALITATIVE STUDY","authors":"C Russell","doi":"10.1016/j.contraception.2025.111127","DOIUrl":"10.1016/j.contraception.2025.111127","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore the lived experiences of active-duty servicewomen obtaining abortion care and assess their knowledge, attitudes, and beliefs regarding policy changes made by the Department of Defense meant to facilitate access to abortion care following the <em>Dobbs</em> decision.</div></div><div><h3>Methods</h3><div>This is a qualitative study. Data were collected anonymously using online open response free-text questions. Participants could opt-in for a semi-structured interview. Thematic analysis was used to analyze data.</div></div><div><h3>Results</h3><div>Fifty participants (n=50) identifying as active-duty servicewomen who obtained abortion care after <em>Dobbs</em> completed the online open response free-text questions and four (n=4) participated in a semi-structured interview. The average age was 28.9 years; 54% (n=27) identified as White, 24% (n=12) as Hispanic; 60% (n=30) were married; 58% (n=29) were Officers; 66% (n=33) served in the Army; and 40% (n=20) were stationed in states with full or partial abortion bans. Only two participants used the DOD travel policy meant to facilitate access to care (but requiring pregnancy disclosure) and 52% (n=26) did not want to disclose their pregnancy to leadership. Medical and travel costs, unsupportive military healthcare providers and leadership, and a lack of training on abortion-related policies were identified as barriers to care. Online services providing medication abortions were identified as a facilitator to care.</div></div><div><h3>Conclusions</h3><div>Future policies meant to facilitate access to abortion care should ensure that servicewomen do not need to disclose their pregnancies to leadership.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111127"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278220","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":"ARE GOOGLE ADS TOO EXPENSIVE FOR ABORTION RESEARCH?: A CASE STUDY IN RECRUITMENT METHODS","authors":"SM Sheffield,&nbsp;A Mastylak,&nbsp;AF Cartwright,&nbsp;SD Reed,&nbsp;JJ Swartz","doi":"10.1016/j.contraception.2025.111082","DOIUrl":"10.1016/j.contraception.2025.111082","url":null,"abstract":"<div><h3>Objectives</h3><div>Google Ads has proven to be a successful recruitment tool for abortion-related research. However, online reproductive health research recruitment may be more challenging following the <em>Dobbs v. Jackson Women’s Health Organization</em> decision given concerns around digital privacy. No studies to date have reported on abortion research recruitment experiences using Google Ads in the post-<em>Dobbs</em> landscape.</div></div><div><h3>Methods</h3><div>Researchers led a Google Ads campaign from May to October 2024 to recruit participants considering an abortion or who had had one in the past year for a 20-minute online survey on abortion decision-making. Sample keywords included: “abortion centers near me,” and “buy abortion pills online.” Alternate recruitment strategies included a study invitation link on a non-profit abortion information website and use of a Centiment online panel, with eligibility criteria modified to include individuals who would consider abortion if pregnant within the next year.</div></div><div><h3>Results</h3><div>Approximately $6,500 was spent on Google Ads over six months. During active advertising periods, the ads yielded 650 clicks and four completed surveys per month at an average of $282 per completed survey. The non-profit abortion information website link cost $52 per completed survey, and the survey vendor cost $6 per completed survey.</div></div><div><h3>Conclusions</h3><div>Google Ads recruitment proved more costly than other strategies. However, our average cost of $282 per completed survey was inside the range ($32 to $532) reported in prior studies. Findings support existing literature showing Google Ads is a relatively expensive recruitment tool for abortion research, which may be exacerbated in the post-<em>Dobbs</em> era.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111082"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278223","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":"EXPULSION RISK FACTORS FOR A LOW-DOSE COPPER IUD","authors":"C Bernard,&nbsp;P Blumenthal,&nbsp;C Cwiak,&nbsp;PM Castaño,&nbsp;E Gray,&nbsp;K Peters,&nbsp;M Jo Schreifels,&nbsp;KR Culwell,&nbsp;DK Turok","doi":"10.1016/j.contraception.2025.111064","DOIUrl":"10.1016/j.contraception.2025.111064","url":null,"abstract":"<div><h3>Objectives</h3><div>This analysis evaluates expulsion rates among participants in a phase 3 study of a novel, low-dose copper (Cu 175mm²) intrauterine device (IUD) with a flexible nitinol frame.</div></div><div><h3>Methods</h3><div>In this prospective, single-arm, open-label study, participants at risk for pregnancy aged 17-45 received a Cu 175mm² IUD and were followed for three years. This secondary analysis evaluates expulsion rates for all enrolled participants with successful device placement and used logistic regression to assess expulsion risk by parity, menstrual cup use (any time during study), BMI category, breastfeeding status, postpartum status (birth within one year prior to enrollment), and age.</div></div><div><h3>Results</h3><div>Of 1,601 participants who had the device successfully placed, 960 (60.0%) were nulliparous; 151 (9.4%) used menstrual cups; 510 (31.9%) had a BMI ≥30.0 kg/m²; 33 (2.1%) reported breastfeeding at the time of placement; and 127 (7.9%) were within one year postpartum. Participants’ mean (SD) age was 27.6 (5.8) years. Overall, 36 (2.2%) participants experienced device expulsion in year 1 and 63 (3.9%) over three years. Over three years, the Kaplan-Meier cumulative incidence of expulsion for menstrual cup users vs. non-menstrual-cup users was 0.11 (95% CI, 0.07-0.17) vs. 0.05 (95% CI, 0.03-0.06). Cumulative expulsion did not vary significantly based on parity, BMI category, breastfeeding status, or postpartum status. Logistic regression only associated menstrual cup use with IUD expulsion over three years (OR, 4.0; p&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>After three years of follow-up, novel Cu 175mm² IUD users experienced a low rate of expulsion with only menstrual cup use associated with a significantly increased risk for IUD expulsion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111064"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278168","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":"REPRODUCTIVE GOVERNANCE AND THE ROLE OF UNCERTAINTY IN CONTRACEPTIVE DECISION MAKING","authors":"S Banks,&nbsp;E Czaja,&nbsp;M Polavarapu,&nbsp;A Bell,&nbsp;V Boydell","doi":"10.1016/j.contraception.2025.111061","DOIUrl":"10.1016/j.contraception.2025.111061","url":null,"abstract":"<div><h3>Objectives</h3><div>The <em>Dobbs v. Jackson Women’s Health Organization</em> decision introduced heightened abortion policy uncertainty across the US, disproportionately impacting Black women already navigating intersecting structural barriers to reproductive care. This study examined how Black women in Ohio respond to this uncertainty by exploring the personal, social, and institutional factors influencing their contraceptive decision making in a restrictive and evolving reproductive policy landscape.</div></div><div><h3>Methods</h3><div>In-depth interviews were conducted with 27 Black women of reproductive age from diverse socioeconomic and geographic backgrounds across Ohio. Using a phenomenological qualitative approach, we employed semi-structured interviews to examine participants’ contraceptive decision making processes. Thematic analysis, guided by Braun and Clarke’s six-step framework, was used to identify recurring patterns and themes. We synthesized findings from these narratives to capture the complexities of reproductive decision making amid policy uncertainty.</div></div><div><h3>Results</h3><div>While some participants modified their contraceptive use to mitigate perceived threats to their reproductive autonomy, political discourse had a limited impact on contraceptive behaviors overall. Decision making was primarily driven by personal, social, and health-related factors, rather than political narratives.</div></div><div><h3>Conclusions</h3><div>The research underscores the nuanced and deliberative nature of contraceptive decision making in the face of policy-driven uncertainty around abortion access. Contraceptive decision making among Black women in Ohio is shaped by intersecting personal, relational, and systemic factors, reflecting the complexity of navigating reproductive autonomy in a restrictive policy environment. Addressing each of these factors is essential to ensuring informed, autonomous reproductive health decision making in the post-<em>Dobbs</em> era.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111061"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278116","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":"DEVELOPMENT OF A DILATION AND EVACUATION SIMULATOR AND TRAINING CURRICULUM","authors":"C Wynn,&nbsp;Z Lucier-Julian","doi":"10.1016/j.contraception.2025.111091","DOIUrl":"10.1016/j.contraception.2025.111091","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to develop a low-cost, low fidelity dilation and evacuation simulator and training program. We sought to increase resident exposure, skills, and confidence with dilation and evacuation in an abortion-restrictive state.</div></div><div><h3>Methods</h3><div>The dilation and evacuation simulator was based on previously designed and tested simulators. A basic learning module was developed. Providers experienced in dilation and evacuation tested the model to assess for accuracy of simulation. The simulator was incorporated into resident didactic time and pre- and post-tests assessed knowledge, skills, and confidence in dilation and evacuation.</div></div><div><h3>Results</h3><div>Participating residents were evenly split between PGY-1 or 2 (n=5) and PGY-3 or 4 (n=5) training levels. Residents demonstrated improvement in knowledge of dilation and evacuation with average pretest score of 73.2% and average post test score of 90%. Prior to simulation, 80% of residents reported they knew the steps of a dilation and evacuation but only 50% felt comfortable performing one with supervision. Experienced providers felt that the cervical dilation was either realistic or very realistic, and that the simulation of calvarium, placenta, and fetal parts was somewhat realistic or neither realistic nor unrealistic.</div></div><div><h3>Conclusions</h3><div>Low-cost simulation can provide a reasonably realistic simulation of dilation and evacuation. Simulation is an effective way to improve resident knowledge and comfort with this procedure. Strengths of this study include a cohort evenly split by training levels and by residents who trained before and after restrictive abortion laws were in place. Limitations include limited number of experienced providers for simulator testing and lack of assessment of resident comfort or skills after training on the simulator.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111091"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278118","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":"CARES: A COMMUNITY-ENGAGED EXPLORATION OF SELF-CARE RESOURCES FOR ABORTION","authors":"T Mathis,&nbsp;ZM Hendrickson,&nbsp;A Pierce,&nbsp;S Ramgopal,&nbsp;A Collins,&nbsp;N Devineni,&nbsp;N Sweet,&nbsp;O Stransky,&nbsp;S Sanders,&nbsp;E Mosley,&nbsp;C Salter","doi":"10.1016/j.contraception.2025.111114","DOIUrl":"10.1016/j.contraception.2025.111114","url":null,"abstract":"<div><h3>Objectives</h3><div>In the wake of <em>Dobbs v Jackson Women’s Health Organization</em>, pregnant individuals face escalating barriers to abortion care in the US, particularly in marginalized communities. This study explores the role of self-care resources used before, during, and after abortion in navigating care in Allegheny County, Pennsylvania, to identify opportunities for more equitable, community-centered support.</div></div><div><h3>Methods</h3><div>The CARES (Self-Care for Abortion through Reproductive Justice, Doulas, and the Arts) Project uses a mixed-methods, community-engaged design. Collaborators include academic researchers, reproductive justice advocates, clinicians, doulas, and local arts organizations. We conducted 19 in-depth interviews and two arts-based workshops with abortion clients and providers. We also administered a structured survey to 48 post-abortion clients. Data collection and thematic and descriptive analyses will conclude in Summer 2025.</div></div><div><h3>Results</h3><div>Preliminary survey findings show that 48% of respondents identified as Black, 42% were aged 25–29, and 44% had a high school diploma/GED or higher. Participants reported receiving emotional (30%), logistical (19%), informational (16%), and financial support (15%) during care-seeking. However, legal (13%), financial (30%), logistical (28%), and social (28%) barriers were common. Half (50%) used self-care resources — such as videos, zines, and pamphlets — primarily before care (68%).</div></div><div><h3>Conclusions</h3><div>Preliminary findings reveal that while self-care tools and community-based supports exist, clients still face major access challenges. To improve abortion support systems, resources should be expanded beyond the pre-abortion period and integrated into more accessible pathways. Centering community voices is essential to closing equity gaps in abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111114"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278305","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 DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION ON FACILITATING ABORTION CARE IN A RESTRICTED STATE","authors":"CM Hale,&nbsp;L Jacques,&nbsp;E Bennett,&nbsp;J Higgins,&nbsp;AS Cutler","doi":"10.1016/j.contraception.2025.111109","DOIUrl":"10.1016/j.contraception.2025.111109","url":null,"abstract":"<div><h3>Objectives</h3><div>Prior to <em>Dobbs</em>, the provision of abortion care and patient need for “referral” differed widely across health systems in Wisconsin. Following <em>Dobbs</em>, Wisconsin physicians faced an 1849 state law widely interpreted to criminalize abortion except in life-saving emergencies. We documented how the post-<em>Dobbs</em> legal landscape shaped how obstetrician-gynecologists (Ob-Gyns) facilitated abortion care for pregnant patients.</div></div><div><h3>Methods</h3><div>Following <em>Dobbs</em>, we recruited 21 Ob-Gyns from rural and urban areas with varying hospital affiliations, scopes of practice, and individual demographics to participate in virtual interviews between September and December 2023. Interviews explored experiences providing pregnancy care under the threat of a statewide abortion ban. Investigators coded and analyzed qualitative data using a combined inductive-deductive approach.</div></div><div><h3>Results</h3><div>Participants described difficulties in facilitating patient-centered abortion care following <em>Dobbs</em>. Referral practices ranged from direct referrals within or between health systems to less formal or absent processes. The degree of institutional support for care facilitation varied widely. Participants cited a lack of robust referral systems as contributing to delayed and discontinuous patient care. The absence of institutional support exacerbated barriers for patients and overburdened physicians.</div></div><div><h3>Conclusions</h3><div>Following <em>Dobbs</em>, a criminal abortion ban increased the need for and barriers to facilitating abortion care for Wisconsinites. Healthcare systems played a significant role in compounding those challenges. In abortion-restricted settings, institutions should actively build and support referral pathways for their patients in need of abortion, within and beyond state borders.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111109"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278309","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}