Contraception最新文献

{"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}

{"title":"POSITIONALITY AND PRIVILEGE POST-DOBBS: A QUALITATIVE ANALYSIS OF OB-GYN GRADUATES’ DECISION-MAKING","authors":"AL Woodcock,&nbsp;M Asadian,&nbsp;E Torres,&nbsp;J Kaiser,&nbsp;J Baayd","doi":"10.1016/j.contraception.2024.110618","DOIUrl":"10.1016/j.contraception.2024.110618","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to understand the impact of the <em>Dobbs v Jackson Women’s Health Organization</em> decision on recent obstetrician gynecologist (Ob-Gyn) graduates with an emphasis on career decisions.</div></div><div><h3>Methods</h3><div>We performed 30 semi-structured interviews of residents who graduated from residencies with Ryan Abortion training Programs in July 2023. Interviewees were invited from a list of those who had previously completed a national survey. Interview questions addressed the professional and personal impact of the <em>Dobbs</em> decision as well as its impact on decision-making for fellowship ranking or attending positions. We analyzed interview transcripts using the Template Analysis Method.</div></div><div><h3>Results</h3><div>Our template analysis resulted in the overarching theme of positionality and privilege. Participants experienced abortion restrictions distinctly in relation to opposing positionalities: being physically located in restrictive vs non-restrictive states, being an abortion vs non-abortion provider, being a healthcare provider vs a patient, and identifying as female vs male. Those of less impacted positionalities commonly cited feeling “privileged,” “fortunate,” or “lucky” when describing the lack of impact of <em>Dobbs</em> on their lives, both personally and professionally. When asked what they desire from lawmakers, the theme of positionality and privilege persisted. Respondents want lawmakers to check their privilege and empathize with the patients who seek abortion care by shadowing clinicians in the office or listening to their stories.</div></div><div><h3>Conclusions</h3><div>Recently graduated Ob-Gyns are navigating through different decision-making realities post-<em>Dobbs</em>. Sharing the experiences of these opposing positionalities can be used to inform shared action and advocacy nationally in abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110618"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426440","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":"Featured research at the 2024 Society of Family Planning Annual Meeting","authors":"Rana E. Barar (MPH; Society of Family Planning at large Board member),&nbsp;Anitra Beasley (MD, MPH; Society of Family Planning Board President-Elect),&nbsp;Nerys Benfield (MD, MPH; Society of Family Planning at large Board member),&nbsp;Catherine Cansino (MD, MPH; Society of Family Planning at large Board member and Co-chair of the Diversity, Equity, and Inclusion Advisory Group),&nbsp;Blair G. Darney (PhD, MPH; Society of Family Planning at large Board member),&nbsp;Sadia Haider (MD, MPH; Society of Family Planning Board President and Chair of scientific abstract selection),&nbsp;Kate Shaw (MD, MS; Society of Family Planning Board Secretary)","doi":"10.1016/j.contraception.2024.110679","DOIUrl":"10.1016/j.contraception.2024.110679","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110679"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395967","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":"LEVONORGESTREL 52 MG INTRAUTERINE DEVICE PLACEMENT WITHOUT SOUNDING: A FEASIBILITY STUDY","authors":"J Brown,&nbsp;S Yazdani,&nbsp;N Economou,&nbsp;A Flynn,&nbsp;H Rankin,&nbsp;MD Creinin","doi":"10.1016/j.contraception.2024.110581","DOIUrl":"10.1016/j.contraception.2024.110581","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate feasibility of levonorgestrel 52 mg intrauterine device (IUD) placement without sounding.</div></div><div><h3>Methods</h3><div>In this three-phase feasibility study, participants in phase one had uterine sounding prior to IUD placement. In the experimental phases, placement occurred without sounding and with (phase two) or without (phase three) concurrent transabdominal sonography. We timed procedure length from the sound (phase one) or IUD inserter (phases two/three) touching the cervix to full inserter removal. Providers used cervical anesthesia per their discretion. Participants rated pain using a 100 mm Visual Analogue Scale. Physicians described procedures as easy, moderate, or difficult. Participants in phases two and three had three-month follow-up with ultrasonography. We estimated 30 participants per phase were needed to ensure that if one failed placement occurred, the lower 95% confidence interval for successful placement would be ≥90%.</div></div><div><h3>Results</h3><div>We enrolled 30 participants per phase. Successful placement without sounding occurred in 30 (100%) participants in phase two and 28 (93.3%) in phase three. Median instrumentation was shorter without sounding (79.7 vs 23.3 vs 42.4 seconds; <em>p</em>=0.04). Median pain was lowest in phase one (21.0 vs 25.5, vs 36.0; <em>p</em>=0.04). Physicians rated IUD placement easy most often in phase two (n=29, 96.7%) compared to phases one (n=22, 73.3%) or three (n=22, 73.3%; <em>p</em>=0.03). Complications included one perforation and one expulsion in phase three.</div></div><div><h3>Conclusions</h3><div>IUD placement without sounding is feasible with concurrent transabdominal sonography. Placement without sounding results in shorter instrumentation time but does not decrease pain. Large studies are indicated to evaluate complication rates when no sound and no ultrasonography is used.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110581"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426165","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":"“I WORK WITH WHAT I HAVE”: MANAGING MEDICATION ABORTION AND MISCARRIAGE IN THE UNHOUSED COMMUNITY","authors":"LE Adams,&nbsp;MJ Arzate,&nbsp;KR Barnes,&nbsp;J Karlin","doi":"10.1016/j.contraception.2024.110588","DOIUrl":"10.1016/j.contraception.2024.110588","url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to provide better support to houseless individuals’ experiences with medication abortion.</div></div><div><h3>Methods</h3><div>We recruited pregnancy-capable persons from Sacramento between the ages of 18-55 who had experienced an abortion or miscarriage, were currently or previously unhoused, and spoke English. Fifteen, 30-minute interviews were conducted where participants were asked about their medication abortion or miscarriage experience, and how they would manage a medication abortion while unhoused given their experience. Inductive and deductive coding were utilized for theme development.</div></div><div><h3>Results</h3><div>Unmet needs fell into three main categories: (1) lack of access to a safe location to complete a medication abortion including hygiene facilities; (2) lack of social support including childcare and communication from their provider throughout and after the medication abortion; and (3) a lack of access to appropriate supplies including pain and bleeding management supplies.</div></div><div><h3>Conclusions</h3><div>Houseless individuals have specific experiences with medication abortion which lead to unique, and unmet, needs when compared with the general population of pregnancy-capable people. Public health providers can ensure patient-centered care by providing them with appropriate resources, such as social services and material goods, to navigate their abortion plan beyond the clinic. Next steps include offering these services and supplies to this population and assessing if the medication abortion experience is improved.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110588"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426175","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}