Contraception最新文献

{"title":"Society of Family Planning Annual Meeting 2024","authors":"","doi":"10.1016/j.contraception.2024.110680","DOIUrl":"10.1016/j.contraception.2024.110680","url":null,"abstract":"","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":"142395968","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":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(24)00412-8","DOIUrl":"10.1016/S0010-7824(24)00412-8","url":null,"abstract":"","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":"142426339","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":"ADVANCING INNOVATIVE MEASUREMENT OF PREGNANCY PREFERENCES WITH A SHORT-FORM DESIRE TO AVOID PREGNANCY SCALE","authors":"I Muñoz,&nbsp;BW Bullington,&nbsp;MR Wilson,&nbsp;CH Rocca","doi":"10.1016/j.contraception.2024.110577","DOIUrl":"10.1016/j.contraception.2024.110577","url":null,"abstract":"<div><h3>Objectives</h3><div>The Desire to Avoid Pregnancy (DAP) Scale represents an important step forward for pregnancy “intention” measurement. The 14-item psychometric instrument captures pregnancy preferences prospectively across domains (cognitive, affective, consequences) and allows for nuance, uncertainty, and ambivalence. However, a DAP short-form scale is needed to reduce respondent burden and facilitate integration of this rigorous, person-centered measure into future research and surveillance.</div></div><div><h3>Methods</h3><div>We used state-representative data from &gt;30,000 self-identified women, aged 18-44 years, from nine diverse US states (Surveys of Women, 2017–2023) to develop a four-item version of the DAP scale (DAP-4). After splitting the dataset in half, stratified by state, we used classical test theory and item response theory methods to iteratively identify a reduced item set that maintained construct validity (eg, included items across conceptual domains and were worded negatively and positively), internal structure validity (eg, monotonicity), and external validity (eg, no differential item functioning), while maintaining reasonable internal consistency reliability. Scale properties were retested on the second half of the dataset.</div></div><div><h3>Results</h3><div>The DAP-4 included two items in the cognitive domain and one each in the affective and practical consequences domains, and items worded in both directions. The internal consistency was high for a short-form (alpha=0.83), covered the full range of respondent pregnancy preferences, and met criteria for internal structure validity. We found no evidence of differential item functioning by age, race and ethnicity, relationship status or parity, and high correlation with the longer DAP scale (0.96).</div></div><div><h3>Conclusions</h3><div>A short-form DAP that maintains psychometric rigor is now available to measure pregnancy preferences.</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":"142426167","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":"PUBLIC SUPPORT FOR REPORTING AND PUNISHING PEOPLE WHO USE ALCOHOL OR DRUGS WHILE PREGNANT","authors":"S Auerbach,&nbsp;SCM Roberts,&nbsp;LJ Ralph,&nbsp;S Kaller,&nbsp;R Schroeder,&nbsp;MA Biggs","doi":"10.1016/j.contraception.2024.110564","DOIUrl":"10.1016/j.contraception.2024.110564","url":null,"abstract":"<div><h3>Objectives</h3><div>Given increased criminalization of pregnant people and erosion of abortion rights, we need a better understanding of the extent of public support for reporting or punishing people for using alcohol or drugs while pregnant.</div></div><div><h3>Methods</h3><div>We administered a national probability-based online survey (December 2021-January 2022) to English- and Spanish-speaking people assigned female at birth (AFAB, ages 15-49) or male at birth (AMAB, ages 18-49) regarding their attitudes about punishing or reporting pregnant people who use alcohol or drugs and whether abortions performed within or outside the healthcare system should be legal. We used weighted analyses to estimate national support for reporting (reporting to police, to child protective services (CPS) and punishing (paying a fine, going to jail) pregnant people who use alcohol or drugs and their association with views on abortion legality.</div></div><div><h3>Results</h3><div>Among the 7,016 AFAB and 360 AMAB survey respondents, most supported reporting pregnant people for using alcohol or drugs to the police (57.6% AFAB, 54.8% AMAB) and CPS (69.1% AFAB, 71.3% AMAB); while fewer respondents supported punishing people with a fine (40.2% AFAB, 40.3% AMAB) or jail (31.3% AFAB, 35.1% AMAB). Support for reporting and punishing people for using alcohol or drugs while pregnant was associated with believing abortion, within or outside the healthcare system, should be illegal (OR 3.0, 95%CI 2.6-3.4 AFAB; OR 1.8, 95%CI 0.9-3.2 AMAB).</div></div><div><h3>Conclusions</h3><div>Public support for criminalizing alcohol and drug use during pregnancy is high and largely associated with views on abortion legality.</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":"142426183","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-RELATED COSTS AS CATASTROPHIC HEALTH EXPENDITURES AND THEIR ASSOCIATIONS WITH IN-STATE OR OUT-OF-STATE TRAVEL TO ABORTION CARE","authors":"O Wasser,&nbsp;L Ralph,&nbsp;S Kaller,&nbsp;MA Biggs","doi":"10.1016/j.contraception.2024.110559","DOIUrl":"10.1016/j.contraception.2024.110559","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to estimate the proportion of people seeking abortion whose out-of-pocket abortion-related costs constitute a catastrophic health expenditure (CHE) and whether these are associated with in-state or out-of-state travel for care.</div></div><div><h3>Methods</h3><div>In 2019, we surveyed people aged 15–45 seeking abortion in four clinics located in abortion-supportive states that serve many out-of-state patients. We calculated participants’ out-of-pocket abortion-related costs (procedure, transportation, accommodation, childcare, previous appointments, missed work, and other expenses) and assessed whether these costs were financially catastrophic by applying a 40% threshold to their estimated non-subsistence monthly household income, based on published methods (Zuniga et al, 2020). Using multivariable Poisson regressions, we examined associations between traveling in-state or out-of-state for care and experiencing abortion-related costs as CHE.</div></div><div><h3>Results</h3><div>784 people (of 1,092 approached) completed the survey; 675 responded to the abortion-related costs questions. We found that 42% of participants experienced out-of-pocket abortion-related costs as financially catastrophic. Patients who traveled out-of-state for care were significantly more likely to experience abortion-related costs as CHE (65%, adjusted Prevalence Ratio (aPR) 2.24, 95% confidence interval (CI) 1.67-3.00) than in-state patients (32%). Individuals who resided more than 100 miles from the clinic (aPR 2.05, 95% CI 1.54-2.74) or sought abortion beyond 13 weeks’ gestation (aPR 1.80, 95% CI 1.30-2.51) were also significantly more likely to experience abortion as CHE, compared to their counterparts.</div></div><div><h3>Conclusions</h3><div>Out-of-pocket costs for abortion care are financially catastrophic for many abortion patients, especially those traveling out-of-state. The adverse impact on people’s financial well-being is likely exacerbated post-<em>Dobbs v Jackson Women’s Health Organization</em>, where more people are traveling for abortion care.</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":"142426317","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":"A QUALITATIVE STUDY EXPLORING PATIENT EXPERIENCES WITH TELEHEALTH AND IN-CLINIC MEDICATION ABORTION: STIGMA, PRIVACY, AND SUPPORT","authors":"M Barnes,&nbsp;E Piqueiras,&nbsp;L Gutierrez-Palominos,&nbsp;R Patil","doi":"10.1016/j.contraception.2024.110621","DOIUrl":"10.1016/j.contraception.2024.110621","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore the experiences of people obtaining medication abortion through telemedicine medication abortion and clinic-based medication abortion at a single academic center.</div></div><div><h3>Methods</h3><div>We conducted an exploratory qualitative study utilizing semi-structured teleconference interviews with 23 (9 telemedicine medication abortion and 14 clinic-based medication abortion) patients with a gestational age up to 77 days who obtained a medication abortion between June 2018 and December 2022. Purposive sampling was adopted for the recruitment of participants at a single academic center in California. All interviews were recorded, transcribed, and coded by the authors to generate salient themes via thematic analysis.</div></div><div><h3>Results</h3><div>Participants discussed the effects of abortion stigma from society and social networks, leading to an increased desire for privacy, support, and urgency with time to appointment. Qualitative analysis indicates that telemedicine medication abortion participants preferred the increased privacy afforded via telemedicine. Clinic-based medication abortion participants highlighted the in-clinic environment as more invasive to their privacy, often requiring more people to know about their abortion which increased feelings of unease. Many participants described uncertainty about sharing abortion information with social networks because they (1) did not want to introduce others' opinions into their decision-making and (2) were unclear about how they might feel or react.</div></div><div><h3>Conclusions</h3><div>The results suggest that telemedicine abortion is an important tool to counteract pervasive societal stigma as well as improve accessibility. This study also suggests that abortion stigma (both actual and perceived) significantly impacts patient experiences despite being in a state with protective abortion laws, and improving accessibility and privacy can counteract the stigma associated with abortion care.</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":"142426344","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":"IMMEDIATE POSTPARTUM LEVONORGESTREL (LNG) IUD INSERTION: ANALYSIS OF INSERTION TECHNIQUE AND EXPULSION RATES","authors":"RA Desai,&nbsp;AR Brant,&nbsp;T Pal,&nbsp;M Yao","doi":"10.1016/j.contraception.2024.110639","DOIUrl":"10.1016/j.contraception.2024.110639","url":null,"abstract":"<div><h3>Objectives</h3><div>Prior studies report expulsion rates for immediate postpartum (IPP) IUDs as high as 27%. It is unclear whether modifiable insertion techniques affect the expulsion rate. We examined whether the technique of IPP LNG IUD insertion after vaginal delivery (manual vs device applicator vs ring forceps) was associated with IUD expulsion or other complications by six months postpartum.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all patients who delivered vaginally and received an IPP LNG IUD (Mirena®) in a multihospital healthcare system from 2019-2022. We identified eligible patients using ICD-10 codes and MAR administration. We manually extracted outcomes and confounding variables: expulsion, IUD complications, use of ultrasound, and obstetrical characteristics. Statistical analysis was performed using chi square tests.</div></div><div><h3>Results</h3><div>We included 647 IPP LNG IUD insertions; 48% (311) were inserted manually, 14% (90) via ring forceps, and 38% (246) via device applicator. The overall expulsion rate was 14.4%. We found no difference in the rate of expulsion between manual, ring forceps, or device applicator insertion (14.8%, 10.0%, and 15.4% respectively; p=0.43), nor was there a difference in the rate of composite IUD complications (13.2%, 10.0%, and 16.7%, respectively; p=0.25). Providers were more likely to use ultrasound with ring forceps (24.4%) and device applicator (22.0%) compared to manual insertion (11.3%; p &lt;0.001).</div></div><div><h3>Conclusions</h3><div>Real world data suggest an LNG IUD expulsion rate of 14% after vaginal delivery. Our study found no difference in rates of IUD expulsion or complication based on insertion technique. These findings should inform pre-delivery long-acting reversible contraception (LARC) counseling and intrapartum practice patterns.</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":"142426404","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":"OXYTOCIN RECEPTION EXPRESSION IN PREGNANCY: “IS IT TIME TO ADD THE PIT?”","authors":"JA Reid,&nbsp;M Baldwin,&nbsp;A Edelman,&nbsp;J Jensen,&nbsp;S Yao,&nbsp;R Godiah,&nbsp;L Han","doi":"10.1016/j.contraception.2024.110595","DOIUrl":"10.1016/j.contraception.2024.110595","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to measure oxytocin receptor (OXTR) expression changes in the myometrium throughout pregnancy to inform clinical management of post-abortion hemorrhage.</div></div><div><h3>Methods</h3><div>We obtained myometrial tissue through transcervical core needle biopsies under ultrasound guidance in anesthetized participants immediately following procedural abortion. We also obtained tissue from non-pregnant and term control participants. We compared relative OXTR expression throughout pregnancy using quantitative PCR (qPCR) to evaluate gene expression and immunohistochemistry to assess OXTR protein in samples.</div></div><div><h3>Results</h3><div>We collected myometrial samples from 29 participants including n=22 following abortion at 6-26 weeks, n=3 undergoing cesarean delivery at term prior to labor, and n=4 undergoing laparoscopic permanent contraception (non-pregnant). Using qPCR, we observed an increase in relative OXTR expression with increasing gestational age. Compared to non-pregnant levels, the relative expression ranges increased from 2.5-fold (SD 3.9) in the first trimester to 96-fold (SD 10.3) at term. To further investigate the changes in expression in the second trimester, we compared mRNA expression in early-, mid-, and late-second trimester subgroups. Compared to the first trimester (&lt;14 week), relative expression increased by 5.8-fold at 14-17 weeks, 16.2-fold at 18-20 weeks, 22.4-fold at 20-26 weeks, and 38.4-fold at term (&gt;37 weeks). Immunohistochemical staining confirmed gestational week dependent increases in OXTR protein levels in the cytosol of myometrial cells.</div></div><div><h3>Conclusions</h3><div>This study defines changes in OXTR expression throughout pregnancy and provides evidence for an increase in the second trimester. This supports the use of oxytocin in second trimester hemorrhage management, with a notable increase in expression by 18 weeks.</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":"142426445","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":"CHANGES IN DISTANCE TRAVELED AMONG CHICAGO ABORTION FUND CALLERS FROM 2020-2023","authors":"LA McGuinn,&nbsp;M Quasebarth,&nbsp;M Daniel,&nbsp;L Hasselbacher,&nbsp;K Rivlin","doi":"10.1016/j.contraception.2024.110609","DOIUrl":"10.1016/j.contraception.2024.110609","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine changes in the distance traveled by Chicago Abortion Fund (CAF) callers from 2020-2023, overall and by demographic and geographic indicators.</div></div><div><h3>Methods</h3><div>We included 6,512 out-of-state CAF callers seeking abortion care in Illinois between 2020-2023 who provided a zip code of residence. We approximated distance traveled by calculating the distance from each caller’s population-weighted zip code centroid to the clinic location. We defined urban/rural status using zip code derived Rural-Urban Community Area categories. We derived area level social deprivation measures using US Census data. We assessed median differences in distances (miles) traveled for callers over time and by geographic indicators.</div></div><div><h3>Results</h3><div>Overall, among out-of-state CAF callers, 68% (n=4,404) traveled ≥ 100 miles to access abortion care. The median one-way travel distance decreased from 90.3 miles (interquartile range [IQR]: 123) in 2020 to 50.6 miles (IQR: 126) in 2021. However, it then increased to 173 miles (IQR: 323) in 2022 and further to 191 miles (IQR: 384) in 2023. Individuals residing in rural zip codes had a median travel distance of 277 miles (IQR: 258), compared to 164 miles (IQR: 315) for those residing in urban zip codes. Individuals in more deprived rural areas traveled further (median: 373 miles, IQR:294) compared to those in less deprived rural areas (median 204 miles, IQR: 200).</div></div><div><h3>Conclusions</h3><div>CAF callers experience complex challenges accessing abortion, including intersections between geography and socioeconomic status. Abortion funds play a critical role in maintaining abortion access for those living in restrictive states, and should account for the structural barriers their grantees face.</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":"142426516","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":"“PEOPLE ARE GETTING STERILIZED TO STAY SAFE”: PERMANENT CONTRACEPTION AMONG YOUNG ADULTS AFTER DOBBS","authors":"J Strasser,&nbsp;E Schenk,&nbsp;S Luckenbill,&nbsp;D Tsevat,&nbsp;L King,&nbsp;Q Luo,&nbsp;J Maslowsky","doi":"10.1016/j.contraception.2024.110649","DOIUrl":"10.1016/j.contraception.2024.110649","url":null,"abstract":"<div><h3>Objectives</h3><div>Young people face a unique constellation of barriers to contraception access and are among the most vulnerable groups who may be forced into parenthood following <em>Dobbs v Jackson Women’s Health Organization</em>. The purpose of this study was to measure young adults’ utilization of vasectomy or tubal sterilization after the leaked <em>Dobbs</em> opinion in May 2022, and to examine adolescents’ and young adults’ perceptions about these methods.</div></div><div><h3>Methods</h3><div>This concurrent mixed-methods analysis used (1) IQVIA medical claims data for 563,273 adults (ages 19-44) from 2021 and 2022 and (2) survey responses from 1,234 adolescents and young adults (ages 14-24) responding to MyVoice surveys in 2022 and 2023. Using claims data, we conducted difference-in-difference analyses of monthly tubal sterilization and vasectomy services among ages 19-26 and 27-44, by state policy category. We conducted thematic content analyses of open-text survey responses from MyVoice, a text-based anonymous poll for individuals ages 14-24.</div></div><div><h3>Results</h3><div>Tubal sterilization and vasectomy services increased in the months following the <em>Dobbs</em> decision leak for all age groups, with greater increases among ages 19-26 than 27-44. Difference-in-difference analyses found greater increases in tubal sterilization (1%, p=0.02) and vasectomy (2%, p =0.02) in states likely to ban abortion compared to states not likely to ban abortion; state-level differences among ages 27-44 were not statistically significant. Survey responses highlight fear for loss of bodily autonomy and changes to pregnancy plans after <em>Dobbs</em>.</div></div><div><h3>Conclusions</h3><div>Young adults increasingly obtained permanent contraception post-<em>Dobbs</em>, especially in states deemed likely to ban abortion, and continue to face challenges to their bodily autonomy.</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":"142426894","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}