Contraception最新文献

{"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":"139 ","pages":"Article 110609"},"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":"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":"139 ","pages":"Article 110595"},"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":"“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":"139 ","pages":"Article 110649"},"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}

{"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":"139 ","pages":"Article 110680"},"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":"FULFILLING AN UNMET NEED: PATIENT PERSPECTIVES ON INTEGRATING FAMILY PLANNING SERVICES INTO OFFICE-BASED ADDICTION THERAPY","authors":"SK O’Connor,&nbsp;R Pancholi,&nbsp;E Patton","doi":"10.1016/j.contraception.2024.110582","DOIUrl":"10.1016/j.contraception.2024.110582","url":null,"abstract":"<div><h3>Objectives</h3><div>Our objective was to study patient perspectives on facilitators and barriers to incorporation of family planning services within office-based addiction therapy (OBAT). After previously exploring provider perspectives, we sought to understand the unique patient considerations on integration within the OBAT model with the goal to support design of a program tailored to meet the reproductive health needs of patients with substance use disorder (SUD).</div></div><div><h3>Methods</h3><div>Following IRB approval, we conducted 20 qualitative semi-structured interviews with Boston Medical Center OBAT patients. Interviews explored participants substance use and reproductive health, OBAT experiences and unique considerations when accessing reproductive healthcare within addiction care. Interview transcripts were analyzed using deductive codes utilizing a conceptual framework informed by our prior work.</div></div><div><h3>Results</h3><div>Our participants overwhelmingly saw reproductive services as not only acceptable within OBAT but preferable to accessing these services elsewhere. Participants described the nuance of early recovery that can hinder other healthcare needs including contraception care. Participants desired reproductive counseling put into context of this recovery process and desired these counseling conversations to be with their trusted addiction care providers who “already knew their stories”.</div></div><div><h3>Conclusions</h3><div>Our findings provide patient-voiced support to the idea that OBAT clinics are an important access point to reproductive health services for patients with SUD. The longitudinal relationship between patients and OBAT staff minimizes stigma and provides focused knowledge on the unique reproductive concerns of these patients. Our participants provide insight into factors necessary for successful integration of family planning services to support the patient-desired idea of an addiction care medical home.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110582"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426163","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":"IS A MISCARRIAGE AN EMERGENCY? A QUALITATIVE STUDY ASSESSING EMERGENCY MEDICINE PHYSICIANS’ VIEWS TOWARD APPROPRIATE CARE FOR EARLY PREGNANCY LOSS IN THE EMERGENCY DEPARTMENT","authors":"E Lantos,&nbsp;E McCoy,&nbsp;A Chipman,&nbsp;BT Nguyen,&nbsp;LS Benson","doi":"10.1016/j.contraception.2024.110627","DOIUrl":"10.1016/j.contraception.2024.110627","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients experiencing early pregnancy loss (EPL) commonly seek care in the emergency department (ED) and often report negative experiences. This qualitative study explores how emergency medicine (EM) physicians view EPL management in the emergency department.</div></div><div><h3>Methods</h3><div>We interviewed 22 EM physicians regarding their treatment of EPL in the ED; we included EM physicians in diverse practice settings, including states with and without abortion restrictions. Semi-structured interviews assessed participants’ current EPL diagnosis and management practices, their attitudes toward what EPL care should be provided in the ED, with attention to the impact of abortion restrictions and differing practice settings. Qualitative data were coded and analyzed for themes.</div></div><div><h3>Results</h3><div>Most participants reported commonly encountering EPL, though being limited by lack of access to ultrasound diagnosis. Most considered communicating EPL diagnoses as within EM’s scope of practice, but felt discomfort in counseling about management, citing lack of education and uncertainty around which options obstetrician gynecologists (Ob-Gyns) would offer. Most participants only felt comfortable providing expectant management without Ob-Gyn involvement. Time, space, lack of training, scope of practice, and medical-legal concerns were cited as barriers to providing medication and procedural treatment. Many believe EPL management could be improved in the ED but acknowledge competing acuity and lack of education as barriers. Abortion restrictions rarely affected participants' views on miscarriage management, but impacted their ability to provide appropriate care.</div></div><div><h3>Conclusions</h3><div>EPL is a common ED complaint, but care varies significantly based on practice setting. Standardization and collaboration between Ob-Gyns and EM may improve care for patients experiencing EPL in the ED.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110627"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426171","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":"INCIDENCE OF ECTOPIC PREGNANCY AMONG PEOPLE SEEKING AND NOT SEEKING ABORTION IN A LARGE INTEGRATED HEALTHCARE DELIVERY SYSTEM: A CASE-CONTROL STUDY","authors":"MA Biggs,&nbsp;M Armstrong,&nbsp;L Tucker,&nbsp;S Kaller,&nbsp;J Rabbani,&nbsp;JW Lee,&nbsp;D Grossman","doi":"10.1016/j.contraception.2024.110623","DOIUrl":"10.1016/j.contraception.2024.110623","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare the incidence of ectopic pregnancy, associated risk factors, and presentation to care among people seeking and not seeking abortion, using a retrospective case-control study.</div></div><div><h3>Methods</h3><div>We selected a random sample of 2,201 ectopic and 1,153 intrauterine pregnancies (out of 385,081 pregnancies) of people enrolled at Kaiser Permanente Northern California from 2016-2021. We reviewed electronic health records to classify pregnancies as seeking or not seeking abortion and to obtain medical history. We used logistic regression analyses weighted to the total pregnancy pool (n=385,081) to assess incidence of ectopic pregnancies, associated risk factors, and whether risk factors accurately identify people with ectopic pregnancies.</div></div><div><h3>Results</h3><div>The adjusted incidence of ectopic pregnancy was lower for people seeking abortion (0.39%) than for people not seeking abortion (1.74%, p&lt;0.001). People seeking abortion were less likely to present with bleeding symptoms (53% and 64%, p&lt;0.01), equally likely to present with unilateral pain (35% and 35%) and received more timely care than people not seeking abortion, including fewer encounters until diagnosis (2.2 vs 2.6, p&lt;0.001) and earlier treatment for ectopic pregnancy (53 days gestation vs 55 days, p&lt;0.05). Among people seeking abortion (n=511), history of IUD use, ectopic pregnancy, and tubal surgery, together identified 12.7% (sensitivity) of ectopic cases, with 93.5% specificity, and a 55.5% area under the receiver operating characteristic (AUROC).</div></div><div><h3>Conclusions</h3><div>People seeking abortion are at lower risk of ectopic pregnancy and receive more timely ectopic care than those not seeking abortion. History-based screening in abortion care may not accurately distinguish people with and without ectopic pregnancy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110623"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426177","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":"LATINO MEN’S ATTITUDES ON NOVEL MALE CONTRACEPTIVE METHODS","authors":"A Montes De Oca,&nbsp;B Nguyen,&nbsp;L Wise,&nbsp;M Withers","doi":"10.1016/j.contraception.2024.110567","DOIUrl":"10.1016/j.contraception.2024.110567","url":null,"abstract":"<div><h3>Objectives</h3><div>Unintended pregnancies and non-use of contraception are disproportionately represented among Latino populations. While novel male contraceptives (NMCs) can fill a gap in contraceptive need, patriarchal norms may prevent uptake among Latino men.</div></div><div><h3>Methods</h3><div>We conducted in-depth semi-structured interviews with heterosexually active, reproductive-aged (18–50), English-speaking Latino men in Los Angeles, CA in 2017. Demographics and reproductive histories were collected. Interviewees were asked about experiences with general contraception, attitudes toward and willingness to use NMCs, with focus on sociocultural barriers. Interviews were transcribed and thematically analyzed.</div></div><div><h3>Results</h3><div>Of 19 participants (mean age, 29), 74% had a high school degree or less, 63% identified as Christian/Catholic, 32% reported an unintended pregnancy, and 68% wanted more children. Nearly all (89.5%) respondents expressed that men should use NMCs, more than half (68.4%) agreed or strongly agreed that they would use NMCs themselves. The majority expressed concerns about NMC use falling into three themes: 1) machismo negatively influencing family, friends’, and personal attitudes about participating in traditionally feminine roles; 2) religion’s effect of censoring discussions of sex, leading to lack of comfort with contraception use in general; and 3) intergenerational involvement in family planning affecting contraceptive autonomy. An additional theme was that these concerns could be mitigated by catering to their desires for more male-based reproductive control and shared reproductive responsibility.</div></div><div><h3>Conclusions</h3><div>Even if they are open to using NMCs themselves, Latino men may still be deterred by sociocultural factors. Framing NMCs as a man’s responsibility may be a strategy for overcoming machismo.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110567"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426186","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":"ACCESSING EMERGENCY CONTRACEPTION NEAR US COLLEGE CAMPUSES: A COMPARISON OF SAME-DAY EMERGENCY CONTRACEPTION AVAILABILITY BY STATE AFTER THE DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION DECISION","authors":"A Rashid,&nbsp;K Patel,&nbsp;M Wood,&nbsp;C Chuang","doi":"10.1016/j.contraception.2024.110641","DOIUrl":"10.1016/j.contraception.2024.110641","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare same-day emergency contraception (EC) availability near US universities in abortion-restrictive versus abortion-protective states after <em>Dobbs v Jackson Women’s Health Organization</em>.</div></div><div><h3>Methods</h3><div>Using a “mystery shopper” script, we conducted a cross-sectional telephone survey in 2023 to ascertain same-day OTC EC availability in pharmacies near universities in abortion-protective states (NY, CA), and abortion-restrictive states (TX, AK). Multivariable analysis modeled likelihood of same-day EC availability by state abortion status, controlling for chain vs. non-chain pharmacies and urban or rural locations. Alternative pharmacy locations were obtained from pharmacies where EC was unavailable.</div></div><div><h3>Results</h3><div>Of the 402 pharmacies contacted, 75% had same-day OTC EC availability, representing 65% of pharmacies in abortion-restrictive vs. 85% in abortion-protective states (p&lt;0.001). Chain pharmacies were more likely to have same-day availability than non-chain pharmacies (92% vs. 52%, p&lt;0.001). In the adjusted analysis, EC was less likely to be available in abortion-restrictive states (adjusted OR (aOR) 0.31, 95% CI 0.17-0.56), and more likely in chain pharmacies (aOR 11.58, 95% CI 6.45-20.80). Of the 102 pharmacies where same-day EC was unavailable, 61 (59%) did not provide an alternative location: 74% were in abortion-restrictive states, while 26% were in abortion-protective states.</div></div><div><h3>Conclusions</h3><div>This study revealed same-day OTC EC availability near universities is lower in abortion-restrictive states compared to abortion-protective states. Fewer pharmacies in abortion-restrictive states compared to abortion-protective states provided an alternative pharmacy if OTC EC was unavailable. Incentives to increase OTC EC availability in non-pharmacy locations and encourage anticipatory purchase should be implemented on and near college campuses to reduce the risk of unintended pregnancy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110641"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426203","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 TAKE IT WHEN I WANT IT”: EXPLORING USE OF ADVANCE PROVISION OF ULIPRISTAL ACETATE AND ITS PROMOTION OF REPRODUCTIVE AUTONOMY FOR POSTPARTUM PATIENTS","authors":"CF Lu,&nbsp;M Serino,&nbsp;L Wegner,&nbsp;L Patterson,&nbsp;M Gurra,&nbsp;A Turner","doi":"10.1016/j.contraception.2024.110636","DOIUrl":"10.1016/j.contraception.2024.110636","url":null,"abstract":"<div><h3>Objectives</h3><div>Emergency contraception remains underutilized with barriers to access. We assess how advance provision of ulipristal acetate (UA) facilitates use and expands reproductive autonomy for postpartum people declining high-efficacy contraception</div></div><div><h3>Methods</h3><div>Participants choosing lower-efficacy contraception were recruited postpartum and received UA prior to discharge (n=73). Surveys were completed at baseline, 6 weeks, 3 months, and 6 months postpartum. Univariate logistic regression models examined the association between UA use and participant demographics. In-depth interviews were conducted at 6 weeks with early UA users and at 6 months with all participants, exploring topics around contraception and reproductive autonomy. Reflexivity and memo-writing enhanced data collection. Interviews were inductively coded in NVivo 12 and analyzed using grounded theory.</div></div><div><h3>Results</h3><div>Twelve participants (16%) reported using UA, with a mean of 2.6 UA uses per participant (SD: 2.4). Those who identified as Latinx had 5.3 greater odds of using UA (95% CI: [1.41, 20.5], p=0.013). Participants with lower income (&lt;$100,000) also had higher odds of using UA (OR: 8.40, 95% CI: [1.37, 163], p=0.019). Semi-structured interviews (n=19) revealed strong approval of advance provision of UA. Participants endorsed improved access, ease and confidence in use, and greater control over their reproductive decision-making. This was especially relevant for those with prior negative experiences with contraception and/or unwanted or coercive counseling from providers.</div></div><div><h3>Conclusions</h3><div>Postpartum patients choosing lower-efficacy contraception valued advance provision of UA and reflected on UA as a user-controlled option, bolstering reproductive autonomy. Advance provision of UA can be a useful intervention to increase contraceptive access for postpartum patients prior to discharge.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110636"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426355","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}