Contraception最新文献

{"title":"MATERNAL MORBIDITY AMONG PATIENTS WITH SEVERE OR LIFE-LIMITING FETAL CONDITIONS","authors":"S Yazdani,&nbsp;ME Weiss,&nbsp;AS McLennan,&nbsp;MD Creinin","doi":"10.1016/j.contraception.2024.110579","DOIUrl":"10.1016/j.contraception.2024.110579","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare maternal morbidity with pregnancy continuation or abortion in pregnancies with severe or life-limiting fetal conditions.</div></div><div><h3>Methods</h3><div>We extracted data from a de-identified quality database of patients with fetal conditions who received care at our institution to compare maternal outcomes with pregnancy continuation and abortion. We included patients with fetal conditions which would significantly impact future quality of life, require serious intervention to sustain life, or be incompatible with life after delivery. We excluded multiple gestations, previable membrane rupture or fetal demise at time of diagnosis, concern for placenta accreta, and patients that delivered outside of our institution. We considered major morbidity as unplanned intra-abdominal surgery, intensive care unit admission, blood transfusion, venous thromboembolism, readmission within 6 weeks, sepsis, fourth-degree vaginal laceration, uterine rupture, and eclampsia. Minor morbidity included uterine infection requiring intravenous antibiotics, retained products requiring repeat procedure, shoulder dystocia, blood patch post-epidural, cervical lacerations, and third-degree vaginal lacerations.</div></div><div><h3>Results</h3><div>Overall, 387 and 423 individuals chose pregnancy continuation and abortion, respectively. Major morbidity occurred in 23(5.9%) and 7(1.7%), respectively (OR 3.76, 95% CI 1.59-8.85). Minor morbidity occurred in 32(8.3%) and 31(7.3%), respectively (OR 1.20, 95% CI 0.72-2.00). In the continuation group, documented fetal/neonatal demise occurred in 46(11.9%) and cesarean delivery occurred in 180(46.5%) patients. Major abdominal surgery (excluding cesarean delivery) occurred in 2(0.5%) and 2(0.5%), respectively. No mortality occurred in either group.</div></div><div><h3>Conclusions</h3><div>We observed increased maternal morbidity with pregnancy continuation compared to abortion in pregnancies with severe or life-limiting fetal conditions.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110579"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRENATAL GENETIC COUNSELORS’ CHANGING MEDICAL DOCUMENTATION PRACTICES IN THE AFTERMATH OF THE DOBBS V JACKSON SUPREME COURT DECISION","authors":"G Joseph,&nbsp;J Harris-Wai,&nbsp;L Riddle,&nbsp;J Silver,&nbsp;M Norton","doi":"10.1016/j.contraception.2024.110573","DOIUrl":"10.1016/j.contraception.2024.110573","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to identify and document the impacts of evolving abortion regulations on prenatal genetic counseling (GC) practice and training.</div></div><div><h3>Methods</h3><div>We conducted semi-structured qualitative interviews with 27 GC Masters program directors, instructors, and clinical supervisors in 15 states and performed thematic content analysis after inductive and deductive coding.</div></div><div><h3>Results</h3><div>We found that documentation practices are changing in states with abortion restrictions. GCs described their medical record documentation as becoming more “vague” or “generic.” Some reported using code words agreed upon among colleagues, making clinical notes more inconspicuous, or not documenting discussions about abortion altogether. Some relied on verbal rather than written communication. Further, GCs reported receiving vague guidance from their institutions’ legal teams, while those practicing in states with exceptions for lethal fetal anomalies highlight complexity in defining ‘lethal’ and specific documentation required to justify abortion. For those in protective states, it can be unclear how best to document care for patients referred from restrictive states.</div></div><div><h3>Conclusions</h3><div>In the aftermath of <em>Dobbs</em>, the risk calculus for documenting abortion, and even pregnancy status in the medical record is shifting. Our study shows GCs are changing documentation practices, sometimes in coordination with other providers (eg, maternal-fetal medicine and complex family planning), or with guidance from institutional lawyers, but often in ad hoc ways. Medical documentation has the potential to impact trust and rapport between patients and providers, care continuity, research and public health surveillance. Our results have implications for providers who work in care teams with GCs and are facing similar challenges in the post-<em>Dobbs</em> environment.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110573"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426181","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":"ESTIMATING EMERGENCY CONTRACEPTION EFFICACY WITH LEVONORGESTREL AND COPPER INTRAUTERINE DEVICES","authors":"SE Nourse,&nbsp;AL Woodcock,&nbsp;KS Brown,&nbsp;DK Turok,&nbsp;A Gero,&nbsp;LM Gawron","doi":"10.1016/j.contraception.2024.110565","DOIUrl":"10.1016/j.contraception.2024.110565","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine observed vs. expected pregnancy risk among levonorgestrel 52 mg and copper T380A intrauterine device (IUD) emergency contraception (EC) users.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of participants in a 1:1 randomized controlled trial comparing levonorgestrel 52 mg IUD and copper T380A IUD EC users who reported all episodes of unprotected intercourse in the two weeks prior to enrollment. We estimated number of expected pregnancies via two established approaches (Trussell, 2003 and modified Wilcox, 2015) to create a range of expected pregnancy risk among methods using risk estimates per menstrual cycle day. With both approaches, we calculated the proportion of pregnancies prevented based on those expected using both the day of most recently reported unprotected intercourse and all reported current menstrual cycle unprotected intercourse.</div></div><div><h3>Results</h3><div>One pregnancy occurred among the 327 participants assigned to the levonorgestrel IUD with 137 (41.9%) reported multiple episodes of unprotected intercourse. No pregnancies occurred among the 328 participants randomized to the copper IUD with 142 (43.2%) reporting multiple episodes of unprotected intercourse. In the levonorgestrel IUD group, expected pregnancies ranged from 12.4 (Trussell)-14.8 (Wilcox) using only the most recent episode of unprotected intercourse to 22.0 (T)-26.3 (W) accounting for all episodes. In the copper IUD group, there were 12.6 (T)-15.0 (W) and 24.8 (T)-29.6 (T) expected pregnancies respectively. Levonorgestrel IUD users prevented 92.0 (T)-96.2 (W)% of pregnancies and copper IUD users experienced 100% pregnancy prevention.</div></div><div><h3>Conclusions</h3><div>Levonorgestrel IUDs for EC prevented 92% of expected pregnancies, approaching the 100% prevention rate observed in the copper IUD group.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110565"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426184","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":"PATIENT OUTCOMES WITH EARLY PREGNANCY COMPLICATIONS AFTER EXPOSURE TO AN EARLY PREGNANCY ASSESSMENT CLINIC","authors":"SI Amaya,&nbsp;J Zhang,&nbsp;A Chen,&nbsp;SK Mulwa,&nbsp;E Booker,&nbsp;TS Gémesi,&nbsp;A Henkel,&nbsp;K Shaw,&nbsp;J Shorter","doi":"10.1016/j.contraception.2024.110630","DOIUrl":"10.1016/j.contraception.2024.110630","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the healthcare burden experienced by patients with early pregnancy complications seen in an early pregnancy assessment clinic (EPAC) and those never seen in an EPAC.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study evaluating patients 18 years and older who presented during the first 12 weeks of pregnancy with a complication including vaginal bleeding or pain, early pregnancy loss (EPL), pregnancy of unknown location (PUL), ectopic, or molar pregnancy. The primary outcome was the healthcare burden for patients seen in an EPAC compared to patients never seen in an EPAC. Healthcare burden was defined as the total number of encounters and the average time spent in the healthcare system.</div></div><div><h3>Results</h3><div>We obtained data from 241 patients between January 2021 and June 2022. Patients never seen in EPAC were more likely to be of Hispanic ethnicity (52% vs 30%, p&lt;0.001), have public or no insurance (59% vs 25%, p&lt;0.001), and report a non-English primary language (33% vs 10%, p&lt;0.001) compared with patients seen in an EPAC. The median (range) total number of healthcare encounters was 4 (2, 5.5) and 3 (2,5) in the EPAC and non-EPAC groups, respectively (p=0.3). The mean in-person healthcare encounter time (hours) was significantly higher in the non-EPAC group (327 vs 120, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Patients never seen in an EPAC were more likely to have socioeconomic and language barriers compared to those seen in an EPAC. Increasing access to expedited evaluation and management of early pregnancy complications may improve patients’ healthcare experience.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110630"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426191","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":"DOES PSYCHOSOCIAL BURDEN DIFFER WHEN ACCESSING MEDICATION ABORTION USING NO-TEST, TELEHEALTH CARE COMPARED TO IN-PERSON CARE WITH ULTRASOUND?","authors":"MA Biggs,&nbsp;C Baba,&nbsp;LJ Ralph,&nbsp;R Schroeder,&nbsp;C McNicholas,&nbsp;A Hagstrom Miller,&nbsp;D Grossman","doi":"10.1016/j.contraception.2024.110622","DOIUrl":"10.1016/j.contraception.2024.110622","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore whether no-test, telehealth abortion care reduces the psychosocial burden of abortion care-seeking.</div></div><div><h3>Methods</h3><div>As part of a study on the safety and effectiveness of telehealth abortion care, from May 2021-March 2023, we surveyed and abstracted medical record data for 583 patients obtaining medication abortion ≤ 70 days gestation, English- or Spanish-speaking, ages ≥ 15 years at four abortion clinic organizations in six US states. We assessed three psychosocial burden dimensions (structural challenges, five items, α=0.80; lack of autonomy, three items, α=0.73; and others’ reactions to the pregnancy, two items, α=0.88, range 0–3) by study group (1) telehealth and mailing medications, (2) no-test and pick-up medications, and (3) in-person with ultrasound.</div></div><div><h3>Results</h3><div>A total 403 enrolled participants completed psychosocial burden items. In adjusted analyses, telehealth by mail was associated with fewer structural challenges than in-person care (-0.12, 95% CI -0.23,-0.00), mostly due to less difficulty traveling for care (24% vs 32%, p&lt;0.05). While mean lack of autonomy scores did not differ by study group, the telehealth by mail (11%) and no-test and pick-up (12%) groups were less likely to feel forced to wait for the abortion after making the decision, when compared to the in-person with ultrasound group (22%, p&lt;0.05). The no-test and pick-up group (35%) was also less likely to be worried about friends/family members’ reaction to the pregnancy than the in-person care group (42%, p&lt;0.05).</div></div><div><h3>Conclusions</h3><div>No-test, telehealth medication abortion care may reduce the psychosocial burden of abortion-seeking, in particular the burden of travel and feeling forced to wait for care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110622"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426199","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":"POSTPARTUM PERMANENT CONTRACEPTIVE PROCEDURES: A 360-DEGREE QUALITATIVE INVESTIGATION","authors":"K Crofton,&nbsp;A Johnston,&nbsp;S Kaszubinski,&nbsp;S Betstadt,&nbsp;E Tal,&nbsp;R Flink-Bochacki","doi":"10.1016/j.contraception.2024.110628","DOIUrl":"10.1016/j.contraception.2024.110628","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore interdisciplinary factors affecting completion of postpartum permanent contraceptive procedures after vaginal delivery.</div></div><div><h3>Methods</h3><div>We conducted a multi-center qualitative study on completion or non-completion of postpartum permanent contraceptive procedures at three academic institutions from July 2023-March 2024. We recruited postpartum patients who desired permanent contraceptive procedures following vaginal delivery. We conducted semi-structured interviews with patients and their nursing, obstetric, and anesthesia teams. We double-coded transcripts using Dedoose and performed inductive thematic content analysis, concluding data collection after thematic saturation.</div></div><div><h3>Results</h3><div>We interviewed 19 patients (11 completed and 9 non-completed procedures) and 47 staff (mean 2.5/patient). We identified three major themes: (1) Standard perioperative counseling can be overshadowed by a focus on overcoming obstacles to completion (<em>“What did [your doctors] tell you to expect?” “Really nothing, they just asked if I was sure I want it…”</em>); (2) Healthcare workers’ personal values influence the prioritization of these procedures <em>(“I believe that some are elective and some are more urgent”)</em>; (3) Procedure completion often relies on one champion to optimize interdisciplinary communication and push past barriers (<em>“We could not get a slot for her on day 1…and then we did on day 2, mostly because [attending] advocated for her</em>”).</div></div><div><h3>Conclusions</h3><div>Unlike most surgeries, the completion of postpartum permanent contraceptive procedures centers around overcoming barriers to access rather than patient needs. The propensity for clinician advocacy to detract from perioperative patient care is a novel finding, and it sustains a culture where contraceptive requests are actualized based on care-team factors rather than patient factors.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110628"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426202","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":"ATTRIBUTES OF PROVIDER COUNSELING ASSOCIATED WITH CONTRACEPTIVE SATISFACTION","authors":"N Luche,&nbsp;E Mosley,&nbsp;N Zite,&nbsp;S Borrero","doi":"10.1016/j.contraception.2024.110646","DOIUrl":"10.1016/j.contraception.2024.110646","url":null,"abstract":"<div><h3>Objectives</h3><div>High-quality contraceptive counseling is associated with increased use of contraception. However, little is known about how counseling influences patient satisfaction with contraceptive method. This study sought to assess characteristics of counseling associated with method satisfaction.</div></div><div><h3>Methods</h3><div>Pregnant participants aged 21-45 years considering postpartum tubal sterilization were recruited from three sites and randomized to receipt of the MyDecision/MiDecisión decision aid tool vs. standard care. Surveys at three months postpartum included eight Likert scale items characterizing perinatal contraceptive counseling quality, and one item assessing current contraceptive method satisfaction. Response options of “strongly agree” (positively worded items) or “strongly disagree” (negatively worded items) were considered optimal. We examined bivariate associations between optimal counseling and optimal method satisfaction. Logistic regression models were then conducted, adjusted for randomization arm and confounding variables (p&lt;0.10) identified in bivariate analysis (age, site).</div></div><div><h3>Results</h3><div>Of 244 participants, 160 (65.6%) reported optimal method satisfaction. In bivariate analysis, optimal ratings on feeling respected, feeling pressured into sterilization or other methods, receiving adequate explanations regarding sterilization or other methods, receiving answers to questions, and counseling satisfaction were all associated with optimal method satisfaction (all p&lt;0.01). In adjusted analysis, optimal ratings on feeling respected (adjusted OR (aOR):5.80;95%CI:2.32-14.49), receiving adequate explanations regarding non-sterilization contraception (aOR:2.14;95%CI:1.07-4.30), feeling minimally pressured into non-sterilization methods (aOR:2.30;95%CI:1.01-5.22), receiving answers (aOR:3.35;95%CI:1.43-7.83), and counseling satisfaction (aOR:4.61;95%CI:2.18-9.74) remained significantly associated with method satisfaction.</div></div><div><h3>Conclusions</h3><div>Aspects of provider contraception counseling that are aligned with patient-centered care are significantly associated with contraceptive method satisfaction. Provision of high-quality contraceptive counseling may have implications both for uptake and continued use of methods.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110646"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426205","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":"DISTANCES TRAVELLED FOR ABORTIONS AND INEQUITIES FOR RURAL RESIDENTS IN OREGON","authors":"EC Nacev,&nbsp;A Mandelbaum,&nbsp;MF Fuerst,&nbsp;MI Rodriguez","doi":"10.1016/j.contraception.2024.110616","DOIUrl":"10.1016/j.contraception.2024.110616","url":null,"abstract":"<div><h3>Objectives</h3><div>Abortion access is dire in most rural areas of the US. Recent studies have shown that most reproductive-aged women live greater than a 30 minute drive from the nearest abortion clinic. True travel distances to abortion care may be even higher, given restrictions in availability by type of abortion and gestational age. This study aims to describe the burden of travel to abortion care for residents of Oregon, a state with no legal restrictions on abortion, by rurality of residence.</div></div><div><h3>Methods</h3><div>We conducted a descriptive study of vital statistics from the Oregon Health Authority of all abortions in Oregon from 2015 to 2021. We calculated distances between county of residence and county of abortion occurrence.</div></div><div><h3>Results</h3><div>Of 57,533 abortions, 90% (n=51,781) were to Oregon residents. Individuals from every county in Oregon needed abortion care during our study period, however abortions were provided in only 25% of counties (n=9). Those that travelled outside their county for abortion care (n=21,808, 37.4%) travelled an average of 56 miles for abortion care. Residents of rural counties (n=4,284) had an average travel distance of 103 miles, with maximum distance travelled of 432 miles.</div></div><div><h3>Conclusions</h3><div>This recent, real-world study describes a high burden of travel for rural residents, even in a state where abortion is legal. This data can support efforts to creatively, strategically, and equitably increase access to abortion, particularly for those with geographic challenges to access.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110616"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) FOR PAIN CONTROL DURING FIRST-TRIMESTER PROCEDURAL ABORTION: A BLINDED RANDOMIZED CONTROLLED TRIAL","authors":"A Henkel,&nbsp;EP Cahill,&nbsp;S Chavez,&nbsp;JM Shorter,&nbsp;SM Liu,&nbsp;SI Amaya,&nbsp;S Kaur,&nbsp;KA Shaw","doi":"10.1016/j.contraception.2024.110617","DOIUrl":"10.1016/j.contraception.2024.110617","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) to manage pain during first-trimester procedural abortion for those not eligible for or otherwise foregoing sedation.</div></div><div><h3>Methods</h3><div>This is a double-blinded, block-randomized superiority trial (IRB approved, NCT05320432) comparing TENS (placed posteriorly, T10-L1 and S2-S4) to sham for pain management during first-trimester procedural abortion. We enrolled pregnant people less than 12 weeks gestation, English- or Spanish-speaking at two outpatient clinics who were not receiving sedation. The primary outcome was self-reported pain by visual analog scale (VAS, 100 mm) with passage of largest cervical dilator. We planned to enroll 70 patients to show a 15 mm difference in median pain score (80% power, α = 0.05).</div></div><div><h3>Results</h3><div>Between January 2023 and March 2024, we enrolled 70 participants. Baseline demographics were balanced between groups: median (range) gestational duration 6.8 (5.1-11.8) weeks, 35.7% nulliparous. Median (range) reported pain with passage of largest dilator was 44mm (0–88) and 50mm (0–96) in the TENS and sham groups, respectively (p=0.56). We did not find a difference in median pain at any collected time point including placement of tenaculum, paracervical block, aspiration, or recovery. The active TENS group was more likely to say they would recommend this method of pain control to others (94mm vs 73mm, p=0.01). More participants receiving TENS unit correctly identified their group allocation (91.4% vs 63.6%, p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>While we did not demonstrate a difference in pain during the procedure, TENS is a non-pharmacologic alternative that may improve patient experience during uterine aspiration.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110617"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“IMAGINE A PREGNANCY”: PERSPECTIVES ON PREGNANCY, ABORTION, AND PARENTING OF LATINE EMERGING ADULTS IN AN AGRICULTURAL COMMUNITY IN CALIFORNIA","authors":"AE Bryson,&nbsp;PS Nordstrom Miranda,&nbsp;MS Zerofsky,&nbsp;AB Baez De Luna,&nbsp;AM Minnis,&nbsp;M Raymond-Flesch","doi":"10.1016/j.contraception.2024.110585","DOIUrl":"10.1016/j.contraception.2024.110585","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe perspectives on pregnancy, abortion, and parenting among Latine emerging adults.</div></div><div><h3>Methods</h3><div>In a mixed-methods prospective cohort study of emerging adults followed since eighth grade, interviews were conducted (5/2023-1/2024) with a subset selected to achieve variation in current relationship experience. Directed content and inductive analyses of transcripts were completed.</div></div><div><h3>Results</h3><div>Forty-one participants (ages 18-21 years; n=21 female, n=18 male, n=2 non-binary; 12% first generation, 71% second generation, and 17% third generation immigrants) were interviewed. Participant-reported reasons to prevent pregnancy currently included educational goals, maturity, “not ready”, finances, desire not to disappoint parents, and other personal goals. When asked to imagine if they (or their partner) were pregnant now, many reported negative feelings (“…being pregnant would be the worst thing right now”), while few reported positive feelings. Participants were split between preferring abortion (“…I just feel like I would have to abort it just because I can’t even take care of myself”) and parenting (“I think if I had a child, I would really want to raise it and be involved in its life”). Adoption was rarely discussed and arose as a second-tier option if abortion was not available. Family values, support systems, and future goals were critical factors driving imagined pregnancy decisions.</div></div><div><h3>Conclusions</h3><div>We captured perspectives on pregnancy, abortion, and parenting of those typically underrepresented in abortion research, including emerging adults, male and non-binary individuals, and those with immigrant identities. Such research is critical to understanding how these populations are navigating their sexual and reproductive health in an evolving abortion policy landscape.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110585"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}