Contraception最新文献

{"title":"THE ROLE OF ABORTION RESTRICTIONS IN COUNSELING AT FETAL CARE CENTERS","authors":"V Manthena,&nbsp;P Gopal,&nbsp;A Akhter,&nbsp;JT Fry,&nbsp;JL Muñoz,&nbsp;J Chor,&nbsp;AF Shaaban,&nbsp;A Premkumar","doi":"10.1016/j.contraception.2025.111118","DOIUrl":"10.1016/j.contraception.2025.111118","url":null,"abstract":"<div><h3>Objectives</h3><div>Fetal care centers (FCCs) or hospital-based institutions focused on the diagnosis and management of congenital anomalies have increased over the past decade, but little is known about their abortion care practices including eliciting interest, counseling, and referrals, or how these practices are influenced by institutional or state policies on abortion care.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study across US North American Fetal Therapy Network (NAFTNet) sites, including FCCs in states or institutions with restrictive and permissive abortion policies, as defined by the Guttmacher Institute. Providers were recruited via snowball sampling, and surveys were distributed electronically through REDCap. Semi-structured key interviews were performed among a subgroup of NAFTnet site representatives. Interviews were audio-recorded, transcribed and analyzed using grounded theory, with quantitative data summarized statistically.</div></div><div><h3>Results</h3><div>Twenty-three providers (3 pediatric surgeons, 20 maternal-fetal medicine (MFM) subspecialists) completed the survey, and 12 providers (1 pediatric surgeon, 11 MFMs) expressed interest in the interview. Among those interviewed, the majority were female (58.3%) and worked at FCCs located in settings with restrictive or partly permissive abortion policies (58.3%). Key themes from interviews by providers located in permissive settings included ease and comfort in abortion counseling, while providers located in hospital systems or states with restrictive abortion policies emphasized counseling practices based on institutional or state restrictions and conscientious provision.</div></div><div><h3>Conclusions</h3><div>Providers working at FCCs face unique issues in eliciting interest in and counseling about abortion care, which diverge based on institutional and state restrictions. Future research should investigate patient experiences of abortion care after consultation at an FCC.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111118"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278302","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":"HOW DO CALIFORNIA OB-GYNS UNDERSTAND THE CONCEPT OF VIABILITY?","authors":"N DiCenzo,&nbsp;K Donnelly,&nbsp;M Gosdin,&nbsp;M Creinin,&nbsp;MJ Chen","doi":"10.1016/j.contraception.2025.111076","DOIUrl":"10.1016/j.contraception.2025.111076","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to understand how California obstetrician-gynecologists (Ob-Gyns) interpret the construct of fetal “viability” used in California abortion legislation.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study with California generalist Ob-Gyns and Complex Family Planning (CFP) subspecialists. One interviewer conducted audio-only interviews using a semi-structured guide, which included informing the participants mid-interview of the legislative text to elicit responses. We recorded, transcribed, de-identified, and coded the interviews. We performed reflexive memoing and thematic analysis throughout data collection and ended recruitment once we reached thematic saturation.</div></div><div><h3>Results</h3><div>We enrolled 12 generalists and 9 CFP subspecialists. Most (n=19) practiced in an urban environment (12 in Northern and 9 in Southern California), with 12 in academic and 9 in community settings. Most participants defined viability as the earliest potential for fetal “intact” survivability and NICU resuscitation. Physicians who didn’t perform abortions were often unsure of state law, but assumed abortion was restricted after 24 weeks. Most physicians expressed more concern about institutional policies and support than about state law. After learning that there is no specific gestational duration restriction in California, physicians expressed fear of expanding abortion care past 24 weeks due to perceived personal risk and assumed patients could receive care elsewhere. Some abortion providers expressed difficulty navigating their own personal limits for abortion care in the absence of explicit policy limits, while others concluded that viability should only be in the eyes of the patient.</div></div><div><h3>Conclusions</h3><div>California Ob-Gyns have varied interpretations of viability, dependent mainly on their individual institutional policies, creating barriers to later abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111076"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278315","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 2025, scientific abstracts, October 25-27, Pittsburgh, PA","authors":"","doi":"10.1016/j.contraception.2025.111180","DOIUrl":"10.1016/j.contraception.2025.111180","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111180"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277980","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":"UPDATED NATIONAL-LEVEL CONTRACEPTIVE USE AND PREFERENCE ESTIMATES IN THE US","authors":"MR Zolna,&nbsp;DW Chiu,&nbsp;P Osias,&nbsp;ML Kavanaugh","doi":"10.1016/j.contraception.2025.111141","DOIUrl":"10.1016/j.contraception.2025.111141","url":null,"abstract":"<div><h3>Objectives</h3><div>The National Survey of Family Growth (NSFG) is considered the gold standard source for data related to individuals’ contraceptive behavior in the US; however, administration of the survey has recently shifted. We sought to update national-level estimates of contraceptive use and preferences among US reproductive-aged women within the context of changes in both the survey and the broader national policy climate regarding sexual and reproductive health.</div></div><div><h3>Methods</h3><div>We drew on nationally representative data of US women aged 15-49 from the 2022-2023 NSFG (n=5,585) to calculate overall contraceptive use and nonuse, allowing for use of multiple methods, and to estimate unfulfilled contraceptive preferences due to cost.</div></div><div><h3>Results</h3><div>As of 2022-2023, the majority of women (57%) and those who were sexually active and not seeking pregnancy (80%) were currently using contraception. The most used methods were female permanent methods and the pill (both 23%), condom (21%), withdrawal (19%), and IUD (16%). About one-quarter of users used multiple methods. One-third of non-users preferred to use a method, while 15% of users preferred to use a different method, if cost were not an issue.</div></div><div><h3>Conclusions</h3><div>Although direct comparisons to previous NSFG estimates are not feasible due to changes in study design and administration, these updated national-level findings signal that individuals continue to commonly use permanent and long-acting methods while our new approach highlights frequent supplementation with coital-related methods. National-level individual unfulfilled contraceptive preferences are lower than measured in other population-level studies; the extent to which this represents true shifts or is indicative of changes in data quality remains unclear.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111141"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277935","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":"CONTRACEPTIVE INFORMATION, CONCERNS, AND KNOWLEDGE AMONG COMMUNITY COLLEGE STUDENTS","authors":"K Lagasse Burke,&nbsp;J Yarger,&nbsp;HK Hecht,&nbsp;K Hopkins,&nbsp;AJ Bell,&nbsp;SM Morse,&nbsp;A Harris,&nbsp;I Rossetto,&nbsp;CC Harper","doi":"10.1016/j.contraception.2025.111136","DOIUrl":"10.1016/j.contraception.2025.111136","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate how sources of contraceptive information differ between students in California and Texas and identify their association with contraceptive concerns and knowledge.</div></div><div><h3>Methods</h3><div>We used baseline data from a cluster randomized trial of community college students in California and Texas aged 18-25, who were assigned female at birth, and sexually active (n=2,038). We described sources of contraceptive information in the past year by state. We used mixed-effects logistic regression to assess how sources of information (social media, Google, classroom, campus presentations) were associated with contraceptive concerns (side effects, hormones) and knowledge of the full range of methods; we adjusted for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Compared with California participants, Texans were more likely to rely on social media for contraceptive information (72% vs. 61%, p&lt;0.01) and less likely to receive information in the classroom (18% vs. 28%, p&lt;0.01) or from a campus presentation (9% vs. 17%, p&lt;0.01). Relying on online sources was associated with greater concerns about side effects (social media aOR=1.46; 95% CI, 1.14-1.86; Google aOR=1.76; 95% CI, 1.39-2.24) and hormones (social media aOR=1.43; 95% CI, 1.13-1.81; Google aOR=1.43; 95% CI, 1.14-1.80). Learning about contraception through Google (aOR=1.34; 95% CI, 1.11-1.61), classroom (aOR=1.29; 95% CI, 1.04-1.60), or campus presentations (aOR=1.38; 95% CI, 1.06-1.79) was associated with greater knowledge.</div></div><div><h3>Conclusions</h3><div>Limited formal education and reliance on social media may exacerbate contraceptive concerns without improving knowledge, particularly in Texas. Expanding sex education and developing culturally relevant, youth-informed digital content could provide critical resources and affirm young people’s right to accurate, stigma-free information, especially in restrictive states.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111136"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277928","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":"MIFEPRISTONE ADVERSE DRUG EVENTS IN THE CONTEXT OF FDA REMS REGULATED DRUGS","authors":"LR Woskie,&nbsp;A VanWilder","doi":"10.1016/j.contraception.2025.111093","DOIUrl":"10.1016/j.contraception.2025.111093","url":null,"abstract":"<div><h3>Objectives</h3><div>Strong evidence shows mifepristone’s safety as an abortifacient. Yet, mifepristone remains on the FDA’s Risk Evaluation and Mitigation Strategy (REMS), a program designed to ensure that safety outweighs risk. We lack a head-to-head comparison of mifepristone with other products with these oversights. We therefore sought to re-evaluate the safety profile of mifepristone relative to other, similarly regulated, drugs.</div></div><div><h3>Methods</h3><div>We analyzed more than 1.6 million ADE reports across more than 60 products from the FDA Adverse Event Reporting System (FAERS) from 1995 to 2024. Mifepristone reports were compared to those for other drugs with a currently active REMS program. We assessed monthly reporting volume, seriousness, fatality, and underlying causes. Report rates were contextualized using abortion estimates from the Guttmacher Institute and CDC.</div></div><div><h3>Results</h3><div>Monthly ADE reports for mifepristone were significantly lower than the REMS median (14.8 vs. 41.6), with fewer serious (5.6 vs. 14.9) and fatal (0.2 vs. 0.9) reports. Most mifepristone-related reports stemmed from known effects, ie, surfaced during clinical trials (86.0% vs. 26.3%) or ineffectiveness (32.3% vs. 2.4%), a report type accepted by the FDA, but not an ADE. When adjusted for estimated use, mifepristone report rates were consistently at or below 1% across all periods.</div></div><div><h3>Conclusions</h3><div>The FDA’s ADE data have been used in recent litigation to suggest that mifepristone is not safe. We find the opposite. FDA data align with pre-market and recent studies indicating a strong safety profile. Adverse event reporting is notably lower than similarly regulated drugs. These findings highlight the importance of contextualized, comparative safety assessments.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111093"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277989","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":"ABNORMAL COAGULATION STUDIES AND BLEEDING COMPLICATIONS IN SECOND-TRIMESTER IUFD","authors":"O Recabo,&nbsp;L Giovinazzo,&nbsp;A Frisse,&nbsp;T Ryntz,&nbsp;J Salcedo,&nbsp;B Stifani","doi":"10.1016/j.contraception.2025.111056","DOIUrl":"10.1016/j.contraception.2025.111056","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to determine the incidence and predictors of abnormal coagulation studies and bleeding complications among patients undergoing dilation and evacuation for second-trimester intrauterine fetal demise (IUFD).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with singleton IUFD measuring 12 weeks and beyond. We defined excessive bleeding as bleeding that required medical interventions (use of two or more non-prophylactic uterotonics; blood transfusion; post-operative bleeding requiring intervention). We defined length of demise as the difference between gestational age by dates and fetus size on day of evaluation and used Perinatology.com reference ranges for coagulation studies. Using Stata SE Version 16.1 with significance level at 5%, we performed chi-squared tests to compare proportions across groups.</div></div><div><h3>Results</h3><div>Of 157 patients, the median demise duration was 16 days (75th percentile: 29 days). Of the 154 patients who underwent dilation and evacuation, 20 (13.0%) had excessive bleeding. Bivariate analysis showed that demise duration was associated with bleeding: 22.9% of those with demise duration beyond 29 days had excessive bleeding vs. 10.1% with shorter demise duration (p=0.048). Coagulation studies were available for 137 patients, with 17 (12.4%) showing abnormal results. Prolonged demise was associated with abnormal coagulation studies: 23.5% of those with demise beyond 29 days had abnormal results, vs. 8.7% of those with shorter duration (p=0.023). There was a trend toward increased interventions for bleeding among those with abnormal coagulation studies, but this was not significant.</div></div><div><h3>Conclusions</h3><div>Prolonged demise duration was associated with bleeding complications and abnormal coagulation factors. Risk stratification for these patients may be warranted.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111056"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278112","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":"IMPACT OF THE EARLY PREGNANCY ASSESSMENT CLINIC (EPAC) AT CLEVELAND CLINIC","authors":"D Sandler,&nbsp;A Brant,&nbsp;M Yao,&nbsp;C Collart","doi":"10.1016/j.contraception.2025.111128","DOIUrl":"10.1016/j.contraception.2025.111128","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare clinical care characteristics for patients experiencing early pregnancy complications who were managed by the Early Pregnancy Assessment Clinic (EPAC) vs. traditional care within a large academic health system.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients who initially presented to the emergency department in 2021 and whose records had ICD-10 codes indicating threatened abortion, abortion, or ectopic pregnancy. We identified EPAC-participants by the presence of a referral order to the EPAC and at least one EPAC encounter. Patient demographics and care characteristics were analyzed. We compared characteristics of care for EPAC participants vs. traditional care.</div></div><div><h3>Results</h3><div>We identified 2,284 eligible patients. No statistically significant differences were noted in demographics between the two groups. One-fifth (21.6%) received interventions: 51.9% received surgical interventions (uterine aspiration, dilation and curettage, laparoscopy), 43.5% received medical interventions (misoprostol, mifepristone, or methotrexate), and 4.6% received both. EPAC participants were twice as likely to receive any intervention as those who received traditional care. Only EPAC participants received mifepristone (p&lt;0.001). Among patients with ectopic pregnancy, EPAC participants were 5.7 times as likely to receive any treatment (12.6% vs. 2.2%), and were 7.3 times as likely (9.5% vs. 1.3%; p&lt;0.001) to receive medical management than those receiving traditional care. Traditional care participants were also 1.7 times as likely to undergo laparoscopy (40% vs. 24%; p&lt;0.002).</div></div><div><h3>Conclusions</h3><div>Within a large cohort of patients experiencing early pregnancy complications, EPAC participants were more likely to receive active management, including medical treatment, than those receiving traditional care. These findings have implications for the reduction of disparities in miscarriage and ectopic pregnancy care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111128"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278219","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":"TELEHEALTH SERVICES USE AND TOP CONCERNS AMONG PREGNANCY-CAPABLE PEOPLE IN THE SOUTH","authors":"A Newton-Levinson,&nbsp;S Narasimhan","doi":"10.1016/j.contraception.2025.111081","DOIUrl":"10.1016/j.contraception.2025.111081","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to identify differences in use of and concerns about telehealth across reproductive health services.</div></div><div><h3>Methods</h3><div>We conducted a regional cross-sectional survey using a Centiment audience panel from August to September 2024 on telehealth reproductive health services (eg, contraceptive provision, prenatal care, and abortion care) among 18–44-year-olds living in 11 US states. Eligible respondents were pregnancy-capable and had sought contraception or had an interest in starting contraception in the past year (n=1,029). We report descriptive and bivariate analyses.</div></div><div><h3>Results</h3><div>Respondents used telehealth for contraceptive counseling (25%), receipt of a contraceptive method/prescription (16%), receipt of emergency contraception (EC) (14%), prenatal care (12%), and abortion care (5%). Respondents with higher incomes (&gt;200% of FPL) reported significantly greater use of contraceptive and EC services. Rural respondents used telehealth services less frequently, but this difference was only significant for EC. Overall, 48% of respondents preferred to use telehealth for contraceptive care; those who experienced prior poor contraceptive care were significantly more likely to prefer telehealth (59%) and to have used it across all services. Respondents reported cost, then insurance coverage, as top logistical concerns for contraceptive and abortion care. For contraceptive care, respondents were concerned about whether “the provider understood their needs” and for abortion care, they cited concerns about “having enough support in the process” and “legal issues”.</div></div><div><h3>Conclusions</h3><div>Use of, preferences for, and top concerns differed across types of reproductive health services in the South and differed significantly by respondents’ income and rurality. As telehealth use increases, understanding these differences may advance appropriately tailored services in the South.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111081"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278222","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":"BEYOND UNINTENDED PREGNANCY: A NOVEL MEASURE OF SELF-ASSESSED PREGNANCY ACCEPTABILITY","authors":"EA Mosley,&nbsp;L Callegari,&nbsp;C Dehlendorf,&nbsp;M Hamm,&nbsp;G Switzer,&nbsp;N Zite,&nbsp;S Borrero","doi":"10.1016/j.contraception.2025.111066","DOIUrl":"10.1016/j.contraception.2025.111066","url":null,"abstract":"<div><h3>Objectives</h3><div>We assessed construct validity of a novel epidemiological measure — self-assessed pregnancy acceptability (SAPA) — as an alternative to the conceptually problematic and increasingly criticized metric of “unintended pregnancy.”</div></div><div><h3>Methods</h3><div>SAPA is an 11-item retrospective survey measure capturing people’s attitudes about and perceived feasibility of parenting, abortion, and adoption soon after pregnancy confirmation. It was developed based on qualitative research regarding people’s conceptualizations and experiences of pregnancy. SAPA categorizes pregnancies as highly acceptable, mixed acceptability, or unacceptable. To assess psychometric properties, we fielded SAPA in a national sample of 572 people who were &lt;15 weeks pregnant. We measured convergence with unintended pregnancy, mental health, decisional conflict, quality of life, substance use, and intimate partner violence using unadjusted regression models.</div></div><div><h3>Results</h3><div>The sample was diverse in age (mean: 32, range:16-45), geography, and race/ethnicity (57.3% White, 20.5% Asian, 14.2% Black, 9.4% multi-racial, 5.4% Latina). Overall, 4.90% of pregnancies were unacceptable, 43.71% were mixed acceptability, and 51.40% were highly acceptable. Compared with highly acceptable pregnancy scores, mixed and unacceptable pregnancy SAPA scores were correlated with unintended pregnancy, lower happiness, greater stress, anxiety and depression, suicidality, decisional conflict, lower quality of life, substance use during pregnancy, and intimate partner violence (all p&lt;0.05 with large effect sizes based on Cohen’s <em>d</em>).</div></div><div><h3>Conclusions</h3><div>SAPA is a valid measure of pregnancy acceptability that strongly correlates with hypothesized measures of health and well-being. SAPA can shift the field beyond the pregnancy intendedness paradigm and toward person-centered epidemiological concepts and measures of sexual and reproductive well-being, while delineating clear policy implications for contraception, abortion, and parenting support.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"151 ","pages":"Article 111066"},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278226","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}