{"title":"Decision-Making and Family Planning among People with Clinical Depressiveness-Findings from a Representative German Panel Study.","authors":"Marie Lehnert, Tanja Gabriele Baudson, Doris Erbe","doi":"10.1111/sifp.70060","DOIUrl":"10.1111/sifp.70060","url":null,"abstract":"<p><p>Personally important decisions, like reproductive choices, may be challenging for individuals with clinical depressiveness, as indecisiveness is a common depressive symptom. This study examines whether decision-making modes related to reproductive behavior differ between individuals with and without clinical depressiveness (H1) and whether these modes remain stable over time, even after the birth of the first child (H2). Data stem from the German Panel Analysis of Intimate Relationships and Family Dynamics (pairfam). Clinical depressiveness was measured using State-Trait Depression Scales and decision-making modes through items on reproductive behavior. H1 was analyzed using multivariate analysis of covariance (MANCOVA) and post hoc analysis of variance (ANOVA); H2 via fixed-effect regressions and cross-lagged panel model. A significant group difference emerged in the combined decision-making modes (Pillai's trace = 0.009, F(6, 4832) = 7.32, p < 0.001). Individuals with clinical depressiveness engaged more in rational and avoidant modes, whereas those without favored normative decision-making. Decision-making remained stable between subjects; within-subject analyses showed alterations over time. Between subjects, decision-making remained stable. Characteristics of depressive symptoms and individual circumstances may explain the results. Future research should incorporate other clinical conditions and qualitative analyses. Practitioners should consider individual costs, benefits, and decisional postponement.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"415-431"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selena P. Anjur‐Dietrich, Funmilola M. OlaOlorun, Elizabeth Omoluabi, Philip Anglewicz, Suzanne O. Bell
{"title":"Social Network Involvement in Abortion Care‐Seeking and Abortion Outcomes among a Population‐Based Sample of Nigerian Women Who Had Abortions","authors":"Selena P. Anjur‐Dietrich, Funmilola M. OlaOlorun, Elizabeth Omoluabi, Philip Anglewicz, Suzanne O. Bell","doi":"10.1111/sifp.70067","DOIUrl":"https://doi.org/10.1111/sifp.70067","url":null,"abstract":"People often engage social networks when navigating abortion access constraints, but limited research links this involvement to abortion outcomes. This cross‐sectional study analyzed <jats:italic>PMA2020</jats:italic> data from 1,144 women in Nigeria who had abortions, identified through population‐based surveys and abortion‐focused follow‐ups conducted in 2018 and 2019–2020, respectively. We examined how social network involvement in care‐seeking—specifically, in method or provider selection—related to abortion outcomes: medically defined abortion safety, use of preferred method and provider, and success of the initial abortion attempt. Social network involvement was common (63 percent) and varied across sociodemographic groups. Outcomes differed by involvement source: when both partners and family/friends were involved, women were least likely to have the least safe abortions (23.9 percent vs. 60.9 percent, <jats:italic>p</jats:italic> < 0.001) or make multiple abortion attempts (13.7 percent vs. 19.1 percent, <jats:italic>p</jats:italic> = 0.009), though they were equally likely to use preferred care as those seeking care alone. Partner‐only involvement was also significantly associated with fewer least safe abortions (36.3 percent vs. 60.9 percent, <jats:italic>p</jats:italic> < 0.001), while family/friend‐only involvement was significantly associated with non‐preferred abortion options (36.6 percent vs. 21.6 percent, <jats:italic>p</jats:italic> < 0.001) and more repeated attempts (27.8 percent vs. 19.1 percent, <jats:italic>p</jats:italic> = 0.038). These findings suggest that social networks have the potential to improve or worsen abortion outcomes, with important variation across person‐centered measures of abortion experiences.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"11 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selena P Anjur-Dietrich, Funmilola M OlaOlorun, Elizabeth Omoluabi, Philip Anglewicz, Suzanne O Bell
{"title":"Social Network Involvement in Abortion Care-Seeking and Abortion Outcomes among a Population-Based Sample of Nigerian Women Who Had Abortions.","authors":"Selena P Anjur-Dietrich, Funmilola M OlaOlorun, Elizabeth Omoluabi, Philip Anglewicz, Suzanne O Bell","doi":"10.1111/sifp.70067","DOIUrl":"https://doi.org/10.1111/sifp.70067","url":null,"abstract":"<p><p>People often engage social networks when navigating abortion access constraints, but limited research links this involvement to abortion outcomes. This cross-sectional study analyzed PMA2020 data from 1,144 women in Nigeria who had abortions, identified through population-based surveys and abortion-focused follow-ups conducted in 2018 and 2019-2020, respectively. We examined how social network involvement in care-seeking-specifically, in method or provider selection-related to abortion outcomes: medically defined abortion safety, use of preferred method and provider, and success of the initial abortion attempt. Social network involvement was common (63 percent) and varied across sociodemographic groups. Outcomes differed by involvement source: when both partners and family/friends were involved, women were least likely to have the least safe abortions (23.9 percent vs. 60.9 percent, p < 0.001) or make multiple abortion attempts (13.7 percent vs. 19.1 percent, p = 0.009), though they were equally likely to use preferred care as those seeking care alone. Partner-only involvement was also significantly associated with fewer least safe abortions (36.3 percent vs. 60.9 percent, p < 0.001), while family/friend-only involvement was significantly associated with non-preferred abortion options (36.6 percent vs. 21.6 percent, p < 0.001) and more repeated attempts (27.8 percent vs. 19.1 percent, p = 0.038). These findings suggest that social networks have the potential to improve or worsen abortion outcomes, with important variation across person-centered measures of abortion experiences.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the Impact of a Family Planning Supply Chain Intervention on Postpartum Contraceptive Use in Senegal Using Difference in Differences.","authors":"Dea Oviedo, Margaret A McConnell, Jessica L Cohen","doi":"10.1111/sifp.70066","DOIUrl":"https://doi.org/10.1111/sifp.70066","url":null,"abstract":"<p><p>Senegal faces high maternal mortality, elevated levels of short‑interval births, and substantial unmet need for postpartum contraception. Supply chain challenges contribute to contraceptive nonuse in the country. Before 2013, Senegal used a pull‑based contraceptive supply chain, in which facility staff estimated demand and procured supplies, leading to frequent stockouts. The informed push model (IPM), launched in 2012, aimed to streamline distribution. We used 2014-2019 DHS data (N = 32,373) and applied an event‑study difference‑in‑differences design with district‑level data to assess changes in the prevalence of modern, long-acting, reversible, and short‑acting contraceptive methods. We further conducted subgroup analyses by wealth and urbanicity. IPM significantly increased contraceptive prevalence. Modern contraceptive use in the postpartum period rose by 7.8 percentage points within 10 quarters post-IPM. Increases were most pronounced for wealthier and more urban districts. Results underscore the value of strong supply chains but show that supply‑side efforts alone may not reach low-income and rural populations. Future work should evaluate the cost-effectiveness and sustainability of alternative financing models and integrated strategies to address persistent supply and access barriers.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impacts of Contraception on Future Fertility: Addressing Concerns to Improve Understanding.","authors":"Lorna Begg,Onikepe Owolabi,Chelsea B Polis","doi":"10.1111/sifp.70065","DOIUrl":"https://doi.org/10.1111/sifp.70065","url":null,"abstract":"Even though one-year pregnancy rates following contraceptive discontinuation are similar to pregnancy rates following nonuse of contraception, there are widespread perceptions that modern contraceptives will have adverse effects on future fertility. There are likely a variety of factors that contribute to these perceptions. One explanation could be the short-term (<12 months) delays in return to fertility following contraceptive cessation, which may be interpreted as evidence of subfertility. In this commentary, we argue that the contraceptive field should embrace evidence-based nuance about return to fertility (including, but not limited to, during contraceptive counseling) to minimize confusion and distrust. Further, greater emphasis on the fertility-preserving aspects of contraception and multipurpose prevention technologies may be helpful in bringing understanding about the effects of contraception into alignment with scientific evidence.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"27 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148349350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agnes Karingo Karume,Alison L Drake,June Moraa,Celestine Atieno,Nancy Ngumbau,Aparna Seth,Kristin Beima-Sofie,John Kinuthia,Jennifer A Unger
{"title":"User and Provider Experiences with a Digital Health Family Planning Counseling Tool for Women Living with HIV in Kenya.","authors":"Agnes Karingo Karume,Alison L Drake,June Moraa,Celestine Atieno,Nancy Ngumbau,Aparna Seth,Kristin Beima-Sofie,John Kinuthia,Jennifer A Unger","doi":"10.1111/sifp.70059","DOIUrl":"https://doi.org/10.1111/sifp.70059","url":null,"abstract":"Women living with HIV(WLHIV) have diverse and complex reproductive health needs that require patient-centered, informed decision-making. Digital tools to support reproductive life planning may improve reproductive health counseling and outcomes for these women. We evaluated user experiences with a self-administered, tablet-based family planning (FP) counseling tool as part of a digital health intervention implemented within a cluster randomized trial in Kenya. We conducted 10 focus group discussions with WLHIV (n = 95) who received the counseling tool and in-depth interviews (n = 10) with providers. Data were collected using semistructured guides, transcribed, translated, and thematically analyzed. Women's median age was 26 years, and 52 percent were married. Providers had a median of seven years' experience. WLHIV and providers found the counseling tool acceptable and felt it improved decision-making, FP knowledge, and patient-provider interactions. Women reported that the counseling tool supported informed FP decisions, improved awareness about less familiar options, and dispelled myths and misconceptions. Providers said the counseling tool helped tailor counseling, though it was challenging to use with women with more FP experience or with a selected method, but helpful among new FP users and adolescents. Participants also felt that the tool was lengthy. Tailoring the counseling tool and making it optional for specific groups of WLHIV may improve feasibility.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"23 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Bayesian Framework to Account for Misclassification Error and Uncertainty in the Estimation of Abortion Prevalence.","authors":"Marija Pejchinovska, Monica Alexander","doi":"10.1111/sifp.70053","DOIUrl":"10.1111/sifp.70053","url":null,"abstract":"<p><p>Obtaining reliable estimates of the prevalence of induced abortion remains a significant challenge in abortion research. Recently, one indirect, survey-based technique for measuring abortion outcomes, the confidante method, has gained particular attention. The method has been applied in various social and legal contexts; however, its efficacy has not been uniformly established. Increasingly, focus has shifted to assessing the method's key assumptions and quantifying the biases that arise from violations of them. We propose a general statistical framework to conceptualize and quantify the impact of biases on measuring abortion prevalence from such surveys. Specifically, we define the relationship between observed and true abortion prevalence based on misclassification error related to the sensitivity and specificity of the survey instrument. This formulation leads naturally to a Bayesian modeling approach to estimate abortion prevalence, allowing for differing knowledge of and different levels of uncertainty about the misclassification parameters to be incorporated in the modeling process, with that uncertainty being propagated through to the final estimates. We illustrate our framework and modeling approach on data from an application of the confidante method in Uganda in 2018, where we account for systematic differences in confidante abortion reports based on the self-reported abortion experiences of survey respondents.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"234-255"},"PeriodicalIF":3.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"It's Time to Get Practical: A Call for Shorter Measures in the Family Planning Community.","authors":"Lotus McDougal","doi":"10.1111/sifp.70056","DOIUrl":"10.1111/sifp.70056","url":null,"abstract":"<p><p>While there is widespread agreement that measurement is an essential component of successful family planning programming, policy-making, and research, current measures are still catching up to the field's shift to more person-centered and agency-focused goals. Concurrently, the global reproductive health and data ecosystems have been profoundly interrupted, and resources are becoming increasingly scarce. This is thus a critical time to reexamine our priorities regarding what and how we measure across different aspects of family planning. In the last decade, new family planning measures had an average of 14 items per measure. This length is impractical for inclusion in most large-scale surveys and unfeasible in many modalities of data collection. In order to meet the very difficult moment in which the family planning community now finds itself, we must embrace pragmatism and promote the development, testing, and use of reliable, valid, and short (five or fewer item) measures. We have a chance to be both responsive and adaptive, and it is timely and necessary that we do so as a family planning measurement community.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"298-304"},"PeriodicalIF":3.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel M Schmitz,Israt Jahan Juie,Olufunke Fasawe,Alisha Graves
{"title":"\"I Need to Space to Help Me Take Care of Myself and My Child\": How Married Adolescent Girls in Northern Nigeria Learn and Practice Birth Spacing through Safe Space Clubs.","authors":"Rachel M Schmitz,Israt Jahan Juie,Olufunke Fasawe,Alisha Graves","doi":"10.1111/sifp.70057","DOIUrl":"https://doi.org/10.1111/sifp.70057","url":null,"abstract":"Adolescent girls in low- and middle-income countries (LMIC) with high levels of poverty face barriers to education, health, and life opportunities. In Northern Nigeria, patriarchal norms and gendered expectations heighten girls' risk of early marriage and high-risk childbearing. Birth spacing, or extending the length of time between births, can be a socially acceptable strategy that girls use to maintain their health. The Centre for Girls Education (CGE)'s Married Adolescent Girls Safe Spaces (MAS) program in rural Northern Nigeria included lessons on birth spacing and visits to health facilities. We conducted a case study of the MAS program, drawing from three years of ethnographic field research, including participant observation, in-depth interviews, and focus groups. Combining scientific evidence and Islamic teachings in MAS safe spaces shaped girls' understanding and appreciation of modern birth spacing methods, and their agency in negotiating usage. However, girls' agency remained constrained by structural and normative barriers limiting their ability to practice birth spacing. The MAS program suggests that integrating scientific information and Islamic teachings on birth spacing in safe spaces can strengthen married adolescent girls' knowledge and agency to use modern methods, while underscoring the need to address persistent structural and gender norms.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"113 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Traditional or Modern Contraception? Association Between Health Worker Contact and Contraceptive Choice in India: Findings From NFHS 2019-2021.","authors":"Nandita Bhan,Nicole Johns,Katherine Hay,Vedavati Patwardhan,Abhishek Singh,Shruti Ambast,Lotus McDougal","doi":"10.1111/sifp.70052","DOIUrl":"https://doi.org/10.1111/sifp.70052","url":null,"abstract":"Despite greater availability and affordability of modern contraception, the use of traditional contraception is rising in India. We examined the relationship between Indian women's contact with a community health worker (CHW) and discussion of family planning (FP) with their contraceptive use. We analyzed data from 306,037 nonpregnant, non-sterilized married women in the 2019-2021 National Family Health Survey (NFHS). Multinomial regression models estimated the association between CHW contact and contraceptive use (consistent use, switching, and discontinuation) in the past three months. Nearly 22 percent of women reported current use of traditional contraception, with 18 percent reporting exclusive use and 4.1 percent concurrent method use. Traditional contraception was more common among older women, women with lower education, higher parity, and in nuclear households. CHW discussion on FP was associated with higher traditional contraceptive use [Adjusted Odds Ratio (AOR) = 1.11 (95 percent Confidence Interval (CI): 1.04, 1.19)], reversible modern method use [AOR = 1.92 (95 percent CI: 1.82, 2.02)], and concurrent use [AOR = 2.19 (95 percent CI: 1.95, 2.45)]. Recent CHW engagement was associated with consistent modern method use [Adjusted Relative Risk Ratio (ARRR) = 2.02 (95 percent CI: 1.91, 2.13)], switching from traditional to modern method [ARRR = 1.67 (95 percent CI: 1.14, 2.46)], and discontinuation of modern contraception [ARRR = 2.10 (95 percent CI: 1.81, 2.44)]. CHW engagement on FP may enable initiation and consistent use of traditional and modern methods, switching, and discontinuation of contraception.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"5 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}