Sexual and Reproductive Health Matters最新文献

{"title":"The \"architecture of distancing\": a mode of abortion governance illustrated by the Italian case.","authors":"Debra Lanfranconi","doi":"10.1080/26410397.2026.2638043","DOIUrl":"10.1080/26410397.2026.2638043","url":null,"abstract":"<p><p>This commentary introduces the concept of an \"architecture of distancing\" to describe a mode of reproductive governance that preserves the legal recognition of abortion while constraining the conditions necessary for exercising this right. Using Italy as a paradigmatic case, it illustrates how the law has, from its inception, embedded mechanisms that maintain formal legality yet distance individuals from access - through strict procedural requirements, institutionalised conscientious objection, and the integration of anti-abortion groups into public services. The Italian case demonstrates that obstacles to abortion access are often not mere implementation failures, but features built within even ostensibly liberal legal frameworks, thereby helping illuminate contexts in which abortion is \"legal but inaccessible\". More broadly, the concept offers a lens for capturing contemporary forms of reproductive governance that restrict without prohibiting. As there is no architecture without architects, the architecture of distancing draws attention to the political, institutional, and social arrangements that sustain these dynamics and underscores the importance of prioritising the material realisation of reproductive rights over their symbolic recognition.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2638043"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sex effect: the prevalence of sex life reasons for contraceptive discontinuation. A systematic review and meta-analysis.","authors":"Mirela Zaneva, Nandita Thatte, Anne Philpott, Clara Maliwa, Rhiana Mills, Lianne Gonsalves","doi":"10.1080/26410397.2025.2552589","DOIUrl":"10.1080/26410397.2025.2552589","url":null,"abstract":"<p><p>The ability to have sex without having an unintended pregnancy is a key motivator for contraceptive use, yet factors related to patients' sexual lives are critically understudied in contraceptive decision-making. We report the first systematic review and meta-analysis examining the extent to which a contraceptive method's effect on a satisfying sexual life results in contraception discontinuation or switching. We searched for relevant qualitative and quantitative literature published during 2004-2023 in 9 databases and included 64 studies, comprising a total of 125,586 participants and corresponding to at least 52,705 discontinuers in need, aged 12-54 and surveyed in clinical or public health settings in diverse global contexts. Our main outcome measures were discontinuation or switching of modern contraceptive methods (excluding condoms) while in need. A meta-analysis of 25 studies indicated that sex life concerns as a reason for contraceptive discontinuation have an overall prevalence of 5% (95% CI: 0.03, 0.08; <i>I</i>² = 94%, <i>τ</i>² = 1.31; <i>Q</i> = 381, <i>p</i> < 0.001). Sub-group meta-analyses and follow-up meta-regressions do not support any differences based on the hormonal content of the contraceptive method, the specific contraceptive method type, or the specific type of sex life reasons. Sex life reasons are important, common reasons for contraceptive discontinuation. Their prevalence is comparable to other reasons for discontinuation, such as cost or access. Future research should investigate impacts of contraceptive methods on sex life more directly and clinicians should include counselling on a method's sexual acceptability as part of the wider conversation on common contraceptive side effects.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2552589"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12557827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive coercion experienced by women living with HIV - a global scoping review.","authors":"Althea Wolfe, Keren Dunaway, Gnilane Turpin, Danielle Lonbong Njiometio, Uma Bhatt, Charity T Mkona, Olena Stryzhak, Diana Weekes, Immaculate Owomugisha, Omar Syarif, Pim Looze, Jean De Dieu Anoubissi, Fletcher Chiu, Daria Ocheret, Laurel Sprague, Carlos Garcia De Leon Moreno, Stefan Baral, Global Scan Committee, Katherine Rucinski, Sophie Brion, Carrie Lyons","doi":"10.1080/26410397.2025.2588004","DOIUrl":"10.1080/26410397.2025.2588004","url":null,"abstract":"<p><p>Biomedical advancements in HIV prevention and treatment have provided opportunities for women living with HIV to move through pregnancy, give birth, and breastfeed while effectively removing the risk of vertical transmission of HIV to their child. However, existing evidence suggests that the reproductive health and rights of women living with HIV are threatened through coercive practices in healthcare settings because of their HIV status. The objective of this scoping review was to synthesise evidence and identify gaps in the literature on reproductive coercion experienced by women living with HIV in clinical settings. This review focused specifically on reproductive coercion in the context of clinical healthcare globally, as opposed to intimate partnerships, and included forced or covertly performed sterilisation, forced abortion, restricted or forced contraceptive methods, forced or denied caesarean sections, and general coercion by healthcare providers regarding fertility-, sexual-, and reproductive-related decision-making. We searched three databases (Embase, PubMed, and LILACS) for quantitative, qualitative, and mixed methods studies. After 2888 unique publications were screened, thirteen publications met the inclusion criteria. Sterilisation was the most common coercion type assessed, and Mexico, the United States, and South Africa were common study settings. Variation in reproductive coercion definitions, study methods, and reporting was observed. Evidence from these studies suggests that reproductive coercion among women living with HIV is severe and pervasive. Therefore, there is a need to expand research on coercion and stigma that women living with HIV face while navigating reproductive healthcare. Additionally, prevention mechanisms and resource expansion for survivors beyond legal settings should be implemented globally.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2588004"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abortion stigma among people seeking abortion care in high-income countries: a mixed-methods systematic review.","authors":"Jana Niemann, Marie Bernard, Dennis Jepsen, Laura Weinhold, Céline Miani, Nadja Freymüller, Claudia Luck-Sikorski","doi":"10.1080/26410397.2026.2709964","DOIUrl":"10.1080/26410397.2026.2709964","url":null,"abstract":"<p><p>Abortion is a common reproductive healthcare process that is often stigmatised. Research on abortion stigma has grown significantly since the last major review over a decade ago, and there is a pressing need for an updated, comprehensive systematic review. The purpose of this review is to examine the extent and subjective experiences of abortion stigma among those seeking an abortion in high-income countries. We aim to explore the theoretical conceptualisations of abortion stigma in relevant studies. We conducted a mixed-method systematic review following the JBI and PRISMA guidelines. PubMed, CINHAL, PsychINFO, LIVIVO and the Cochrane Library were searched for peer-reviewed articles. Quantitative studies were summarised narratively. Qualitative studies were synthesised using the JBI meta-aggregative approach. We included 41 qualitative, nine quantitative and three mixed-methods studies. Most studies lacked a substantial theoretical conceptualisation of abortion stigma. Quantitative studies reported prevalence rates of perceived abortion stigma ranging from 37% to 60%, suggesting that stigma remains a common experience among abortion seekers. Findings also indicate associations between abortion stigma and various sociodemographic factors (e.g. religion, race and age), as well as adverse mental health outcomes. In the qualitative studies, people seeking abortion care reported experiencing and anticipating judgment from healthcare professionals, anti-abortion activists and their close social circle. Their experiences also centred on the internalisation of shame and guilt. Some studies highlighted the mitigating effect of social support. Longitudinal and mixed-methods approaches with consistent assessment would be useful to better understand the developmental pathways of abortion stigma. This understanding is necessary to provide individual and structural support for people seeking abortion care. <i>DOI: 10.1080/26410397.2026.2709964 Trial registration number</i>: https://doi.org/10.17605/OSF.IO/2XPJD.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2709964"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A global, descriptive analysis of the sources used to regulate abortion care.","authors":"Sanhita Ambast, Hazal Atay, Antonella Lavelanet","doi":"10.1080/26410397.2026.2710920","DOIUrl":"10.1080/26410397.2026.2710920","url":null,"abstract":"<p><p>An enabling environment is essential for delivering quality, comprehensive abortion care. According to the WHO, abortion should be treated like other healthcare services, regulated by healthcare law, and guided by evidence-based standards and guidelines. This paper examines abortion regulations across 183 countries, drawing on data from the Global Abortion Policies Database, up to May 2025. It divides sources relevant to the regulation of abortion care into seven categories: Criminal/Penal Code, Abortion-specific Law, Health Regulation/Clinical Guidelines, Constitution, Case Law, Essential Medicines List /Registered List, and other sources. The findings of this paper indicate that abortion is regulated through an often complex and fragmented framework, characterised by over-reliance on the general criminal law, the use of multiple and sometimes contradictory sources, and information gaps in certain key areas. 169 countries regulate abortion through their Criminal or Penal Code, with general criminal law the only source regulating abortion in 27 countries. Information about grounds and gestational limits for abortion can be found in the general criminal law in 123 countries. 46 countries have abortion-specific laws; 16 countries include relevant provisions in their constitution; in 90 countries, abortion-related information is spread across five or more source documents; and the status of conscientious objection is not regulated by any document in 109 countries. This landscape risks exacerbating existing barriers to abortion care, including stigma and inadequate access to information, and reinforces abortion exceptionalism. These findings raise questions about how reforming the regulation of abortion, including the nature and number of source documents involved, can shape an enabling environment for abortion care. They also highlight the need to identify effective strategies for safeguarding the health and rights of people seeking abortions. DOI: 10.1080/26410397.2026.2710920.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2710920"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hegemonic medicine and self-managed abortion: reclaiming Latin American feminists' contributions to knowledge and practice development.","authors":"Sara Larrea, Suzanne Veldhuis","doi":"10.1080/26410397.2025.2576263","DOIUrl":"10.1080/26410397.2025.2576263","url":null,"abstract":"<p><p>In this commentary, we challenge the narrative that presents self-managed medication abortion (SMA) as a recent \"discovery\" of Western biomedicine. Drawing on our lived experience and a literature review, we compare how different key concepts - autonomy, empowerment, person-centred care, privacy, confidentiality, and demedicalisation - are understood by the feminist SMA movement in Latin America, versus hegemonic medicine. We argue that when the radical ideas of the feminist SMA movement are appropriated by mainstream health systems without proper recognition of their political foundations, they lose their original meaning and may fail to achieve the positive outcomes envisioned by activists. For instance, autonomy, privacy, and demedicalisation may result in individuals feeling unsupported, while person-centred care often means merely being treated without stigma or violence. Maintaining medical control over SMA restricts access, while neoliberal policies that promote \"self-care\" and the commodification of abortion pills enable states to evade responsibility with regard to abortion care. We advocate for integrating key concepts taken from SMA activism into formal health systems, while honouring their origins and political significance. This requires meaningful, horizontal collaborations between SMA activists and biomedical professionals, acknowledging that SMA activists are abortion experts and should be treated as such.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2576263"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers of maternal and infant healthcare access for undocumented migrants in the first 1000 days of life: a systematic review of the literature.","authors":"Caterina Montagnoli, Nathalie Bettina Neeser, Bernice Simone Elger, Tenzin Wangmo","doi":"10.1080/26410397.2025.2560189","DOIUrl":"10.1080/26410397.2025.2560189","url":null,"abstract":"<p><p>Adequate access to maternal and infant healthcare in the first 1000 days of life is concurrent with lifelong well-being and should be guaranteed regardless of nationality, legal status, and social conditions. By exploring how migration status affects the social determinants of health, this review provides a nuanced understanding of the barriers and facilitators encountered accessing healthcare by undocumented women and their infants in the first 1000 days of life. Following the PRISMA guidelines and the registered protocol (CRD42022328220), a literature search was conducted in PubMed, Embase, CINAHL, PsycInfo, and Scopus. The search focused on manuscripts including undocumented migrants as study participants and reported direct or indirect data on the utilisation or outcomes of maternal and infant healthcare within the defined first 1000 days of life. Fifty-two studies met the inclusion criteria. A narrative synthesis was performed to summarise the information obtained from the data extraction process. Identified barriers include legal barriers (e.g. criminalisation of migrants or complexity of administrative procedures) and socio-cultural barriers (e.g. inadequate health literacy and financial challenges). Facilitators encompassed legal facilitators, like dedicated healthcare clinics, and socio-cultural facilitators, such as language support and healthier lifestyle habits. Ethical issues in connection to healthcare access of undocumented migrants in the first 1000 days were also mapped from the included papers. Considering the health consequences on future generations, the economic implications, and the vulnerability of migrant women, the findings offer positive examples that could be put into place to move towards universal health coverage through a holistic approach that shifts from exclusion and criminalisation to support and compassion. <i>DOI: 10.1080/26410397.2025.2560189</i>.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2560189"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between contraception and hormones: a qualitative analysis of the lived experiences of former contraceptive pill users.","authors":"Jana Niemann, Lisa Glaum, Lea Hofmann, Nadja Freymüller, Liane Schenk","doi":"10.1080/26410397.2025.2563393","DOIUrl":"10.1080/26410397.2025.2563393","url":null,"abstract":"<p><p>Contraceptive decision-making is an ongoing process that affects reproductive life and involves method uptake, use, and discontinuation. Contraceptive pills have been widely studied for their side effects, lived experiences, and links to biomedicalisation. However, there is a lack of research that integrates the entire subjective contraceptive pill experience from implementation to the period after discontinuation. This study explores the lived experience of pill use in Germany through 19 oral contraceptive pill biographies using thematic analysis, a deductive-inductive, iterative coding approach, and team-based discussions. This work is grounded in the theoretical framework of the contraceptive journey and feminist inquiry. Our analysis illustrated the complexity of pill use, with frequent switching, stopping, and restarting influenced by biopsychological issues, normalisation of use, and adverse effects. Attitudes towards hormones and pregnancy risk evolve over time and age. Former users consider their contraceptive journey to be successful in preventing pregnancy, but desire more male contraceptive options and improved information and counselling services. These findings emphasise the importance of prioritising former users' informal knowledge and lived experiences in future research, policy, and practice. This approach can support healthcare providers in incorporating individual and diverse health needs, aligning with the principles of reproductive justice.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2563393"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12548073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating structural and personal dilemmas: a phenomenological study of midwives providing legal abortion care in Nampula, Mozambique.","authors":"Gilda Gondola Sitefane, Khátia Munguambe, Pia Axemo, Johanna Belachew, Birgitta Essén, Esmeralda Mariano","doi":"10.1080/26410397.2026.2637328","DOIUrl":"10.1080/26410397.2026.2637328","url":null,"abstract":"<p><p>Legal reform allowing abortion is often considered a proxy for the provision of services. While the law establishes a legal framework, the provision of services is closely tied to the engagement of midwives in service delivery. In 2014, Mozambique decriminalised abortion under specific conditions. Studies of this legal reform focus on the experience of pregnant women, leaving the experience of midwives largely unexplored. This study focuses on midwives providing abortion services to young women (ages 15-24). A qualitative phenomenological study was conducted in Nampula province, northern Mozambique. In-depth interviews were conducted with 10 purposively selected midwives across six primary healthcare facilities in three districts. Inductive thematic analysis was employed, and an intersectionality lens guided the discussion. We employed continuous reflection and adhered to COREQ guidelines for the conduct, analysis and reporting of this study. Despite general support among midwives for abortion service availability and provision, some expressed distress and objections to providing the service themselves. A complex interplay between structural and personal factors was significant in shaping their experiences. Traumatic encounters with abortion-related complications emerged as the central factor behind their distress and objections. The intersections of personal factors with structural dilemmas, including a few health facilities authorised to provide services, a lack of abortion medicines, and legal restrictions for adolescents under age 16, shaped their professional experience, often leading to work-related distress, and challenged their willingness to provide services. Policy efforts should address these barriers, prioritising expansion of service provision, alignment with human rights standards, and midwife training and support.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2637328"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13072679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The right to science in sexual and reproductive health and the legal status of the human embryo.","authors":"Silke Dyer, Alison B Edelman, Asha S George, Tari Turner, Joanna N Erdman","doi":"10.1080/26410397.2025.2524970","DOIUrl":"10.1080/26410397.2025.2524970","url":null,"abstract":"<p><p>Through the examination of scientific evidence related to human embryo development, the aim of this commentary is to support the right to science in sexual and reproductive health, to outline why science supports a legal approach to embryos as the biological material of human life but not as human persons, and to recognise that international human rights law adopts this approach in the protection of sexual and reproductive health and rights.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2524970"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}