Perspectives on Sexual and Reproductive Health最新文献

{"title":"A Qualitative Study of Physicians' Decision-Making in Four US States With Abortion Bans.","authors":"Lauren J Shiman, Catherine E W Freeland, Diana Romero, Wendy Chavkin","doi":"10.1111/psrh.70085","DOIUrl":"https://doi.org/10.1111/psrh.70085","url":null,"abstract":"<p><strong>Background: </strong>Physicians in various specialties practicing in states in the United States (US) with near-total abortion bans are constrained in providing appropriate care. There is a lack of understanding about how these constraints affect care quality, especially in care provided to pregnant people outside of obstetric care.</p><p><strong>Methods: </strong>The Medical Integrity Initiative study team conducted 32 in-depth interviews with physicians currently or recently practicing in four states with near-total abortion bans (Alabama, Idaho, Oklahoma, and Tennessee). Participants were practicing in emergency medicine, maternal-fetal medicine, obstetrics, oncology, or reproductive endocrinology. Between July and October 2024, we conducted interviews via Zoom and then transcribed them. The analytic team conducted thematic analyses informed by grounded theory methodology. Analysts coded data in Dedoose using open coding followed by axial coding, then iteratively analyzed them.</p><p><strong>Results: </strong>Participants shared experiences related to clinical decision-making which comprised three themes: (1) physicians have lost capacity and security in making independent treatment decisions; (2) physicians are forced to compromise care quality when all medical options aren't permitted; and (3) some participants engaged in acts of resistance to uphold their integrity as physicians.</p><p><strong>Conclusions: </strong>Physicians practicing in four states with near-total abortion bans face profound ethical, legal, and emotional challenges that alter their approach to the provision of evidence-based care. These findings contribute to understanding workforce attrition, physician burnout, and the status of care provision in states with restrictive abortion laws.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814200","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":"Understanding the Reproductive Life Planning Experiences of People With Disabilities in Ontario, Canada: A Qualitative Exploration.","authors":"Momina Khan, Hilary K Brown, Yona Lunsky, Lesley A Tarasoff","doi":"10.1111/psrh.70079","DOIUrl":"https://doi.org/10.1111/psrh.70079","url":null,"abstract":"<p><strong>Introduction: </strong>Reproductive life planning can be a valuable component of reproductive health promotion. However, little is known about attitudes, desires, and intentions regarding pregnancy among people with disabilities. This exploratory qualitative study aimed to understand the reproductive life planning experiences of women and gender-diverse people with physical, intellectual, and developmental disabilities.</p><p><strong>Methods: </strong>We used purposeful sampling to recruit 29 reproductive-aged individuals with physical, intellectual, and/or developmental disabilities living in Ontario, Canada. We conducted semi-structured interviews virtually in 2020-2021. We audio-recorded the interviews and used thematic analysis to synthesize the data.</p><p><strong>Results: </strong>Many societal, structural, interpersonal, and individual factors shaped participants' reproductive life planning experiences. External perceptions of disability and parenthood, silence and stigma about sexuality from parents, barriers to accessible reproductive healthcare, and socioeconomic challenges were important factors. Partner dynamics, including experiences of sexual violence, perceived vulnerability in reproductive life plans, management of co-occurring health conditions and safety, and apprehensions related to pregnancy and childbirth also influenced participants' experiences. Participants' reproductive aspirations were positively shaped by self-advocacy and their support networks, with resilience prominently shaping their reproductive life planning experiences.</p><p><strong>Discussion: </strong>The persistence of societal biases and structural barriers, including ableism and disability microaggressions, experienced by participants highlights a need for inclusive social and healthcare environments that support the reproductive rights of women and gender-diverse people with disabilities. Training for healthcare providers, tailored reproductive health resources for people with disabilities, and enhanced support networks are needed to foster positive reproductive life planning experiences for this population.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799438","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":"An Intersectional Exploration of Sexual Lifestyles and Health Across the Life Course in France.","authors":"Caroline Moreau, Aline Bohet, Laurent Rigal, Claire Sauvage, Florence Lot","doi":"10.1111/psrh.70075","DOIUrl":"https://doi.org/10.1111/psrh.70075","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between sexuality and health is complex, with both beneficial and detrimental aspects. We examined how these associations varied by age, gender, social condition, and disability among adults in France.</p><p><strong>Methods: </strong>This study draws on the CSF-2023 national survey on sexuality in France. Our analytic sample comprised 19,192 sexually active respondents aged 18-89 years. We used multivariable logistic regressions to examine associations between dimensions of sexuality (sexual activity in the past year, frequency of sex, penetrative sex, masturbation, lifetime sexual violence, sexual dysfunction, and sexual satisfaction) and three health outcomes (self-perceived health, depression, and anxiety). We tested for interactions by gender, sexual identity, partnership status, economic hardship, and disability/chronic illness.</p><p><strong>Results: </strong>Over a quarter of respondents reported poor/fair health and 18% experienced symptoms of depression or anxiety. Sexual dissatisfaction and past sexual violence increased the likelihood of poor/fair health, depression, and anxiety for both genders. Other associations varied by sexuality indicator, health condition, and age. Younger respondents experienced more negative health impacts from sexual violence, while sexual inactivity was more strongly linked to depression among men over 60 years and anxiety among women over 60 years. Additionally, masturbation was only associated with decreased odds of anxiety among women over 60 years.</p><p><strong>Conclusions: </strong>This study underscores the intricate relationship between sexuality and health, uncovering varying positive correlations across the life course. Considering the strong connections between health and sexual satisfaction, quality of sexual life should be part of clinical assessments as an integral component of health and well-being.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799447","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 Common Is Abortion Coercion? Evidence From a Large US Sample of People Assigned Male at Birth.","authors":"Karen Trister Grace, Elizabeth Miller, Elizabeth Tobin-Tyler","doi":"10.1111/psrh.70077","DOIUrl":"https://doi.org/10.1111/psrh.70077","url":null,"abstract":"<p><strong>Objective: </strong>Reproductive coercion encompasses a range of partner behaviors that violate reproductive autonomy, including contraceptive sabotage, coercion to become pregnant, and controlling pregnancy outcome (i.e., forced continuation or termination). Coerced abortion is often cited as a reason to restrict abortion access. We examined data on the prevalence of reproductive coercion behaviors including abortion coercion.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 3199 people living in the United States and assigned male at birth, administered by Prolific, which measured lifetime use of 13 reproductive coercion behaviors.</p><p><strong>Results: </strong>Participants most commonly removed condoms without consent (13.1%) and refused to use condoms (8.8%). 2.0% of participants reported attempts to force abortion and 4.3% reported blocking abortion access.</p><p><strong>Conclusion: </strong>Restricting abortion access was twice as common as forced abortion, undermining legislative rationales for abortion restrictions.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799475","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":"Conditions That Limit Outpatient Abortion Care at Clinics in the United States.","authors":"Katrina Kimport, Melissa J Chen, Mitchell D Creinin","doi":"10.1111/psrh.70072","DOIUrl":"https://doi.org/10.1111/psrh.70072","url":null,"abstract":"<p><strong>Objective: </strong>While most people in the United States obtain abortion care in outpatient settings, such facilities may limit care for some individuals because of a variety of conditions. The situations when abortion care cannot be obtained in the outpatient setting have not been evaluated, leaving a deficit in understanding the need for hospital-based abortion care.</p><p><strong>Methods: </strong>We obtained outpatient abortion facility care protocols from the Society of Family Planning #We Count project, which, in January 2024, invited participating organizations with outpatient physical facilities to share their protocols for determining when patients were unable to be cared for in their facility(ies). Using summative content analysis, we identified health conditions for which a patient could be deemed ineligible, organizing individual conditions thematically and, as appropriate, by organ system.</p><p><strong>Results: </strong>We analyzed 20 unique protocols. Protocols delineated ineligibility for temporary conditions (e.g., fever), conditions specific to current pregnancy (e.g., placenta previa), conditions related to the patient's reproductive history or conditions (e.g., history of uterine surgery), and chronic conditions (e.g., hypertension). Protocols varied in quantity of limiting conditions (range: two to 26 conditions) and most frequently included limits to outpatient care for heart disease (15 [75%]), bleeding conditions (15 [75%]), seizure disorders (15 [75%]), hypertension (13 [65%]), anemia (12 [60%]), and asthma (11 [55%]). The definitions for a given condition as a limit for care frequently varied between protocols.</p><p><strong>Conclusions: </strong>US outpatient abortion clinics commonly define limitations to outpatient care, but the specific limiting conditions and their criteria vary substantially across protocols.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Was Determined to Take Control of My Own Body\": Self-Managed Abortion in the US Appalachian Region.","authors":"Amy Alspaugh, Zak Amen, Denette Jackson, Beau Morgan, Gretchen E Ely","doi":"10.1111/psrh.70070","DOIUrl":"https://doi.org/10.1111/psrh.70070","url":null,"abstract":"<p><strong>Background: </strong>Many people living along the Appalachian mountain region, which spread down the eastern side of the United States, experience limited access to abortion care and report high levels of distrust in health care providers. Therefore, Appalachians are likely to have a unique lens through which to view the use of self-managed abortion. The purpose of this study is to better understand Appalachians' perceptions of self-managed abortions.</p><p><strong>Methods: </strong>Data was collected via an online survey. Participants were recruited by trusted community partners and boosted ads on social media. Inclusion criteria included pregnancy-capacity, 18+ years old, living in an Appalachian county, and having a history of either considering or attempting self-managed abortion. Open-ended responses were coded using deductive thematic analysis guided by our theoretical framework.</p><p><strong>Results: </strong>Participants [N = 159] representing every Appalachian state responded to the survey. Three themes were identified: (1) self-managed abortion is often a decision made in the absence of choice but can be empowering within these constraints, (2) anticipating failure: the expectation of failure and health complications for those using self-managed abortion, and (3) connection with others is critical to having a more positive self-managed abortion experience.</p><p><strong>Conclusions: </strong>These findings reveal that self-managed abortion is often pursued not out of preference but due to barriers such as cost, legal restrictions, stigma, or lack of access to clinical care. Improving access to accurate information, emotional support, and follow-up care could greatly enhance confidence in the safety of abortion and improve the well-being of those seeking abortion care in Appalachia.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702570","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":"Understanding Trust, Delays and Black Women's Experiences Obtaining Abortion Care in the US Midwest.","authors":"Tamika Odum, Jeremy Brenner-Levoy, Sarah Bostic, Abigail Norris Turner, Katherine Rivlin, Zoe Muzyczka, Alison H Norris, Danielle Bessett","doi":"10.1111/psrh.70069","DOIUrl":"https://doi.org/10.1111/psrh.70069","url":null,"abstract":"<p><strong>Introduction: </strong>Abortion scholars treat the timing of care as an important measure of access. Despite the legacy of medical mistreatment of Black people, few studies have explored the racialized relationship between medical trust and when abortion care is obtained. We examined how differences in healthcare provider trust impact the timing of receiving abortion care.</p><p><strong>Methods: </strong>In 2020-2021, we invited people seeking abortion care in West Virginia, Kentucky, and Ohio to complete an electronic survey. We assessed the prevalence of general healthcare provider trust and abortion provider trust and examined associations among race, trust, and timing of obtaining abortion care.</p><p><strong>Results: </strong>Respondents who reported that they did not trust the last healthcare provider they saw for an issue other than the abortion (8% of respondents) were more likely to have a second trimester abortion (odds ratio (OR): 1.74, 95% confidence interval (CI): 1.00-3.06). This association was stronger for Black respondents (OR: 2.63, 95% CI: 1.27-5.47). Not trusting the abortion provider was uncommon (1% of respondents) and was not significantly associated with the timing of obtaining abortion care (OR: 1.24, 95% CI: 0.28-5.42).</p><p><strong>Conclusions: </strong>Not trusting the last healthcare provider was associated with receiving abortion care later than those who did trust their last provider. More research is needed to fully understand the nuanced relationship between race, trust, and delays in abortion care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340001","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":"Trends in Non-Resident Abortion Rates in Illinois From 2001-2018.","authors":"Erica S Bishop, Elizabeth Gray, Leanne R McCloskey","doi":"10.1111/psrh.70068","DOIUrl":"https://doi.org/10.1111/psrh.70068","url":null,"abstract":"<p><strong>Objective: </strong>To describe trends in resident and non-resident abortion rates in Illinois between 2001 and 2018.</p><p><strong>Methods: </strong>Using Illinois Department of Public Health data, we calculated the resident abortion rate (abortions obtained by Illinois residents per 1000 reproductive age Illinois residents) and the non-resident abortion rate (abortions obtained in Illinois by non-residents per 1000 reproductive age residents of contiguous states). We modeled the relationship between abortion rate and time from 2001 to 2018 using binomial regression. We compared change in abortion rates and clinical and demographic characteristics using chi-squared tests.</p><p><strong>Results: </strong>The non-resident abortion rate increased from 0.61 in 2001 to 0.82 in 2018 (p = 0.04), versus no significant change in the resident abortion rate (p = 0.18). In the secondary analysis, the non-resident abortion rate decreased from 0.61 in 2001 to 0.46 in 2013 (p < 0.001), versus no significant change in the resident abortion rate (p = 0.07). The non-resident abortion rate increased from 0.43 in 2014 to 0.82 in 2018 (p < 0.001), versus no significant change in the resident abortion rate (p = 0.58). Non-residents were more likely to be 25 years or older (64.2% vs. 61.6%, p < 0.001), be 16 weeks gestational age or greater (7.6% vs. 5.2%, p < 0.001), and obtain a medication abortion (45.4% medication vs. 39.1% procedural, p < 0.001) than Illinois residents.</p><p><strong>Conclusion: </strong>Non-resident abortion rates in Illinois increased from 2001 to 2018, coinciding with passage of restrictive abortion legislation in neighboring states. Understanding past trends is critical, as supportive states plan for additional restrictions on abortion access.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212934","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":"\"You're Trying to Do What Now?\" A Mystery Shopper Study on Judicial Bypass in Alabama, Georgia, and Mississippi.","authors":"Erin Carroll, Sophie Hartwig, Melissa Kottke, Rachel Rebouché, Jaaie Varshney, Kelli Stidham Hall, Kari White","doi":"10.1111/psrh.70066","DOIUrl":"10.1111/psrh.70066","url":null,"abstract":"<p><strong>Introduction: </strong>Judicial bypass is a legal process that allows pregnant minors to obtain abortion without mandated parental involvement after obtaining approval from a judge. However, courthouse staff's familiarity with bypass and quality of information provided about the process may vary.</p><p><strong>Methods: </strong>Between July 2019 and February 2020, we conducted mystery shopper calls to county courthouses in three states mandating parental involvement: Alabama, Georgia, and Mississippi. Research assistants called courthouses and asked about the bypass process, using a semi-structured script. We calculated the percentage of counties where courthouse staff could not provide callers with sufficient information about the process and conducted a content analysis of the call transcripts.</p><p><strong>Results: </strong>Courthouse staff in 50% of the 214 contacted counties suggested bypass might be possible, but could not provide specific information and 28% communicated bypass would not be possible. Lacking familiarity with the process, staff often referred callers to places that did not handle judicial bypass (e.g., health departments) and sometimes conflated bypass with emancipation, or said abortion was not legal. In 21 counties, courthouse staff stepped outside their professional role and engaged with callers in a personal manner that was often unsupportive of a minor's abortion decision.</p><p><strong>Discussion: </strong>Minors attempting to access judicial bypass information directly from courthouse staff may not receive sufficient information or support despite state laws' requirements. Absent the repeal of parental involvement laws, courthouse staff need training on judicial bypass, and policymakers and advocates should enhance resources and pragmatic support for minors navigating the complex legal landscape.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"151-158"},"PeriodicalIF":3.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844361","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":"Innovations That Meet the Moment: Research Presented at the National Abortion Federation's 49th Annual Meeting (Spring 2026, Pennsylvania).","authors":"Alice Mark, Angel M Foster, Gabriela Aguilar, Tiffany Hailstorks, Rachel Jones, Melissa Madera, Sarah Prager","doi":"10.1111/psrh.70061","DOIUrl":"10.1111/psrh.70061","url":null,"abstract":"","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"205-239"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634738","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}