Paula M Kett, Marieke S van Eijk, Grace A Guenther, Susan M Skillman
{"title":"\"This work that we're doing is bigger than ourselves\": A qualitative study with community-based birth doulas in the United States.","authors":"Paula M Kett, Marieke S van Eijk, Grace A Guenther, Susan M Skillman","doi":"10.1363/psrh.12203","DOIUrl":"https://doi.org/10.1363/psrh.12203","url":null,"abstract":"<p><strong>Context: </strong>Community-based birth doulas support pregnant women, transgender men, and gender non-binary individuals during the perinatal period and provide essential services and expertise that address health inequities, often taking on additional roles to fill systemic gaps in perinatal care in the United States (US). Despite the benefits that community-based birth doulas provide, there is little research exploring the work-related conditions and stressors community-based doulas experience. To address this gap, we examined the work experiences, related stressors, and stress management strategies of individual community-based birth doulas.</p><p><strong>Methods: </strong>In this qualitative, descriptive study we conducted 18 interviews in March through June 2021 with individuals who self-identified as community-based doulas working in underserved communities in the US. We analyzed the interviews for themes, which we defined and finalized through team consensus.</p><p><strong>Results: </strong>The doulas reported engaging in specific strategies in their work to address perinatal inequities. They also described facing several work-related stressors, including witnessing discrimination against clients, experiencing discrimination in medical environments, and struggling with financial instability. To mitigate these stressors and job-related challenges, interviewees reported they relied on doula peer support and reconnected with their motivations for the work.</p><p><strong>Conclusions: </strong>Community-based doulas provide essential services and expertise which address inequities and systemic gaps in perinatal care. However, as they work to improve perinatal health, doulas themselves are providing equity work amidst an inequitable system and with insufficient political or financial support. Increased compensation and systemic support which acknowledges the breadth of services provided is needed to strengthen and sustain this critical part of the perinatal workforce.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477674","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}
Lara Elizabeth Stein, Kara N Goldman, Sarah Takimoto, Barbara Neshek, Maryam Guiahi
{"title":"Provision of fertility services to women in same-sex relationships at Catholic and non-Catholic clinics in the United States.","authors":"Lara Elizabeth Stein, Kara N Goldman, Sarah Takimoto, Barbara Neshek, Maryam Guiahi","doi":"10.1363/psrh.12206","DOIUrl":"https://doi.org/10.1363/psrh.12206","url":null,"abstract":"<p><strong>Introduction: </strong>This study addressed deficient information on the provision of infertility care in obstetrics and gynecology clinics. We additionally evaluated the availability of these services based on clinic affiliations or stated sexual orientation.</p><p><strong>Methodology: </strong>We performed a national cross-sectional \"mystery caller\" survey of 293 general obstetrics and gynecology clinics in 2017-2018. We matched clinics identified by web-based search engine in a 1:1 ratio by Catholic hospital affiliation, after determining number of clinics based on state-population densities. A standard call script included questions regarding provision of infertility services, ovulation induction methods, and information about the caller's sexual orientation. We performed descriptive frequencies and compared responses based on hospital affiliations.</p><p><strong>Results: </strong>Of the 293 clinics included, 49% were affiliated with Catholic and 17% with academic hospitals. The majority offered infertility care (85%, 248/293), and of these 97% (240/248) offered ovulation induction. Only 3% (6/240) reported they would not provide to women in same-sex relationships. Most clinics not offering infertility evaluations (43/45, 96%) cited it was outside of their scope of care and of these 33% (15/45) did not provide information for self-referral. Clinics affiliated with academic (aOR 0.23) or Catholic (aOR 0.34) hospitals were less likely to provide evaluations. Those with academic affiliation were more likely to provide information for self-referral (aOR 19.2).</p><p><strong>Discussion: </strong>Most general obstetrics and gynecology practices offered appointments for infertility evaluation and ovulation induction. Clinics rarely denied services to women reporting a same-sex partnership, regardless of hospital affiliation. These findings provide reassurance to same-sex couples seeking fertility care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447427","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}
Jessica L Dozier, Carolyn Sufrin, Blair O Berger, Anne E Burke, Suzanne O Bell
{"title":"COVID-19 impacts on abortion care-seeking experiences in the Washington, DC, Maryland, and Virginia regions of the United States.","authors":"Jessica L Dozier, Carolyn Sufrin, Blair O Berger, Anne E Burke, Suzanne O Bell","doi":"10.1363/psrh.12202","DOIUrl":"https://doi.org/10.1363/psrh.12202","url":null,"abstract":"<p><strong>Context: </strong>Many people wanted to avoid or delay childbearing during the COVID-19 pandemic. This study sought to examine the extent COVID-19 influenced abortion care-seeking in a region that did not enact policy restricting abortion due to the pandemic, has high service availability, and few abortion-restrictive policies.</p><p><strong>Methodology: </strong>We conducted telephone surveys with adults (n=72) requesting abortion appointments between September 2020 and March 2021 at five clinics in Washington, DC, Maryland, and Virginia. We used χ<sup>2</sup> tests to compare sociodemographic, reproductive history, service delivery characteristics, and pandemic-related life changes by whether COVID-19 influenced abortion care-seeking.</p><p><strong>Results: </strong>Most respondents (93%) had an abortion at the time of the survey, 4% were awaiting their scheduled appointment, and 3% did not have an appointment scheduled. Nearly 40% of people reported COVID-19 influenced their decision to have an abortion. These individuals were significantly more likely to report \"not financially prepared\" (44% vs. 16%) as a reason for termination compared to people reporting no influence of COVID-19. They were also more likely to have lost or changed their health insurance due to pandemic-related employment changes (15% vs. 2%), report substantial money difficulties due to COVID-19 (59% vs. 33%), and report that paying for their abortion was \"very difficult\" (25% vs. 2%).</p><p><strong>Conclusion: </strong>COVID-19 influenced many people to have an abortion, particularly those financially disadvantaged by the pandemic. Expansion of Medicaid abortion coverage in Washington, DC and Virginia could reduce financial barriers to care and help people to better meet their reproductive needs amid future crises.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349554/pdf/PSRH-9999-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40573205","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}
Payal Chakraborty, Stef Murawsky, Mikaela H Smith, Michelle L McGowan, Alison H Norris, Danielle Bessett
{"title":"How Ohio's proposed abortion bans would impact travel distance to access abortion care.","authors":"Payal Chakraborty, Stef Murawsky, Mikaela H Smith, Michelle L McGowan, Alison H Norris, Danielle Bessett","doi":"10.1363/psrh.12191","DOIUrl":"10.1363/psrh.12191","url":null,"abstract":"<p><strong>Context: </strong>Since March 2021, the Ohio legislature has been actively considering laws that would ban abortion if the United States Supreme Court overturns the Roe v. Wade decision that legalized abortion nationally in 1973.</p><p><strong>Methods: </strong>We used a national database of publicly advertised abortion facilities to calculate driving distances for Ohioans before and after the activation of proposed abortion bans. Using a legal analysis of abortion laws following the overturn of Roe, we determined which states surrounding Ohio would continue providing abortion care. We calculated distances from each Ohio county centroid to the nearest open abortion facility in three scenarios: (1) as of February 2022, (2) the best-case post-Roe scenario (two of the five surrounding states continue to offer abortion care), and (3) worst-case post-Roe scenario (no surrounding states continue to offer abortion care). We calculated population-weighted distances using county-level data about women aged 15-44 years from the 2019 American Community Survey.</p><p><strong>Results: </strong>In February 2022, all Ohio county centroids were at most 99 miles from an abortion facility (median = 50 miles). The best-case post-Roe scenario shows 62 of Ohio's 88 counties to be 115-279 miles away from the nearest facility (median = 146). The worst-case shows 85 counties to be 191-339 miles away from the nearest facility (median = 264). The current average population-weighted driving distance from county centroid to the nearest facility is 26 miles; the post-Roe scenarios would increase this to 157 miles (best-case) or 269 miles (worst-case).</p><p><strong>Conclusions: </strong>Ohio's proposed abortion bans would substantially increase travel distances to abortion care, impacting over 2.2 million reproductive-aged Ohioans.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47032632","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 frequency of pregnancy recognition across the gestational spectrum and its consequences in the United States","authors":"Katie Watson, C. Angelotta","doi":"10.1363/psrh.12192","DOIUrl":"https://doi.org/10.1363/psrh.12192","url":null,"abstract":"People recognize they are pregnant at gestational ages ranging from implantation to delivery, yet there is no comprehensive study that identifies the prevalence of pregnancy recognition at different points across this spectrum in the United States. To help clinicians, policymakers, researchers, educators, and public health advocates understand what is known about the spectrum of pregnancy recognition, this commentary integrates key research in three types of literature that have not been brought together before—retrospective studies of people who carried a pregnancy to term, studies of pregnant people presenting for abortion care, and postpartum studies of people who did not recognize their pregnancy until between 20 weeks and delivery. Our commentary also offers a corrective to the psychiatric literature’s inaccurate description of later pregnancy recognition as “pregnancy denial,” which forecloses consideration of the physiological and sociological reasons a pregnancy might be undetected until after 20 weeks. The term “pregnancy recognition” does not have a standard definition, so in this commentary we repeat the meaning used by each article we discuss. For example, in some research “pregnancy recognition” refers to the gestational age at which a person self-reports that they knew they were pregnant, but that research does not specify whether the subject is referring to a personal conclusion based on the first missed period or other pregnancy symptoms, a positive result from a home pregnancy test, or receiving the news (or confirmation of a home test) via urine test or ultrasound from a physician. In addition, some of these studies do not ask respondents whether they are counting weeks from when they believe fertilization occurred, from the first day of their last menstrual period (LMP), or somewhere in between. There is also no standard definition of “late pregnancy recognition,” so we state the meaning each article discussed ascribes to this term as well. Research on “pregnancy recognition” typically treats this phenomenon as an instantaneous, binary process—an informational switch is flipped and an unrecognized pregnancy becomes a recognized pregnancy. However, Peacock and colleagues argue that pregnancy discovery should be understood as a complex process which includes the phases of assessing pregnancy risk, perceiving and correctly interpreting signs and symptoms, and seeking confirmation, and that pregnancy should be acknowledged as a socially constructed phenomenon as well as a biological reality. Similarly, Bell and Fissell suggest that the binary model of pregnant versus not pregnant does not capture many women’s* experiences and propose an alternate model that emphasizes ambiguities in determining or confirming a pregnancy. A liminal state is the period or process when one is betwixt and between different social states. The time between conception and delivery has been analyzed as a transformative liminal experience between being a no","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43514409","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":"Who are the women who relinquish infants for adoption? Domestic adoption and contemporary birth motherhood in the United States.","authors":"G. Sisson","doi":"10.1363/psrh.12193","DOIUrl":"https://doi.org/10.1363/psrh.12193","url":null,"abstract":"INTRODUCTION\u0000The social context of pregnancy decision-making has changed in recent decades in the United States (US), but little research has examined how these changes manifest in the context of infant adoption.\u0000\u0000\u0000METHODS\u0000To create an updated profile of US birth mothers, this analysis uses demographic data collected and aggregated from six adoption agencies, with information on 8658 private adoptions that occurred between 2011 and 2020.\u0000\u0000\u0000RESULTS\u0000Based on this sample, birth mothers today are older and more racially and ethnically diverse than counterparts in previous generations; a majority have other had children and a substantial proportion were parenting other children at the time of relinquishment. They report living on low incomes and, when considered with other measures (e.g., employment, health insurance, homelessness), seem to lack the economic resources that would give them meaningful power over the options available to themselves and their children. Most birth mothers contact agencies late in their pregnancies or after delivery, at a point when abortion care is likely inaccessible or unavailable. An important minority of birth mothers will relinquish more than one infant for adoption over the course of their reproductive lives.\u0000\u0000\u0000CONCLUSION\u0000Given the underlying shift in the demographic profile of women who relinquish infants, it is likely that the underlying circumstances that lead to adoption have also diverged. More research is needed into how women make decisions about adoption; such research carries implications for how best to support women's decision-making and ensure access to needed services throughout pregnancy and beyond.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44294742","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":"Is third‐trimester abortion exceptional? Two pathways to abortion after 24 weeks of pregnancy in the United States","authors":"K. Kimport","doi":"10.1363/psrh.12190","DOIUrl":"https://doi.org/10.1363/psrh.12190","url":null,"abstract":"Abstract Context In the United States, third‐trimester abortions are substantially more expensive, difficult to obtain, and stigmatized than first‐trimester abortions. However, the circumstances that lead to someone needing a third‐trimester abortion may have overlaps with the pathways to abortion at other gestations. Methods I interviewed 28 cisgender women who obtained an abortion after the 24th week of pregnancy using a modified timeline interview method. I coded the interviews thematically, focusing on characterizing the experience of deciding to obtain a third‐trimester abortion. Results I find two pathways to needing a third‐trimester abortion: new information, wherein the respondent learned new information about the pregnancy—such as of an observed serious fetal health issue or that she was pregnant—that made the pregnancy not (or no longer) one she wanted to continue; and barriers to abortion, wherein the respondent was in the third trimester by the time she was able to surmount the obstacles to abortion she faced, including cost, finding a provider, and stigmatization. These two pathways were not wholly distinct and sometimes overlapped. Conclusions The inherent limits of medical knowledge and the infeasibility of ensuring early pregnancy recognition in all cases illustrate the impossibility of eliminating the need for third‐trimester abortion. The similarities between respondents' experiences and that of people seeking abortion at other gestations, particularly regarding the impact of barriers to abortion, point to the value of a social conceptualization of need for abortion that eschews a trimester or gestation‐based framework and instead conceptualizes abortion as an option throughout pregnancy.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45865828","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}
Jenny A Higgins, Renee Kramer, Leigh Senderowicz, Bethany Everett, David K Turok, Jessica N Sanders
{"title":"Sex, poverty, and public health: Connections between sexual wellbeing and economic resources among US reproductive health clients.","authors":"Jenny A Higgins, Renee Kramer, Leigh Senderowicz, Bethany Everett, David K Turok, Jessica N Sanders","doi":"10.1363/psrh.12189","DOIUrl":"https://doi.org/10.1363/psrh.12189","url":null,"abstract":"<p><strong>Objective: </strong>To document associations between socioeconomics and indicators of sexual wellbeing.</p><p><strong>Methods: </strong>We obtained our data from the HER Salt Lake Initiative, a large, longitudinal cohort study of family planning clients in the United States who accessed free contraceptive services between March 2016 and March 2017. Baseline socioeconomic measures included Federal Poverty Level, receipt of public assistance, and difficulty paying for housing, food, and other necessities. Sexual wellbeing measures assessed sexual functioning and satisfaction, frequency of orgasm, and current sex-life rating. Among participants who had been sexually active in the last month (N = 2581), we used chi-square tests to examine bivariate associations between sexual and socioeconomic measures.</p><p><strong>Results: </strong>We found strong and consistent relationships between sexual wellbeing and economic resources: those reporting more socioeconomic constraints also reported fewer signs of sexual flourishing.</p><p><strong>Conclusions: </strong>Financial scarcity appears to constrain sexual wellbeing. To support positive sexual health, the public health field must continue to focus on economic reform, poverty reduction, and dismantling of structural classism as critical aspects of helping people achieve their full health and wellbeing potential. ClinialTrials.gov Identifier: NCT02734199.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/75/PSRH-54-25.PMC9035091.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037281","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}
Jennet Arcara, Lauren Caton, Anu Manchikanti Gómez
{"title":"Desire, acceptability, and expected resolution: A latent class analysis of current pregnancy orientation in the United States.","authors":"Jennet Arcara, Lauren Caton, Anu Manchikanti Gómez","doi":"10.1363/psrh.12187","DOIUrl":"https://doi.org/10.1363/psrh.12187","url":null,"abstract":"<p><strong>Background: </strong>Scant research has examined latent and contextual dimensions of pregnancy intentions, conventionally classifying unintended pregnancies as mistimed (wanted later) or unwanted (not wanted at all). Being at risk of mistimed pregnancy likely encompasses a broad spectrum of emotions and expectations regarding pregnancy and merits further exploration.</p><p><strong>Method: </strong>Using a national sample from GfK's online KnowledgePanel of women aged 15-39 considered at risk of mistimed pregnancy in 2017 (n = 1278), we conducted a latent class analysis to assess underlying patterns of current pregnancy orientation using three items: pregnancy desire, pregnancy acceptability, and expected pregnancy resolution. As class structure varied by relationship status (serious or not), we stratified analyses by relationship status.</p><p><strong>Results: </strong>Among women in serious relationships, three classes emerged: \"No,\" \"Slightly okay,\" and \"Acceptable.\" For those not in serious relationships, there were two classes: \"Strong no\" and \"Ambiguous.\" Overall, the classes indicate varied patterns of wantedness, acceptability, and anticipated resolution to potential pregnancy.</p><p><strong>Conclusions: </strong>This analysis reinforces that the construct of mistimed pregnancy is too restrictive to reflect the inherent diversity of prospective pregnancy orientation. The combination of relationship type as a grouping variable for stratified analyses, financial hardships' impact, and the overall effect of increasing age on increasing interest in pregnancy suggest the importance of locating pregnancy intentions within the broader reproductive life course. Scholars, clinicians, and public health programs should allow for multidimensionality of pregnancy perspectives, locate them within the broader life course, and acknowledge the potential impacts of stratified relationship formation on eventual pregnancy intentions.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39916810","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}
Michelle C Menegay, Rebecca Andridge, Katherine Rivlin, Maria F Gallo
{"title":"Delivery at Catholic hospitals and postpartum contraception use, five US states, 2015-2018.","authors":"Michelle C Menegay, Rebecca Andridge, Katherine Rivlin, Maria F Gallo","doi":"10.1363/psrh.12186","DOIUrl":"https://doi.org/10.1363/psrh.12186","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether the prevalence of postpartum contraceptive use was lower among people who delivered at a Catholic hospital compared to a non-Catholic hospital.</p><p><strong>Methods: </strong>We linked 2015-2018 Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from five states to hospital information from the corresponding birth certificate file. People with a live birth self-reported their use of contraception methods on the PRAMS survey at 2-6 months postpartum, which we coded into two dichotomous (yes vs. no) outcomes for use of female sterilization and highly-effective contraception (female/male sterilization, intrauterine device, implant, injectable, oral contraception, patch, or ring). We conducted multilevel log-binomial regression to examine the relationship between birth hospital type and postpartum contraception use adjusting for confounders.</p><p><strong>Results: </strong>Prevalence of female sterilization for people who delivered at a Catholic hospital was 51% lower than that of their counterparts delivering at a non-Catholic hospital (adjusted prevalence ratio: 0.49; 95% confidence interval: 0.37-0.65).</p><p><strong>Conclusion: </strong>We found lower use of postpartum female sterilization, but no difference in highly effective contraception overall, for people who delivered at a Catholic hospital compared to a non-Catholic hospital.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/29/PSRH-54-5.PMC9305525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39915983","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}