Womens Health Issues最新文献

{"title":"Nicotine Use and Postpartum Depression: Comparison of E-Cigarette, Cigarette, and Dual Usage in Pregnancy.","authors":"Eleanor B Steffens, Monica S Treviño, Emily D Gerstein","doi":"10.1016/j.whi.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.009","url":null,"abstract":"<p><strong>Objective: </strong>As e-cigarette use remains prevalent among women of reproductive age, understanding its implications for maternal mental health is increasingly important. Although research has found combustible cigarette use in pregnancy to be associated with a higher risk of maternal postpartum depressive symptoms, it is not clear whether risks are similar for those who use combustible and e-cigarettes simultaneously. This study examines the association between prenatal nicotine use (e-cigarette, combustible cigarette, and dual use) and postpartum depression symptoms. Additionally, we investigate maternal sociodemographic characteristics associated with use during pregnancy to inform public health interventions and policy.</p><p><strong>Methods: </strong>Utilizing Phase 8 of the PRAMS survey, a national, cross-sectional survey (N = 245,431), descriptive and χ² statistics examined associations among sociodemographic characteristics, maternal use practices, and birth complications. Multivariate logistic regressions examined associations between maternal use practices and postpartum depression symptoms.</p><p><strong>Results: </strong>E-cigarette and dual use in pregnancy was associated with greater odds of postpartum depression symptoms (odds ratio [OR] = 1.52 and 1.63, respectively) than combustible cigarettes alone (OR = 1.34). This relationship remained significant when accounting for relevant sociodemographic characteristics and prepartum depression (p< .001), which were also significant predictors in our model. Younger and less educated women were more likely to use e-cigarettes in pregnancy.</p><p><strong>Conclusions: </strong>Women who utilize e-cigarettes in pregnancy may be at greater risk for developing postpartum depression. Findings underscore the need for targeted screening, prevention, and policy efforts to reduce prenatal nicotine exposure and address maternal mental health, particularly among those with less education.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844585","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":"The VA Women's Health Research Network: Building a Foundation for Women's Health Research to Accelerate Impacts on Evidence-Based Practice and Policy.","authors":"Elizabeth M Yano, Susan M Frayne, Adriana Rodriguez, Diane Carney, Alison B Hamilton","doi":"10.1016/j.whi.2026.03.008","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.008","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822304","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 Is Still Paying Out-of-Pocket for Their IUDs Despite the ACA Contraceptive Coverage Requirement? Analysis of a Large National Cohort Using Claims Data.","authors":"Hallie N Nelson, Guodong Liu, Sarah Horvath, Carol S Weisman, Douglas L Leslie, Jessica Atrio, Cynthia H Chuang","doi":"10.1016/j.whi.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.003","url":null,"abstract":"<p><strong>Objectives: </strong>After the Affordable Care Act's (ACA's) contraceptive coverage requirement went into effect, out-of-pocket costs fell for all forms of Food and Drug Administration-approved prescription contraception. This analysis examines which subgroups of privately insured women are continuing to pay more than $0 for their intrauterine device (IUD) insertions.</p><p><strong>Study design: </strong>Using 2017-2021 Merative MarketScan Commercial Claims Database, we examined trends in out-of-pocket costs among 727,482 privately insured women. Multivariable analyses modeled the likelihood of paying $0 out-of-pocket (vs. >$0) for the IUD insertion, adjusting for year, age group, IUD type, U.S. census region, and place of service.</p><p><strong>Results: </strong>Most women (71.5%) paid $0 for their IUD insertion regardless of type. Compared with the 52-mg levonorgestrel (Mirena) IUD users, all others were less likely to pay $0, specifically those with newer to market IUDs (13.5-mg levonorgestrel IUD [Skyla] adjusted odds ratio [aOR] .854 [.832, .876] and 19.5-mg levonorgestrel IUD [Kyleena] aOR .839 [.824, .855]). Independent of IUD type, younger women (<26 years old) were less likely to pay $0 (13- to 17-year-olds aOR .872 [.844, .900]; 18- to 25-year-olds aOR .887 [.876, .899]).</p><p><strong>Conclusion: </strong>Privately insured women are more likely to pay out-of-pocket if younger or if using a newer to market IUD, specifically the 13.5-mg levonorgestrel IUD (Skyla). Out-of-pocket cost may be a barrier to access for these individuals. Future monitoring is needed to understand the continuing impact of the ACA contraceptive coverage requirement on IUD costs.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822251","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":"\"Every Person Is Going to Have Different Needs and Different Expectations\": Reproductive Health Care Experiences of LGBTQ+ Veterans Assigned Female at Birth Within the Veterans Health Administration.","authors":"Samantha K Benson, Ashley C Mog, Aarthi Yogendran, A M Racila, Siobhan S Mahorter, Lisa S Callegari","doi":"10.1016/j.whi.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.007","url":null,"abstract":"<p><strong>Background: </strong>Research outside of the Veterans Health Administration (VHA) suggests that sexual and gender minority (LGBTQ+) people assigned female at birth face barriers to accessing needed reproductive health care and receive poorer-quality care in reproductive health settings such as OB/GYN offices and fertility clinics. Little is known about the experiences of LGBTQ+ veterans receiving reproductive health care within the VHA.</p><p><strong>Objective: </strong>We aimed to understand LGBTQ+ VHA users' reproductive health care experiences and preferences using in-depth semistructured qualitative interviews.</p><p><strong>Methods: </strong>We purposively sampled cisgender women, transgender men, and nonbinary veterans to explore variation in experiences by self-reported gender identity. Participants were 18-50 years old, assigned female sex at birth, and identified as LGBTQ+. Interviews were conducted via telephone using a structured interview guide and analyzed in team meetings using deductive and inductive content analysis concurrently with interviews.</p><p><strong>Results: </strong>We conducted interviews with 20 veterans. Participants emphasized the importance of providers demonstrating respect for their identities and avoiding assumptions about their health needs based on their appearance. Many participants highlighted pelvic exams as a barrier to reproductive health care due to past sexual trauma, concerns about pain management in gynecologic procedures, and/or gender dysphoria. Reproductive health care delivery within designated \"Women's Clinics\" in VHA felt exclusionary to transgender participants. According to participants, restrictions on VHA coverage for in vitro fertilization and gender-affirming surgeries signaled devaluation of LGBTQ+ people. Finally, participants offered recommendations for improving reproductive health care delivery for LGBTQ+ veterans.</p><p><strong>Conclusions: </strong>LGBTQ+ veterans reported positive and negative experiences receiving reproductive health care within the VHA and identified provider behaviors and VHA policies as targets for future quality improvement efforts.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785839","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":"Perceptions of Pregnancy Risk and Self-Protective Health Decision Making Among Black Women: \"We Can Protect Ourselves From the System, Right?\"","authors":"Tiwaladeoluwa B Adekunle, Toluwani E Adekunle, Khaila Prather, Alyssa Arreola, Sathveka Sembian, Ayooluwatomiwa Adekunle","doi":"10.1016/j.whi.2026.01.005","DOIUrl":"https://doi.org/10.1016/j.whi.2026.01.005","url":null,"abstract":"<p><strong>Background: </strong>Racism across the life course has led to disproportionately high rates of maternal morbidity and mortality among Black women in the United States. Yet, few studies examine Black women's subjective interpretations of pregnancy-related risk, particularly within the context of their health care experiences. This qualitative study, informed by Social Amplification of Risk Framework and Black Feminist Theory, explores how Black women perceive pregnancy-related risk, how these perceptions influence health behaviors, and how gendered racism within health care settings constrains their agency.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with 28 self-identified Black women who were currently pregnant, recently pregnant, or planning to become pregnant. Transcripts were analyzed using reflexive thematic analysis to examine healthcare interactions and experiences within health care systems and their impacts on risk perceptions and decision making.</p><p><strong>Results: </strong>Participants expressed concerns related to the impact of pregnancy on the health and well-being of self and fetus and a perception of health care as generally safe yet potentially harmful. Participants enacted agency to mitigate these risks by maintaining a healthy lifestyle, seeking information, engaging in self-advocacy, and making intentional decisions about their care provider and birth plan. However, participants reported that health care providers constrained enactment of their agency through disempowering responses to Black women's participation in their health care.</p><p><strong>Conclusions: </strong>Findings underscore the need to rebuild the trustworthiness of health care systems and highlight the ways in which clinicians may foster Black women's agency to facilitate shared decision making and improve quality of care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785809","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":"Exercise-Induced Improvements in Renal and Inflammatory Markers in Postmenopausal Women With Obesity: A Randomized Study.","authors":"Wissal Abassi, Nejmeddine Ouerghi, Antonella Muscella, Santo Marsigliante, Anissa Bouassida, Moncef Feki, Katja Weiss, Beat Knechtle","doi":"10.1016/j.whi.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.006","url":null,"abstract":"<p><strong>Background: </strong>The convergence of obesity and postmenopausal status is likely associated with renal function decline. Because exercise improves kidney function, this study assessed kidney markers and different types of white blood cells (WBCs) that indicate kidney function, in postmenopausal women with obesity after a 10-week moderate-intensity interval walking training (MIIWT).</p><p><strong>Methods: </strong>The MIIWT consisted of five repetitions of walking for 6 minutes at 60-80% of the participant's own 6-minute walk (6MWT) test pace with 6-minutes active recovery between repetitions. Thirty-six postmenopausal women with obesity were randomized to the MIIWT group (n = 18) or control group (n = 18). Body composition, kidney function markers (serum creatinine [sCr], blood urea nitrogen [BUN], serum uric acid, and glomerular filtration rate), and WBC subpopulations (neutrophils, lymphocytes, monocytes, eosinophils, and basophils) were assessed before and after intervention.</p><p><strong>Results: </strong>Significant group × time interactions were observed for body mass (BM), body mass index (BMI), body fat percentage (%BF), waist circumference, hip circumference, waist-to-hip ratio (WHR), 6MWT distance, sCr, BUN, WBCs, neutrophils, lymphocytes, and monocytes (all p ≤ .05). Post hoc analyses indicated that MIIWT induced modest reductions in BM (p < .001, d = .20), BMI (p < .001, d = .17), %BF (p = .001, d = .23), and WHR (p = .021, d = .47), with more pronounced decreases in waist (p < .001, d = .68) and hip circumference (p = .005, d = .32). MIIWT also significantly reduced sCr (p = .013), BUN (p = .005), WBCs (p < .001), neutrophils (p = .016), lymphocytes (p = .014), and monocytes (p = .037).</p><p><strong>Conclusions: </strong>MIIWT produced modest improvements in overall body composition and significant reductions in central adiposity, along with favorable changes in kidney function and systemic inflammation markers in postmenopausal women with obesity. These findings support the feasibility of MIIWT and provide preliminary evidence to inform larger, longer-term trials aimed at preventing kidney function decline in this high-risk population.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov identifier: </strong>NCT06905236.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785791","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":"Associations Between Posttraumatic Stress Disorder and Depression and Cardiovascular Risk Health Behaviors Among Women Veterans: A Scoping Review.","authors":"Caroline Dancu, Linda G Park, Karen M Goldstein, Cherry Leung, Oi Saeng Hong","doi":"10.1016/j.whi.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>Women veterans experience high rates of posttraumatic stress disorder (PTSD) and depression, both of which are linked to adverse cardiovascular outcomes. Understanding the relationship between these mental health conditions and cardiovascular risk health behaviors is crucial for targeted interventions.</p><p><strong>Objective: </strong>We examined existing literature for associations among PTSD, depression, and cardiovascular risk health behaviors-specifically alcohol use, cigarette smoking, diet, and physical activity-among women veterans.</p><p><strong>Methods: </strong>A systematic search was conducted across EMBASE, CINAHL, and PubMed for studies published from 2016 to October 2024 examining PTSD and/or depression and cardiovascular risk health behaviors (alcohol use, cigarette smoking, diet, and physical activity). Studies were included if they assessed the prevalence or severity of PTSD and/or depression and associations with one of the defined cardiovascular risk health behaviors.</p><p><strong>Results: </strong>A total of 11 studies met the inclusion criteria and were analyzed (four articles related to alcohol use, four articles related to diet, two related to cigarette smoking, and one related to physical activity). Most studies examined the Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veteran population (75%), five studies used national Department of Veterans Affairs cohort studies (50%), and only three studies sampled from women-only veterans (25%). Among the 11 included articles, there is some evidence linking PTSD and depression to risky cardiovascular risk health behaviors in women veterans, although variability in study designs and outcome measures limits direct comparisons.</p><p><strong>Conclusion: </strong>The existing literature demonstrates associations between PTSD and depression and adverse cardiovascular risk health behaviors among women veterans, necessitating further research to standardize methodologies and develop targeted interventions that mitigate cardiovascular risk in this population.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785804","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":"Individual and Geographical Factors Associated With Follow-Up Care After an Abnormal Cervical Cancer Screening Result.","authors":"Katherine C Hall, Mary W Stewart, Carolann Risley, Sydney Reaves, Nicholas Wentzensen, Christina D Ferrell, Jimmie Wells, Rhonda Rives, Jung Hye Sung, Swatantra R Kethireddy, Jon Daniels, Katherine Farrington, Megan A Clarke","doi":"10.1016/j.whi.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.002","url":null,"abstract":"<p><strong>Introduction: </strong>Guideline-concordant screening and timely follow-up of abnormal results aid in the prevention and early diagnosis of cervical cancer. From a cohort of Mississippi patients screened for cervical cancer in 2018-2021, we identified those with abnormal screening results and examined variables associated with follow-up care.</p><p><strong>Methods: </strong>We performed a retrospective analysis of electronic health record data to identify individuals with an abnormal screening result in the STRIDES (STudying Risk to Improve DisparitiES) cohort between February 2018 and August 2021 to identify documented follow-up with clinically indicated colposcopy. We evaluated associations of individual-level (i.e., age, race, cytology, residential region, driving distance) and neighborhood-level socioeconomic factors (i.e., residential rurality, social vulnerability) with documentation of follow-up colposcopy using multilevel logistic regression models.</p><p><strong>Results: </strong>The strongest predictors of lacking documented follow-up included age <30 (adjusted odds ratio [aOR] = 1.86; 95% confidence interval [CI]: 1.41-2.43), residence in the Northern (aOR = 2.26, 95% CI [1.59, 3.23]) or Central region (aOR = 1.43, 95% CI [1.00, 2.04]), non-Hispanic Asian race (aOR = 1.54, 95% CI [1.02, 2.33]), and greater driving distance to care (aOR = 1.01 per mile, 95% CI [1.00, 1.02]). Individuals whose cervical screening results showed any abnormal cytology cells were more likely to have documented follow-up care than those whose results appeared normal but tested positive for high-risk human papillomavirus. The likelihood of documented follow-up increased with severity of abnormality of the cytology result.</p><p><strong>Conclusion: </strong>Our findings suggest that individual and neighborhood geographical factors, such as age, location, distance to care, and severity of cytology result, are associated with documented follow-up cervical cancer care. These findings will inform future efforts to identify and address barriers and facilitators to accessing and completing cervical cancer care, with the goal of reducing health disparities in cervical cancer prevention statewide.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724400","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":"Where U.S. Women Obtained Contraceptive and Related Care and How They Paid for It in 2022-2023: An Analysis of the National Survey of Family Growth.","authors":"Hannah Olson, Mia Zolna","doi":"10.1016/j.whi.2026.02.007","DOIUrl":"https://doi.org/10.1016/j.whi.2026.02.007","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine receipt of contraceptive and other sexual and reproductive health (SRH) services among U.S. women of reproductive age in 2022-2023, sources of care, and payment methods, with attention to implications for the SRH safety net.</p><p><strong>Materials and methods: </strong>Using female respondent data from the 2022-2023 National Survey of Family Growth, we examined receipt of and source of care for 14 SRH services, including contraceptive, preventive gynecologic, sexually transmitted infection testing, and pregnancy-related services. We examined payment methods for contraceptive services by source of care, classified by provider type and funding status, and demographic characteristics.</p><p><strong>Results: </strong>In the prior year, most U.S. women aged 15-49 (64%) received at least one SRH service and more than one-third received contraceptive services. While most obtained SRH care from private providers, publicly supported clinics served a notable share of adolescent, low-income, publicly insured, and uninsured women (30-36%). Overall, private insurance was the most common way individuals paid for contraceptive services (65%), but this varied by income, type of insurance coverage, and source of care. More than 40% of women who received contraceptive services at publicly supported clinics reported paying with Medicaid, compared with 18% at private providers. Out-of-pocket payments were most common among uninsured women (60%) and least common among those with Medicaid (13%). Uninsured women reported receiving no-cost services more often than those with insurance.</p><p><strong>Implications for policy and practice: </strong>Publicly supported clinics are essential sources of SRH care, particularly for under-resourced populations. Recent policy changes threaten this safety net. Protecting publicly funded SRH services and maintaining robust provider networks is critical to ensuring equitable access to essential care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717469","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":"County-Level Pregnancy Criminalization Rates and Prenatal Care Initiation and Utilization in Alabama, 2014-2022.","authors":"Taylor Riley, Jaquelyn L Jahn, Maeve E Wallace","doi":"10.1016/j.whi.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.whi.2026.03.004","url":null,"abstract":"<p><strong>Objective: </strong>We investigated whether higher rates of county-level pregnancy-related arrests were associated with delayed and inadequate prenatal care among births in Alabama (2014-2022).</p><p><strong>Methods: </strong>We used restricted-use natality data from the National Center for Health Statistics and data on annual pregnancy-related arrests by county from Pregnancy Justice. We fit log Poisson generalized estimating equation models with cluster robust standard errors to estimate the relative risk and 95% confidence intervals (CIs), stratified by race and ethnicity, and adjusted for individual- and county-level confounders.</p><p><strong>Results: </strong>Fully adjusted models suggest individuals living in counties with higher pregnancy criminalization rates were moderately more likely to delay prenatal care initiation (1.11, 95% CI [1.08, 1.14]) and receive inadequate prenatal care (1.05, 95% CI [1.03, 1.06]) compared with those living in a county with no arrests. We found positive associations among non-Hispanic white and Latina/Hispanic women, and null or slightly protective associations among non-Hispanic Black women.</p><p><strong>Conclusions: </strong>These findings suggest pregnancy criminalization has an indirect chilling impact on prenatal health care access. The rise in the criminalization and surveillance of pregnancy, particularly in a post-Dobbs context, requires evidence-based policy responses that support maternal health and reproductive autonomy.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717480","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}