Womens Health Issues最新文献

{"title":"Black Women Benefit From Psychotherapies for Insomnia, but Experience Adherence Challenges: Results of a Comparative Effectiveness Trial in Women Veterans.","authors":"Kimiko J May, Alexander J Erickson, Gwendolyn C Carlson, Monica R Kelly, Yeonsu Song, Kaddy Y Revolorio, Michael N Mitchell, Donna L Washington, Elizabeth M Yano, Cathy A Alessi, Sarah Kate McGowan, Constance H Fung, Jennifer L Martin","doi":"10.1016/j.whi.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.whi.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>Black women and veterans experience disproportionally high rates of insomnia. Few studies have examined how treatment adherence and outcomes vary by racial identity. We found that cognitive behavioral therapy for insomnia (CBT-I) and an acceptance and commitment therapy (ACT)-based insomnia treatment similarly improve sleep outcomes for women veterans, and this analysis examined differences in adherence and outcomes of these treatments based on racial identity groups.</p><p><strong>Purpose: </strong>Analyses examined differences in adherence and treatment outcomes in Black compared with white women veterans who engaged in CBT-I or an ACT-based insomnia treatment (i.e., acceptance and the behavioral changes to treat insomnia [ABC-I]).</p><p><strong>Methods: </strong>As part of a larger clinical trial (NCT02076165), 40 Black and 51 white women veterans with insomnia disorder completed 5-sessions of CBT-I or ABC-I. The Insomnia Severity Index (ISI) and sleep diaries were completed at baseline, posttreatment, and 3-month follow-up. The Credibility and Expectancy Questionnaire was completed at the end of the first treatment session. Multiple and fractional regression models were used to evaluate the association between race group and change in ISI, sleep diary sleep efficiency, and adherence to weekly sleep schedule prescriptions in CBT-I and ABC-I.</p><p><strong>Results: </strong>Treatment benefits were comparable between Black and white women veterans; however, Black women had transiently lower adherence to sleep restriction time in bed recommendations in the week immediately after sleep restriction therapy was introduced in both treatments. There were no other differences between the groups.</p><p><strong>Conclusions: </strong>Future research is needed to understand potential barriers to early adherence to recommendations experienced by Black women veterans and seek to identify treatment adaptations to meet their needs.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294096","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":"Invisible Tethers: The Role of Social Networks in Intimate Partner Violence and Mental Health Among Adult Women.","authors":"Marina Katague, Trace Kershaw, Laurel Sharpless, Kamila A Alexander, Tiara C Willie","doi":"10.1016/j.whi.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.whi.2025.09.001","url":null,"abstract":"<p><strong>Introduction: </strong>Intimate partner violence (IPV) is associated with high rates of posttraumatic stress disorder (PTSD) and depression, and women experiencing IPV often face social isolation that may exacerbate mental health concerns. This study examines the relationship among IPV, social networks, and mental health outcomes in women. It aims to understand how social network characteristics relate to the presence of PTSD and depression among women with and without experiences of IPV.</p><p><strong>Methods: </strong>We collected data on IPV experiences, participants' social networks, and PTSD and depression symptomatology from women aged 18-35 in Connecticut who reported risk indicators for pre-exposure prophylaxis candidacy (N = 204). Multivariable logistic regression models were used to assess the relationship between IPV and mental health, while adjusting for demographic factors and covariates. We also examined whether social network characteristics moderated this relationship.</p><p><strong>Results: </strong>Women experiencing IPV had fewer men in their networks, more network members who had experienced IPV, and more network members with violence-acceptable attitudes compared with women without IPV experiences. IPV experience was also significantly associated with higher PTSD symptomatology. IPV moderated two associations between network characteristics and depression: among women experiencing IPV, greater network closeness was associated with less severe depression symptoms, whereas among women without IPV experience, a higher percentage of men in the network was associated with less severe depression symptoms.</p><p><strong>Conclusion: </strong>There are significant differences in social network characteristics among women with and without IPV experiences. Trauma-informed interventions and services should acknowledge how network members might influence depression when engaging with women experiencing IPV.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276127","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":"Mistrust Limits Possibilities for Patient-Provider Discussions Regarding Cannabis Use During Pregnancy.","authors":"Heather Gould, Claudia Zaugg, Karen A Scott, Sarah C M Roberts","doi":"10.1016/j.whi.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.whi.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Recent changes in cannabis policy and use among pregnant people have prompted recommendations that health care providers discuss cannabis use with pregnant patients. We explored pregnant people's perceptions of their interactions with health care providers regarding cannabis use during pregnancy.</p><p><strong>Methods: </strong>We conducted in-depth interviews with 34 individuals who were either pregnant or had been pregnant within the past 2 years and who used cannabis before or during their pregnancy. The interviews explored people's experiences with and perspectives on communication with health care providers about cannabis use during pregnancy.</p><p><strong>Results: </strong>Most participants reported an absence of provider-initiated inquiries about cannabis use and few disclosed their cannabis use to a provider. Participants expressed distrust in providers as sources of accurate cannabis information, as they understood providers as grouping cannabis with alcohol and other drugs, which they saw as conflicting with their perception of a lack of conclusive scientific evidence about health effects of cannabis use during pregnancy. They worried about providers judging and reporting them to child welfare if providers learned about their cannabis use. Participants described using cannabis for medical reasons, but only rarely recalled experiencing providers talking with them about risks and benefits of cannabis versus other treatments.</p><p><strong>Conclusions: </strong>Although many pregnant people use cannabis as a medicine to manage pregnancy symptoms or health conditions, they perceive providers as viewing and treating cannabis as a harmful recreational drug. This disconnect, along with their fears of provider judgment and of providers reporting them to child welfare, appears to be limiting effective, person-focused discussions regarding risks and benefits of different approaches to treating the symptoms and health conditions for which pregnant people use cannabis.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276123","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":"Incidence of Ectopic Pregnancy and Diagnostic Accuracy of Ectopic Pregnancy Screening Criteria Among People Seeking Versus Not Seeking Abortion: A Retrospective Case-Control Study.","authors":"M Antonia Biggs, Mary Anne Armstrong, Lue-Yen Tucker, Shelly Kaller, Juleon Rabbani, Justine W Lee, Giulia Chillemi, Daniel Grossman","doi":"10.1016/j.whi.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.whi.2025.08.006","url":null,"abstract":"<p><strong>Objectives: </strong>We estimated the incidence of ectopic pregnancy, associated risk factors, and accuracy of three history-based screening criteria for medication abortion (history of ectopic pregnancy, tubal surgery, and intrauterine device [IUD] in place) in detecting ectopic pregnancies among people seeking versus not seeking abortion.</p><p><strong>Study design: </strong>We conducted a retrospective case-control study by reviewing electronic health records of a random sample of 2,201 ectopic and 1,153 intrauterine pregnancies of people enrolled at Kaiser Permanente Northern California (2016-2021). After classifying pregnancies as those to people seeking or not seeking abortion, we used logistic regression weighted to the total sample of pregnancies (N = 385,081) to estimate the incidence of ectopic pregnancies, associated risk factors, and accuracy of three history-based screening criteria.</p><p><strong>Results: </strong>The adjusted incidence of ectopic pregnancy was significantly lower for people seeking abortion (.39%; 95% confidence interval [CI] [.30%, .47%]) than for people not seeking abortion (1.74%; 95% CI [1.55%, 1.94%]). People seeking abortion received ectopic pregnancy treatment earlier in pregnancy than those not seeking abortion (53 vs. 55 days gestation, p = .04). Among people seeking abortion, combined history of IUD use, ectopic pregnancy, and tubal surgery had low sensitivity (17.6%; 95% CI [12.4%, 23.8%]), high specificity (93.5%; 95% CI [90.2%, 96.0%]), and a low area under the receiver operating characteristic curve value (55.5%; 95% CI [52.5%, 58.6%]).</p><p><strong>Conclusions: </strong>The incidence of ectopic pregnancy among people seeking abortion is extremely low and lower than among people not seeking abortion. The three history-based screening criteria we evaluated had very low sensitivity and performed poorly in accurately identifying ectopic pregnancies, suggesting they may have limited clinical utility and may create barriers to access to no-test abortion. Further research is needed to refine protocols to better identify, evaluate, and monitor people for possible ectopic pregnancies in the context of no-test provision of medication abortion.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245644","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":"Contribution of Maternal Age to Increasing Severe Maternal Morbidity During Birth and Up to 1 Year Postpartum.","authors":"Samuel H Nyarko, Lucy T Greenberg, Scott A Lorch, Jeannette Rogowski, Jeffrey S Buzas, Ciaran S Phibbs, George R Saade, Molly Passarella, Nansi S Boghossian","doi":"10.1016/j.whi.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.whi.2025.08.005","url":null,"abstract":"<p><strong>Purpose: </strong>We examined whether increasing severe maternal morbidity (SMM) rates are driven by changes in maternal age distribution or age-specific SMM rates.</p><p><strong>Methods: </strong>In a retrospective cohort study across three states, we analyzed data from two time points (2008-2009 to 2019-2020). We used Kitagawa decomposition analysis to determine the contributions of changes in maternal age distribution and age-specific SMM rates to SMM rates both with and without transfusion during birth and up to 1 year postpartum, stratified by race/ethnicity. We examined the following racial/ethnic groups: non-Hispanic white, non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander.</p><p><strong>Results: </strong>Between 2008-2009 and 2019-2020, SMM and non-transfusion SMM rates increased from 213.6 to 260.5 and from 109.6 to 154.8 per 10,000 births, respectively. Across all racial and ethnic groups, the proportion of younger birthing individuals (<25 years) decreased and the proportion of older individuals (≥30 years) increased. The decomposition analysis showed that increases in SMM and non-transfusion SMM were primarily due to increases in age-specific SMM rates (100.0% and 94.6%, respectively), particularly among younger birthing individuals. Changes in maternal age distribution had a minimal overall contribution. However, when stratified by race/ethnicity, changes in maternal age distribution had a greater contribution to SMM (28.9%) and non-transfusion SMM (22.7%) rates among non-Hispanic Black individuals, with little to no contribution observed in the other groups.</p><p><strong>Conclusion: </strong>The increasing rates of birth-related and postpartum SMM rates stem from increasing rates of SMM in every age group rather than shifts in maternal age distribution.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208049","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":"Social Media Descriptions of Pain and Pain Management During Intrauterine Device Insertion: \"Women's Pain is Not Taken Seriously\".","authors":"Gabrielle Schweitzer, Azza Elrashid, Lakshmi Sundaresan, Kathleen Mehari, Lauren Owens, Lauren D Oshman","doi":"10.1016/j.whi.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.whi.2025.08.002","url":null,"abstract":"<p><strong>Introduction: </strong>Intrauterine devices (IUDs) are a highly effective and safe method of contraception, yet IUD insertion can be painful. Social media is a trusted source of health information for reproductive-age adults and accounts of painful and traumatic insertion are prevalent on social media. The aim of this study was to explore the experiences of social media users with pain, trauma, and pain management during IUD insertion.</p><p><strong>Methods: </strong>We identified common IUD-related hashtags or search terms on TikTok, Instagram, and Twitter; identified the top posts (defined as the posts at the top of each search) and their comments for each hashtag or search term on each platform; performed directed qualitative content analysis; and summarized code frequency under each theme with descriptive statistics.</p><p><strong>Results: </strong>Analysis of a total of 214 total posts and comments identified three major themes describing user experiences: 1) Severe pain experiences were more common than tolerable or mild experiences, 2) some participants shared traumatic and negative emotional responses, and 3) negative or dismissive health care professional responses to painful IUD insertion were more frequent than positive and supportive responses.</p><p><strong>Conclusion: </strong>Health care professionals should be aware of common narratives on social media and provide trauma-informed pain management to ensure that all patients have appropriate counseling for IUDs.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132223","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":"Factors Associated With Guideline-Concordant Cervical Cancer Screening Exit: A Mixed Methods Study.","authors":"Abigael Olson, Lindsay Fuzzell, Naomi C Brownstein, Holly B Fontenot, Alexandra Michel, Paige Lake, Susan T Vadaparampil, Rebecca B Perkins","doi":"10.1016/j.whi.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.whi.2025.07.006","url":null,"abstract":"<p><strong>Background: </strong>More than 20% of cervical cancers are diagnosed in women older than 65 years. Guidelines recommend screening exit at age 65 for average-risk patients only if certain criteria are met, yet most women aged 64-66 years in the United States are inadequately screened. In this mixed methods study, we explored clinician knowledge of exit criteria.</p><p><strong>Methods: </strong>We explored factors associated with clinician-reported guideline-concordant screening exit, as well as facilitators and barriers to appropriate cervical cancer screening exit. Guideline concordance required that clinicians be aware that patients can exit screening if they have received a hysterectomy for benign reasons or had either three consecutive negative Pap tests or two consecutive negative human papilloma virus tests-and that they should not exit screening if they have a history of precancer treatment in the prior 25 years.</p><p><strong>Results: </strong>In 2021, a national sample of 1,251 clinicians completed surveys; a subset (n = 55) completed qualitative interviews. Although most (>70%) correctly identified criteria related to hysterectomy and prior negative screening requirements, only 35% of participants (n = 434) responded correctly to all screening exit items. In logistic regression models, male clinicians, OB/GYNs, and those in academic or hospital-based practices were more likely to respond correctly. Interview responses indicated variable understanding of the nuances of exit criteria. Those who continued screening patients past age 65 cited concerns related to new sexual partners and missing cancers. Several providers noted difficulty accessing adequate records.</p><p><strong>Conclusions: </strong>Clinicians who routinely perform cervical cancer screening have knowledge gaps around exit criteria and also describe difficulty applying the criteria in practice. As fewer women undergo hysterectomy and life expectancy increases, the number of individuals older than 65 at risk for cervical cancer will continue to rise. Adjusting guidelines to decrease the complexity of exit criteria should be considered.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030837","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":"“Am I Truly Invisible?”: A Qualitative Study on Black Women's Experiences of and Coping With Intersectional Invisibility in Uterine Fibroid Treatment","authors":"Arianne N. Malekzadeh MA ,&nbsp;Ami R. Zota ScD, MS ,&nbsp;Myla Lyons BA ,&nbsp;Tamara Taggart PhD, MPH","doi":"10.1016/j.whi.2025.05.005","DOIUrl":"10.1016/j.whi.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Black women are disproportionately burdened by uterine leiomyomas<span> (fibroids) and face intersectional invisibility wherein their needs are ignored in health care settings due to sexism and racism. Our objective was to elucidate Black women's experiences in fibroid treatment and the strategies they use to protect their health and counter their intersectional invisibility.</span></div></div><div><h3>Methods</h3><div>We recruited participants from the Fibroids Observational Research on Genes and the Environment (FORGE) Study. We conducted semistructured individual interviews (average length 45 minutes) on Black women's experiences in fibroid treatment. We analyzed the transcripts using a thematic analytical approach and intersectionality, a critical analytical framework that allows for the examination of how sexism and racism intersect to influence health inequities.</div></div><div><h3>Results</h3><div>Participants were 16 Black women aged 30–52 years who were seeking fibroid treatment in Washington, DC. Our analysis revealed that participants experience gendered racism (the intersection of sexism and racism) in fibroid treatment, mirroring a historical and ongoing pattern of how Black women are treated in health care settings, and that they manage their intersectional invisibility by engaging in strategies characteristic of the superwoman schema: projecting strength, suppressing emotions, resisting being dependent, and striving to succeed despite limited resources. Participants also highlighted that their ideal fibroid-related care would include a holistic approach and social support.</div></div><div><h3>Conclusions</h3><div>Our findings emphasize that Black women's intersectional invisibility extends to fibroid treatment, reflecting the social-structural inequities that they face in health care settings more broadly. Attendance to Black women's voices in research and practice can help decrease their intersectional invisibility and subsequently improve their fibroid treatment and related health outcomes.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 342-349"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592687","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":"Experiences and Perspectives of Sexual and Reproductive Health Among Women in Recovery From Opioid Use Disorder","authors":"Nicole M. Mattson PhD, RN, CNS-BC,&nbsp;Aleigha Barry RN, BSN,&nbsp;Jessica Zemlak PhD, MSN, RN","doi":"10.1016/j.whi.2025.07.003","DOIUrl":"10.1016/j.whi.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Women in recovery from opioid use disorder (OUD) have unmet sexual and reproductive health (SRH) needs resulting in health disparities such as unintended pregnancy and sexually transmitted infections/HIV infection compared with women without OUD. The purpose of this qualitative descriptive study was to explore the perceptions and experiences of co-occurring multiple social-ecologic influences (individual, interpersonal, community, society) on SRH among women in recovery from OUD.</div></div><div><h3>Methods</h3><div>Purposive sampling was used to recruit cis-gender women aged 18–49 who self-identify as being in recovery from OUD and speak English. We conducted one 45- to 60-minute audio-recorded semistructured telephone interview with each participant.</div></div><div><h3>Results</h3><div>In our sample (N = 22), 59% identified as white and the mean age was 34.7 years (SD = 6.8). We identified themes related to SRH across social-ecological levels. <em>Holistic Definition of SRH</em>: Participants described an evolution of their knowledge and behaviors related to SRH during recovery to include preventive health, emotional well-being, and healthy relationships. <em>Reevaluation of Relationships</em>: Participants described undergoing a critical appraisal of their relationships and identified relationships that strengthened or threatened their recovery. <em>Built and Lived Community</em>: Participants described a rebuilding and restructuring of both social and physical domains of community. <em>Shadow of Stigma</em>: Participants described experiencing stigmatizing behaviors related to the interconnectedness of their childbearing capacity, SRH, and recovery.</div></div><div><h3>Conclusions</h3><div>Women's expansive descriptions of SRH in recovery extend beyond access to contraception and sexually transmitted infection/HIV screening. Interventions focused on SRH must account for the complex multilevel influences on the health of women in recovery from OUD.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 405-413"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884060","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":"Demand for Medication Abortion Through Telehealth Before and After the Dobbs v. Jackson Supreme Court Decision in States Where Abortion Is Legal","authors":"Anna E. Fiastro PhD, MPH, MEM ,&nbsp;Elissa Brown MPH ,&nbsp;Rebecca Gomperts MD, MPP, PhD ,&nbsp;Emily M. Godfrey MD, MPH","doi":"10.1016/j.whi.2025.06.003","DOIUrl":"10.1016/j.whi.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>The provision of medication abortion through telehealth accounts for an increasing share of total abortions in the United States, offering a private and affordable option for patients in both restrictive and supportive states. This study compares demand for telehealth medication abortion before and after the U.S. Supreme Court decision in <em>Dobbs v. Jackson Women's Health Organization (Dobbs)</em> in states where abortion access is protected, to understand how patients seeking care in supportive states may have been impacted by the landmark decision.</div></div><div><h3>Methods</h3><div>We compared the volume of patients receiving medication abortion from a U.S.-based telehealth service in 18 states, the sociodemographic characteristics of patients, and self-reported reasons for choosing telehealth before and after the <em>Dobbs</em> decision using electronic medical records from March 24, 2022–September 24, 2022. All states examined support legal access to abortion; results were stratified to compare two levels of protective abortion policies.</div></div><div><h3>Results</h3><div>A total of 6,296 patients received medication abortion through telehealth during the study period. Daily demand increased by 74%, from an average of 25.0 patients per day in the pre-<em>Dobbs</em> period to 43.4 patients per day post-<em>Dobbs</em> (difference 18.4; 95% confidence interval [15.4, 21.5]; <em>p</em> &lt; .001). No sociodemographic differences were observed between patient populations before and after the <em>Dobbs</em> decision. Comfort and privacy were the most frequently selected reasons for choosing telehealth in both time periods. Concern over legal restrictions was more frequently cited after the <em>Dobbs</em> decision. A larger increase in demand (88%) was observed in states with fewer protections post-<em>Dobbs</em> compared with states with the most protective policies (68%) (<em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Demand for telehealth medication abortion increased after the <em>Dobbs</em> decision in states where abortion remained legal. Telehealth provides an essential pathway to access safe and effective abortion care for a broad range of patients across different policy environments.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 324-329"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769196","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}