Womens Health Issues最新文献

{"title":"Reproductive Health Services in Abortion-Providing Clinics: A Scoping Review of Provision and Policy Contexts.","authors":"Katherine M Mahoney, Licia Bravo, Arden McAllister, Kacie Bogar, Sean Hennessey, Courtney A Schreiber, Alice Abernathy","doi":"10.1016/j.whi.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.whi.2025.07.007","url":null,"abstract":"<p><strong>Objectives: </strong>Abortion-providing clinics often offer preventive reproductive health services. We conducted a scoping review to characterize provision of contraceptive care, sexually transmitted infection (STI) testing and/or treatment, and cervical cancer prevention and/or screening at U.S. abortion-providing clinics and to highlight policy drivers of variation in access to and provision of these services at the time of abortion by abortion-providing clinics.</p><p><strong>Data sources: </strong>Researchers screened articles and extracted data from PubMed, Embase, Scopus, and CINAHL from inception through March 2023.</p><p><strong>Methods of study selection: </strong>Articles were eligible for review if they related contraceptive care, STI testing and/or treatment, or cervical cancer prevention and/or screening to abortion access, demand, or provision. Within these articles, we closely examined any discussion of health policy, conceptualized broadly based on existing literature describing policy associations with reproductive health care to identify policy drivers of reproductive health care provision in abortion care settings.</p><p><strong>Tabulation, integration, and results: </strong>A total of 5,359 articles were screened; 74 were included in the review. Sixty-five were about contraceptive care, seven on STI testing and/or treatment and two on cervical cancer prevention and/or screening. Drivers of variation in provision of preventive reproductive health services included insurance and billing policies and regulatory requirements on abortion-providing facilities and clinicians. Existing data on the association between policies that restrict or protect abortion access and provision of preventive health services by abortion-providing clinics on a national scale are limited.</p><p><strong>Conclusion: </strong>Abortion-providing clinics are an access point for reproductive health services. Legislative trends to constrain abortion access may have spillover effects on provision of preventive reproductive health care such as contraceptive care, STI testing and/or treatment, and cervical cancer prevention and/or screening.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974309","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":"Corrigendum to: An Exploratory Analysis of Factors Associated With Spontaneous Preterm Birth Among Pregnant Veterans With Post-Traumatic Stress Disorder [Women's Health Issues 33 (2023) 191-198]","authors":"Danielle M. Panelli MD ,&nbsp;Caitlin S. Chan SM ,&nbsp;Jonathan G. Shaw MD, MS ,&nbsp;Megha Shankar MD ,&nbsp;Rachel Kimerling PhD ,&nbsp;Susan M. Frayne MD, MPH ,&nbsp;Tiffany C. Herrero MD ,&nbsp;Deirdre J. Lyell MD ,&nbsp;Ciaran S. Phibbs PhD","doi":"10.1016/j.whi.2025.09.003","DOIUrl":"10.1016/j.whi.2025.09.003","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Page 414"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092496","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":"Patterns of Antepartum Care in Ontario Before and During a Time of COVID-19 and Virtual Care: A Population-Based Study","authors":"Stephanie C. Lapinsky MD, MSc ,&nbsp;Nancy N. Baxter MD, PhD ,&nbsp;Rinku Sutradhar PhD ,&nbsp;Karl Everett PhD ,&nbsp;Joan Porter MSc ,&nbsp;Mark H. Yudin MD, MSc ,&nbsp;Eliane M. Shore MD, MSc ,&nbsp;Howard Berger MD ,&nbsp;Douglas M. Campbell MD, MSc ,&nbsp;John W. Snelgrove MD, MSc ,&nbsp;Andrea N. Simpson MD, MSc","doi":"10.1016/j.whi.2025.05.002","DOIUrl":"10.1016/j.whi.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic resulted in changes to the way health care was delivered, including expansion of virtual care. We aimed to understand differences in antepartum care delivery prior to and during the pandemic.</div></div><div><h3>Methods</h3><div>We conducted a population-based retrospective cohort study of people 15–50 years with an in-hospital birth at 20+ weeks’ gestation in Ontario, Canada, across two time periods: December 1, 2020–November 30, 2022 (pandemic), and December 1, 2017–November 30, 2019 (pre-pandemic). Outcomes were total number and timing of antepartum visits, ultrasounds, and acute care encounters. Outcomes were compared between cohorts, and between those who did and did not receive virtual care during the pandemic. Regression modeling was used to examine associations between pregnancy during the pandemic and rates of outcomes.</div></div><div><h3>Results</h3><div>A total of 228,551 pandemic and 218,126 pre-pandemic births were included. Median number of antepartum visits was 10 (6–13) in the pandemic period and 9 (4–12) pre-pandemic (standardized difference (StD): 0.32), corresponding to a relative rate of 1.21 (95% CI [1.20, 1.21]). Significantly more individuals in the pandemic had &gt;11 visits, with no differences in acute care encounters and only a small increase in health care costs (&lt;10%). Those in the pandemic cohort were more likely to have their initial visit during the first trimester (79.3% vs. 66.5%, StD: 0.29). Those receiving virtual care were more likely to live in an urban area and be more materially advantaged.</div></div><div><h3>Interpretation</h3><div>Pregnancy during the pandemic was associated with in an increased rate of ambulatory antepartum visits and increased care in the first trimester.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 5","pages":"Pages 330-341"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601906","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":"Engaging Rural Women Veterans in Mental Health Research: A Call to Action","authors":"Alexandra B. Caloudas PhD ,&nbsp;Juinell B. Williams PhD ,&nbsp;Giselle Day MPH ,&nbsp;Rajinder Sonia Singh PhD ,&nbsp;Mary Shapiro PhD ,&nbsp;Amanda McCorkindale PsyD ,&nbsp;Deleene Menefee PhD ,&nbsp;Jan A. Lindsay PhD ,&nbsp;Derrecka Boykin PhD","doi":"10.1016/j.whi.2025.03.004","DOIUrl":"10.1016/j.whi.2025.03.004","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 225-229"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020591","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":"Perception of Having Enough Information to Make Contraceptive Decisions: A Novel Metric of Person-Centered Contraceptive Access","authors":"Ariana H. Bennett DrPH, MPH ,&nbsp;Alex Schulte BA, BSPH ,&nbsp;Jennet Arcara PhD, MPH, MPP ,&nbsp;Jamie Bardwell MPP ,&nbsp;Denicia Cadena BA ,&nbsp;Aisha Chaudhri MA ,&nbsp;Laura Davis MA ,&nbsp;Brittni Frederiksen PhD, MPH ,&nbsp;Catherine Labiran MA ,&nbsp;Raegan McDonald-Mosley MD, MPH ,&nbsp;Ellen Pliska MHS ,&nbsp;Whitney Rice DrPH, MPH ,&nbsp;Ena Suseth Valladares MPH ,&nbsp;Cassondra Marshall DrPH, MPH ,&nbsp;Anu Manchikanti Gomez PhD, MSc","doi":"10.1016/j.whi.2025.04.003","DOIUrl":"10.1016/j.whi.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Information is a critical component of contraceptive access. This study presents a new person-centered metric of contraceptive access: perception of having sufficient information to choose a contraceptive method.</div></div><div><h3>Methods</h3><div>Between January and March 2022, we fielded a nationally representative online survey among 15- to 44-year-olds assigned female sex at birth using NORC's AmeriSpeak panel. We describe whether respondents felt they had enough information for contraceptive decision making and types of information needed. We investigate bivariate associations between perception of having enough information and key respondent characteristics. We use logistic regression to investigate whether past experiences of sexual and reproductive health (SRH) care and contraceptive self-efficacy are associated with feeling one has enough information.</div></div><div><h3>Results</h3><div>Of the analytic sample (unweighted n = 3,037), 73.5% felt they had enough information to decide about contraception, 11.8% did not, and 14.7% were unsure. Those who did not feel they had enough information (unweighted <em>n</em> = 687) most commonly needed information about side effects (33.4%). In bivariate analyses, respondents who were younger, were gay/lesbian, had lower educational attainment, and were uninsured were less likely to feel they had adequate information. Regression analyses indicated a positive association between feeling one had enough information and past experiences of high-quality SRH care and contraceptive self-efficacy.</div></div><div><h3>Implications and Conclusions</h3><div>Our data indicate inequities in who felt they had enough information to make contraceptive decisions. Perception of having enough information is related to quality of care and perceived future ability to access contraception. This paper supports the importance of recognizing information as a key part of person-centered contraceptive access.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 233-244"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327284","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":"Adolescent and Young Adult Perspectives on Contraception Post-Dobbs: “The Next Closest Step to Having Control Over My Own Body”","authors":"Lauryn King PhD, MPP ,&nbsp;Julia Strasser DrPH, MPH ,&nbsp;Sara Luckenbill MPH ,&nbsp;Ellen Schenk MPP ,&nbsp;Danielle Tsevat MD, MSCR ,&nbsp;Julie Maslowsky PhD","doi":"10.1016/j.whi.2025.04.001","DOIUrl":"10.1016/j.whi.2025.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Adolescents and young adults (AYAs) face unique barriers to contraceptive care that may be exacerbated by the June 2022 <em>Dobbs v. Jackson Women's Health Organization</em> decision that removed federal protections for abortion rights. We examined AYA perspectives on contraception and measured changes in AYA contraceptive use pre- and post-<em>Dobbs</em>.</div></div><div><h3>Materials and Methods</h3><div>This study used a mixed-methods design. We analyzed qualitative data from the MyVoice project, an SMS-based survey among AYAs ages 14–24 in the United States. The research team analyzed open-ended responses to questions about the influence of changes to abortion access on AYA contraceptive decision making. We analyzed quantitative data from the IQVIA Longitudinal Pharmacy and Medical Claims data for patients ages 15–26. We identified monthly new contraceptive prescriptions and services for intrauterine device insertion and implant placement in 2021 and 2022. We used segmented regression analyses to test for changes in prescriptions and services post<em>-Dobbs.</em></div></div><div><h3>Main Findings</h3><div>Our qualitative analysis identified themes of risk aversion, urgency and fear, and access concerns in response to the <em>Dobbs</em> decision. Our quantitative analysis demonstrated a slight increase in both prescriptions and services in the months immediately after <em>Dobbs</em>, but there were no significant changes in the slope for monthly services post-<em>Dobbs</em> for any age group or method type. We also identified an overall decreasing trend for all age groups and all method types during the full study period of January 2021–December 2022.</div></div><div><h3>Conclusions</h3><div>Limited changes in contraceptive use despite AYA expressions of fear, feelings of lost agency, and concerns over access may reflect continued (or worsened) barriers to contraceptive access post-<em>Dobbs</em>.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 245-252"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133199","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":"Patient Language and Differences in Administration of Analgesia for Pelvic Pain","authors":"Tierney Wolgemuth MD ,&nbsp;Annie Gauf MD ,&nbsp;Denise Monti MD, MPH ,&nbsp;Dhara Amin MD ,&nbsp;Julia Geynisman-Tan MD","doi":"10.1016/j.whi.2025.05.006","DOIUrl":"10.1016/j.whi.2025.05.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient-provider language discordance is known to impact medical care; however, whether patient language is associated with differences in analgesia administration has not been well studied. This study aimed to evaluate the association between patients’ primary language and analgesia administration among women seeking emergency care for acute pelvic and abdominal pain.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective cohort study to assess the association between patient language and differences in administration of analgesic medications to non-pregnant adult women presenting to the emergency department (ED) with a primary diagnosis of abdominal or pelvic pain. The primary outcome was the receipt of any analgesic medication. Secondary outcomes were receipt of opioid medications, receipt of intravenous analgesia, and association between diagnosis and receipt of analgesia.</div></div><div><h3>Results</h3><div>Among 817 patients, 427 spoke English and 390 spoke another primary language. More than half (53.7%) were given some form of pain medication, with 211 (25.8%) receiving an opioid and 228 (27.9%) receiving only non-opioids. On bivariate analysis, there is no difference between whether any analgesic was administered between those with and without English as their primary language (52.9% and 54.6%, respectively, <em>p</em> = .65). However, those who spoke English as a primary language were more likely to receive an opioid analgesic (53.1% vs. 42.7%, <em>p</em> = .038). Among individuals who received at least one analgesic, those with English as a primary language had an adjusted odds ratio [95% confidence interval] of 1.49 [1.02, 2.20], <em>p</em> = .04, for receipt of an opioid when adjusted for highest pain score. Patients with abdominal pain were more likely to receive any analgesic (55.6% vs. 45.0%, <em>p</em> = .049) and more likely to receive opioid pain medication compared with those with pelvic pain (52.4% vs. 22.1%, <em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Abdominal and pelvic pain in women may be undertreated in the ED setting, particularly among those for whom English is not the primary language and those presenting with the primary diagnosis of pelvic pain.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 261-266"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568004","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":"Promoting Improved Access to Tailored Hormonal Contraceptive Regimens for Menstrual Suppression","authors":"Beth Sundstrom PhD, MPH ,&nbsp;Angela Dempsey MD, MPH","doi":"10.1016/j.whi.2025.02.009","DOIUrl":"10.1016/j.whi.2025.02.009","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 219-224"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811977","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":"Evolving the Health Care Service Model for Menopause With Digital Health","authors":"Constance Guille MD, MSCR ,&nbsp;Hannah Jahnke PhD,&nbsp;Neel Shah MD, MPP,&nbsp;Natalie Henrich PhD, MPH","doi":"10.1016/j.whi.2025.03.005","DOIUrl":"10.1016/j.whi.2025.03.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 230-232"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041729","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":"Impact of Dobbs v. Jackson Women's Health Organization on Obstetrics and Gynecology Training One Year Later: Qualitative Analysis of Physician Perspectives","authors":"Sarah E. Andiman MD ,&nbsp;A. Jenna Beckham MD, MSPH ,&nbsp;Gabriela E. Halder MD, MPH ,&nbsp;Angela DiCarlo-Meacham MD ,&nbsp;William D. Winkelman MD ,&nbsp;Shunaha Kim-Fine MD, MS ,&nbsp;Rebecca Rogers MD ,&nbsp;Cheryl Iglesia MD ,&nbsp;Cara L. Grimes MD, MAS ,&nbsp;Society of Gynecologic Surgeons Collaborative Research in Pelvic Surgery Consortium (SGS CoRPS)","doi":"10.1016/j.whi.2025.04.005","DOIUrl":"10.1016/j.whi.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>On June 24, 2022, the Supreme Court of the United States' <em>Dobbs v. Jackson Women's Health Organization</em> decision ended constitutional protection for abortion, resulting in severely restricted access to reproductive health care and raising concerns about the repercussions on obstetrics and gynecology trainees.</div></div><div><h3>Objective</h3><div>This qualitative study examines the observed effects of the <em>Dobbs</em> decision on obstetrics and gynecology training and practice one year out.</div></div><div><h3>Methods</h3><div>Obstetrics and gynecology physicians involved in patient care and medical education were invited to participate in online focus groups. We attempted to recruit participants from a diversity of subspecialties and regions of the United States. Eighteen physicians participated in five sessions conducted July–October 2023. Using an iterative process, two independent researchers coded transcripts to identify themes and subthemes. An additional reviewer resolved discrepancies.</div></div><div><h3>Results</h3><div>Eight themes were identified: dichotomy of care in restrictive versus protective states, loss of the patient-physician relationship, moral distress to physicians, legal concerns for physicians, new issues for training programs, loss of patient care experiences for trainees, loss of access to care for patients, and disappointment and frustration with policy makers. Themes were grouped into their effects on patients, trainees, physicians, and society overall, reflecting negative changes in patient care, training, and physician morale.</div></div><div><h3>Conclusions</h3><div>This qualitative study found that physicians see the <em>Dobbs</em> ruling as having negative effects on patients, trainees, and physicians. Participants observed that these changes are leading to a dichotomy of care in which patients in restrictive and protective states receive different care and some patients may not receive medically necessary treatment.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 253-260"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250324","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}