BMJ Sexual & Reproductive Health最新文献

{"title":"Abortion patients' perspectives on enhancing a telemedicine model of post-abortion contraception: a qualitative study.","authors":"Nicola Boydell, Sophie Buijsen, John Joseph Reynolds-Wright, Sharon T Cameron, Jeni Harden","doi":"10.1136/bmjsrh-2024-202428","DOIUrl":"10.1136/bmjsrh-2024-202428","url":null,"abstract":"<p><strong>Background: </strong>Access to post-abortion contraception (PAC) is critical for reducing unintended pregnancies and supporting reproductive decision-making. Patients often face challenges in identifying, accessing and initiating their preferred contraceptive methods post-abortion. This may be particularly so with telemedicine models of care with absence of in-person appointments, and reduced opportunities to provide some contraceptive methods. This qualitative service evaluation explored patients' perspectives on PAC consultations and decision-making to inform future PAC service models in the era of telemedicine.</p><p><strong>Methods: </strong>Qualitative interviews with 15 patients who had telemedicine medical abortion at home up to 12 weeks' gestation. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Contraceptive discussions during pre-abortion consultations were valued for supporting informed choices about future contraceptive use. Decision-making was influenced by previous contraception experiences, emotional state at the time of abortion and concerns about contraceptive 'failure'. Some preferred non-hormonal methods due to past negative experiences with hormonal contraceptives. However, limited information about 'natural' contraceptive methods and concerns about discussing these with healthcare professionals were described. Barriers to accessing preferred methods, particularly long-acting reversible contraception (LARC), included reduced availability of appointments and caring responsibilities. Fast-tracked appointments for LARC fitting post-abortion were valued. The need for flexible PAC consultations and access after abortion, for example, remote consultations complemented by personalised interactions with sexual and reproductive health experts, was emphasised.</p><p><strong>Conclusion: </strong>The findings highlight the need for flexible and more accessible PAC service models in the era of telemedicine care to ensure timely access to preferred contraceptive methods.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding structural barriers to abortion care under the counselling regulation in Germany: results of a qualitative interview study.","authors":"Amelie Kolandt, Susanne Michl, Mirjam Faissner","doi":"10.1136/bmjsrh-2025-202798","DOIUrl":"10.1136/bmjsrh-2025-202798","url":null,"abstract":"<p><strong>Objective: </strong>Abortion care in Germany is under-researched. Available data show regional disparities in the availability and accessibility of abortion services, but the structural causes for this remain unclear. In Germany, abortion is technically illegal but is exempt from punishment under the counselling regulation, which means that the pregnant person has to undergo mandatory counselling and observe a 3-day waiting period. This qualitative interview study examines the perspectives of abortion care providers on the provision of abortion care under this regulation in Germany.</p><p><strong>Design: </strong>We included 42 gynaecologists and abortion counsellors nationwide. We conducted in-depth, guideline-based interviews that explored the participants' perspectives on challenges in abortion care. The data were analysed using qualitative content analysis according to Mayring. The results were evaluated against the WHO's components of the right to sexual and reproductive health: availability, accessibility, acceptability, quality, and equity, inclusivity and patient-centredness of care.</p><p><strong>Results: </strong>We identified various structural barriers that limit the availability, accessibility, acceptability and quality of abortion care under the counselling regulation in Germany. Interviewees named the shortage of doctors performing abortions as one structural root cause for insufficient abortion care that is exacerbated by the procedure's criminalisation. A lack of information transparency, complex legal requirements, language barriers, disinformation as well as social stigmatisation were cited as important barriers to abortion care. These barriers were described as having a particularly strong impact on patients from marginalised groups.</p><p><strong>Conclusions: </strong>Our study indicates that structural barriers associated with the current legal regulation create significant hurdles for both patients and providers and undermine the access, availability, acceptability, quality of care, and patient-centredness of care. In this context, we strongly support the recommendation of the German government's expert commission to revise the current legal regulation of abortion in Germany.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing appointment times for intrauterine device insertion procedures: a post-intervention service review.","authors":"Shingisai Ndoro, Sana Zaman, Esther Okon","doi":"10.1136/bmjsrh-2025-202941","DOIUrl":"10.1136/bmjsrh-2025-202941","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the environmental and financial impact of intrauterine contraception.","authors":"Catherine Zoe Mercer Stace, Georgina Forbes","doi":"10.1136/bmjsrh-2024-202688","DOIUrl":"10.1136/bmjsrh-2024-202688","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embedding a culture of research in independent sector abortion services: opportunities and challenges.","authors":"Danielle Perro, Patricia A Lohr","doi":"10.1136/bmjsrh-2025-202860","DOIUrl":"10.1136/bmjsrh-2025-202860","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind the gap(s): training abortion providers for a safer future.","authors":"Bec McKay, Samuel Yosef","doi":"10.1136/bmjsrh-2025-202981","DOIUrl":"10.1136/bmjsrh-2025-202981","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating contraceptive shared decision-making into consultations for individuals with epilepsy: facilitating a holistic and dynamic approach.","authors":"Christine McKnight, Sarah Louise Griffiths, Denitza Williams, Rhiannon Phillips, Sarah Brown, Delyth James","doi":"10.1136/bmjsrh-2025-202751","DOIUrl":"10.1136/bmjsrh-2025-202751","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to first-trimester medication abortion in telemedicine versus in-person care: a prospective cohort study in Colombia, 2024.","authors":"Biani Saavedra-Avendano, Karen Cárdenas-Garzón, Paola Montenegro-Ramírez, Guillermo Antonio Ortiz-Avendaño","doi":"10.1136/bmjsrh-2025-202796","DOIUrl":"10.1136/bmjsrh-2025-202796","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should patient-centred abortion care involve the offer of an ultrasound to all, including those who do not clinically require it?","authors":"Sinead Cook, Carrie Hazel, Sarah Wallage","doi":"10.1136/bmjsrh-2024-202538","DOIUrl":"10.1136/bmjsrh-2024-202538","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving intrauterine contraceptive device follow-up with a scan-only clinic model in a specialist community contraception service.","authors":"Maryam Nasri, Azza Malik","doi":"10.1136/bmjsrh-2025-202815","DOIUrl":"10.1136/bmjsrh-2025-202815","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}