BMJ Sexual & Reproductive Health最新文献

{"title":"Human papillomavirus vaccination and cervical screening uptake among women presenting for abortion: exploring opportunities for health care interventions.","authors":"Gina Bonar, Sharon Cameron","doi":"10.1136/bmjsrh-2025-203018","DOIUrl":"10.1136/bmjsrh-2025-203018","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is predominantly caused by infection with high-risk human papillomavirus (HPV). Prevention efforts rely on vaccination and cervical screening. This study aimed to determine HPV vaccination and in-date cervical screening rates among women seeking abortion to determine whether this care setting could provide an opportunity to deliver catch-up prevention services.</p><p><strong>Methods: </strong>Retrospective database study examining HPV vaccination and cervical screening coverage among women accessing abortion in Edinburgh, Scotland, UK from October to December 2024. National Health Service electronic systems recording HPV vaccinations and the Scottish Cervical Call Recall System were examined together with clinical records to determine if an in-person clinical visit was made as part of care.</p><p><strong>Results: </strong>Some 798 individuals presented for abortion over the study period (n=297, ≤25 years and n=501, >25 years). Of those aged ≤25 years reviewed for HPV vaccination, 161/297 (54.2%) were vaccinated, 37 (12.5%) were unvaccinated and 99 (33.3%) had no record of vaccination status. Of the 501 women of cervical screening age >25 years, 289 (57.7%) were up to date, 70 (14%) were overdue and 142 (28.3%) had never been screened. Of the 37 unvaccinated individuals, 29 (78.4%) attended the clinic in person as did 158 (74.5%) of the 212 overdue/never-screened women.</p><p><strong>Conclusions: </strong>A significant proportion of those individuals who present for abortion are not vaccinated against HPV or up to date with cervical screening. Three-quarters of this group made an in-person visit, indicating an opportunity for delivering cervical cancer preventative services in the future. Future research is required to determine the feasibility of HPV vaccination and cervical screening in this setting.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"95-100"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502109","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":"Expulsion rates and risk factors for intrauterine device expulsion following medical management of first-trimester incomplete abortions: A prospective cohort study in central Uganda.","authors":"Herbert Kayiga, Emelie Looft-Trägårdh, Amanda Cleeve, Othman Kakaire, Nazarius Mbona Tumwesigye, Josaphat Byamugisha, Kristina Gemzell-Danielsson","doi":"10.1136/bmjsrh-2025-203045","DOIUrl":"10.1136/bmjsrh-2025-203045","url":null,"abstract":"<p><strong>Objective: </strong>Intrauterine device (IUD) user rates remain below 5% in low-income countries yet fertility after first-trimester abortions returns within 2 weeks. IUDs provide effective contraception. This study set out to explore the risk factors for IUD expulsion after medical management of first-trimester incomplete abortions.</p><p><strong>Design: </strong>Prospective cohort study SETTING: Multicentre study at five public health facilities in central Uganda.</p><p><strong>Participants: </strong>1050 women with first-trimester incomplete abortion managed with misoprostol, recruited on giving informed consent.</p><p><strong>Intervention: </strong>After selecting either copper or levonorgestrel (LNG) IUDs, participants were randomised to early (within 1 week) or standard (at 2-4 weeks) insertion and assessed on IUD expulsion 6 months later.</p><p><strong>Main outcome measures: </strong>Primary outcome was IUD expulsion rates at 6 months. Secondary outcomes were risk factors for IUD expulsions.</p><p><strong>Results: </strong>Between 8 July 2023 and 31 May 2024, 532 (50.7%) participants chose LNG IUDs, 488 (46.5%) chose copper IUDs, while 30 (2.9%) participants chose not to use IUDs. The IUD expulsion rate was 4.6% (95% CI 3.48 to 6.07). IUD expulsion was significantly associated with low overall satisfaction with IUD insertion procedure and use (adjusted odds ratio (aOR)=7.99, 95% CI 4.83 to 13.22, p<0.001), anxiety during the IUD insertion (aOR=4.28, 95% CI 1.09 to 16.85, p=0.038), use of ultrasound at follow-up (aOR=8.41, 95% CI 4.56 to 15.5, p<0.001) and breastfeeding at the time of IUD insertion (aOR=1.48, 95% CI 0.26 to 4.98, p=0.042).</p><p><strong>Conclusion: </strong>Offering IUD insertion immediately after medical management of first-trimester incomplete abortion is associated with low expulsion rates and should be offered as a safe choice.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"109-119"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958946","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":"Implementing routinely discussing and offering local anaesthesia for intrauterine device insertions.","authors":"Hannat Akintomide, Catherine McLoughlin, Nataliya Brima, Kathryn Mary Clement","doi":"10.1136/bmjsrh-2024-202672","DOIUrl":"10.1136/bmjsrh-2024-202672","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"157-158"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966063","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":"'Problem representations' in post-abortion contraception: a critical review of UK literature.","authors":"Marie Larsson, Jeni Harden, John Joseph Reynolds-Wright, Sharon Cameron, Nicola Boydell","doi":"10.1136/bmjsrh-2025-202887","DOIUrl":"10.1136/bmjsrh-2025-202887","url":null,"abstract":"<p><strong>Objective: </strong>To critically review post-abortion contraception literature from the UK based on Bacchi's 'What's the Problem Represented to Be?' (WPR) approach.</p><p><strong>Methods: </strong>A systematic search of six electronic databases - complemented by a grey literature search encompassing reports, policy documents and government publications - identified a total of 31 publications: 19 peer-reviewed articles and 12 items of grey literature.</p><p><strong>Results: </strong>Multiple - and sometimes conflicting - 'problem representations' coexisted across the texts, operating at different levels of abstraction. Applying the WPR approach, six 'problems' were identified: existing abortion rates and repeat abortion; risky groups; meeting service users' needs; organisational capacity; knowledge of contraceptive methods; and abortion stigma.</p><p><strong>Conclusions: </strong>While some problem representations focused on service user needs, care satisfaction and organisational capacity, the dominant framing positioned abortion rates - particularly subsequent abortions - as the central 'problem'. It is implied that too many abortions are being had and that a key purpose of post-abortion contraception is to address this issue. Abortion was often framed as an individual's failure to use (effective) contraception (correctly). This places the burden on individuals, further exacerbates abortion stigma and obscures structural constraints. Several conceptual slippages were identified, including using 'unplanned', 'unintended' and 'unwanted' pregnancy synonymously. Such practices risk collapsing and misrepresenting different kinds of lived experiences, creating barriers to the provision of person-centred abortion and contraceptive care. We recommend greater critical reflection on the language and assumptions within post-abortion contraception discourse to ensure research, policy and practice remain person-centred, evidence-informed and committed to principles of reproductive justice.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"120-129"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943579","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":"Women's preferences for interconception care: a discrete choice experiment study.","authors":"Sharon James, Peiwen Jiang, Jody Church, Edwina Dorney, Danielle Mazza","doi":"10.1136/bmjsrh-2025-202928","DOIUrl":"10.1136/bmjsrh-2025-202928","url":null,"abstract":"<p><strong>Background: </strong>Interconception care (ICC), provided between pregnancies, can improve women's health, pregnancy outcomes and infant health. Women face challenges in accessing and prioritising ICC due to issues including caring roles, transport and clinician availability. We aimed to elicit women's preferences for ICC engagement.</p><p><strong>Methods: </strong>A discrete choice experiment (DCE) was conducted to assess women's preferences about ICC. Australian women who had experienced pregnancy completed an online survey in March 2024 comprised of questions about sociodemographic characteristics, ICC attitudes regarding informational needs, healthcare professional involvement and service location. We used a mixed logit model to analyse DCE responses, willingness to pay estimates for different attribute levels and applied latent class modelling to explore preference heterogeneity. Free text responses were grouped by key ideas.</p><p><strong>Results: </strong>From 191 responses, numbers were similar across age categories, 46% had experienced pregnancy loss, and 87% had a child/children. Respondents preferred ICC provided by a nurse/midwife, offered during home visits or in-person consultations with a child-friendly waiting area, with appointments lasting 30 or 60 min, and at lower costs. There were no strong preferences regarding appointment wait times. Respondents favoured consultations scheduled up to 1 year after delivery. Follow-up questions indicated that most identified informational needs about emotional and mental health support (74.3%) as important, midwives were a preferred healthcare professional (71.7%) and general practice was the most favoured ICC location (64.9%).</p><p><strong>Conclusions: </strong>Ensuring clinician and setting familiarity, longer appointment times and lower appointment costs will support women's access to ICC. Policy and funding support are needed for ICC provision.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"86-94"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238134","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":"155-156"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","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}

{"title":"Sexual and reproductive health experiences and outcomes of incarcerated women and gender-diverse people in Australia: a scoping review.","authors":"Clare Heggie, Anna C Noonan, Chloë Fuller, Shelley McKibbon, Martha Paynter","doi":"10.1136/bmjsrh-2025-202903","DOIUrl":"10.1136/bmjsrh-2025-202903","url":null,"abstract":"<p><strong>Background: </strong>Women and gender-diverse people are a fast-growing population in prisons in Australia. Incarceration can create barriers to accessing sexual and reproductive healthcare. The objective of this scoping review was to identify what is known about the sexual and reproductive health experiences, needs and outcomes of women and gender-diverse people incarcerated in Australia.</p><p><strong>Methods: </strong>We used the Joanna Briggs Institute methodology for systematic scoping reviews. Databases searched included PsycINFO, Gender Studies Database, MEDLINE and CINAHL. The search yielded 658 titles and abstracts of which 17 met the criteria for inclusion.</p><p><strong>Results: </strong>We identified 17 studies published between 2000 and 2023 across three states. The studies included qualitative, quantitative and mixed-methods designs. The main outcomes of interest included: pregnancy and maternal health, contraception, sexually transmitted infections, experiences of sexual violence, and cervical health screening and outcomes.</p><p><strong>Conclusions: </strong>Evidence indicates that women and gender-diverse populations in prison in Australia experience high rates of sexually transmitted infections, poor perinatal health outcomes, and unmet needs related to contraception access and perinatal health services and programmes. The negative health impacts of incarceration are especially pronounced for Aboriginal and/or Torres Strait Islander women, who face additional discriminatory institutional barriers to participating in health programmes and experience a lack of culturally safe and appropriate care.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"130-141"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243728","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":"Association between menstrual cycle pattern regularity and changes in menstrual bleeding following COVID-19 vaccination: secondary analysis of an observational study.","authors":"Emily R Boniface, Blair G Darney, Agathe van Lamsweerde, Eleonora Benhar, Leo Han, Kristen Matteson, Victoria Male, Sharon Cameron, Alexandra Alvergne, Alison Edelman","doi":"10.1136/bmjsrh-2024-202564","DOIUrl":"10.1136/bmjsrh-2024-202564","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"161-162"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purchase of hormonal contraceptive methods after delivery: a population-based study from Finland.","authors":"Camilla Jäntti, Elena Toffol, Jari Haukka, Oskari Heikinheimo","doi":"10.1136/bmjsrh-2025-203105","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-203105","url":null,"abstract":"<p><strong>Background: </strong>Postpartum contraception start and use are important to avoid unplanned pregnancy and to optimise birth spacing. There is inconsistent knowledge concerning the background factors influencing the type and timing of contraceptive initiation and adherence after delivery.</p><p><strong>Methods: </strong>This was a historic cohort study. We identified 26 650 women that delivered between 1 January 2019 and 31 December 2019, using the Finnish Medical Birth Register. Postpartum follow-up time for each woman was 1 year. The primary outcome of the study was postpartum purchase of hormonal contraception from a pharmacy, identified from the Prescription Centre. Additionally, we analysed if mode of delivery, epidural analgesia, induction of labour, hypertensive complications, fear of childbirth or gestational diabetes affected hormonal contraception purchase.</p><p><strong>Results: </strong>Altogether, 33% (n=8902) of the women purchased a hormonal contraception method postpartum. The most purchased method was the desogestrel-only pill (56%, n=4978), and other progestogen-only preparations, which covered almost 90% of all methods started. Additionally, 4% (n=1141) received an intrauterine device (IUD) in primary healthcare. Instrumental delivery (OR 1.15, 95% CI 1.06 to 1.25), caesarean section (OR 1.26, 95% CI 1.13 to 1.41 for planned caesarean section and OR 1.25, 95% CI 1.15 to 1.36 for emergency caesarean section), epidural analgesia (OR 1.12, 95% CI 1.05 to 1.18) and induction of labour with intracervical balloon (OR 1.14, 95% CI 1.01 to 1.28) were associated with a significantly higher rate of hormonal contraception purchase.</p><p><strong>Conclusions: </strong>Overall, 37% of women purchased a hormonal contraception method or received an IUD during the first postpartum year. Common delivery complications were associated with higher rate of postpartum hormonal contraception purchase.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632425","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":"The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC).","authors":"","doi":"10.1136/bmjsrh-2026-UKMEC","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-UKMEC","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":"52 Suppl 1","pages":"1-138"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608284","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}