BMJ Sexual & Reproductive Health最新文献

{"title":"Privacy, temporal flexibility and connection: how online spaces shape abortion support.","authors":"Rachel Victoria Wilson-Lowe, Carrie Purcell, Ruth Lewis, Lisa McDaid","doi":"10.1136/bmjsrh-2026-203253","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-203253","url":null,"abstract":"<p><strong>Background: </strong>Online spaces are increasingly used by people seeking support around sexual and reproductive healthcare and can offer anonymity and flexibility. Relatively little is known about how these spaces are used in relation to abortion. This article explores what informal online spaces (eg, social media and discussion forums) offer to those seeking support around abortion, in the face of increasingly digitalised healthcare, persistent abortion stigma and resource constraints on sexual and reproductive health services.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with individuals who had sought abortion-related support online. Twenty-three women, aged 20-54 years, who had undergone abortion and were living in Scotland at the time of the interview were recruited through social media and online advertisements. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>We identified three principal affordances of online spaces that shaped participants' experiences of accessing support online: (1) privacy-participants chose online spaces based on perceptions of the potential (in)visibility of their interactions with abortion-related content and anonymity; (2) temporal flexibility-support could be sought as and when needed, derived from posts long after they were created; and (3) connection to others with experiential knowledge of abortion-engagement ranged from active interactions to anonymous browsing, with one-way participation providing meaningful support at low social cost.</p><p><strong>Conclusions: </strong>Our findings suggest that online spaces can provide flexible, stigma-sensitive, abortion-affirming support. Those who provide abortion services should consider ways in which trustworthy online spaces can be integrated into existing care pathways to reduce isolation and address unmet social support needs.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583604","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":"Adolescents' motivations for obtaining online medication abortion in the United States: a mixed-methods analysis.","authors":"Dana M Johnson, Doris Huijsmans, Dirk Essink, Rebecca Gomperts","doi":"10.1136/bmjsrh-2026-203347","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-203347","url":null,"abstract":"<p><strong>Background: </strong>State-level abortion bans, parental involvement laws and structural barriers to abortion care create a complicated landscape for adolescents under 18 years old seeking clinic-based abortion. Because of such obstacles, adolescents may seek medication abortion from online sources. We aimed to understand their individual motivations for obtaining medication abortion from one online telemedicine service instead of in-person clinic-based care.</p><p><strong>Methods: </strong>We conducted a mixed-methods study among adolescents who requested medication abortion between 1 July and 30 November 2022 from a service providing asynchronous clinician consultation and medication dispensed by mail to people in all 50 United States (US) states. We examined demographic characteristics, reasons for request, and conducted a content analysis of a subsample of anonymised email communications.</p><p><strong>Results: </strong>Over a 5-month period, 558 adolescents requested medication. The most frequently selected motivations were: I would rather keep my abortion private (66%); I would be more comfortable at home (64%); I need to keep my treatment a secret from my partner/family (64%); Pills at home are more affordable (47%); I prefer to take care of my own treatment (47%); and I want to have my partner/friend with me (45%). In email communications, adolescents expressed an urgent need for abortion and articulated additional barriers including the high cost of the service and lack of access to credit cards or digital payment methods.</p><p><strong>Conclusions: </strong>Our results provide insights into why adolescents in the US pursue online medication abortion services and raise the need to address cost and payment barriers to telehealth abortion.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547893","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":"Use of contraception after birth, experience of contraception counselling and structural barriers to access: a mixed-methods survey.","authors":"Eleanor M F Richards, Annette Thwaites, Jennifer Hall","doi":"10.1136/bmjsrh-2026-203315","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-203315","url":null,"abstract":"<p><strong>Background: </strong>To avoid unplanned, rapid repeat pregnancies, women are recommended to use effective contraception by day 21 postpartum. This study describes postpartum contraception use, impact of contraception counselling, and structural barriers to access from the perspective of doctor-mothers who have knowledge of health systems and high health-literacy.</p><p><strong>Methods: </strong>This is a secondary analysis of a survey which compared postpartum contraception use in women who had conceived spontaneously versus with in vitro fertilisation, using data from doctor-mothers who conceived spontaneously. Contraception use over time is presented as a Sankey plot. Chi-squared or Fisher's exact tests compared contraception effectiveness by sociodemographics and pregnancy planning. Qualitative data on contraception counselling experience were analysed using thematic analysis.</p><p><strong>Results: </strong>Of 634 records, 177 participants were eligible for analysis, with 72 providing qualitative data. Most (146/177, 82.5%) reported vaginal sex post-birth, and 19.8% had had sex within 6 weeks. Only 11.6% (17/146) of sexually active participants used very effective methods as first contraception. Greater contraception effectiveness was associated with earlier initiation (p<0.001). Of sexually active participants who initiated contraception within 3 weeks postpartum, 92.3% (12/13) used effective or very effective methods. Counselling only at place of birth was associated with initiation of effective contraception (p=0.041). Qualitative analysis of counselling experience generated three themes: (1) counselling style, (2) multidisciplinary working and (3) need for self-advocacy.</p><p><strong>Conclusions: </strong>Use of effective postpartum contraception was low overall, despite a highly health-literate population. Counselling at place of birth has a potentially significant impact on the individual. Of those who initiated contraception before 3 weeks, almost all chose effective methods indicating acceptability where available.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535408","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":"Longitudinal trends and characteristics of medication abortion provision in Australian general practice: a national open-cohort study using MedicineInsight, 2014 to 2021.","authors":"Gizat M Kassie, Danielle Mazza, Kristina Edvardsson, Kirsten Black, Laura Schummers, Wendy V Norman, Luke E Grzeskowiak","doi":"10.1136/bmjsrh-2026-203337","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-203337","url":null,"abstract":"<p><strong>Objectives: </strong>To examine longitudinal trends in the provision of medication abortion (MA) in Australian general practice.</p><p><strong>Study design: </strong>Retrospective study of Australian females aged 14-49 years attending Australian general practices between 2014 and 2021. Data were sourced from the national general practice dataset, MedicineInsight. We calculated rates of MA provision and reported characteristics of those receiving and providing MA services.</p><p><strong>Results: </strong>We identified 4306 instances of MA provision to 3980 unique individuals. The rate of MA provision increased from 0.11 per 1000 females in 2014/15 to 2.10 per 1000 females in 2020/21. A greater absolute increase in the rate of MA was evident among those aged 25-29 years, those residing in regional areas or those in areas of lower socioeconomic status. The proportion of general practices providing MA increased from 4.4% in 2014 to 22.7% in 2021. The proportion of general practices providing MA was higher among those located outside of major cities and in higher socioeconomic status areas.</p><p><strong>Conclusions: </strong>Despite modest increases in the rates of MA provision in general practice over time, less than one third of general practices provide MA. Significant geographical variation in MA provision is also evident according to remoteness, socioeconomic status and state/territory. The findings emphasise the need for additional initiatives to ensure equitable access to abortion care within the general practice setting, and future research should examine the underlying reasons for differences in MA uptake by patient characteristics and geographical location, informing targeted interventions and service planning.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535396","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":"Postpartum contraception priorities for a collaborative network to support informed decision-making and optimise pregnancy planning and spacing.","authors":"Jessica R Botfield, Jenna Perkins, Clare J Boerma, Danielle Mazza, Kirsten I Black","doi":"10.1136/bmjsrh-2026-203379","DOIUrl":"https://doi.org/10.1136/bmjsrh-2026-203379","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469184","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":"236-237"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","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":"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":"238-239"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","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":"Real world performance of an atraumatic cervical stabiliser for intrauterine device insertion: single centre observational study.","authors":"Sandra Molin, Caroline Rosvall Hansson, Maria Sjöstrand, Sofia Almén, Susanna Henriques","doi":"10.1136/bmjsrh-2025-202949","DOIUrl":"10.1136/bmjsrh-2025-202949","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"240-241"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069144","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":"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":"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":"184-191"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","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":"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":"234-235"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","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}