BMJ Sexual & Reproductive Health最新文献

{"title":"Preconception counselling at long-acting reversible contraception (LARC) removals.","authors":"Georgina Blake, Helen Thomas, Judith M Stephenson, Rachel D'Souza, Jennifer Anne Hall","doi":"10.1136/bmjsrh-2024-202494","DOIUrl":"10.1136/bmjsrh-2024-202494","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"232-234"},"PeriodicalIF":3.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963841","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":"Lifestyle risk reduction engagement during interconception: a qualitative descriptive study of women's preferences.","authors":"Sharon James, Sarah E Ratcliffe, Anisa Rojanapenkul Assifi, Jessica Botfield, Kirsten Black, Mark Hanson, Danielle Mazza","doi":"10.1136/bmjsrh-2024-202518","DOIUrl":"10.1136/bmjsrh-2024-202518","url":null,"abstract":"<p><strong>Background: </strong>Prevention and self-management of lifestyle risks can reduce non-communicable disease risks and improve the health of mothers and their children. We explored Australian women's preferences for lifestyle risk reduction engagement during the interconception period.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive interview study between February and May 2022. Women and people who have been pregnant and intended to have more children were recruited. We asked participants about their preferences for lifestyle risk reduction between pregnancies. Following reflexive thematic analysis, we conceptualised findings using the COM-B system.</p><p><strong>Results: </strong>Among 17 participants, most had given birth to one child and intended to have another child in 1 to 2 years. Our analysis found that most described lifestyle risk reduction engagement through nutrition and exercise, informed by personal experiences and their health goals for a future pregnancy/child. Key attributes affecting engagement in lifestyle risk reduction activities included their feasibility and practicality, habits and routines, motivation, pregnancy planning, and the source and quality of information. Participants' capacity and capability to engage in lifestyles supportive of interconception health were varied and influenced by juggling the routines of work, finances, health and evolving caring responsibilities. Community-based influences, including the availability of recreational infrastructure, the level of support provided by partners/family/peers and culture, also influenced participants' engagement in lifestyle risk reduction activities.</p><p><strong>Conclusions: </strong>For lifestyles that encourage interconception health, maximising participants' capability and opportunities required motivation and access to infrastructure supportive of healthy meal options and exercise, health services and community networks.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"e4"},"PeriodicalIF":3.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073894","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":"Method of anaesthesia impact on total operating room time for second-trimester procedural abortion.","authors":"Simranvir Kaur, Jessica Ansari, Andrea J Traynor, Paul D Blumenthal, Andrea Henkel","doi":"10.1136/bmjsrh-2025-202793","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202793","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based second-trimester dilation and evacuation (D&E) procedures are often completed using general anaesthesia (GA) despite emerging evidence for the safety of monitored anaesthesia care (MAC). Limited data exist comparing these approaches for key clinical outcomes.</p><p><strong>Study design: </strong>This retrospective cohort study compared those who received GA versus MAC during second-trimester (14-24 weeks' gestation) hospital-based D&Es. The primary outcome was total operating room (OR) time; secondary outcomes included surgical time, anaesthetic time, post anaesthesia care unit (PACU) time, estimated blood loss, and respiratory complications. We hypothesised that MAC would reduce the total OR time. We estimated that a sample size of 63 participants in each group would detect a 15-min or greater difference in total OR time with 80% power and a significance level of 0.05. Propensity score matching was used for sensitivity analysis.</p><p><strong>Results: </strong>During the study period, 125 patients received GA and 67 received MAC. Those receiving GA had significantly longer OR times (GA: 60.2±18.1 min vs MAC: 50.1±13.2 min, p=0.005) and greater estimated blood loss (GA: 150±286 mL vs MAC: 88±47 mL, p<0.001). No respiratory complications occurred in either group. A propensity score-matched analysis similarly found GA associated with longer OR time and higher blood loss.</p><p><strong>Conclusions: </strong>MAC may offer additional clinical benefits compared with GA during hospital-based D&E care. MAC reduces OR time and blood loss without compromising safety, which may optimise patient care and resource use in abortion care settings.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324528","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":"Highlights from the literature.","authors":"","doi":"10.1136/bmjsrh-2024-202600","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202600","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246533","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":"Frequency and patterns of emergency contraceptive demand among users of a UK-based free online sexual and reproductive health service: an observational study using routinely collected health data.","authors":"Paula Baraitser, Shaun Anthony Brown","doi":"10.1136/bmjsrh-2025-202737","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202737","url":null,"abstract":"<p><strong>Objective: </strong>To describe patterns of oral emergency contraception (EC) orders among users of a free service, commissioned by the UK National Health Service, ordered online and delivered by post.</p><p><strong>Study design: </strong>Routinely collected anonymised data from an online sexual health service in the UK from 1 January to 31 December 2023 were analysed. The number of times EC was ordered and prescribed was calculated and the age and level of deprivation assigned to the postcode where the user resided were extracted. Individual time lines were developed for those prescribed more than 10 times in 12 months.</p><p><strong>Results: </strong>During 2023 there were 32 659 oral EC requests from 19 501 users, resulting in 29 073 prescriptions from 17 576 users. Ulipristal acetate (UPA) was prescribed in 90% of the orders. The majority of users (n=12 238; 69.63%) received EC once a year, 5237 (29.80%) received it more than once and 101 (0.57%) received it more than 10 times. The mean (SD) number of prescribed orders per user was 1.65 (1.49) and the highest was 29. Oral EC had been used in the previous week by 794 of the 17 576 users (4.5%) and nine (0.05%) were prescribed more than 150 mg of UPA in 30 days.</p><p><strong>Conclusions: </strong>A small group of people order EC repeatedly, sometimes within the same cycle, putting them at increased risk of pregnancy. A minority of people order doses of UPA of >150 mg in 30 days.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179678","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":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/bmjsrh-2025-202876","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-202876","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076042","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":"Reflections and future directions for patient and public involvement and engagement (PPIE) in abortion research and service improvement.","authors":"Nicola Boydell, Rebecca Blaylock","doi":"10.1136/bmjsrh-2024-202441","DOIUrl":"10.1136/bmjsrh-2024-202441","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"83-85"},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909304","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":"A revisit of knowledge, attitude and practice of emergency contraception in Hong Kong.","authors":"Yat Yee Shizuka Chan, Siu Fan Rebecca Wan, Hang Wun Raymond Li, Sue Seen-Tsing Lo","doi":"10.1136/bmjsrh-2024-202331","DOIUrl":"10.1136/bmjsrh-2024-202331","url":null,"abstract":"<p><strong>Objectives: </strong>To revisit women's knowledge, attitudes and practices (KAP) regarding emergency contraception (EC) in Hong Kong. The research sought to provide insights for improving the accessibility and quality of EC services.</p><p><strong>Study design: </strong>A cross-sectional study, where self-administered questionnaires were distributed at a major community sexual and reproductive health service in Hong Kong over a 3-month period between July 2023 and October 2023. Descriptive and regression analyses were used.</p><p><strong>Results: </strong>Of 1127 respondents, the majority (n=1057, 93.8%) reported using contraception and 513 (45.6%) had used EC. The main contraceptive methods used were male condoms and oral contraceptive pills. The majority (n=1035, 91.8%) of respondents demonstrated awareness about EC and 938 (83.2%) participants correctly reported the timeframe for oral EC. Around two-thirds reported the internet as being their leading source of EC knowledge. Over 93% of respondents advocated for enhancing public awareness. Acceptance of non-traditional means of obtaining EC, such as over-the-counter provision (51.3%), pharmacy provision (49.8%) and telemedicine consultation (43.1%), were higher than face-to-face EC consultations (32.9%).</p><p><strong>Conclusions: </strong>Family planning service users' characteristics and KAP regarding EC have significantly changed over the last 20 years. Women now demonstrate greater awareness, knowledge and openness regarding EC, indicating improved readiness for more liberal delivery of EC nowadays. This study highlights the need for restructuring EC service provision in Hong Kong to address women's changing preferences and contraceptive needs, and to minimise barriers to EC access. We recommend reclassifying emergency contraceptive pills as non-prescription drugs in Hong Kong to align with international practice.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"122-128"},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280457","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":"Oral contraception prescribing trends in Scottish general practices between 2016 and 2023.","authors":"Elliot Johnson-Hall","doi":"10.1136/bmjsrh-2024-202387","DOIUrl":"10.1136/bmjsrh-2024-202387","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"160-161"},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092499","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":"Nurse practitioner medication abortion providers in Canada: results from a national survey.","authors":"Emma Stirling-Cameron, Andrea Carson, Abdul-Fatawu Abdulai, Ruth Martin-Misener, Regina Renner, Madeleine Ennis, Wendy V Norman","doi":"10.1136/bmjsrh-2024-202379","DOIUrl":"10.1136/bmjsrh-2024-202379","url":null,"abstract":"<p><strong>Background: </strong>In 2017, nurse practitioners (NPs) became the first non-physician healthcare providers authorised to independently provide medication abortion (MA) in Canada. We aimed to report on demographic and clinical characteristics of NPs providing mifepristone/misoprostol MA in Canada and to identify context-specific barriers and enablers to NP provision of mifepristone/misoprostol MA in Canada among MA providers and non-providers.</p><p><strong>Methods: </strong>From August 2020 to February 2021, we invited Canadian NPs to complete a national, web-based, bilingual (English/French) survey. The survey was distributed through national and provincial nursing associations and national abortion health professional organisations. We collected demographic and clinical care characteristics and present descriptive statistics and bivariate analyses to compare the experiences of NP providers and non-providers of MA.</p><p><strong>Results: </strong>The 181 respondents represented all Canadian provinces and territories. Sixty-five NPs (36%) had provided MA at the time of the survey and 116 (64%) had not. Nearly half (47%) of respondents worked in rural or remote communities and 81% in primary care clinics. Significant barriers impacting non-providers' abilities to provide MA included limited proximity to a pharmacy that dispensed mifepristone/misoprostol, few experienced abortion providers in their community of practice, poor access to procedural abortion services, policy restrictions in NPs' places of employment, and no access to clinical mentorship. Some 98% of NPs providing MA services had never encountered anti-choice protest activity.</p><p><strong>Conclusions: </strong>NPs appear prepared and able to provide MA, yet barriers remain, particularly for NPs in smaller, lower-resourced communities. Our findings inform the development of supports for NPs in this new practice to improve abortion access in Canada.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"102-110"},"PeriodicalIF":3.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458416","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}