Contraception最新文献

{"title":"Over-the-counter contraceptive pill availability in New York State.","authors":"Carolyn Joyce, Komal Keerthy, Sedna Gandhi, Ann Frisse, Bianca M Stifani","doi":"10.1016/j.contraception.2026.111482","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111482","url":null,"abstract":"<p><strong>Objective: </strong>To map access to norgestrel 0.075mg (Opill) in New York state one year after approval for over-the-counter (OTC) sale.</p><p><strong>Study design: </strong>We called a random sample of New York pharmacies posing as minors enquiring about Opill. We collected information about pharmacy type and location. We used the Chi Squared test to compare proportions.</p><p><strong>Results: </strong>Of the 379/7143 (3.5%) registered pharmacies reached, 214 (56.46%) stocked norgestrel and 76/165 (46.06%) could order it. The average monthly cost was $25.29. Chain pharmacies were more likely to stock than others (p<0.001). There was no difference by location.</p><p><strong>Conclusions: </strong>The OTC contraceptive pill is not universally available in New York.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111482"},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abortion Volume Reported by Graduating Residents in Obstetrics and Gynecology Training Programs.","authors":"Anita Pershad, Alyssa Wilkinson, Thomas Kimble","doi":"10.1016/j.contraception.2026.111483","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111483","url":null,"abstract":"<p><strong>Objective: </strong>Recent legislative changes in the U.S. have increasingly restricted access to abortion care, creating challenges not only for patients but also for the clinical training of obstetrics and gynecology (OB/GYN) residents. As abortion restrictions expand, concerns grow about the adequacy of procedural training for future OB/GYNs. Our objective is to evaluate national trends in procedural abortion training by examining the number of procedures reported by graduating U.S. OB/GYN residents over the past 15 years.</p><p><strong>Study design: </strong>We conducted a retrospective, cross-sectional analysis of data from the Accreditation Council for Graduate Medical Education (ACGME) case logs for academic years 2009-2010 through 2023-2024. The mean number of abortions performed per resident per year, along with the number of graduating residents and residency programs, were recorded. Linear regression is used to assess trends over time.</p><p><strong>Results: </strong>From 2009 to 2024, there was a statistically significant increase in the number of graduating residents (mean increase of 20.2/year) and residency programs (mean increase of 2.7/year) (p less than 0.001). In contrast, the mean number of abortions per graduating resident declined from 46.1 to 43.9, representing a 4.7% decrease % (p<0.03).</p><p><strong>Conclusions: </strong>While OB/GYN residency programs have expanded, abortion procedural experience per resident has declined. This highlights a potential gap in clinical training and raises concerns about the future competency of the OB/GYN workforce. Continued monitoring and the development of innovative training solutions are essential to ensure comprehensive reproductive healthcare education.</p><p><strong>Implications: </strong>This study analyzes trends in the number of procedural abortions performed by graduating residents over the past 15 years, highlighting a significant decline despite the increasing number of accredited residency programs. The findings underscore the need for alternative educational strategies to ensure resident competency.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111483"},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives as Abortion Care Providers: Evidence from a National Survey of Early Career U.S. Midwives.","authors":"Laura D Lindberg, Julie Blumenfeld, Amy Alspaugh","doi":"10.1016/j.contraception.2026.111481","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111481","url":null,"abstract":"<p><strong>Objectives: </strong>To examine early-career U.S. midwives' involvement in abortion care provision.</p><p><strong>Study design: </strong>We analyzed data from a 2024 national survey of certified nurse-midwives and certified midwives within five years of certification, assessing self-reported abortion care provision.</p><p><strong>Results: </strong>Overall, 18.8% of respondents reported providing abortion care; among those practicing in states where abortion is legal and permitted under licensure, 26.0% reported providing abortion care. Provision varied by policy context and provider characteristics.</p><p><strong>Conclusions: </strong>Early-career midwives contribute to abortion care in the United States.</p><p><strong>Implications: </strong>Findings inform understanding of the abortion care workforce.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111481"},"PeriodicalIF":2.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Committee Statement: Telemedicine in family planning care part 1 - Background and overarching principles.","authors":"Rajita Patil, Divya Dethier, Montida Fleming, Emily Godfrey, Julia E Kohn","doi":"10.1016/j.contraception.2025.110914","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110914","url":null,"abstract":"<p><p>Telemedicine is an effective modality for remote family planning care delivery. Telemedicine increases reach, reduces barriers to care, and facilitates person-centered care. As the demand for telemedicine increases, evidence-based guidance is crucial for optimal practice. This clinical guidance series offers evidence-informed, person-centered, and equity-driven recommendations to enhance telemedicine delivery of contraceptive services and medication abortion in the US. Providing care via telemedicine may not be for everyone, and thus, clinicians should take a person-centered approach to ensure telemedicine meets the needs of the person receiving care. Ensuring that telemedicine remains accessible, regardless of whether a person also requires in-person clinical services, is essential to person-centered family planning care. Telemedicine family planning services should be integrated across practice settings and codesigned with persons from marginalized communities to ensure services are linguistically appropriate, equitable, and accessible. Clinicians should engage in implementation and advocacy efforts that combat health, digital, and structural inequities contributing to disparities in telemedicine family planning care access. Telemedicine family planning care should address the privacy and confidentiality of the person receiving care. Telemedicine family planning care clinicians should be familiar with their state, regional, and institutional laws or regulations regarding abortion care and, more broadly, telemedicine before providing care. Where uncertainty exists, clinicians should consult a lawyer experienced in telemedicine and abortion care. The companion documents, Society of Family Planning Clinical Recommendation: Telemedicine for abortion and contraception part 2 - Contraception and Society of Family Planning Clinical Recommendation: Telemedicine for abortion and contraception part 3 - Abortion, build upon this document and focus on actionable clinical recommendations.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110914"},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial.","authors":"","doi":"10.1016/j.contraception.2026.111478","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111478","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111478"},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 2 - Contraception.","authors":"Rajita Patil, Divya Dethier, Montida Fleming, Emily Godfrey, Julia E Kohn","doi":"10.1016/j.contraception.2025.110984","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110984","url":null,"abstract":"<p><p>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize contraceptive care via telemedicine in the United States. Recommendations include offering the following contraceptive services via telemedicine: contraceptive counseling, initiation, renewals for methods not requiring procedural placement, and follow-up care for symptoms or complication management not requiring physical exam (GRADE 1B). The person receiving care should have the option to choose their preferred telemedicine service delivery mode, including audio-video, audio-only, or asynchronous care. When prescribing combined hormonal contraceptives (CHCs), we suggest clinicians provide clear guidance on how to remotely collect and report blood pressure measurements, why these data are important, and the availability of alternative contraception options if an unacceptable health risk is identified (GRADE 2C). We recommend prescribing a 1-year supply of CHCs without requiring follow-up within that year unless requested by the person receiving care (GRADE 1A). We recommend progestin-only methods as safe and effective options for telemedicine and self-administered contraception provision (GRADE 1A). We recommend a hybrid approach combining telemedicine and in-person care for long-acting reversible contraception (LARC) methods (GRADE 2B). However, it is important to maintain the option for same-day, in-person LARC provision without requiring prior telemedicine counseling. This document builds upon the Society of Family Planning Committee Statement: Telemedicine in family planning care part 1 - Background and overarching principles and parallels recommendations outlined in the Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 3 - Abortion. Readers are encouraged to review parts 1 and 3 for this additional context.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110984"},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induced abortions during COVID-19 in Japan: deviation from long-term trends in a setting with self-imposed mobility reduction.","authors":"Kuniaki Ota, Tsuyoshi Takiuchi, Tadashi Kimura, Koichiro Shimoya","doi":"10.1016/j.contraception.2026.111462","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111462","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether induced abortions in Japan deviated from pre-pandemic trends during FY2020-FY2024 and whether changes coincided with mobility reduction.</p><p><strong>Study design: </strong>National annual induced-abortion counts were analyzed using Poisson log-linear models, with expected FY2020-FY2024 counts projected from FY2011-FY2019.</p><p><strong>Results: </strong>Abortions were lower than expected in FY2020-FY2022 (IRR 0.899, 95% CI 0.895-0.903) and remained below expected in FY2023-FY2024 (IRR 0.957, 95% CI 0.950-0.963). Mobility decreased despite non-compulsory measures.</p><p><strong>Conclusions: </strong>Induced abortions declined below counterfactual expectations during COVID-19 in Japan and remained below the pre-pandemic trajectory after FY2022.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111462"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Intrauterine Anesthesia on Pain Management During IUD Insertion: A Meta-Analysis of Randomized Controlled Trials.","authors":"Rebecca Fonseca De Azevedo, Ingryd de Almeida Silva, Ana Carolina Mendes Dominguez, Julia Terra Molisani, Ellen Silva Rodrigues, Pedro Henrique Costa Matos da Silva","doi":"10.1016/j.contraception.2026.111463","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111463","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate intrauterine anesthesia (IUA) compared with normal saline infusion for pain reduction during intrauterine device (IUD) placement.</p><p><strong>Study design: </strong>Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing IUA with saline in nulliparous and parous women undergoing IUD insertion. Eligible studies were RCTs reporting at least one pain related outcome; postpartum insertions were excluded. We searched PubMed, Embase, and Cochrane databases in November 2024. The primary outcome was pain during IUD insertion. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and heterogeneity using I². Analyses were performed in Review Manager (RevMan) version 7.12.0.</p><p><strong>Results: </strong>Six RCTs involving 651 women were included; 68% were nulliparous and 49.3% received IUA. Five studies with 427 women contributed to the analysis of pain during IUD insertion, which was significantly lower with IUA compared with placebo (SMD -0.47; 95% CI -0.90 to -0.03; p = 0.04; I² = 58%). In subgroup analysis, two studies including a total of 262 patients receiving lidocaine demonstrated a significant reduction in pain during IUD insertion (p = 0.0002), whereas two studies including 165 patients utilizing other anesthetic agents showed no significant effect (p = 0.27). Pain after insertion did not differ significantly between groups (p = 0.05). All studies had low risk of bias.</p><p><strong>Conclusion: </strong>Intrauterine anesthesia reduced pain during IUD insertion compared with saline infusion; however, the effect of infusion itself on procedural discomfort remains uncertain.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111463"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PASS, VAS, or Satisfaction: A prospective observational study of IUD placement pain experiences.","authors":"Sara McAllaster, Gentry Carter, Rebecca G Simmons, Jami Baayd, David K Turok, Lori M Gawron","doi":"10.1016/j.contraception.2026.111461","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111461","url":null,"abstract":"<p><strong>Objectives: </strong>To identify factors associated with unacceptable Patient Acceptable Symptom State (PASS) responses, Visual Analog Scale (VAS) scores, and satisfaction at time of intrauterine device (IUD) placement.</p><p><strong>Study design: </strong>Recruitment occurred at six Utah clinics between 6/24-2/25. Participants completed procedure surveys on demographics, reproductive history, anticipated pain, anxiety, and coping skills. Post-placement surveys assessed PASS responses, experienced pain by VAS (1-100mm) and satisfaction with IUD placement (5-point Likert scale). We determined factors associated with unacceptable PASS responses and a cut point delineating \"low\" vs \"high\" pain to assess measure associations.</p><p><strong>Results: </strong>Of 194 participants, 21% (n=41) reported an unacceptable PASS, which was associated with higher mean anticipated (65mm vs 51mm; p_adj=0.01) and experienced (76mm vs 46mm; p_adj<0.001) pain, prior sexual assault (55% vs 28%; p_adj=0.016), or violent death of someone close (25% vs 7%; p_adj=0.024). In controlled analysis, higher experienced pain predicted unacceptable PASS (OR:1.10;95%CI:1.06, 1.14). \"High\" pain (≥61mm) occurred in 44% of all participants. Of those with high pain, 55% reported an acceptable PASS response. History of prior pelvic exam (p=0.02, p_adj 0.20), prior IUD placement (p=0.003; p_adj 0.12), or violent death of someone close (p=0.011; p_adj 0.13) influenced unacceptable PASS responses in this group. Of all participants, 21% reported dissatisfaction (n=16) or neutral response (n=24) regarding their IUD placement, among which only 13 reported an unacceptable PASS (32%). Satisfaction was influenced by mean VAS score (61mm dissatisfied/neutral vs 50mm satisfied; p=0.01; p_adj 0.90).</p><p><strong>Conclusions: </strong>IUD placement pain level may influence satisfaction, but less than half of those with high pain (≥61mm) reported an unacceptable experience.</p><p><strong>Implications: </strong>IUD placement pain experiences are multi-dimensional and cannot be described by pain level alone. High levels of placement pain influence satisfaction and overlap but are not collinear with acceptability responses. Acceptability of IUD may be subject to temporal bias and influenced by whether their goals/needs are met and whether the pain was ultimately worth it.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111461"},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global family planning programs after the demise of U.S. Foreign Aid: How do we measure success?","authors":"Win Brown, Amy Ong Tsui","doi":"10.1016/j.contraception.2026.111460","DOIUrl":"10.1016/j.contraception.2026.111460","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111460"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}