Contraception最新文献

{"title":"Hormonal Contraception after Use of Ulipristal Acetate as Emergency Contraception: A Systematic Review.","authors":"Emily M Snyder, Kathryn M Curtis, Antoinette T Nguyen, Ananya Tadikonda, Katherine Kortsmit, Lauren B Zapata, Maura K Whiteman","doi":"10.1016/j.contraception.2025.110898","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110898","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review literature on whether hormonal contraception following ulipristal acetate (UPA) for emergency contraception decreases the effectiveness of either drug.</p><p><strong>Study design: </strong>We searched multiple databases through December 2022 for studies assessing the interaction between UPA and hormonal contraception. The primary outcome was contraceptive effectiveness, measured by pregnancy rates or proxy measures (e.g., ovarian activity). We extracted and summarized findings from identified studies, assessed risk of bias for each study, and determined certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Four studies met inclusion criteria; all had low risk of bias. Two studies assessed whether UPA use affected the ability of oral contraceptives (OCs) to inhibit ovulation; no differences were observed in ovarian activity when starting OCs one day after UPA compared with starting OCs one day after placebo. Two studies assessed whether OC use affected the ability of UPA to delay ovulation; both studies observed higher proportions of ovulation when UPA was followed by OC use versus delayed or no OC use. One study assessed ovulation risk when UPA was taken after missed OCs, followed by immediate versus delayed OC resumption; no ovulations occurred within the first five days after UPA administration in either group, but there was greater risk of ovulation beyond five days with delayed versus immediate OC resumption.</p><p><strong>Conclusions: </strong>While there is no evidence that UPA affects the ability of hormonal contraception to inhibit ovulation, hormonal contraception use immediately or soon after UPA may decrease UPA's ability to delay ovulation. The certainty of evidence ranged from moderate to very low.</p><p><strong>Implications: </strong>If a patient desires hormonal contraception after UPA, an interaction with UPA can be avoided by delaying initiation or resumption of hormonal contraception. The risk of pregnancy due to decreased effectiveness of UPA with immediate hormonal contraception should be balanced against the risk of subsequent pregnancy due to delay or non-start of hormonal contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110898"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789415","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":"Psychosocial burden when accessing medication abortion when using no-test telehealth care compared to in-person care with ultrasound.","authors":"M Antonia Biggs, C Finley Baba, Lauren J Ralph, Rosalyn Schroeder, Colleen McNicholas, Amy Hagstrom Miller, Daniel Grossman","doi":"10.1016/j.contraception.2025.110894","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110894","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether model of abortion care and living in a state with an abortion ban are associated with the psychosocial burden of care-seeking.</p><p><strong>Methods: </strong>From May 2021-March 2023, we surveyed patients obtaining medication abortion < 70 days gestation, ages > 15 years at four abortion clinic organizations in six U.S. states. We used negative binomial regression to assess three psychosocial burden dimensions: structural challenges (5 items, α=.80); lack of autonomy (3 items, α=.73); and others' reactions to the pregnancy (2 items, α=.88) by abortion care model (no-test telehealth + mail, no-test + pickup, and in-person + ultrasound) and living in a state with an abortion ban.</p><p><strong>Results: </strong>Of the 486 people who initiated a survey, 400 completed psychosocial burden items. In adjusted analyses, no-test telehealth + mail was associated with less overall psychosocial burden [incident rate ratio (IRR) 0.82, 95% Confidence Interval (CI) 0.70,0.95], including fewer structural challenges (IRR 0.78, 95% CI 0.67,0.91) and less lack of autonomy (IRR 0.65, 95% CI 0.47,0.90) than in-person care with ultrasound, mostly due to less difficulty traveling for abortion care (24% vs 32%, p<.05) and feeling less forced to wait after making the decision (11% vs 22%, p<.05). People in states with bans reported more psychosocial burden (IRR 1.62, 95% CI 1.26,2.08) including more structural challenges (IRR 1.95 0.36, 95% CI 1.53,2.29) than people in states without bans.</p><p><strong>Conclusion: </strong>No-test telehealth abortion care may reduce the psychosocial burden of care-seeking, especially the difficulties of travel and feeling forced to wait for care.</p><p><strong>Implications: </strong>Findings add to the body of evidence in support of expanding telehealth abortion care by reducing travel burden and potentially increasing autonomous decision-making when seeking abortion care.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110894"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743910","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: Contraceptive considerations for individuals with cancer and cancer survivors part 2 - Breast, ovarian, uterine, and cervical cancer.","authors":"Pelin Batur, Ashley Brant, Carolyn McCourt, Eleanor Bimla Schwarz","doi":"10.1016/j.contraception.2025.110867","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110867","url":null,"abstract":"<p><p>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven recommendations to facilitate the management of and access to contraceptive care for individuals who are diagnosed with, being actively treated for, or who have previously been treated for breast, ovarian, uterine, or cervical cancer. For individuals with a history of breast cancer, we recommend nonhormonal contraceptives as the first-line option (GRADE 1B); additional guidance is provided for hormonal contraception depending on breast cancer hormone receptor status. For individuals with a history of or active ovarian cancer, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B); in individuals diagnosed with hormonally-sensitive ovarian malignancies, such as adult granulosa cell tumors, low-grade serous, and endometrioid adenocarcinomas, who are considering hormonal contraception, we suggest shared decision-making with the individual and their oncologist (GRADE 2C). Estrogen-containing contraceptives should be avoided by individuals treated with estrogen-blocking therapy (BEST PRACTICE). For individuals with a history of endometrial cancer, we recommend clinicians provide access to all available contraceptive methods utilizing a person-centered approach (GRADE 1B); in individuals with active endometrial cancer requesting an intrauterine device (IUD), we suggest shared decision-making with the individual and their oncologist (GRADE 1B). Recommendations for individuals with gestational trophoblastic disease are provided based on factors such as evidence of persistent intrauterine disease, human chorionic gonadotropin (hCG) levels, and the individual's preferred contraceptive method. For individuals with cervical dysplasia or a history of cervical cancer, we suggest clinicians provide access to all available contraceptive methods (GRADE 2B); we suggest against IUD placement in individuals with active cervical malignancy (GRADE 2C). This document is part 2 of a three-part series that updates the Society of Family Planning's 2012 Cancer and contraception clinical guidance. It builds upon the considerations outlined in the Society of Family Planning Committee Statement: Contraceptive considerations for individuals with cancer and cancer survivors part 1 - Key considerations for clinical care and parallels recommendations outlined in the Society of Family Planning Clinical Recommendation: Contraceptive considerations for individuals with cancer and cancer survivors part 3 - Skin, blood, gastrointestinal, liver, lung, central nervous system, and other cancers. Readers are encouraged to review parts 1 and 3 for this additional context.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110867"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797294","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: Prevention of infection after abortion and pregnancy loss.","authors":"Terri Cheng, Nimisha Kumar, Laura Laursen, Sharon L Achilles, Matthew F Reeves","doi":"10.1016/j.contraception.2025.110895","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110895","url":null,"abstract":"<p><p>This Clinical Recommendation serves as a revision to the Society of Family Planning's 2010 Prevention of infection after induced abortion guidance. It examines infection risk, identifiable risk factors, and prophylactic measures for the prevention of infection associated with procedural and medication management of abortion and pregnancy loss to make evidence-based recommendations for the clinical care of patients. The following are the Society of Family Planning's recommendations: We recommend clinicians test and treat patients for gonorrhea and chlamydia at the time of abortion if there is (1) high clinical suspicion, (2) a positive diagnosis, or (3) the pregnant individual is under 25 years old and due for routine screening according to CDC guidelines; clinicians should not delay abortion while awaiting diagnosis or treatment (GRADE 1C). We recommend against screening for bacterial vaginosis (BV) before abortion (GRADE 1C). Since the rate of infection is low for nonprocedural abortion and the number needed to treat is high, coupled with inherent risks associated with antibiotic use, we recommend against the use of universal antibiotic prophylaxis in the setting of medication abortion, medication management of early pregnancy loss, or self-managed abortion (GRADE 1C). We recommend universal antibiotic prophylaxis for patients undergoing procedural abortion across all gestational durations (GRADE 1A). For procedural management of pregnancy loss, we recommend antibiotic prophylaxis (GRADE 1A). We recommend clinicians initiate antibiotic prophylaxis for procedural abortion and procedural management of pregnancy loss before instrumentation to maximize efficacy (GRADE 1B). Antibiotics should be given with adequate time for absorption, but data on the optimal timing for prophylaxis is lacking. In the setting of osmotic cervical dilator use, there is insufficient evidence to recommend for or against routine antibiotic prophylaxis before osmotic cervical dilator placement. We recommend discontinuing antibiotic prophylaxis after the procedure is completed (GRADE 1B). We recommend a single dose of doxycycline 200 mg orally or azithromycin 500 mg orally before a procedural abortion or procedural management of pregnancy loss (GRADE 1B). Metronidazole is a second-line option as it has evidence to suggest a prophylactic effect despite being less effective than doxycycline or azithromycin against aerobic bacteria. We recommend against the use of fluoroquinolones for prophylaxis in the setting of procedural abortion or procedural management of pregnancy loss due to the increased risk of side effects and complications (GRADE 1B). There is insufficient evidence to recommend for or against vaginal preparation with a local antiseptic solution or to recommend a specific vaginal preparation regimen before procedural abortion or procedural management of pregnancy loss.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110895"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743913","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":"Effects of estetrol/drospirenone on Self-Reported Physical and Emotional Premenstrual and Menstrual Symptoms: Data from the Phase 3 Clinical Trial in the United States and Canada.","authors":"Céline Bouchard, Johannes Bitzer, Melissa J Chen, Jeffrey T Jensen, Andrew M Kaunitz, Maud Jost, Jean-Michel Foidart, Mitchell D Creinin","doi":"10.1016/j.contraception.2025.110889","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110889","url":null,"abstract":"<p><strong>Objective: </strong>To describe the effects of estetrol 15mg/drospirenone 3mg on physical and emotional premenstrual and menstrual symptoms in a North American population.</p><p><strong>Study design: </strong>We used Menstrual Distress Questionnaire (MDQ) data from an open-label phase 3 trial conducted in the United States and Canada that enrolled participants 16-50 years to use estetrol/drospirenone for up to 13 cycles. Four most bothersome MDQ domains were evaluated: the physical domains of Pain and Water Retention and the emotional domains of Negative Affect and Impaired concentration. We assessed mean changes from baseline to end of treatment in premenstrual and menstrual scores in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain.</p><p><strong>Results: </strong>Of 1,864 treated participants, 1,308 (70.2%) completed both MDQs of which 676 (51.7%) were starters and 1179 (90.1%) were US participants. Starters reported significant improvements (p<0.05) for menstrual Pain (-3.3), premenstrual (-1.5) and menstrual (-2.0) Water Retention and premenstrual Negative Affect (-1.2). Switchers reported no significant changes in any of the four domains. We observed a decrease in symptom intensity in >40% of participants within the domain Pain for Headache, Cramps, Backache, Fatigue, and General Aches and Pain; within the domain Water Retention for Weight Gain, Skin Blemish, Painful or Tender Breast, and Swelling; and within the domain Negative Affect for Anxiety, Mood Swings, and Irritability.</p><p><strong>Conclusion: </strong>Estetrol/drospirenone starters experienced the most significant improvements in the MDQ domains Pain, Water Retention, and Negative Affect. Domain scores for switchers remained stable.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110889"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694737","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: Management of undesired pregnancy of unknown location and abortion at less than 42 days of gestation.","authors":"Siripanth Nippita, Catherine Cansino, Alisa B Goldberg, Neena Qasba, Katharine White, Vinita Goyal, Angeline Ti, Christy Boraas","doi":"10.1016/j.contraception.2025.110865","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110865","url":null,"abstract":"<p><p>Pregnancy of unknown location is a condition in which a pregnancy test is positive, but no intrauterine or extrauterine pregnancy is visualized using transvaginal ultrasonography. We recommend using standardized nomenclature and definitions to describe intrauterine pregnancy (IUP), probable IUP, pregnancy of unknown location (PUL), probable ectopic pregnancy (probable EP), and ectopic pregnancy (EP) (Best Practice). Among abortion-seeking patients found to have a PUL, the incidence of ectopic pregnancy (EP) is 4-8%. We recommend clinical judgment in assessing the risk for EP in the setting of PUL; the absence of an intrauterine gestational sac (GS) or yolk sac should not delay care (GRADE 1B). In asymptomatic individuals with an undesired PUL who prefer to proceed with immediate treatment (medication or procedural management without delay) and have a low risk of EP, as determined by the clinician based on history, symptoms, and all other available data, we recommend medication management with mifepristone and misoprostol or procedural management via uterine aspiration and clear plans for ensuring pregnancy resolution in a timely fashion (GRADE 1B). While both medication and procedural management of undesired PUL are associated with earlier pregnancy resolution and identification of EP, the two main risks of inadequate follow-up include ongoing pregnancy and missing or delaying a subsequent diagnosis of EP. For individuals with PUL choosing immediate treatment with medication management, we recommend clinicians obtain a baseline serum quantitative hCG at the time of medication provision to aid in diagnosis and follow-up (GRADE 1A). Following medication management of PUL with mifepristone and misoprostol, we suggest a repeat serum quantitative hCG level, with pregnancy resolution defined as either a 50% decline or greater at 48-72 hours after misoprostol or an 80% decline or greater at seven days after mifepristone or 5-10 days after misoprostol (GRADE 2B). We recommend against direct extrapolation of follow-up recommendations from no-test abortion clinical protocols to individuals with a documented PUL treated with mifepristone and misoprostol, given the higher risk of EP among individuals with a known PUL (GRADE 1C). When uterine aspiration is performed at less than 42 days of gestation, including for individuals with PUL or probable IUP, and both chorionic villi and GS are not visualized, we recommend repeat ultrasonography (if an IUP or probable IUP was seen initially), serum quantitative hCG follow-up, or both (GRADE 1B). When both chorionic villi and GS are not visualized after uterine aspiration and serial serum hCG follow-up is warranted, we recommend testing on the day of the procedure and 24-72 hours later, with pregnancy resolution defined as greater than 50% decline 24 hours after aspiration, greater than 70% by 48 hours, or greater than 80% by approximately 72 hours (GRADE 1B).</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110865"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694641","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 - Abortion.","authors":"Rajita Patil, Divya Dethier, Montida Fleming, Emily Godfrey, Julia E Kohn","doi":"10.1016/j.contraception.2025.110864","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110864","url":null,"abstract":"<p><p>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize medication abortion management via telemedicine in the US. Key recommendations include: We recommend telemedicine medication abortion with or without pre- or posttreatment testing as a safe option before 12 0/7 weeks of gestation. No-test telemedicine medication abortion (NTMA) and hybrid models are shown to be safe and effective (GRADE 1B). We recommend over-the-counter nonsteroidal anti-inflammatory agents as the first line for pain management for telemedicine medication abortion with consideration of opioids as needed when providing telemedicine medication abortion care (GRADE 1C). We recommend principles of noncoercive person-centered communication be applied to meet the abortion counseling needs of the person receiving care (GRADE 1B). We suggest assessing the person's desire for contraceptive counseling at the time of telemedicine medication abortion and, depending on the preference of the person receiving care, either defer it to a later time to allow for deliberation and increased autonomy or provide contraceptive counseling if desired (GRADE 2C). We recommend assessing telemedicine medication abortion completion using a standardized patient symptom checklist (such as the sample validated checklist in Table 2) two weeks after mifepristone ingestion in conjunction with a home pregnancy test (GRADE 1C). 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 - Contraception. Readers are encouraged to review parts 1 and 3 for this additional context.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110864"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617901","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":"Mapping ethical concerns in algorithm-driven period and fertility tracking technologies.","authors":"Maria Carmen Punzi, Tamara Thuis","doi":"10.1016/j.contraception.2025.110837","DOIUrl":"10.1016/j.contraception.2025.110837","url":null,"abstract":"<p><strong>Objective: </strong>The proliferation of algorithms in period and fertility tracking technologies has increased reliance on data and analytics to interpret menstrual cycle symptoms and guide health and fertility-related action. We set out to map the ethical concerns of the (often invisible) algorithmic influence on users' experience of, and behavior related to their menstrual cycle and fertility.</p><p><strong>Study design: </strong>Reviewing literature and media, we map six ethical concerns of algorithms in period and fertility tracking technologies - inconclusive evidence, inscrutable evidence, misguided evidence, unfair outcomes, transformative effects, traceability - and highlight their potential implications, particularly for vulnerable groups.</p><p><strong>Results: </strong>Based on this mapping, we identify three overarching themes for further analysis: self-knowledge, power and control, representation and inclusion. We find that organizational activity, individual user activity and societal dynamics interact with each other and influence how we can prevent and address the mapped ethical concerns of algorithms.</p><p><strong>Conclusion: </strong>Algorithm-driven period and fertility tracking technologies carry more (and more nuanced) ethical concerns than those currently discussed in the literature and in media. We call for future research to integrate the ethics of (AI) algorithms into the field of sexual and reproductive health, recognizing the complex connections between individual, organizational, and societal levels.</p><p><strong>Implications: </strong>When taking the mapped ethical concerns seriously, we see a potential for algorithm-driven period and fertility tracking technologies to empower - and not discriminate - its users; for users to learn about their bodies and use the technologies responsibly; and for society to actively scrutinize its biases and achieve health equity.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110837"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384111","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":"Use of period- or fertility-tracking technologies pre- and post-Dobbs.","authors":"Emily Neiman, Marta Bornstein, Abigail Norris Turner, Megan L Kavanaugh, Maria F Gallo","doi":"10.1016/j.contraception.2025.110812","DOIUrl":"10.1016/j.contraception.2025.110812","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate whether the use of period- or fertility-tracking technologies decreased from pre- to post-Dobbs and to identify user characteristics and changes in reasons for use.</p><p><strong>Study design: </strong>We used data from the Surveys of Women, population-based surveys on reproductive health among self-identified women aged 18 to 44 years, conducted in five states. We compared the prevalence of use of period- or fertility-tracking technologies and reasons for use pre-Dobbs (2018-2019 in Iowa and Ohio; 2019-2020 in Arizona, New Jersey, and Wisconsin) and post-Dobbs (2022-2023 in all five states), overall and stratified by state. To examine the prevalence of use, we adjusted for age, race/ethnicity, education level, and marital status.</p><p><strong>Results: </strong>Period- or fertility-tracking technology use increased from pre-Dobbs to post-Dobbs overall, with an adjusted prevalence ratio (aPR) of 1.20 (95% CI 1.15-1.26). User prevalence increased in four of the five states: Arizona (aPR = 1.17; 95% CI 1.06-1.30), Iowa (aPR = 1.32; 95% CI 1.19-1.47), New Jersey (aPR = 1.21; 95% CI 1.11-1.31), and Ohio (aPR = 1.28; 95% CI 1.16-1.40); prevalence was unchanged in Wisconsin (aPR = 1.06; 95% CI 0.95-1.18). The only change in the reason for use was a decrease in reports of using an app \"to become pregnant\" post-Dobbs (aPR = 0.85; 95% CI 0.75-0.97).</p><p><strong>Conclusions: </strong>The increase in period- or fertility-tracking technology use pre- to post-Dobbs may demonstrate that data privacy was less of an issue for users than anticipated.</p><p><strong>Implications: </strong>While the Dobbs decision led legal and data privacy experts, media, and reproductive health advocates on social media to warn period- or fertility-tracking technology users to delete their tracking technology out of concern for data privacy and potential prosecution for abortion, the prevalence of technology users instead increased from pre- to post-Dobbs.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110812"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973642","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":"Contraception and abortion attitudes among military medical students: An exploratory study.","authors":"Nicole M Mahr, Jill E Brown","doi":"10.1016/j.contraception.2024.110489","DOIUrl":"10.1016/j.contraception.2024.110489","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate military medical students' attitudes toward contraception and abortion after clerkships.</p><p><strong>Study design: </strong>We adapted a survey of civilian medical student attitudes for military students. We asked how clerkships changed perspectives and comfort discussing these topics.</p><p><strong>Results: </strong>Eighty-five (85%) of 100 respondents felt more comfortable discussing contraception and abortion after clerkships. More students changed perspectives on contraception than abortion (29% vs 17%, p = 0.043). Students noted limited exposure to abortion.</p><p><strong>Conclusions: </strong>Clerkships increased comfort discussing contraception and abortion but were unlikely to change their attitudes.</p><p><strong>Implications: </strong>More exposure to abortion care is needed.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110489"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960838","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}