Contraception最新文献

{"title":"First trimester suction aspiration without septum resection for transverse vaginal septum: A case report.","authors":"Abraham Fessehaye Sium, Gebresilassie Andualem Asmare","doi":"10.1016/j.contraception.2025.110954","DOIUrl":"10.1016/j.contraception.2025.110954","url":null,"abstract":"<p><p>A 27 years-old G2 Para 1 patient with a known uterine didelphys presented at 11 weeks of gestation with 3 days of vaginal bleeding. Evaluation demonstrated a fetal demise and a thin transverse vaginal septum with a central dimple. We successfully performed a mannual vacuum aspiration without septoplasty by dilating the dimple with vacuum cannulas.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110954"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087058","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":"Estimating emergency contraception efficacy with levonorgestrel and copper intrauterine devices.","authors":"Susan E Nourse, Alexandra L Woodcock, Kathryn S Brown, Alexandra Gero, Lori M Gawron, David K Turok","doi":"10.1016/j.contraception.2025.110946","DOIUrl":"10.1016/j.contraception.2025.110946","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine observed vs expected pregnancy risk among levonorgestrel 52 mg and copper T380A intrauterine device (IUD) emergency contraception (EC) users.</p><p><strong>Study design: </strong>This is a secondary analysis of participants seeking EC randomly assigned to a levonorgestrel 52 mg or copper T380A IUD. Participants had at least one episode of unprotected intercourse (UPI) in the 5 days preceding enrollment and reported all episodes in the preceding 5 days. We report the proportion of pregnancies prevented of those expected at 1 month following IUD insertion using an established approach that assigns pregnancy risk by menstrual cycle day of intercourse. We calculated proportion of pregnancies prevented using both the day of most recent UPI and all reported UPIs within 5 days of presentation.</p><p><strong>Results: </strong>One pregnancy occurred among the 312 participants who received the levonorgestrel 52 mg IUD, with 137 (43.9%) reporting multiple episodes of UPI. No pregnancies occurred among the 318 participants who received the copper IUD, of whom 142 (44.6%) reported multiple episodes. In the levonorgestrel 52 mg IUD group, 14.8 pregnancies were expected using the most recent episode of UPI, and 22.0 pregnancies were expected using all episodes within 5 days of presentation. In the copper IUD group, we calculated 15.0 and 23.1 expected pregnancies, respectively. Levonorgestrel 52 mg IUDs prevented 93.2% to 95.7% of expected pregnancies, and copper IUDs prevented 100% of expected pregnancies.</p><p><strong>Conclusions: </strong>The results of this analysis provide additional data quantifying the pregnancy risk reduction for both the levonorgestrel 52 mg IUD and copper IUD in a realistic population of EC users.</p><p><strong>Implications: </strong>The levonorgestrel 52 mg IUD for emergency contraception prevented 93% to 96% of expected pregnancies using an established pregnancy risk method, while copper IUD users experienced 100% pregnancy prevention.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110946"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082365","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":"Thrombosis risk with the use of hormonal contraception among women with thrombophilia: An updated systematic review.","authors":"Naomi K Tepper, Antoinette T Nguyen, Kathryn M Curtis, Caitlin Baumhart, Laura Schieve, Maura K Whiteman","doi":"10.1016/j.contraception.2025.110943","DOIUrl":"10.1016/j.contraception.2025.110943","url":null,"abstract":"<p><strong>Objectives: </strong>Thrombophilia is associated with an elevated risk of thrombosis, which may be further elevated with the use of hormonal contraception. Our objective was to update a previously published systematic review on thrombosis risk with the use of hormonal contraception among women with thrombophilia.</p><p><strong>Study design: </strong>We conducted a systematic review of five databases from database inception through December 8, 2022. We searched for articles that examined risk of venous thromboembolism (VTE) or arterial thromboembolism (ATE) in women with thrombophilia using hormonal contraception compared with women using nonhormonal or no contraception. We assessed the risk of bias for each study and certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Eighteen articles met inclusion criteria; four had moderate risk of bias and 14 had high risk of bias. Odds of VTE in women with factor V Leiden (FVL) mutation or prothrombin (PT) gene mutation were elevated in combined oral contraception (COC) users vs nonusers. Odds of VTE were elevated in COC users with FVL mutation, PT gene mutation, both FVL and PT mutations, antithrombin deficiency, or protein C deficiency compared with nonusers without the mutation. Odds of stroke were elevated in COC users with FVL mutation compared with nonusers without the mutation. Evidence was mixed on whether risk was elevated in women with protein S deficiency using COC compared with nonuse. One study found elevated odds of VTE in women with FVL mutation but not women with PT gene mutation using progestin-only contraception (POC), compared with nonusers without the mutation.</p><p><strong>Conclusions: </strong>Overall, studies found elevated odds of VTE and ATE in women with thrombophilia using COC compared with nonusers without thrombophilia. The certainty of evidence for all outcomes is low. Evidence is also limited by small numbers of women and minimal evidence on the use of patch, ring, or progestin-only contraception and is insufficient to assess differential risk by all thrombophilia types.</p><p><strong>Implications: </strong>Use of estrogen-containing hormonal contraception might further elevate the risk of thrombosis among women with thrombophilia. Further study is needed on safety of POC use in women with thrombophilia.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110943"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994145","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":"Not here, not now: a mystery caller study of availability of mifepristone in community pharmacies in Alberta, Canada.","authors":"Erin A Brennand, Natalie V Scime, Beili Huang, Alam Randhawa, Shunaha Kim-Fine, Orly Aziza, Jadine Paw, Erin L Nelson","doi":"10.1016/j.contraception.2025.110945","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110945","url":null,"abstract":"<p><strong>Objectives: </strong>This study assessed same-day availability, dispensing practices, and information provision for mifepristone in Alberta pharmacies.</p><p><strong>Study design: </strong>Cross-sectional data from 1620 pharmacies (>99% response) were collected from pharmacy respondents using a mystery caller approach (January-October 2024). Using a standardized script, team members inquired about mifepristone availability, Alberta's coverage plan, and dispensing. Outcomes included: (i) same-day stock availability, (ii) willingness to order, (iii) refusal to order (iv) conscientious objection. Accuracy of cost information, and adherence to regulatory standards were assessed. Geographic patterns and associations with the deprivation index of pharmacy location were explored.</p><p><strong>Results: </strong>Same day dispensing was available at 12.9% pharmacies, and 76.2% offered to order it, with delivery times estimated from next day to 10 days. A small number of pharmacies (n=86, 5·3%) did not offer to order with no reason given; conscientious objection was reported by 90 pharmacies (5·6%), of which only 10.0% (n=9) provided onward referrals. Awareness of Alberta's universal coverage for mifepristone was low; 71.1% of respondents incorrectly stated that uninsured patients must pay out of pocket. Mifepristone was less often in stock in Alberta's two major cities; pharmacies in high-deprivation areas were less likely to have mifepristone in stock and more often expressed conscientious objection.</p><p><strong>Conclusion: </strong>Same-day mifepristone availability in Alberta pharmacies is limited, and adherence to referral standards among objectors is poor. Awareness of universal coverage is suboptimal, raising concern about overcharging. Enhancing access may require collaboration between abortion providers and pharmacies, increased communication about coverage policies, and innovative solutions related to dispensing.</p><p><strong>Implications: </strong>Limited same-day access to mifepristone, compounded by poor adherence to regulatory standards and low awareness of public coverage, highlights equity gaps in abortion care across Alberta, Canada. Targeted policy reforms and pharmacist education are needed to improve timely, reliable access, particularly for socioeconomically disadvantaged communities.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110945"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011081","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":"Psychometric evaluation of the desire to avoid pregnancy scale in India.","authors":"Sarah Averbach, Nicole E Johns, Shweta Tomar, Marielle E Meurice, Namratha Rao, Mohan Ghule, Anita Raj","doi":"10.1016/j.contraception.2025.110940","DOIUrl":"10.1016/j.contraception.2025.110940","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the psychometric performance of the Desire to Avoid Pregnancy (DAP) scale in India.</p><p><strong>Study design: </strong>We utilized survey data from married women enrolled in a family planning intervention in Maharashtra, India, who provided responses to the 14-item DAP scale at 18-month intervention study follow-up. We assessed scale internal consistency using Cronbach α and used exploratory factor analysis to evaluate scale unidimensionality and item response theory (IRT) to assess item performance. We used regression models to assess whether DAP predicts current reported contraceptive use, as well as future contraceptive use and pregnancy, to evaluate construct validity.</p><p><strong>Results: </strong>A total of 1088 participants responded to 18-month intervention study follow-up survey; 99% of eligible participants (887/888) provided the full-scale response. One item, \"makes me smile,\" performed in the reverse direction as anticipated (negative item-test correlation) and was excluded for use in this analysis. The mean 13-item DAP score (DAP-13) was 2.14 of 4 (SD 0.95, range 0-4); internal consistency was high (Cronbach α = 0.92). Most items fit the partial credit model on IRT. Exploratory factor analyses supported either a one- or two-factor model; the unidimensional model was considered acceptable for use as the single factor explained 71% of all variance, and all items had stable absolute factor loadings ≥0.38. DAP-13 score only differed by parity; nulliparous women had the lowest scores (0.56), followed by women with one (1.94), two (2.60), or three or more births (2.56; p < 0.001). A one-point increase in DAP-13 was associated with greater odds of current contraception use reported at time of DAP assessment (adjusted odds ratio [aOR] 1.79, 95% CI 1.43-2.26), subsequent contraception use reported 18 months after DAP assessment (aOR 1.88, 95% CI 1.44-2.44), and half the odds of subsequent pregnancy in the 18-month period after DAP assessment (aOR 0.57, 95% CI 0.46-0.71).</p><p><strong>Conclusions: </strong>The DAP scale demonstrated good reliability and unidimensionality in this population. Higher DAP scores were associated with higher odds of contraception use and lower odds of pregnancy, supporting construct validity. Future research on the DAP scale in Maharashtra should explore alternative translations of the \"makes me smile\" item that better capture local expressions of joy about potential childbearing.</p><p><strong>Implications: </strong>A modified version of the DAP scale is acceptable for use in an Indian population and can be utilized in future research and program evaluation that focus on contraception and pregnancy prevention in this context. One item was excluded and requires additional formative research to better capture the intended emotional valence in this cultural context.</p><p><strong>Clinical trial registration number: </strong>NCT03514914.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110940"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055163","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":"Beyond pain medication: striving toward more patient-centered placement of intrauterine devices.","authors":"Angela Dempsey, Claire Aucoin, Will Stallings, Anna Kulangara, Beth Sundstrom","doi":"10.1016/j.contraception.2025.110944","DOIUrl":"10.1016/j.contraception.2025.110944","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess patient experiences and preferences for counseling, addressing pain and anxiety, and provider support during placement of intrauterine devices (IUDs).</p><p><strong>Study design: </strong>This mixed-methods study included a survey and in-depth interviews of patients undergoing IUD placement. Participants reported pain, satisfaction, and importance of aspects of care during IUD placement. Ten provider behaviors measured on a Likert scale (1-5) sum to create a \"provider support score\" (range 10-50). We measured pain with categorical variables and a visual analog scale (0-10). We performed descriptive statistics, bivariate analysis, and multivariable analysis on survey data. Qualitative data analysis utilized inductive analytics with NVivo.</p><p><strong>Results: </strong>Among 79 respondents, the three factors most frequently cited as \"very important\" included explaining steps before the procedure (74.7%), discussing pain concerns in advance (72.2%), and being attentive to comfort during the procedure (72.2%). The mean (SD) pain score was 5.7/10 (2.8). Most participants were satisfied (24.1%) or very satisfied (62%) with their IUD placement. The mean provider support score was 32.8/50. When controlling for pain score, higher provider support scores predicted satisfaction; with each unit increase in provider support score, the odds of satisfaction increased by 69% (adjusted odds ratio 1.69). Themes emerging from qualitative data included the importance of acknowledging rather than minimizing pain experiences, setting clear and realistic expectations, and both exploring and attending to individualized patient preferences around IUD placement.</p><p><strong>Conclusions: </strong>Answering the call for more patient-centered IUD placement requires not only addressing pain but also tailoring a range of supportive behaviors to each patient to improve satisfaction.</p><p><strong>Implications: </strong>In addition to addressing pain, clinicians need to focus on a range of other supportive behaviors related to IUD placement, including clear counseling, provider empathy, and forthcoming expectation setting to make the procedure more patient-centered and improve patient satisfaction.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110944"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000530","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":"Virtual reality simulation in reducing discomfort and pain during intrauterine device insertion: a randomized controlled trial.","authors":"Sander Dumont, Ann-Sophie Page, Kobe Dewilde, Jolien Ceusters, Ben Van Calster, Wouter Froyman, Dirk Timmerman","doi":"10.1016/j.contraception.2025.110939","DOIUrl":"10.1016/j.contraception.2025.110939","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the patient-reported overall experience when using virtual reality (VR) simulation during intrauterine device (IUD) insertion (primary), the impact of VR in reducing pain, on patient satisfaction, and to assess the difficulty and success of the procedure utilizing VR (secondary).</p><p><strong>Study design: </strong>This was a single-center randomized controlled trial in a Belgian tertiary teaching hospital. Two hundred participants, requesting a levonorgestrel-releasing IUD, were 1:1 computer randomized in either the VR group, where participants wore VR goggles, or in the standard-of-care group. The primary outcome is the patient's overall experience assessed by means of a Visual Analog Scale (VAS; 0-100 mm, continuous, higher is better). A Numeric Pain Rating Scale (0-100, continuous, higher is more pain) was used to address pain during insertion.</p><p><strong>Results: </strong>In the VR group, 95 participants were included (five were excluded due to failed previous IUD extraction), and in the standard-of-care group, 100 participants were included. There is no evidence for differences in general patient experience (median VAS 72 [intervention] vs 70 [control]; odds ratio [OR] 1.22, 95% CI 0.92-1.61) or pain (median Numeric Pain Rating Scale 50 [intervention] vs 45 [control]; OR 1.04, 95% CI 0.79-1.37) between groups. After 6 weeks, VR-patients reported no evidence for improved general experience (median VAS 70 [intervention] vs 74 [control]; OR 1.09, 95% CI 0.83-1.43) and were less likely to repeat the procedure or recommend it compared to the control group (OR 2.03, 95% CI 1.17-3.56).</p><p><strong>Conclusions: </strong>VR simulation does not conclusively alter the overall experience or reduce pain, therefore not reducing discomfort during IUD insertion in this randomized controlled trial.</p><p><strong>Implications: </strong>Although VR has already been successfully used in the management of acute pain or during procedures, this study cannot demonstrate improved patient-reported outcomes during the insertion of a levonorgestrel-containing IUD.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110939"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026833","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":"Effect of contraceptive methods on the vaginal microbiome and host immune factors.","authors":"Myrna G Serrano, David Edwards, Khatija Ahmed, Veronique C Bailey, Mags Beksinska, Laahirie Edupuganti, Rushil Harryparsad, Florence L D'Hellencourt, Bahiah Meyer, Celia Mehou-Loko, Nina Radzey, Ongeziwe Taku, Anna-Lise Williamson, Jennifer Smit, Katherine Spaine, Bin Zhu, Kimberly K Jefferson, Kavita Nanda, Jerome F Strauss Iii, Charles S Morrison, Jennifer Deese, Lindi Masson, Gregory A Buck","doi":"10.1016/j.contraception.2025.110936","DOIUrl":"10.1016/j.contraception.2025.110936","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess alterations in vaginal microbiota and immune markers over the first 3 months following initiation of copper intrauterine device (copper IUD), levonorgestrel (LNG) implant, and intramuscular depot medroxyprogestone acetate (DMPA-IM).</p><p><strong>Study design: </strong>We included 162 participants from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial, which enrolled healthy, HIV-negative women seeking contraception and randomized them to a copper IUD, LNG implant, or DMPA-IM. Microbiome and immune profiles in vaginal swab samples collected at enrollment, 1 month and 3 months were analyzed. We categorized microbiome profiles as ''optimal'', ''intermediate'', or ''non-optimal'' based on established criteria [1]. We compared microbiome and immune markers across contraceptive groups and evaluated changes to 1 and 3 months.</p><p><strong>Results: </strong>Copper IUD users had a more diverse vaginal microbiome and generally increased inflammatory cytokines and antimicrobial peptides over the 3-month follow-up, compared to LNG-implant and DMPA-IM users [2]. LNG-implant users had less complex vaginal microbiomes with reduced inflammation, while DMPA-IM showed little change in either microbiome composition or inflammatory markers. Copper IUD users exhibited lower microbiome stability and a higher likelihood of transitioning to less optimal profiles. In contrast, LNG-implant users showed greater stability and a higher probability of transition to optimal microbiome and immune marker profiles.</p><p><strong>Conclusions: </strong>Contraceptive methods affect the vaginal microbiome differently. Copper IUD use may lead to less favorable profiles and increased levels of some immune markers, indicating potential adverse health effects. Conversely, LNG-implant usage promotes a more favorable microbiome and immune marker balance.</p><p><strong>Implications: </strong>Our findings suggest that copper IUDs are associated with decreased prevalence of Lactobacillus-dominated microbiomes, higher transition rates towards less optimal microbiome and increased inflammatory profiles, which may lead to negative implications for gynecologic and reproductive health, the LNG-implant may offer positive health benefits with increased prevalence of L. crispatus-dominated microbiomes.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110936"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053861","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":"One-year continuation of the etonogestrel contraceptive implant initiated with oral emergency contraception.","authors":"Lori M Gawron, Corinne D Sexsmith, Gentry Carter, Jennifer E Kaiser, Alexandra Woodcock, David K Turok","doi":"10.1016/j.contraception.2025.110938","DOIUrl":"10.1016/j.contraception.2025.110938","url":null,"abstract":"<p><strong>Objectives: </strong>To report the 1-year continuation rate of etonogestrel (ENG) implant users who initiated the method with same-day oral levonorgestrel emergency contraception (EC).</p><p><strong>Study design: </strong>EC clients age 18-35 years at four Utah family planning clinics between February 2021 and April 2023 initiated an ENG implant and completed follow-up surveys through 12-months.</p><p><strong>Results: </strong>At 12 months, we accounted for 132 (82.5%) of 160 participants: 79 (59.8%) still used their implant and 53 (40.2%) discontinued. A higher proportion of privately-insured participants discontinued (42% vs. 24%, p = 0.04).</p><p><strong>Conclusions: </strong>Nearly 60% of participants who chose guideline-supported ENG implant placement at an EC clinical visit continued use at 1 year.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110938"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058329","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":"Awareness and perceptions related to self-managed abortion in Ohio after Dobbs.","authors":"Katlynn McFarland, Maria F Gallo, Mikaela H Smith, Abigail Norris Turner, Danielle Bessett","doi":"10.1016/j.contraception.2025.110941","DOIUrl":"10.1016/j.contraception.2025.110941","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyze awareness and perceptions related to self-managed abortion in Ohio after Dobbs and subsequent changes in Ohio abortion law.</p><p><strong>Study design: </strong>We analyzed data from the most recent wave (September 2022 to August 2023) of the Ohio Survey of Women, a cross-sectional survey of a population representative sample of women aged 18-44 years in Ohio (full sample N = 2473). Our variables of interest were awareness of self-managed medication abortion (SMMA) and perceptions of self-managed abortion (SMA). Respondents were considered to have awareness of SMMA if they reported having heard of pills they can buy and use at home to conduct an abortion without going to a clinic or consulting a doctor. All respondents were also asked to indicate methods that they understand to mean SMA.</p><p><strong>Results: </strong>A plurality (41.6%) of respondents were aware of SMMA. Non-Hispanic Black and non-Hispanic Asian women had less awareness of SMMA compared to non-Hispanic White women (prevalence ratio [PR] = 0.72, 95% CI, 0.54-0.95 and PR = 0.45, 95% CI, 0.26-0.77, respectively). When compared with women who hold a bachelor's degree or higher educational level, women with less than a high school education, those with a high school degree, and those with only some college had less awareness of SMMA (respectively, PR = 0.58, 95% CI, 0.36-0.94; PR = 0.71, 95% CI, 0.58-0.86; PR = 0.78, 95% CI, 0.68-0.88). About 30.3% of women identified Plan B, and 24.4% indicated herbs as methods of SMA.</p><p><strong>Conclusions: </strong>The findings highlight disparities in awareness of SMMA abortion in adult, reproductive-aged women in Ohio.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110941"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026831","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}