Contraception

No abstract text is available yet for this article.

OBJECTIVE: The availability of family planning and abortion training in residency is a concern for applicants, particularly following the overturning of Roe v Wade. We aimed to characterize public information on abortion training in obstetrics and gynecology residency programs in states with and without abortion bans. STUDY DESIGN: We abstracted residency program data using a publicly available database of obstetrics and gynecology residency programs. We performed a systematic internet search of each program's website to identify information on abortion training...

OBJECTIVE: To determine if pharmacies in Los Angeles County had implemented legislation that had been in effect since 2017 requiring insurance companies based in California to fully reimburse for 13 cycles of oral contraceptives dispensed at once. STUDY DESIGN: We conducted a secret shopper telephone survey of Los Angeles County pharmacies nearly five years after the legislation went into effect. We chose the categorial state family program (Family PACT) to represent all programs covered by the legislation...

Hemorrhage after abortion is rare, occurring in fewer than 1% of abortions, but associated morbidity may be significant. Although medication abortion is associated with more bleeding than procedural abortion, overall bleeding for the two methods is minimal and not clinically different. Hemorrhage can be caused by atony, coagulopathy and abnormal placentation, as well as by such procedure complications as perforation, cervical laceration and retained tissue. Evidence on which to make recommendations regarding risk factors and treatment for postabortion hemorrhage is extremely limited...

OBJECTIVE: Determine if replacement of patient-initiated, individual contraceptive education with mandatory group contraceptive education, during US Navy basic training, was associated with decreased LARC continuation. METHODS: Secondary analysis of administrative billing data from female military recruits who began basic training between September 2012 and February 2020. RESULTS: Servicewomen who started a LARC method during rather than after basic training had higher continuation rates...

OBJECTIVES: The ACGME requires all obstetrics and gynecology residents have access to "opt-out" abortion training. The impact of Dobbs v Jackson on training remains unknown. We aimed to describe residency programs affected by abortion bans and those lacking abortion training despite permissive state abortion policies. We considered demographic data to understand the impacts on residents underrepresented in medicine. STUDY DESIGN: We used publicly available databases and program websites to abstract data...

OBJECTIVES: The last nationwide evaluation of abortion education in undergraduate medical schools was conducted by Espey et. al. more than 15 years ago. To better understand what medical schools are teaching medical students about abortion care, we conducted a brief assessment of abortion education and training at U.S. medical schools. STUDY DESIGN: In April 2019, the study team emailed a three-item survey to the Obstetrics & Gynecology clerkship directors at AAMC-accredited U...

OBJECTIVES: The ExPAND Mifepristone learning collaborative (ExPAND) aims to support community-based primary care providers in overcoming logistical barriers to mifepristone provision. This qualitative study describes clinician and staff perspectives on the impact of ExPAND in two federally qualified health center networks (FQHCs). STUDY DESIGN: Researchers interviewed a purposive sample of clinicians, staff members, and clinic leaders from two participating Illinois FQHCs using an interview guide grounded in the Consolidated Framework for Implementation Research...

OBJECTIVES: To assess access to abortion pills offered by clinics providing state-funded family planning services in California. METHODS: We attempted to make two scripted calls to a 20% random sample of family planning clinics in California, stratified by county, as "secret shoppers" in 2020 and 2021. RESULTS: Clinic staff responded to 407 calls. Only 50 respondents (12%) reported their clinic offered abortion pills and 23 respondents (6%) accurately indicated to callers that abortion pills were available free to low-income individuals in California...

OBJECTIVE: To estimate the annual number of incarcerated pregnant people in state and federal prisons needing an abortion. STUDY DESIGN: We used 2021 Bureau of Justice Statistics data and prior studies' findings to estimate the number of pregnant incarcerated people, then calculated state-specific abortion ratios to determine the number potentially needing an abortion. RESULTS: Out of 638 pregnant people incarcerated in prisons annually, 110 would be expected to need an abortion, including 55 in states where abortion is currently banned or restricted...

OBJECTIVES: We sought to understand how adolescents perceive two commonly used contraceptive decision aids and which elements adolescents identified as most important to them. STUDY DESIGN: We conducted a cross-sectional qualitative study of adolescents' perceptions of two decision aids, Your Birth Control Choices designed by the Reproductive Health Access Project and Birth Control: What's Important to You? designed by Power to Decide for Bedsider.org. We conducted semistructured interviews with 20 adolescents (aged 15-19 years) who were assigned female sex at birth and attended a single clinic in North Carolina...

OBJECTIVE: To investigate Vietnamese community pharmacists and pharmacy customers' knowledge, attitudes, and practices about emergency contraceptive pills (ECPs). STUDY DESIGN: We recruited 400 pharmacists and 396 customers via a non-probability convenience sampling technique. We used univariate and multivariate linear regression models to determine factors associated with the knowledge and attitudes towards ECPs among pharmacists and customers. We selected variables in the multivariate models through the Bayesian Model Averaging method using R software (version 4...

OBJECTIVE: Advocacy is an important part of the reproductive healthcare profession, but barriers to participating in the legislative process are not well understood. This study examines the barriers experts in reproductive health experience to testifying at state legislative committee hearings regarding abortion. STUDY DESIGN: We conducted in-depth semi-structured interviews with 40 experts in reproductive health, including OBGYNs, midwives, pediatricians, nurses, primary care providers, and professional advocates...

OBJECTIVE: We examined the differences in postpartum contraception between patients with and without opioid use disorder (OUD). STUDY DESIGN: We conducted a retrospective, single-institution, cohort analysis assessing differences in desired method of postpartum contraception and plan fulfillment. RESULTS: Patients with OUD comprised 200/8,654 (2.3%) of our study cohort. After 2:1 matching, method desired (mOR 0.86, 95% CI 0.60-1.23 for highly vs moderately effective) and receipt (mOR 0...

OBJECTIVES: Prior studies found increased hair cortisol concentration (a surrogate marker for hypothalamic pituitary adrenal axis activation) in users of the levonorgestrel intrauterine device (LNG 52mg IUD). We evaluated change in hair cortisol and psychometric tests in women initiating a copper (CuT380 IUD) or LNG 52mg IUD. STUDY DESIGN: We prospectively enrolled healthy women initiating a LNG 52mg IUD or CuT380 IUD. Participants provided hair and blood samples and completed psychometric inventories [Patient Health Questionnaire-9; Positive and Negative Affect Schedule; Psychological General Well-Being Index] after IUD insertion and at six and 12 months...

OBJECTIVES: To explore Planned Parenthood Medicaid patients' experiences getting reproductive health care in Texas after the state terminated Planned Parenthood providers from its Medicaid program in 2021. STUDY DESIGN: Between January and September 2021, we recruited Medicaid patients who obtained care at Planned Parenthood health centers prior to the state termination using direct mailers, electronic messages, community outreach, and flyers in health centers. We conducted baseline and two-month follow-up semi-structured phone interviews about patients' previous experiences using Medicaid at Planned Parenthood and other providers and how the termination affected their care...

OBJECTIVE: To evaluate differences by recruitment method in the characteristics of participants who are considering abortion. STUDY DESIGN: Between June 2021- April 2022, we recruited pregnant people considering abortion in Indiana from: (1) online posts; (2) abortion funds; and (3) abortion clinics. We compared participant characteristics reported in an online survey by recruitment source. RESULTS: Compared to those recruited from clinics (n=94), participants recruited online (n=84) and through abortion funds (n=239) were later in their pregnancy, already parenting, received less formal education, struggled financially, and were more likely to be Black or African American or LGBTQ+...

No abstract text is available yet for this article.

OBJECTIVE: To evaluate the feasibility and effectiveness of providing bedside family planning services to women with chronic medical conditions in the inpatient setting. STUDY DESIGN: We initiated a parallel randomized controlled trial of patients listed as female aged 18 to 44 years who were admitted to the hospital from February 2018 to May 2021 with at least one chronic medical condition associated with lower rates of contraception usage and no documentation of contraception...

OBJECTIVES: This study aimed to compare contraceptive efficacy and safety of drospirenone 4 mg in a 24/4-day regimen in nonobese and obese users and describe pharmacokinetics according to bodyweight. STUDY DESIGN: We analyzed data from three drospirenone 4 mg trials (2 European and 1 United States) to report outcomes in nonobese (body mass index <30 kg/m2 ) and obese (body mass index ≥30 kg/m2 ) users. We used data from the US trial to calculate the Pearl Index (pregnancies per 100 woman-years) in nonbreastfeeding participants aged ≤35 years at enrollment for confirmed pregnancies...