Hannah R Simons, Sarah Diemert, Rebecca Passman, Gillian Dean
OBJECTIVE: Routine ultrasound before medication abortion may create an impediment to expanding abortion access. This study examines clinical outcomes of medication abortion (MAB) without pretreatment ultrasound evaluation at Planned Parenthood health centers in multiple states. METHODS: We conducted a secondary analysis of data from 23 U.S.-based Planned Parenthood affiliates that provided MAB without pretreatment ultrasound for eligible patients from March 2020-December 2021...
April 17, 2024: Contraception
Caila Brander, Kathryn Risher, George Odwe, Yohannes Dibaba Wado, Francis Obare, John Cleland, Kazuyo Machiyama
OBJECTIVES -: Global unmet need for contraception remains high. Contraceptive health-related beliefs are a barrier to contraceptive use but are poorly understood. This study examined quantitative differences in two health-related beliefs between pills, injectables and implants. STUDY DESIGN -: We used cross-sectional baseline data collected between August-December 2016 from Nairobi (urban) and Homa Bay (rural) Kenya among women aged 15-39 years (N=5081). Dichotomous outcome variables were constructed for two health-related beliefs (infertility and serious health problems) for the three methods...
April 17, 2024: Contraception
Roselle R Bleck, Antoinette A Danvers, Anushri Nimbvikar, Elizabeth P Gurney
OBJECTIVES: To evaluate the implementation of mifepristone and misoprostol for medical management of early pregnancy loss (EPL) in emergency departments (EDs) by comparing efficacy, complication, and follow-up rates for patients treated in EDs to those in the Complex Family Planning (CFP) outpatient office. STUDY DESIGN: In COVID-19's first wave, we expanded medication management of EPL to our EDs. This retrospective study evaluated 72 patients receiving mifepristone and misoprostol for EPL from 4/1/2020-3/31/2021, comparing treatment success, safety outcomes, and follow-up rates by location...
April 17, 2024: Contraception
Jayme L Congdon, Eric Vittinghoff, Christine Dehlendorf
INTRODUCTION: Pregnancy intention is widely used to screen for contraceptive needs, yet its relevance to postpartum individuals has not been demonstrated. METHODS: We surveyed 234 postpartum individuals to assess the alignment between pregnancy intentions in the next year and current desire to prevent pregnancy. RESULTS: Most individuals (87%) desired pregnancy prevention now, including 73% of individuals who desired or were ambivalent about pregnancy in the next year...
April 16, 2024: Contraception
Alicja Zawistowska
OBJECTIVES: To compare attitudes toward abortion among youth before and after the Polish Constitutional Tribunal introduced abortion ban in October 2020. STUDY DESIGN: The study uses two nationally representative samples of final-year secondary school students conducted in Poland before (year 2018, N=1,609) and after the abortion ban (year 2021, N=1,513). RESULTS: The support for abortion increased between 2018 and 2021 (OR=2.77 in foetus impairment case; OR=2...
April 13, 2024: Contraception
Juliana Almeida Oliveira, Karine Eskandar, Júnea Chagas, Livia Leni de Oliveira do Nascimento, Daniel Dias Ribeiro, Ana Luiza Lunardi Rocha, Flávia Ribeiro de Oliveira
PURPOSE: Inherited bleeding disorders may cause heavy menstrual bleeding in women, impacting quality of life and impairing daily and social activities. The levonorgestrel-releasing intrauterine system is a potential treatment for these women, which might reduce menstrual blood loss. METHODS: We performed a systematic review and single-arm meta-analysis to examine the levonorgestrel-releasing intrauterine system in women with inherited bleeding disorders and heavy menstrual bleeding...
April 11, 2024: Contraception
Sofía Filippa, Ruvani T Jayaweera, Kelly Blanchard, Daniel Grossman
BACKGROUND: Miscarriage is a common experience; yet individuals often have negative experiences when receiving miscarriage care, signaling a gap in the quality of miscarriage care. We explore the literature on individuals' experiences with miscarriage care across a variety of dimensions and assess how these experiences align with practice recommendations. METHODS: We conducted a scoping review of peer-reviewed studies in PubMed published in English through April 30, 2022, and focused on individuals' experiences with miscarriage care in healthcare settings and on practice recommendations for providing care in a variety of countries...
April 6, 2024: Contraception
Grace A Masters, Clevanne Julce, Smita Carroll, Sharina D Person, Jeroan Allison, Nancy Byatt, Tiffany A Moore Simas
OBJECTIVES: Depression is common during pregnancy and the year following childbirth (the perinatal period). This study assessed the association of depressive symptoms and contraception decisions in perinatal individuals. STUDY DESIGN: We conducted a secondary analysis using data from the PRogram in Support of Moms (PRISM) study, a cluster randomized controlled trial of active interventions which aimed to address perinatal depression. This analysis included 191 individuals aged 18-45 who screened positive for depression on the Edinburgh Postnatal Depression Scale (EPDS, score ≥10) during pregnancy or up to 3-months postpartum...
April 5, 2024: Contraception
E Lazaris, J N Sanders, G Carter, J Olsen, A Gero, L M Gawron
OBJECTIVES: We examined differences in contraceptive uptake and discontinuation between gender-expansive individuals and cis-women in the HER Salt Lake Contraceptive Initiative. STUDY DESIGN: We used self-reported survey data to assess associations between gender identity, contraceptive uptake, and discontinuation. RESULTS: Of participants (n=4,289), 178/4289(4%) identified as gender-expansive with 157/178(88%) reporting recent sexual activity with men...
April 5, 2024: Contraception
Rachel K Jones
OBJECTIVE: The Guttmacher Institute estimated that, in 2014, 24% of US women of reproductive age would have an abortion by age 45 if the 2014 abortion rate was maintained. This study updates the estimated lifetime incidence of abortion in the year(s) just prior to the Dobbs decision, which removed federal protections for abortion. STUDY DESIGN: We used data from the Guttmacher Institute's 2021-2022 Abortion Patient Survey (APS) and population data for 2020 and 2021 from the Census Bureau, as well as abortion counts from the Guttmacher Institute's 2020 Abortion Provider Census, to estimate abortion rates, first abortion rates and cumulative abortion rates, all by age group...
April 2, 2024: Contraception
Madison Lands, Rachel L Dyer, Jane W Seymour
No abstract text is available yet for this article.
March 29, 2024: Contraception
Brian T Nguyen
OBJECTIVE: To estimate the potential market for novel male contraceptives (NMCs) using United States National Survey of Family Growth (NSFG) data, 2015-2017. STUDY DESIGN: We described the market for NMCs via secondary analysis of the 2015-2017 NSFG's weighted male respondent data, utilizing surrogate markers for contraceptive switching (NSFG) and contraceptive discontinuation data from the Contraceptive CHOICE project. Potential NMC users included men relying on: (1) no methods or less effective methods but who reported that they would be "very upset" if they got someone pregnant, (2) permanent methods but who reported that they might still want more children, (3) a female partner's method that she might discontinue in the next year, (4) a male method even when his partner uses her own contraceptive...
March 28, 2024: Contraception
Alexandra E Monaco, Carolyn L Westhoff
OBJECTIVE(S): To describe patient-reported quality of care for virtual contraceptive counseling, using the 4-item Person-Centered Contraception Counseling (PCCC) scale. Secondary analyses evaluated PCCC scores by patient subgroups. STUDY DESIGN: From December 2021 to May 2022, we offered an anonymous web-based survey, to English and Spanish-speaking female patients 18 to 45 years old who had virtual visits through two Family Planning offices affiliated with Columbia University/New York Presbyterian Hospital in New York City...
March 27, 2024: Contraception
Cara Clure, Jeanelle Sheeder, Aaron Lazorwitz
OBJECTIVES: To assess the pharmacokinetics and pharmacodynamics of the etonogestrel (ENG) contraceptive implant when inserted at an alternative scapular site. STUDY DESIGN: We conducted a pilot study of healthy, reproductive-age females who underwent subdermal insertion of an ENG implant over the inferior edge of the non-dominant scapula (scapular insertion). We measured serum ENG levels over one year at nine time points. Participants completed questionnaires on insertion site and bleeding side effects...
March 27, 2024: Contraception
Tanja Boehnke, Anja Bauerfeind, Lisa Eggebrecht, Camille Cellier, Jens A Lange, Klaas Heinemann, Tessa Madden
OBJECTIVE: To compare the incidence of expulsion for different copper intrauterine device (IUD) shapes. STUDY DESIGN: We conducted a secondary analysis of the ongoing, prospective, non-interventional European Active Surveillance Study on LCS12 (EURAS-LCS12). Users of newly inserted IUDs were recruited in 10 European countries via a network of approximately 1,200 clinicians. We restricted the analysis to copper IUD users. In the main analysis, we classified copper IUDs by shape [Nova-T frame, Tatum-T frame, Multiload frame, frameless IUDs and intrauterine balls], without differentiation of size...
March 27, 2024: Contraception
Yahui Wang, Qianying Chen, Zhengnan Liu, Yun Chen, Yingling Zheng, Jialu Guo, Fan Zhou, Nengyuan Lv, Jianying Zhao, Siyi Shen, Qiaolei Yuan, Jinyi Tong
OBJECTIVE: The majority of intrauterine devices (IUDs) inserted in China are tailless, requiring intrauterine manipulations for removal and causing pain. This study aimed to investigate the analgesic efficacy of lidocaine injection into a novel disposable injectable cervical dilator for IUD removal procedures. STUDY DESIGN: A double-blinded, placebo-controlled, randomized clinical trial was conducted with women aged 18-65 years old requesting outpatient IUD removal...
March 27, 2024: Contraception
Andrea Stewart, Lisa Romero, Katherine Kortsmit, Stacey Hurst, Rachel Powell, Eva Lathrop, Maura K Whiteman, Lauren B Zapata
OBJECTIVE: To describe unmet desire for long-acting reversible contraception (LARC) after the Zika Contraception Access Network (Z-CAN) in Puerto Rico during the 2016-2017 Zika outbreak. STUDY DESIGN: Z-CAN patients completed web-based surveys about contraception experiences over a three-year period. RESULTS: Of 1,809 survey respondents, 3% never used LARC, but reported wanting it since their initial visit. As reasons for not getting LARC, nearly 50% indicated a provider-related reason and 25% reported cost...
March 27, 2024: Contraception
Christine Mauck, Andrea Thurman, Jeffrey T Jensen, Courtney A Schreiber, Jeff Baker, Melody Y Hou, Steven Chavoustie, Clint Dart, Hongsheng Wu, Jacques Ravel, Pawel Gajer, Betsy C Herold, Terry Jacot, Nadene Zack, Jessica Hatheway, Dave Friend
OBJECTIVE: Evaluate safety of Ovaprene, an investigational non-hormonal vaginal contraceptive designed for monthly use. STUDY DESIGN: Open-label, multicenter study enrolling heterosexually-active women with previous permanent contraception who underwent assessments during five menstrual cycles: baseline postcoital test cycle, diaphragm postcoital test cycle, Ovaprene safety cycle, and two Ovaprene postcoital test cycles. Safety outcomes included treatment emergent adverse events (TEAEs), systemic laboratory findings, pelvic examinations, colposcopies, Nugent scores, determination of community state types of vaginal microbiota, and anti-Escherichia coli activity and inflammatory markers in cervicovaginal fluids...
March 27, 2024: Contraception
Abigail Humphreys, Amanda Jean Stevenson, Sara Yeatman
OBJECTIVE: To describe the changes in contraceptive method use and mix among Colorado Title X clients following the 2009 Colorado Family Planning Initiative (CFPI), which allowed Colorado Title X providers to offer all contraceptive methods without medically unnecessary barriers. STUDY DESIGN: Using data on all visits to Colorado Title X clinics between 2007 and 2016 for women aged 10-49 years, we described trends in contraceptive method use by age group and race/ethnicity prior to and following the implementation of CFPI...
March 21, 2024: Contraception
Kelsey A Petrie, Erin E McCoy, Lyndsey S Benson
OBJECTIVE: Intrauterine device (IUD) users often encounter barriers to desired removal. Self-removal, while previously found to be successful only 19% of the time, may mitigate these obstacles. Our primary objective was to evaluate the effectiveness of our previously developed IUD self-removal guide. Our secondary objectives were to evaluate acceptability of the guide and characterize the self-removal process. METHODS: This was a randomized controlled trial comparing IUD self-removal success rates with and without a guide...
March 20, 2024: Contraception
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