Madison Lands, Rachel L Dyer, Jane W Seymour
INTRODUCTION: Understanding barriers to abortion care is particularly important post-Dobbs. However, many abortion access studies recruit from abortion-providing facilities, which overlooks individuals who do not present for clinic-based care. To our knowledge, no studies have reviewed research recruitment strategies in the literature or considered how they might affect our knowledge of abortion barriers. We aimed to identify populations included and sampling methods used in studies of abortion barriers in the United States (US)...
November 25, 2023: Contraception
Lori M Gawron, Corinne D Sexsmith, Gentry Carter, Jennifer E Kaiser, Misha Pangasa, David K Turok
OBJECTIVE: To determine a one-month pregnancy rate point estimate and 95% confidence interval for guideline-supported, same-day initiation of an etonogestrel implant plus oral levonorgestrel emergency contraception. STUDY DESIGN: In this single-arm, prospective observational study, all emergency contraception clients who presented to four Planned Parenthood Association of Utah clinics from February 2021 to March 2023 received information about oral levonorgestrel with same-day etonogestrel implant insertion...
November 24, 2023: Contraception
Sonya Bharadwa, Isabel Fulcher, Jennifer Fortin, Katherine D Pocius, Alisa B Goldberg
OBJECTIVES(S): Describe human chorionic gonadotropin (hCG) trends for patients with a pregnancy of unknown location (PUL) presenting for medication abortion by management strategy and outcome. STUDY DESIGN: This retrospective cohort study included patients presenting for medication abortion with a PUL at ≤42 days gestation managed with either 1) immediate mifepristone with serial hCG follow-up (same-day-start) or 2) serial hCG testing every 48-72 hours ± ultrasonography to confirm pregnancy location followed by treatment (delay-for-diagnosis)...
November 24, 2023: Contraception
Demsash Hailu, Hanna Teklu, Abraham Fessehaye Sium
OBJECTIVES: To investigate whether induction to expulsion interval during second-trimester medication abortion in pregnancies complicated by anencephaly or other fetal anomalies is prolonged compared to pregnancies without fetal anomalies STUDY DESIGN: This was a retrospective cohort study of women who had second-trimester medication abortion at St. Paul's Hospital Millennium Medical College (Addis Ababa, Ethiopia). We assigned subjects to one of three groups based on fetal diagnosis: 1) anencephaly group 2) other congenital anomaly group 3) no anomaly group...
November 20, 2023: Contraception
Elizabeth G Raymond, Laura J Frye, Kristina Tocce, Shay Gingras, Amy Almquist, Ann Firstenberg, Cynthia Ortega, Paul D Blumenthal, Beverly Winikoff, Christy Boraas
OBJECTIVE: To assess the feasibility, safety, and acceptability of asynchronous screening for medication abortion eligibility using a programmed questionnaire. STUDY DESIGN: For this study, we developed an informational website about medication abortion with a linked questionnaire programmed to produce a conclusion regarding eligibility according to standard criteria. We enrolled people in Colorado and Minnesota who submitted questionnaires indicating eligibility...
November 20, 2023: Contraception
Jane W Seymour, Jenny A Higgins, Sarah C M Roberts
OBJECTIVES: We aimed to measure both stated and experimentally "revealed" abortion-provision preferences among US people with capacity for pregnancy. STUDY DESIGN: In July 2022, we recruited US residents assigned female sex at birth and aged 18-55 using Prolific, an online survey hosting platform. We asked participants what first-trimester abortion method and delivery model they would prefer. We also assessed abortion care preferences with a discrete choice experiment, which examined the relative importance of the following care attributes: method, distance, wait time for appointment, delivery model (telehealth versus in-clinic), and cost...
November 16, 2023: Contraception
Katharine Sznajder, Katrina Thaler, Jamie Perin, Anne E Burke, Geoffrey C Williams, Carolyn Sufrin
OBJECTIVES: We aimed to adapt and validate person-centered measures to evaluate various contributors to self-determination in perinatal contraceptive decision-making. STUDY DESIGN: We developed and administered four scales, adapted from existing measures in the context of Self-Determination Theory: the Treatment Self-Regulation Questionnaire (TSRQ), Perceived Competence Scale (PCS), modified Health Care Climate Questionnaire (mHCCQ), and Important Other Climate Questionnaire (IOCQ)...
November 16, 2023: Contraception
Alexandra Woodcock, Gentry Carter, Jami Baayd, David K Turok
OBJECTIVE: To understand how the Dobbs decision impacted graduating resident physicians in Utah, and to understand residents' perspectives on abortion access. STUDY DESIGN: We invited all 2023 graduating residents at the University of Utah, from all specialties, to participate in this survey. We analyzed univariate relationships between respondent demographics and change of career plans post-Dobbs. We also performed a thematic analysis of free text responses. RESULTS: We received responses from 85 residents (55% of all graduating residents from the University of Utah) representing 19 specialties...
November 15, 2023: Contraception
Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski
No abstract text is available yet for this article.
November 10, 2023: Contraception
Alicia Baier, Anna-Lisa Behnke
OBJECTIVE: While abortion is a common medical procedure in Germany, the number of abortion-providing facilities declined by 46% between 2003 and 2022. As existing data do not paint a complete picture of the factors influencing this decline, an understanding into the perspectives of health care professionals (HCPs) is necessary. We set out to examine attitudes of HCPs in Berlin, Germany towards different aspects of abortion, to identify barriers that might prevent them from providing abortions...
November 5, 2023: Contraception
Klaira Lerma, Whitney Arey, Anna Chatillon, Kari White
OBJECTIVE: Following the implementation of a restrictive abortion law in Texas (Senate Bill 8), we conducted in-depth interviews with pregnant people about their experiences seeking abortion care. In this analysis, we explore participants' motivations for taking part in a research study. STUDY DESIGN: Between October 2021 and August 2022, we conducted 120 in-depth interviews with Texans (aged ≥ 15 years) who, after considering abortion, had a facility-based abortion, self-managed their abortion, experienced miscarriage or ectopic pregnancy, or continued their pregnancy...
November 3, 2023: Contraception
Rebecca H Allen, Jennifer Fortin, Rie Maurer, Deborah Bartz, Alisa B Goldberg, Alison Edelman, Melissa A Clark
OBJECTIVES: To identify predictors of patient satisfaction with their chosen pain control regimen for procedural abortion at less than 12 weeks gestation in the outpatient setting. STUDY DESIGN: In this prospective cohort study, we developed an instrument to evaluate predictors of satisfaction with pain control regimens among patients choosing local anesthesia alone (paracervical block with 20 mL of 1% buffered lidocaine) or local anesthesia plus intravenous (IV) moderate sedation with 100 mcg of fentanyl and 2 mg of midazolam...
October 31, 2023: Contraception
Kim Jonas, Kate Bergh, Zoe Duby, Kgahliso Mangoale, Neo Mogari, Caroline Kuo, Tarylee Reddy, Catherine Mathews
OBJECTIVE: We investigated the coverage of contraception services (excluding condoms) to prevent unintended pregnancy among young women and girls aged 15-24 years who were beneficiaries of one of the two largest combination HIV and pregnancy prevention programme in South Africa. STUDY DESIGN: We invited 2,160 randomly sampled beneficiaries who were living in six of the 12 programme districts across six provinces to participate in a telephone survey. We created pregnancy prevention coverage cascades and conducted univariate and multivariable analyses using Poisson regression to identify key barriers and facilitators associated with each step of the cascade...
October 18, 2023: Contraception
Leanne L Free, Jeanelle Sheeder, Rebecca H Cohen
OBJECTIVE: To compare satisfaction with procedural abortion prior to 10 weeks' gestation in patients randomized to lavender essential oil aromatherapy versus placebo (jojoba oil). STUDY DESIGN: This randomized trial compared lavender aromatherapy versus placebo in patients undergoing procedural abortion <10 weeks' gestation. Participants self-administered and inhaled oil during their procedures. Our primary outcome was composite mean score on the Iowa Satisfaction with Anesthesia Scale (ISAS)...
October 17, 2023: Contraception
Marie Linder, Juliane Schoendorf, Federica Pisa, Renate Schulze-Rath, Carolyn E Cesta
OBJECTIVE: The levonorgestrel-releasing intrauterine device containing 13.5 mg of levonorgestrel (LNG 13.5 mg IUD), Jaydess®, was approved for contraception by the European Medicines Agency in 2013. We aimed to describe the characteristics of new users of LNG 13.5 mg IUD in Sweden within the first 3 years after approval (2014-2016). STUDY DESIGN: We conducted an observational, population-based study using data from the Swedish national registers. Women with a first pharmacy dispensation of LNG 13...
October 14, 2023: Contraception
Allison Liu, Valeria Hernandez, Annie Dude, L Philip Schumm, Manoradhan Murugesan, Ashley McHUGH, Debra Stulberg
OBJECTIVE: We examined the impact of Catholic hospital delivery on short interval pregnancy in the California 2010-14 Medicaid population. METHODS: We used Cox regression to estimate the association between hospital affiliation and short interval pregnancy adjusting for patient factors. RESULTS: Catholic hospital delivery had increased risk of pregnancy within 6 months for Black [Hazard Ratio (HR) 1.11, 95% CI 1.06, 1.17] and Hispanic [HR 1...
October 12, 2023: Contraception
Jisun Paik, Michael Haenisch, Andy Kim, Jessica M Snyder, John K Amory
OBJECTIVES: We examined the return to fertility and transgenerational impact of treatment with WIN 18,446, an experimental male contraceptive, in mice. STUDY DESIGN: We paired male mice treated with WIN 18,446 for 4 weeks to suppress spermatogenesis followed by a nine-week recovery and mated them with normal females to assess fertility. F1 generation mice were subsequently mated to ascertain any transgenerational impact of treatment on fertility. Testes were examined histologically...
October 7, 2023: Contraception
Erin Wingo, Christine Dehlendorf
OBJECTIVES: To assess relationship between pregnancy intention and current desire for pregnancy prevention. STUDY DESIGN: Using data from two state population-based surveys, we compared One Key Question® and current pregnancy prevention desire. RESULTS: The majority who indicated ambivalence toward pregnancy (54%) and some respondents who indicated that they want to become pregnant in a year (30%) desired pregnancy prevention now. CONCLUSIONS: One Key Question® did not capture current pregnancy prevention desires of a sizeable minority of respondents...
October 6, 2023: Contraception
Hillary Wolff, Ashley McHugh, Sameen Qadir, Meg Lassar, Kai Tao, Debra Stulberg
OBJECTIVE: Nearly one-third of low-income women of reproductive age in the U.S. receive care in federally qualified community health centers, but comprehensive reproductive care is not consistently provided. Illinois Contraceptive Access Now (ICAN!) is an initiative addressing the access gap to high-quality contraceptive care with a focus on normalizing reproductive health screening for patients in federally qualified community health centers (FQHCs). STUDY DESIGN: This multi-method program evaluation used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, with retrospective and prospective data collection from three Illinois FQHCs who participated as Quality Hubs, and from a Community Advisory Board...
October 6, 2023: Contraception
Jessica Y Shim, Morgan E Ryan, Carly E Milliren, Sofya Maslyanskaya, Claudia Borzutzky, Sarah Golub, Sarah Pitts, Amy D DiVasta
OBJECTIVE: This study aimed to estimate and compare continuation rates of hormonal intrauterine devices (IUDs) when placed for contraceptive or menstrual management indications in adolescents and young adults. STUDY DESIGN: We conducted a secondary analysis of a prospectively collected database of all hormonal IUD insertions from January 1, 2017 through December 31, 2020, with at least one-year follow-up, across four Adolescent Medicine practices. IUD insertions without known indication were excluded...
October 6, 2023: Contraception
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