Journals Perspectives on Sexual and Rep...

Perspectives on Sexual and Reproductive Health
Erin Wingo, Shashi Sarnaik, Martha Michel, Danielle Hessler, Brittni Frederiksen, Megan L Kavanaugh, Christine Dehlendorf
CONTEXT: The Person-Centered Contraceptive Care measure (PCCC) evaluates patient experience of contraceptive counseling, a construct not represented within United States surveillance metrics of contraceptive care. We explore use of PCCC in a national probability sample and examine predictors of person-centered contraceptive care. METHODS: Among 2228 women from the 2017-2019 National Survey of Family Growth who reported receiving contraceptive care in the last year, we conducted univariate and multivariable linear regression to identify associations between individual characteristics and PCCC scores...
September 1, 2023: Perspectives on Sexual and Reproductive Health
K Olivia Mock, Anne Moyer, Marci Lobel
CONTEXT: With abortion no longer deemed a constitutional right in the United States (US), the importance of effective contraceptive methods cannot be overstated. Both male sterilization (vasectomy) and female sterilization (tubal ligation) have the lowest failure rates of available means of contraception. Despite the less invasive and reversible nature of vasectomy compared to tubal ligation procedures and even though some healthcare professionals dissuade certain women, especially those who are white and/or economically advantaged, from undergoing a sterilization procedure, female sterilization is approximately three times more prevalent than male sterilization in the US...
August 18, 2023: Perspectives on Sexual and Reproductive Health
Mikaela H Smith, Molly Broscoe, Payal Chakraborty, Jessie Hill, Robert Hood, Michelle McGowan, Danielle Bessett, Alison H Norris
INTRODUCTION: During early stages of COVID-19 in the United States, government representatives in Kentucky, Ohio, and West Virginia restricted or threatened to restrict abortion care under elective surgery bans. We examined how abortion utilization changed in these states. METHODOLOGY: We examined COVID-19 abortion-related state policies implemented in March and April 2020 using publicly available sources. We analyzed data on abortions by method and gestation and experiences of facility staff, using a survey of 14 facilities...
August 12, 2023: Perspectives on Sexual and Reproductive Health
Andrea J Hoopes, Aletha Y Akers, Andrea Jimenez-Zambrano, Sarah Cain, Julie Maslowsky, Jeanelle Sheeder
CONTEXT: Adolescents need support to make informed decisions about contraception. Few clinical questionnaires exist to help adolescents and their healthcare providers align contraception decisions with patient needs and preferences. METHODS: Our mixed-methods study involved a convenience sample of English-speaking, female patients aged 13-19 seeking contraception services at an adolescent reproductive health clinic in Colorado, USA. Qualitative interviews informed development of clinical questionnaire items...
August 9, 2023: Perspectives on Sexual and Reproductive Health
Elizabeth A Mosley, Alyssa Lindsey, Daria Turner, Priya Shah, Ayeesha Sayyad, Amber Mack, Ky Lindberg
INTRODUCTION: In Georgia, maternal mortality is relatively high, and Black women are three times as likely to die from pregnancy-related causes as white women. Doulas can improve perinatal health and reduce disparities, but doula accessibility in Georgia is unclear. METHODS: This community-engaged mixed methods study surveyed and interviewed 17 doulas in Georgia. Surveys included structured questions on demographics, businesses, clientele, training, and challenges; we analyzed them using descriptive statistics...
August 2, 2023: Perspectives on Sexual and Reproductive Health
Kari White, Ophra Leyser-Whalen, Brooke Whitfield, Asha Dane'el, Alexis Andrea, Anna Rupani, Bhavik Kumar, Ghazaleh Moayedi
CONTEXT: Abortion assistance funds constitute an important part of the healthcare safety net by covering some of abortion patients' out-of-pocket costs. Few studies have examined the other ways abortion assistance fund staff and volunteers support callers who need help obtaining care. METHODS: Between June and September 2020, we conducted in-depth interviews with 23 staff and volunteers at 11 local abortion assistance funds that helped Texans seeking abortion care following a March 2020 state executive order that prohibited most abortions...
July 25, 2023: Perspectives on Sexual and Reproductive Health
Carly Demont, Jill Doctoroff, Britt Neron, Angel M Foster
OBJECTIVES: Both the National Abortion Federation Canada and Action Canada for Sexual Health and Rights operate national toll-free hotlines that provide information, financial support, and travel assistance to abortion seekers. We aimed to characterize callers to both hotlines before and after the onset of the COVID-19 pandemic. METHODS: Hotline personnel routinely document information about callers and type(s) of assistance needed and received. We received call logs from both organizations for a two-year period (April 1, 2019 through March 31, 2021)...
July 24, 2023: Perspectives on Sexual and Reproductive Health
Brandon L Crawford, Megan K Simmons, Ronna C Turner, Wen-Juo Lo, Kristen N Jozkowski
CONTEXT: Abortion is common in the United States (US), although access is becoming more difficult for some. In addition to restrictive policies that ban most abortion, limit the number of providers and increase costs, barriers to access also include less supportive cultural climates and stigma related to abortion. Prior to the Dobbs v. Jackson Women's Health decision of the United States Supreme Court, research suggested that people generally believed it was easy to access abortion, but this research did not examine the underlying factors that drive these perceptions...
July 20, 2023: Perspectives on Sexual and Reproductive Health
Sara Yeatman, Christie Sennott
CONTEXT: Despite substantial critiques of retrospective measures of fertility intentions, researchers widely use the metrics of unwanted and mistimed pregnancies as tools for monitoring patterns and trends in reproductive health. However, in focusing exclusively on the timing and numeric elements of fertility these constructs ignore partner-specific desires, which may lead to considerable measurement error and threaten their validity. METHODOLOGY: We use data on births in the last 5 years from the 2017-2019 United States National Survey of Family Growth to compare responses to the standard retrospective measure of fertility intentions with responses to a partner-specific question that asks respondents about whether they had ever desired a child with that partner...
July 2, 2023: Perspectives on Sexual and Reproductive Health
Sara Neill, Mugdha Mokashi, Alisa Goldberg, Jennifer Fortin, Elizabeth Janiak
CONTEXT: Early pregnancy loss (EPL) affects 1 million patients in the United States (US) annually, but integration of mifepristone into EPL care may be complicated by regulatory barriers, practice-related factors, and abortion stigma. METHODS: We conducted qualitative, semi-structured interviews among obstetrician-gynecologists in independent practice in Massachusetts, US on mifepristone use for EPL. We recruited participants via professional networks and purposively sampled for mifepristone use, practice type, time in practice, and geographic location within Massachusetts until we reached thematic saturation...
July 2, 2023: Perspectives on Sexual and Reproductive Health
Carolyn B Sufrin, Ashley Devon-Williamston, Lauren Beal, Crystal M Hayes, Camille Kramer
OBJECTIVE: To understand how the punitive, rights-limiting, and racially stratified environment of incarceration in the United States (US) shapes the abortion desires, access, and pregnancy experiences of pregnant women, transgender men, and gender non-binary individuals. METHODS: From May 2018-November 2020, we conducted semi-structured, qualitative interviews with pregnant women in prisons and jails in an abortion supportive and an abortion restrictive state. Interviews explored whether participants considered abortion for this pregnancy; attempted to obtain an abortion in custody; whether and how incarceration affected their thoughts about pregnancy, birth, parenting, and abortion; and options counseling and prenatal care experiences, or lack thereof, in custody...
July 2, 2023: Perspectives on Sexual and Reproductive Health
Carmela Zuniga, Hannah Forsberg, Kate Grindlay
CONTEXT: Removing the prescription requirement and making oral contraceptive pills available over the counter (OTC) could increase contraceptive access in the United States. Despite current efforts to make a progestin-only pill (POP) available OTC, there are no qualitative data exploring the experiences of POP users and their perspectives on making POPs available OTC. METHODS: We conducted six online, asynchronous focus group discussions with 36 POP users between July and November 2020...
June 2023: Perspectives on Sexual and Reproductive Health
Lavanya Rao, Corinne H Rocca, Isabel Muñoz, Brittany D Chambers, Sangita Devaskar, Ifeyinwa V Asiodu, Lisa Stern, Maya Blum, Alison B Comfort, Cynthia C Harper
INTRODUCTION: Agency in contraceptive decision-making is an essential aspect of reproductive autonomy. We conducted qualitative research to investigate what agency means to patients seeking contraceptive care to inform the development of a validated measure of this construct. METHODOLOGY: We held four focus group discussions and seven interviews with sexually-active individuals assigned female at birth, ages 16-29 years, recruited from reproductive health clinics in Northern California...
May 22, 2023: Perspectives on Sexual and Reproductive Health
Laura Jacques, Taryn Valley, Shimin Zhao, Madison Lands, Natalie Rivera, Jenny A Higgins
INTRODUCTION: The initial stages of the COVID-19 pandemic affected abortion care in the United States (US) in myriad ways. While research has documented systems-level pandemic-related impacts on abortion access and care delivery little information exists about the experiences of abortion seekers during this period. We sought to document the effects of COVID-19 pandemic restrictions US abortion seekers by analyzing posts on Reddit, a popular social media website. METHODS: We compiled and coded 528 anonymous posts on the abortion subreddit from 3/20/2020 to 4/12/2020 and applied inductive qualitative analytic techniques to identify themes...
May 11, 2023: Perspectives on Sexual and Reproductive Health
Rachel K Jones, Doris W Chiu
BACKGROUND: As a result of the June 2022 decision of the United States (US) Supreme Court, as many as 24 states have, or are expected to, ban or severely restrict abortion. We provide baseline information about abortion patients living in different state environments prior to this decision. METHODS: We obtained surveys from 6674 women, transgender men, and other pregnancy capable individuals accessing abortion care at 56 facilities across the US between June 2021 and July 2022...
April 11, 2023: Perspectives on Sexual and Reproductive Health
Erica Hobby, Nicholas D E Mark, Alison Gemmill, Sarah K Cowan
OBJECTIVES: Much of reproductive health care policy in the United States focuses on enabling women to have intended pregnancies. Investigating whether the association between pregnancy intention and adverse outcomes for mothers and children in the immediate and longer term is due to intention or a mother's demographics provides valuable context for policy makers aiming to improve maternal and child outcomes. METHODS: We investigated relationships between pregnancy intention and pregnancy, infant, early childhood, and maternal outcomes using data from the Pregnancy Risk Assessment Monitoring System survey, conducted 2-8 months after the child's birth, and follow-up surveys from three states (Alaska, Missouri, and Oklahoma), administered at age 2-3 years old...
March 22, 2023: Perspectives on Sexual and Reproductive Health
Laura Graham Holmes, Kristy Anderson, Greg S Sieber, Paul T Shattuck
BACKGROUND: Sexual and reproductive health services promote the ability of people to have safe, satisfying, non-coercive sexual experiences and make informed decisions about pregnancy. Stakeholder input is needed to understand barriers or facilitators to service access for autistic people, who report unmet needs. METHODS: We recruited 18 autistic people, 15 parents, and 15 service providers in the United States to participate in an interview and two surveys. Using their input, we created a conceptual model of sexual and reproductive health service needs, access barriers, and facilitators...
February 7, 2023: Perspectives on Sexual and Reproductive Health
Suzanne O Bell, Blair O Berger, Carolyn Sufrin, Jessica L Dozier, Anne E Burke
OBJECTIVES: This exploratory study aimed to assess COVID-19-related changes in abortion service availability and use in Washington, DC, Maryland, and Virginia. DESIGN: Data came from a convenience sample of eight abortion clinics in this region. We implemented a cross-sectional survey and collected retrospective aggregate monthly abortion data overall and by facility type, abortion type, and patient characteristics for March 2019-August 2020. We evaluated changes in the distribution of the total number of patients for March-August in 2019 compared to March-August 2020...
February 7, 2023: Perspectives on Sexual and Reproductive Health
Dana M Johnson, Mira Michels-Gualtieri, Rebecca Gomperts, Abigail R A Aiken
OBJECTIVES: To evaluate self-reported outcomes and serious adverse events following self-managed medication abortion using misoprostol alone provided from an online service. STUDY DESIGN: We conducted a retrospective record review of self-managed abortion outcomes using misoprostol obtained from Aid Access, an online telemedicine organization serving United States (US) residents, between June 1, 2020, and June 30, 2020. The main outcomes were the proportion of people who reported ending their pregnancy without instrumentation intervention and the proportion who received treatment for serious adverse events...
February 6, 2023: Perspectives on Sexual and Reproductive Health
Abigail S Cutler, Laura T Swan, Madison Lands, Nicholas B Schmuhl, Jenny A Higgins
OBJECTIVE: To examine factors associated with physicians' level of concern and perceived consequences of publicly supporting abortion at Wisconsin's largest and only publicly funded medical school. METHODS: We surveyed physicians at the University of Wisconsin School of Medicine and Public Health about their knowledge, attitudes, and referral practices regarding abortion care. Among those who expressed support for abortion (N = 701), we analyzed perceived concerns about making their support public...
January 11, 2023: Perspectives on Sexual and Reproductive Health
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