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Garon-Bissonnette J, Bean CAL, Cárdenas EF, Jackson M, Abitante G, Humphreys KL, Kujawa A. Longitudinal associations between prenatal internalizing symptoms and mindfulness traits with postnatal bonding difficulties. Arch Womens Ment Health 2024:10.1007/s00737-024-01518-1. [PMID: 39316178 DOI: 10.1007/s00737-024-01518-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 09/16/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE Mothers' reported connection, or bond, with their infants develops across the early postnatal period and is relevant to mother and offspring functioning. Little is known, however, about early predictors of bonding difficulties over time. The present study examined prenatal anxiety, depressive symptoms, and trait mindfulness and variation in bonding difficulties in mothers across the first two months postnatal. METHODS Participants were 120 pregnant women (Mage=31.09 years, SD = 4.81; 80% White). Measures of anxiety, depression, and five facets of mindfulness were administered mid-pregnancy (approximately 20 weeks gestation) and bonding difficulties were assessed every two weeks from approximately 1 to 7 weeks postnatal. RESULTS Using multilevel modeling to account for within-person repeated assessments, we found an inverted U-shaped pattern across time such that bonding difficulties initially worsened before improving around five weeks postnatal. Prenatal anxiety and depressive symptoms were longitudinally associated with greater bonding difficulties overall and were unrelated to the trajectory of change. The mindfulness facets of acting with awareness and being nonjudging of one's own experience were longitudinally associated with less bonding difficulties overall, weaker initial increases in bonding difficulties, and earlier improvements. CONCLUSIONS Prenatal anxiety and depression may be risk factors for bonding difficulties that are persistent across the early postnatal period. In contrast, mindfulness tendencies before childbirth, specifically acting with awareness and being nonjudging towards oneself, may support early feelings of bonding over time.
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Affiliation(s)
- Julia Garon-Bissonnette
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
- Department of Special Education, Vanderbilt University, 230 Appleton Place, Nashville, TN, USA.
| | - Christian A L Bean
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Emilia F Cárdenas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Maya Jackson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - George Abitante
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Mekonnen BD, Vasilevski V, Bali AG, Sweet L. Association between pregnancy intention and completion of newborn and infant continuum of care in Sub-Saharan Africa: systematic review and meta-analysis. BMC Pediatr 2024; 24:567. [PMID: 39237944 PMCID: PMC11378494 DOI: 10.1186/s12887-024-05036-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND The newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa. METHODS We searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle-Ottawa Scale to assess the quality of the included studies. The Cochran's Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18. RESULTS Eleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies. CONCLUSION Intended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women's opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42023409148.
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Affiliation(s)
- Birye Dessalegn Mekonnen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia.
- Amhara Public Health Institute, Bahir Dar, Ethiopia.
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia
- Western Health Partnership, Victoria, Australia
| | - Ayele Geleto Bali
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia
- Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia
- Western Health Partnership, Victoria, Australia
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3
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Beumer WY, Koot MH, Vrijkotte T, Roseboom TJ, van Ditzhuijzen J. Long-term effects of unintended pregnancy on children: Findings from the Dutch prospective birth-cohort Amsterdam born children and their development study. Soc Sci Med 2024; 357:117200. [PMID: 39142143 DOI: 10.1016/j.socscimed.2024.117200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 07/25/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
Several studies investigated short-term risks of children born from unintended pregnancies, however evidence about long-term risks is lacking. We aimed to examine whether children born from unintended pregnancies experience psychosocial problems up into adolescence. This study is based on the longitudinal birth cohort study 'Amsterdam Born Children and their Development' (n = 7784). Unintended pregnancy was measured as a multidimensional construct, based on self-reports on the extent of pregnancy mistiming ('This pregnancy happened too soon'), unwantedness ('I did not want to be pregnant (anymore)') and unhappiness ('I am happy to be pregnant'; recoded). Further, children's psychosocial problems were measured with the Strengths and Difficulties Questionnaire, at 5-6, 11-12 and 15-16 years old. Multiple over-time associations between unintended pregnancy and children's psychosocial problems were analysed using Structural Equation Modelling, while controlling for confounders. Results showed that pregnancy mistiming was a significant predictor of internalizing (β = 0.10, p < 0.001) and externalizing problems (β = 0.07, p = 0.006) and unwanted pregnancy of internalizing problems (β = 0.13, p < 0.001) at 5-6 years. These associations were substantially mediated by maternal mental health and poorer maternal bonding. Associations were no longer present at 11-12 and 15-16 years. Thus, we conclude that children born from unintended pregnancies experience more psychosocial problems at 5-6 years, but no longer at 11-12 and 15-16 years. Unintended pregnancies often coincide with maternal mental health problems and socioeconomic factors. Most importantly, the associations between unintended pregnancy and children's psychosocial problems are influenced by maternal mental health and poorer bonding. Therefore it is important to improve maternal mental health and bonding for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy per se.
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Affiliation(s)
- Wieke Y Beumer
- Amsterdam UMC location University of Amsterdam, Obstetrics and Gyneacology, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands.
| | - Marjette H Koot
- Amsterdam UMC location University of Amsterdam, Obstetrics and Gyneacology, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands
| | - Tanja Vrijkotte
- Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
| | - Tessa J Roseboom
- Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
| | - Jenneke van Ditzhuijzen
- Amsterdam UMC location University of Amsterdam, Obstetrics and Gyneacology, Meibergdreef 9, Amsterdam, Netherlands; Utrecht University, Interdisciplinary Social Science, Social Policy and Public Health, Heidelberglaan 1, Utrecht, Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
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4
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Brar A, Mannava SV, Patwardhan UM, Sullins VF, Berdan EA, Greves CD, Gow KW, Carlisle E, Tsao K, Hunter C, Baerg JE, Knod JL. Navigating the Impact of the Dobbs Decision: Perspectives from Pediatric Surgeons on Reproductive Healthcare. J Am Coll Surg 2024; 239:309-316. [PMID: 38577986 DOI: 10.1097/xcs.0000000000001092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Nationwide abortion restrictions resulting from the Dobbs v Jackson Women's Health Organization (2022) decision have generated confusion and uncertainty among healthcare professionals, with concerns for liability impacting clinical decision-making and outcomes. The impact on pediatric surgery can be seen in prenatal counseling for fetal anomaly cases, counseling for fetal intervention, and recommendations for pregnant children and adolescents who seek termination. It is essential that all physicians and healthcare team members understand the legal implications on their clinical practices, engage with resources and organizations that can help navigate these circumstances, and consider advocating for patients and themselves. Pediatric surgeons must consider the impact of these changing laws on their ability to provide comprehensive and ethical care and counseling to all patients.
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Affiliation(s)
- Amanpreet Brar
- From the Department of Surgery, University of Michigan, Ann Arbor, MI (Brar)
| | - Sindhu V Mannava
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (Mannava)
| | - Utsav M Patwardhan
- Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA (Patwardhan)
| | - Veronica F Sullins
- Division of Pediatric Surgery, University of California, Los Angeles, CA (Sullins)
| | - Elizabeth A Berdan
- General Pediatric and Thoracic Surgery, Mary Bridge Children's Hospital and Health Center, Tacoma, WA (Berdan)
| | - Cole D Greves
- Division of Maternal-Fetal Medicine, Orlando Health Winnie Palmer Hospital for Women & Babies, Orlando, FL (Greves)
| | - Kenneth W Gow
- Division of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA (Gow)
| | - Erica Carlisle
- Division of Pediatric Surgery, The University of Iowa Stead Family Children's Hospital, Iowa City, IA (Carlisle)
| | - KuoJen Tsao
- Division of General and Thoracic Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, TX (Tsao)
| | - Catherine Hunter
- Division of Pediatric Surgery, Oklahoma Children's Hospital, Oklahoma City, OK (Hunter)
| | - Joanne E Baerg
- Division of Pediatric Surgery, Presbyterian Healthcare Services, Albuquerque, NM (Baerg)
| | - J Leslie Knod
- Division of Pediatric General and Thoracic Surgery, Connecticut Children's Medical Center, Hartford, CT (Knod)
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5
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McKenzie M, Humphreys C, Tarzia L. Mothering in the Aftermath of Reproductive Coercion and Abuse. Violence Against Women 2024:10778012241263102. [PMID: 39043121 DOI: 10.1177/10778012241263102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
A partner's reproductive coercion and abuse (RCA) can significantly undermine women's physical health and psychological wellbeing. Yet little research has explored how RCA affects experiences of mothering and relationships with children. Based on an analysis of interviews with 30 Australian mothers, we found that RCA affected mothering in complex ways. Many struggled with feeling detached, resentful, and guilty toward their children, while some found mothering an emotionally and morally restorative experience after the RCA. All felt compelled to conceal their abuse from their children and others. The findings have implications for how healthcare practitioners can support mothers in the aftermath of RCA.
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Affiliation(s)
- Mandy McKenzie
- Department of General Practice & Primary Care, The University of Melbourne, Carlton, Victoria, Australia
| | - Cathy Humphreys
- Department of Social Work, University of Melbourne, Parkville, Australia
| | - Laura Tarzia
- Department of General Practice & Primary Care, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
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Wenze SJ, Mikula CM, Battle CL. Two babies, two bonds: Frequency and correlates of differential maternal-infant bonding in mothers of twins. Infant Ment Health J 2024; 45:286-300. [PMID: 38403982 DOI: 10.1002/imhj.22108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/18/2024] [Accepted: 02/02/2024] [Indexed: 02/27/2024]
Abstract
We assessed prevalence and correlates of differential maternal-infant bonding (i.e., experiencing a stronger bond with one baby vs. the other) in mothers of twins, focusing on aspects of maternal mental health, well-being, and pregnancy/birth that have been previously linked with maternal-infant bonding. Participants (N = 108 American women, 88.89% White, 82.41% non-Hispanic, aged 18-45, who gave birth to twins in the past 6-24 weeks) were recruited from postpartum support websites. Participants completed a Qualtrics survey assessing pregnancy/birth history, symptoms of depression and anxiety, sleep, stress, romantic relationship satisfaction, and postpartum bonding. Twenty-six participants (24.07%) reported a bonding discrepancy. These participants endorsed higher symptoms of depression and anxiety, lower relationship satisfaction, lower average postpartum bonding, higher general and parenting stress, and longer pregnancy (all ps > .05). Greater degree of bonding discrepancy correlated with more depression, higher parenting stress, longer pregnancy, and lower relationship satisfaction (all ps > .05). Mothers of twins may benefit from postpartum mental health support, stress management strategies, and interventions to improve bonding. Future work should assess the role of breastfeeding difficulties, delivery method, birth-related trauma, infant regulatory capacity, and temperament. Longitudinal studies will help test cause and effect and potential long-term repercussions of maternal-infant bonding discrepancies.
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Affiliation(s)
- Susan J Wenze
- Department of Psychology, Lafayette College, Easton, Pennsylvania, USA
| | - Cynthia M Mikula
- Department of Psychology, Lafayette College, Easton, Pennsylvania, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Women and Infants' Hospital of Rhode Island, Providence, Rhode Island, USA
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7
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Pineda-Torres M, Rodgers YVDM. Looking Back: The Changing Landscape of Abortion Care in Louisiana. Am J Public Health 2024; 114:463-466. [PMID: 38489499 PMCID: PMC11008291 DOI: 10.2105/ajph.2024.307606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Mayra Pineda-Torres
- Mayra Pineda-Torres is with the School of Economics, Georgia Institute of Technology, Atlanta. Yana van der Meulen Rodgers is with the Labor Studies and Employment Relations Department, Rutgers University, New Brunswick, NJ
| | - Yana van der Meulen Rodgers
- Mayra Pineda-Torres is with the School of Economics, Georgia Institute of Technology, Atlanta. Yana van der Meulen Rodgers is with the Labor Studies and Employment Relations Department, Rutgers University, New Brunswick, NJ
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8
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Coates EE, de Heer R, McLeod A, Porter SC, Hoffman SB. "Shouldn't Nobody Make a Woman do What they Don't Want to do with their Body": Black Women's Reactions to the Supreme Court's Overturn of Roe v. Wade. J Racial Ethn Health Disparities 2024; 11:968-979. [PMID: 36976512 DOI: 10.1007/s40615-023-01577-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 11/27/2022] [Accepted: 03/19/2023] [Indexed: 03/29/2023]
Abstract
Black women, particularly those with low-income, are projected to be the most negatively impacted group following the Supreme Court's overturn of Roe v Wade. It is expected that the rate of increase in live births, as well as the rate of maternal mortality, will be steepest for Black women due to high rates of unmet needs for contraception, unintended pregnancies, poverty, barriers to legal abortion access, and systemic racism. Previous research has shown that the legalization of abortion in 1973 significantly improved educational and employment outcomes for Black women, in particular. The current study seeks to assess the perceptions of predominantly under-resourced Black women following the overturning of Roe v Wade. Eighteen Black women participated in one of five focus groups during the summer of 2022 and shared their reactions to the Supreme Court ruling. Using grounded theory, researchers generated the following themes: sexism via forced births, economic implications, and dangers of banned abortions. Based on participants' concerns resulting from the Roe v Wade overturn, policy implications are provided for improving the following systems: safety net, child welfare, and infant and perinatal mental health care.
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Affiliation(s)
- Erica E Coates
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA.
- MedStar Georgetown University Hospital, 2115 Wisconsin Ave NW, Washington, DC, 20007, USA.
| | - Rebecca de Heer
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Alison McLeod
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Shy C Porter
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA
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9
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Lands M, Dyer RL, Seymour JW. Sampling strategies among studies of barriers to abortion in the United States: A scoping review of abortion access research. Contraception 2024; 131:110342. [PMID: 38012964 DOI: 10.1016/j.contraception.2023.110342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Understanding barriers to abortion care is particularly important post-Dobbs. However, many abortion access studies recruit from abortion-providing facilities, which overlook 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. STUDY DESIGN We used a scoping review protocol to search five databases for articles examining US-based individuals' experiences accessing abortion. We included English-language articles published between January 2011 and February 2022. For included studies, we identified the sampling strategy and population recruited. RESULTS Our search produced 2763 articles, of which 71 met inclusion criteria. Half of the included papers recruited participants at abortion-providing facilities (n = 35), while the remainder recruited from online sources (n = 14), other health clinics (n = 10), professional organizations (n = 8), abortion funds (n = 2), community organizations (n = 2), key informants (n = 2), and an abortion storytelling project (n = 1). Most articles (n = 61) reported information from people discussing their own abortions; the rest asked nonabortion seekers (e.g., physicians, genetic counselors, attorneys) about barriers to care. CONCLUSIONS Studies of abortion barriers enroll participants from a range of venues, but the majority recruit people who obtained abortions, and half recruit from abortion clinics. IMPLICATIONS As abortion access becomes constrained and criminalized in the post-Roe context, our findings indicate how investigators might recruit study participants from a variety of settings to fully understand the abortion seeking experience.
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Affiliation(s)
- Madison Lands
- University of Wisconsin Collaborative for Reproductive Equity, Madison, WI, United States.
| | - Rachel L Dyer
- University of Wisconsin Collaborative for Reproductive Equity, Madison, WI, United States; University of Wisconsin Department of Counseling Psychology, Madison, WI, United States
| | - Jane W Seymour
- University of Wisconsin Collaborative for Reproductive Equity, Madison, WI, United States
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10
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Axelson SM, Steiner RJ, Jones RK. Characteristics of U.S. Abortion Patients Who Obtained Care Out of State Prior to the Overturning of Roe v. Wade. Womens Health Issues 2024; 34:142-147. [PMID: 38102056 DOI: 10.1016/j.whi.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023]
Abstract
CONTEXT In light of the Dobbs v. Jackson Women's Health Organization decision overturning Roe v. Wade, the number of people who need to travel out of state for abortion is increasing as several states impose abortion bans. Better understanding the characteristics of patients who obtained out-of-state abortions before the decision can provide a reference point for future research and inform efforts to improve abortion access. METHODS We used data from the 2014 Abortion Patient Survey, administered by the Guttmacher Institute, to examine the prevalence and characteristics of patients obtaining nonhospital abortions outside of their state of residence. We examined bivariate and multivariable associations between selected characteristics and obtaining an abortion out of state. RESULTS Six percent of abortion patients traveled out of state for care. Among patients who obtained their abortion out of state, more than half (56.9%) were non-Hispanic (NH) white, 26.6% were non-Hispanic Black, and 10.2% were Hispanic. Two-fifths (43.9%) resided in the South, one-third (34.3%) resided in the Midwest, 15% resided in the Northeast, and 7% resided in the West. More than one-third (38.2%) had family incomes below 100% of the federal poverty level (FPL), and two-thirds (67.7%) paid out of pocket; only 3% used Medicaid. Profiles of out-of-state abortion patients differed from in-state abortion patients by all characteristics except age. In adjusted analyses, NH Black (adjusted odds ratio [AOR]: 0.76; 95% confidence interval [CI]: 0.61-0.96), NH Asian, South Asian, and Asian Pacific Islander (AOR: 0.37; 95% CI: 0.20-0.67), and Hispanic (AOR: 0.46; 95% CI: 0.33-0.64) patients had lower odds of traveling out of state compared with their NH white counterparts. Compared with those paying for their abortion with private insurance, those who paid out of pocket had higher odds of traveling out of state (AOR: 1.75; 95% CI: 1.29-2.37) and those paying with Medicaid had lower odds (AOR: 0.27; 95% CI: 0.15-0.47). CONCLUSION Given the observed differences by race/ethnicity and method of payment for abortion, people of color and those without resources to pay out of pocket may especially benefit from efforts to support access to abortion care via interstate travel as an increasing number of states ban abortion.
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Affiliation(s)
- Sarah M Axelson
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
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11
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Bernard M, Niemann J, Weinhold L, Jepsen D, Miani C, Luck-Sikorski C. Abortion stigma among abortion seekers, healthcare professionals and the public in high-income countries: A mixed-methods systematic review protocol. BMJ Open 2024; 14:e076602. [PMID: 38238049 PMCID: PMC10806672 DOI: 10.1136/bmjopen-2023-076602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/07/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Abortion is a crucial sexual and reproductive right. However, the legal situation of pregnancy termination is rather heterogeneous across countries and regions. The political climate and cultural perception may result in abortion-related stigma. This mixed-methods systematic review protocol aims to detail the proposed methods for assessing the current state of research on abortion stigma in high-income countries from an abortion seeker, healthcare provider and public perspective. METHODS AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline, we conducted a systematic literature search of peer-reviewed studies from high-income countries in relevant electronic databases: PubMed, CINHAL, PsycINFO, LIVIVO and Cochrane Library. Qualitative, quantitative and mixed-method studies that measured or examined abortion-related stigma in abortion seekers, healthcare professionals and the general public will be included. Assessment of risk of bias, data synthesis and qualitative meta-aggregation will be carried out. ETHICS AND DISSEMINATION The results of the systematic review will be submitted to peer-reviewed journals and presented at relevant conferences.
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Affiliation(s)
- Marie Bernard
- Institute of Medical Sociology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Jana Niemann
- Institute of Medical Sociology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Laura Weinhold
- Institute of Medical Sociology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Dennis Jepsen
- Institute of Medical Sociology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Celine Miani
- Department of Social Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Claudia Luck-Sikorski
- SRH Hochschule fur Gesundheit GmbH, Gera, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University, Leipzig, Germany
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12
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Wagner B, Cleland K. Retail demand for emergency contraception in United States following New Year holiday: time series study. BMJ 2023; 383:e077437. [PMID: 38123174 PMCID: PMC10731423 DOI: 10.1136/bmj-2023-077437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To estimate the increase in sales of emergency contraception following the New Year's Eve/New Year's Day holiday. DESIGN Time series analysis using autoregressive integrated moving average (ARIMA) model. SETTING Traditional (that is, "bricks and mortar") retail outlets-grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets-in the United States from 2016 to 2022. DATA SOURCE Marketing data on weekly aggregated sales of items classified as emergency contraception gathered between 2016 and 2022 (n=362). On the basis of dates, weeks were classified as following the New Year holiday (n=6) or not (n=356). MAIN OUTCOME MEASURE Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population. RESULTS Sales of levonorgestrel emergency contraception significantly increased after the New Year holiday (0.63 (95% confidence interval 0.58 to 0.69) unit increase per 1000 women aged 15-44). Holidays that share some aspects of the elevated risks of unprotected sexual intercourse with the New Year holiday (Valentine's Day, St Patrick's Day, US Independence Day) were associated with increased sales, albeit to a lesser degree, with respective sales increases per 1000 women aged 15-44 of 0.31 (0.25 to 0.38), 0.14 (0.06 to 0.23), and 0.20 (0.11 to 0.29). Holidays without these expectations (Easter, Mother's Day, Father's Day) were not significantly associated with sales of levonorgestrel emergency contraception. CONCLUSIONS Increased sales of emergency contraception following the New Year's holiday suggest that this period is associated with increased risks of unprotected vaginal intercourse compared with other holidays. Targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception around holidays may limit the risks associated with unprotected vaginal intercourse.
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Affiliation(s)
- Brandon Wagner
- Department of Sociology, Anthropology, and Social Work, Texas Tech University. Texas, USA
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Seymour JW, Goode BA, Guerrero P, Campos AM, Kyles K, Dreyfus-Pai P, Baum SE. Emotional, informational, and decision-making support needs among people seeking abortion in the US: perspectives from All-Options Talkline callers. Sex Reprod Health Matters 2023; 31:2248742. [PMID: 37728428 PMCID: PMC10512898 DOI: 10.1080/26410397.2023.2248742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
People seeking abortion may need or want emotional or informational support before, during, and after their abortion. Feeling supported and affirmed contributes to perceptions of quality care. The All-Options Talkline offers free, telephone-based, peer counselling to callers anywhere in the United States. This study aimed to explore the types of support received through the Talkline and the ways it supplemented other forms of support received by people who obtained an abortion. Between May 2021 and February 2022, we conducted 30 interviews via telephone or Zoom with callers recruited through the Talkline. We coded the interviews and conducted thematic analysis, focusing on themes related to gaps of support from family, friends, and healthcare professionals, as well as types of support received through the Talkline. We identified four key motivations for calling the Talkline, including the need for (1) decision-making support and validation, (2) a neutral perspective, (3) emotional support to discuss negative or complex feelings, and (4) information about the abortion process. Participants indicated that interactions with family, friends, and healthcare professionals ranged from unsupportive and negative, to substantially supportive. Access to the Talkline was particularly useful prior to clinical interactions and in the weeks or months after an abortion. We found that the All-Options Talkline provided person-centred, remote support for callers, filling gaps or supplementing support from one's community or healthcare professionals. Abortion support from non-medically trained support people contributes to high-quality abortion care, especially in a time of increasing abortion restrictions and use of remote abortion services.
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Affiliation(s)
- Jane W. Seymour
- Research Scientist, Collaborative for Reproductive Equity (CORE), Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Bria A. Goode
- Senior Research Manager, Ibis Reproductive Health, Oakland, CA, USA
| | | | | | - Kai Kyles
- Project Coordinator, All-Options, Cleveland, OH, USA
| | | | - Sarah E. Baum
- Senior Research Scientist, Ibis Reproductive Health, Oakland, CA, USA
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14
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Martinez NG, Roberts SCM, Achu-Lopes RA, Samura TL, Seidman DL, Woodhams EJ. Reconsidering the use of urine drug testing in reproductive settings. Am J Obstet Gynecol MFM 2023; 5:101206. [PMID: 37871695 DOI: 10.1016/j.ajogmf.2023.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
The urine drug test is ubiquitous within reproductive healthcare settings. Although the test can have evidence-based use for a patient and clinician, in practice, it is often applied in ways that are driven by bias and stigma, do not correctly inform decisions about clinical aspects of patient care, and cause devastating ripple effects through social and legal systems. This paper proposes a framework of guiding questions to prompt reflection on (1) the question the clinical team is trying to answer, (2) whether a urine drug test answers the question at hand, (3) how testing benefits compare with the associated risks, (4) a more effective tool for clinical decision-making if the urine drug test does not meet the standards for use, and (5) individual and institutional biases affecting decision-making. We demonstrate the use of this framework using 3 common uses of the urine drug test within abortion care and labor and delivery settings.
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Affiliation(s)
- Noelle G Martinez
- Division of Addiction Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Martinez).
| | - Sarah C M Roberts
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA (Dr Roberts)
| | - Rachel A Achu-Lopes
- Department of Anesthesia, Boston Medical Center, Boston University School of Medicine, Boston, MA (Dr Achu-Lopes)
| | - Tirah L Samura
- Los Angeles County Department of Health Services, Harbor-University of California Los Angeles Medical Center, Los Angeles, CA (Dr Samura); Los Angeles County Department of Health Services, Martin Luther King, Jr. Outpatient Center, Los Angeles, CA (Dr Samura)
| | - Dominika L Seidman
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA (Dr Seidman)
| | - Elisabeth J Woodhams
- Department of Obstetrics & Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, MA (Dr Woodhams)
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15
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Downey MM, Daniel C, McGlynn-Wright A, Haugeberg K. Protect and Control: Coverture's Logics Across Welfare Policy and Abortion Law. PSYCHOLOGY OF WOMEN QUARTERLY 2023; 47:478-493. [PMID: 38606316 PMCID: PMC11008606 DOI: 10.1177/03616843231186320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
In the aftermath of Dobbs v. Jackson Women's Health Organization, which overturned the federal constitutional right to abortion, states have begun to recriminalize the procedure. These abortion bans raise important questions about the political and social status of women and pregnant people in the United States. Moreover, restrictions in social welfare programs such as the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children and Temporary Assistance for Needy Families, which serve low-income pregnant people and parents, raise similar questions. The regulation and administration of all three are framed by race, class, and gender. To understand how these restrictions (a) claim to protect women but ultimately function to control, police, and surveil and (b) rely on imagined, stereotype-laden psychological states such as vulnerability, irresponsibility, or irrationality, we turn to the British Common Law doctrine of coverture, which subsumed a married woman's legal, financial, and political identities under her husband's. The American colonies, and later, states of the United States, drew from British Common Law to craft laws that regulated relationships between men and women. Taken together, this analysis can provide a more comprehensive accounting of the cumulative harms experienced by women, poor people, people of color, and pregnant people in today's health and social welfare landscape. We conclude with recommendations for psychologists and other mental health providers to address, in practice and advocacy, the ethical dilemmas and obligations raised by the reach of coverture's logics in people's lives.
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Affiliation(s)
| | - Clare Daniel
- Newcomb Institute, Tulane University, New Orleans,
USA
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16
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Yalamanchi P, Faucett EA, Shuman AG. Otolaryngologists and Reproductive Rights. Otolaryngol Head Neck Surg 2023; 169:1393-1396. [PMID: 37210612 DOI: 10.1002/ohn.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/19/2023] [Accepted: 04/23/2023] [Indexed: 05/22/2023]
Abstract
Our nation faces contentious questions regarding reproductive rights and access to abortion which have long been viewed as beyond the scope of otolaryngology. The broad implications of the recent Supreme Court ruling in Dobbs v Jackson Women's Health Organization (Jackson) impact all people who are, or can become, pregnant and their health care providers. The consequences for otolaryngologists are thus far-reaching and poorly understood. Here we describe how the post-Dobbs landscape is relevant to the practice of otolaryngology and offer suggestions for how otolaryngologists can best respond, prepare, and support their patients in this tenuous political landscape.
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Affiliation(s)
- Pratyusha Yalamanchi
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Erynne A Faucett
- Department of Otolaryngology-Head and Neck Surgery, UC Davis Children's Hospital, Sacramento, USA
| | - Andrew G Shuman
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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17
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Yang G, Hisada A, Yamamoto M, Kawanami A, Mori C, Sakurai K. Effect of nausea and vomiting during pregnancy on mother-to-infant bonding and the mediation effect of postpartum depression: the Japan Environment and Children's Study. BMC Pregnancy Childbirth 2023; 23:704. [PMID: 37784021 PMCID: PMC10544486 DOI: 10.1186/s12884-023-06014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Mother-to-infant bonding (MIB) is critical for the health and well-being of the mother and child. Furthermore, MIB has been shown to boost the social-emotional development of infants, while also giving mothers a sense of happiness in raising their children. Nausea and vomiting during pregnancy (NVP) is a normal complication of pregnancy, occurring in approximately 50-90% of pregnant women in the early stages of pregnancy. Despite widespread knowledge of MIB and postpartum depression, little research attention has been given to the effects of NVP on MIB. This study aimed to investigate the relationship between NVP and MIB and the mediating effects of postpartum depression. METHODS We analyzed the data of 88,424 infants and 87,658 mothers from the Japan Environment and Children's Study (JECS), which is a government-funded nationwide birth prospective cohort study. The Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) was used to assess MIB, and the Edinburgh Postpartum Depression Scale (EPDS) was utilized to assess postpartum depression. We divided participants into four groups according to a self-reported questionnaire assessing NVP (No NVP, Mild NVP, Moderate NVP, and Severe NVP). MIB disorder was defined as a MIBS-J score ≥ 5. Logistic analysis was performed to evaluate the effect of NVP on MIB disorder at one year after delivery. A mediation analysis was conducted to examine whether postpartum depression mediated the association between NVP and MIBS-J scores. RESULTS The logistic regression analysis results revealed reduced risks of MIB disorder among mothers with Moderate NVP (adjusted OR 0.93; 95% confidence interval, 0.86-0.99) and Severe NVP (adjusted OR 0.81; 95% confidence interval, 0.74-0.89), compared to those with No NVP. The mediation analysis revealed that NVP positively correlated with MIBS-J score in the indirect effect via postpartum depression, while NVP (Mild NVP, Moderate NVP, and Severe NVP) negatively correlated with MIBS-J score in the direct effect. CONCLUSION The risks of MIB disorder were reduced in the Moderate NVP and Severe NVP mothers, although NVP inhibited the development of MIB via postpartum depression. The development of effective interventions for postpartum depression is important to improve MIB among mothers with NVP.
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Affiliation(s)
- Gui Yang
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Aya Hisada
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Akiko Kawanami
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan.
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18
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Barnes-Davis ME, Cortezzo DE. The patient/physician relationship in a post-Roe world: a neonatologist viewpoint. J Perinatol 2023; 43:968-972. [PMID: 36528653 PMCID: PMC10325948 DOI: 10.1038/s41372-022-01583-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
The Supreme Court ruling in Dobbs v. Jackson Women's Health Organization has far-reaching implications that go beyond the practice of obstetrics and gynecology. The ruling and subsequent laws and bills impact many specialties and have implications for healthcare as a whole. The rapidly changing medicolegal landscape has significant bearings on and implications for the fields of neonatology and pediatrics. These rulings have an impact on the patient-physician relationship and a shared decision-making approach to care. Furthermore, there are significant sequelae of forced birth and resuscitation. This review provides a clinically relevant update of the current medicolegal landscape and applications to the practice of neonatology.
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Affiliation(s)
- Maria E Barnes-Davis
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, USA, OH.
| | - DonnaMaria E Cortezzo
- Division of Neonatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Pain and Palliative Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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19
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Poehling C, Downey MM, Singh MI, Beasley CC. From Gaslighting to Enlightening: Reproductive Justice as an Interdisciplinary Solution to Close the Health Gap. JOURNAL OF SOCIAL WORK EDUCATION 2023; 59:S36-S47. [PMID: 38606421 PMCID: PMC11008595 DOI: 10.1080/10437797.2023.2203205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 04/13/2024]
Abstract
This conceptual article aims to inform social work educators on facilitating critical discourse among social work students by applying reproductive justice, leveraging interdisciplinary practice, and addressing the Social Work Grand Challenges. Reproductive justice tenets provide an interdisciplinary framework that assists in the development of the learning environment, participant's critical thinking, self-awareness, and self-regulation; preparing them for professional dialog and ethical decision making. This article will outline the tenets of reproductive justice, providing resources and tools for creating an environment that will assist in the facilitation of critical and professional conversations; while providing strategies that incorporate interdisciplinary partners into the classroom thus providing a reproductive justice sensitive analysis and solutions for approaching social issues that affect the people social workers serve.
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Affiliation(s)
- Catherine Poehling
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Margaret Mary Downey
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Melissa Indera Singh
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Candice C Beasley
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
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20
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Tokuda N, Tanaka H, Sawai H, Shibahara H, Takeshima Y, Shima M. Analyzing the relationship between feelings about pregnancy and mother-infant bonding with the onset of maternal psychological distress after childbirth: The Japan Environment and Children's Study. J Affect Disord 2023; 329:531-538. [PMID: 36858269 DOI: 10.1016/j.jad.2023.02.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Strengthening maternal mental health from early pregnancy is essential. This study investigated the factors affecting the onset of maternal psychological distress at 12 months after childbirth in women who had not experienced it during pregnancy. METHODS Feelings about pregnancy were assessed using a questionnaire in the first trimester, and maternal mental health was assessed using the 6-Item Kessler Psychological Distress Scale (K6) in the first and second/third trimesters and at 12 months after childbirth. Mother-infant bonding was assessed using the Japanese version of Mother-to-Infant Bonding Scale (MIBS-J) in the first, sixth, and twelfth months after childbirth. This study comprised 46,053 mothers without psychological distress (K6 ≤ 4) during pregnancy from the 97,415 mothers enrolled in the Japan Environment and Children's Study. RESULTS The onset of psychological distress at 12 months after childbirth was associated with negative maternal feelings about pregnancy, a history of infertility treatment before the current pregnancy, and poor mother-infant bonding after childbirth. Abortion history was not associated with psychological distress. The strongest factor affecting the onset of psychological distress was mother-infant bonding (β = 0.28), and the indirect effect of feelings about pregnancy was also observed (β = 0.10). LIMITATIONS We used the full version of MIBS-J consisting of 10 items at 12 months after childbirth but included only five items in the first and sixth months. CONCLUSIONS Inadequate mother-infant bonding was associated with the onset of maternal psychological distress after childbirth. Supporting mother-infant bonding is critical throughout the perinatal period, considering maternal feelings about pregnancy.
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Affiliation(s)
- Narumi Tokuda
- Hyogo Regional Center for the Japan Environment and Children's study, Hyogo Medical University, Nishinomiya, Japan; Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Hiroyuki Tanaka
- Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Hideaki Sawai
- Department of Clinical Genetics, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Hiroaki Shibahara
- Hyogo Regional Center for the Japan Environment and Children's study, Hyogo Medical University, Nishinomiya, Japan; Department of Obstetrics and Gynecology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Yasuhiro Takeshima
- Hyogo Regional Center for the Japan Environment and Children's study, Hyogo Medical University, Nishinomiya, Japan; Department of Pediatrics, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Masayuki Shima
- Hyogo Regional Center for the Japan Environment and Children's study, Hyogo Medical University, Nishinomiya, Japan; Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
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21
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Jung C, Oviedo J, Nippita S. Abortion Care in the United States - Current Evidence and Future Directions. NEJM EVIDENCE 2023; 2:EVIDra2200300. [PMID: 38320010 DOI: 10.1056/evidra2200300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Abortion Care in the United StatesAbortion services are a vital component of reproductive health care. Jung and colleagues review medication abortion and procedural abortion as well as implications of increasing restrictions on access in the United States.
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Affiliation(s)
- Christina Jung
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine
| | - Johana Oviedo
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine
| | - Siripanth Nippita
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine
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22
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Moseson H, Smith MH, Chakraborty P, Gyuras HJ, Foster A, Bessett D, Wilkinson TA, Norris AH. Abortion-Related Laws and Concurrent Patterns in Abortion Incidence in Indiana, 2010-2019. Am J Public Health 2023; 113:429-437. [PMID: 36795983 PMCID: PMC10003501 DOI: 10.2105/ajph.2022.307196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 02/18/2023]
Abstract
Objectives. To analyze abortion incidence in Indiana concurrent with changes in abortion-related laws. Methods. Using publicly available data, we created a timeline of abortion-related laws in Indiana, calculated abortion rates by geography, and described changes in abortion occurrence coincident with changes in abortion-related laws between 2010 and 2019. Results. Between 2010 and 2019, Indiana's legislature passed 14 abortion-restricting laws, and 4 of 10 abortion-providing clinics closed. The Indiana abortion rate decreased from 7.8 abortions per 1000 women aged 15 to 44 years in 2010 to 5.9 in 2019. At all time points, the abortion rate was 58% to 71% of the Midwestern rate and 48% to 55% of the national rate. By 2019, nearly 1 in 3 (29%) Indiana residents who obtained abortion care did so outside the state. Conclusions. Access to abortion in Indiana over the past decade was low, required increases in interstate travel to obtain care, and co-occurred with the passage of numerous abortion restrictions. Public Health Implications. These findings preview unequal abortion access and increases in interstate travel as state-level restrictions and bans go into effect across the country. (Am J Public Health. 2023;113(4):429-437. https://doi.org/10.2105/AJPH.2022.307196).
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Affiliation(s)
- Heidi Moseson
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Mikaela H Smith
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Payal Chakraborty
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Hillary J Gyuras
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Abigail Foster
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Danielle Bessett
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Tracey A Wilkinson
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
| | - Alison H Norris
- Heidi Moseson is with Ibis Reproductive Health, Oakland, CA. Mikaela H. Smith, Hillary J. Gyuras, Abigail Foster, and Alison H. Norris are with the Ohio Policy Evaluation Network, Ohio State University, Columbus. Danielle Bessett is with the Ohio Policy Evaluation Network, University of Cincinnati, Cincinnati. Payal Chakraborty is with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Tracey A. Wilkinson is with the Indiana University School of Medicine, Indianapolis
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23
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MONTEZ JENNIFERKARAS, GRUMBACH JACOBM. US State Policy Contexts and Population Health. Milbank Q 2023; 101:196-223. [PMID: 37096608 PMCID: PMC10126966 DOI: 10.1111/1468-0009.12617] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points This Perspective connects the dots between the polarization in US states' policy contexts and the divergence in population health across states. Key interlocking forces that fueled this polarization are the political investments of wealthy individuals and organizations and the nationalization of US political parties. Key policy priorities for the next decade include ensuring all Americans have opportunities for economic security, deterring behaviors that kill or injure hundreds of thousands of Americans each year, and protecting voting rights and democratic functioning.
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24
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Adams SY, Henner N, Watson K. The role of paediatrics in the abortion debate. Acta Paediatr 2023; 112:582-584. [PMID: 36394353 DOI: 10.1111/apa.16600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/25/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Shannon Y Adams
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Natalia Henner
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Katie Watson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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25
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LANTZ PAULAM, MICHELMORE KATHERINE, MONIZ MICHELLEH, MMEJE OKEOMA, AXINN WILLIAMG, SPECTOR‐BAGDADY KAYTE. Abortion Policy in the United States: The New Legal Landscape and Its Threats to Health and Socioeconomic Well-Being. Milbank Q 2023; 101:283-301. [PMID: 36960973 PMCID: PMC10126955 DOI: 10.1111/1468-0009.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/06/2023] [Indexed: 03/25/2023] Open
Abstract
Policy Points The historic 2022 Supreme Court Dobbs v Jackson Women's Health Organization decision has created a new public policy landscape in the United States that will restrict access to legal and safe abortion for a significant proportion of the population. Policies restricting access to abortion bring with them significant threats and harms to health by delaying or denying essential evidence-based medical care and increasing the risks for adverse maternal and infant outcomes, including death. Restrictive abortion policies will increase the number of children born into and living in poverty, increase the number of families experiencing serious financial instability and hardship, increase racial inequities in socioeconomic security, and put significant additional pressure on under-resourced social welfare systems.
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Affiliation(s)
| | | | - MICHELLE H. MONIZ
- University of Michigan
- Michigan Medicine Department of Obstetrics and Gynecology
| | - OKEOMA MMEJE
- University of Michigan
- Michigan Medicine Department of Obstetrics and Gynecology
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Kruse DE, Houk JL, Minkemeyer VM, Thomas SP, Jaffe TA. Reproductive rights are not a political issue, they are a healthcare issue. Clin Imaging 2023; 96:56-57. [PMID: 36812807 DOI: 10.1016/j.clinimag.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Affiliation(s)
- Danielle E Kruse
- Department of Radiology, Box 3808, Duke University Medical School, Durham, NC 27710, United States of America.
| | - Jessica L Houk
- Department of Radiology, Box 3808, Duke University Medical School, Durham, NC 27710, United States of America.
| | - Vivian M Minkemeyer
- Department of Radiology, Box 3808, Duke University Medical School, Durham, NC 27710, United States of America.
| | - Sarah P Thomas
- Department of Radiology, Box 3808, Duke University Medical School, Durham, NC 27710, United States of America.
| | - Tracy A Jaffe
- Department of Radiology, Box 3808, Duke University Medical School, Durham, NC 27710, United States of America.
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Liang AC, Sanders NS, Anderson ES, Heeney ME, Hirschman CM, Kane AR, Wills CP. "ContraceptED": A Multidisciplinary Framework for Emergency Department-Initiated Contraception. Ann Emerg Med 2023; 81:630-636. [PMID: 36925395 DOI: 10.1016/j.annemergmed.2023.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 03/15/2023]
Abstract
Emergency departments (EDs) are common access points for patients who are at high risk for unintended pregnancy. Low-barrier access to effective contraception represents a crucial and low-cost intervention to address this public health need. Same-day initiation of contraception during an ED visit is a unique opportunity to provide reproductive health care for high-risk patients with otherwise limited health care access. We collaborated with our obstetrics and gynecology (OB/GYN) department, pharmacists, and a team of community health advocates to support emergency clinicians (namely, emergency physicians and advanced practice providers) in assessing pregnancy and contraceptive readiness, increasing proficiency in contraception counseling, prescribing hormonal contraception, counseling on barrier and emergency contraception, and inserting (and removing) the Nexplanon implant, a form of long-acting reversible contraception. With this novel approach, we found that emergency clinicians voluntarily participated in trainings on contraception, including low-threshold long-acting reversible contraception initiation; and, after completing these trainings, clinicians integrated these skills into their workflow in the ED. We report our results after screening 38 patients during our current Pilot Phase of implementing this program.
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Affiliation(s)
- Amy C Liang
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA.
| | - Noah S Sanders
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA
| | - Erik S Anderson
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA; Department of Medicine-Substance Use Disorder Program, Highland Hospital, Alameda Health System, Oakland, CA
| | - Megan E Heeney
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA
| | - Claire M Hirschman
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA
| | - Amy R Kane
- Department of Obstetrics and Gynecology, Alta Bates Summit Medical Center, Berkeley, CA
| | - Charlotte P Wills
- Department of Emergency Medicine, Highland Hospital, Alameda Health System, Oakland, CA
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Miller M, Lindley AR, West JD, Thayer EK, Godfrey EM. Does lower use of academic affiliation by university faculty in top U.S. newspapers contribute to misinformation about abortion? JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:7-20. [PMID: 36919808 DOI: 10.1080/17538068.2022.2150166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. METHODS Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. RESULTS We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects - 0.13, p = 0.02). CONCLUSIONS Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past.
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Affiliation(s)
- Madison Miller
- Medical Student, University of Washington School of Medicine, Seattle, WA, USA
| | - Alexa R Lindley
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Jevin D West
- Information School, Co-Founder of the Center for an Informed Public, University of Washington, Seattle, WA, USA
| | - Erin K Thayer
- Department of Family Medicine, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Emily M Godfrey
- Departments of Family Medicine and Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
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Cioffi A, Cecannecchia C, Cipolloni L, Santurro A, Cioffi F. The Importance of the International Community in Protecting the Right to Abortion: The Cases of Malta and of the US Supreme Court. Healthcare (Basel) 2023; 11:520. [PMID: 36833054 PMCID: PMC9957392 DOI: 10.3390/healthcare11040520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
According to the World Health Organization (WHO), abortion is often necessary and is not a criminalizable medical act. Unfortunately, despite the global trend in recent years tending towards liberalization of abortion as a fundamental right of women in certain circumstances, it is still not guaranteed in all countries of the world in the same way. Moreover, the abortion debate is often characterized by unscientific opinions based on political and/or religious ideologies. Recently, a European episode has rekindled the debate on abortion: in Malta, a tourist was unable to have an abortion, with consequent risks, even serious ones, on her health. In addition, even in the United States a Supreme Court ruling created a considerable stir: the Roe v. Wade (1973) ruling that had legalized abortion at the federal level was revoked. After the ruling of the Supreme Court, each state of the USA can decide for itself whether and how to legalize abortion. These recent international developments are particularly worrying and make even more evident the need for abortion to be protected at an international level as an inalienable and fundamental human right, and therefore not to be limited.
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Affiliation(s)
- Andrea Cioffi
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, 71100 Foggia, Italy
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
| | - Camilla Cecannecchia
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Roma, Italy
| | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, 71100 Foggia, Italy
| | - Alessandro Santurro
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
| | - Fernanda Cioffi
- Fertilitas Day Surgery Reproductive Medicine, 84127 Salerno, Italy
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Wisner KL, Appelbaum PS. Abortion Restriction and Mental Health. JAMA Psychiatry 2023; 80:285-286. [PMID: 36753289 DOI: 10.1001/jamapsychiatry.2022.4962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This Viewpoint discusses the specific concerns for psychiatrists about the impact of abortion restrictions on people with mental illness.
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Affiliation(s)
- Katherine L Wisner
- Asher Center for the Study and Treatment of Depressive Disorders, Chicago, Illinois
| | - Paul S Appelbaum
- Center for Law, Ethics and Psychiatry, Columbia University, New York, New York
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Coverdale J, Gordon MR, Beresin EV, Guerrero APS, Louie AK, Balon R, Morreale MK, Aggarwal R, Brenner AM. Access to Abortion After Dobbs v. Jackson Women's Health Organization: Advocacy and a Call to Action for the Profession of Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:1-6. [PMID: 36369427 PMCID: PMC9652041 DOI: 10.1007/s40596-022-01729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Non-barrier contraceptive use patterns among Latina adolescents attending California reproductive health centers: A longitudinal study. Contraception 2023; 118:109897. [PMID: 36240905 DOI: 10.1016/j.contraception.2022.09.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To describe use of non-barrier contraceptives over a 9-month period, consistency in method use, and identify factors associated with method nonuse, switching, and consistency among Latina adolescents attending California sexual and reproductive health (SRH) centers. STUDY DESIGN We conducted a cohort study using data self-reported at baseline, and 3- and 9-months post-baseline. The analysis included 1162 sexually active adolescents aged 18 to 19 who self-identified as female and Latina, indicated that they were not currently pregnant or trying to become pregnant, and who attended California SRH centers between June 2016 and June 2020. We used binomial generalized multivariable linear models with a log link to assess the likelihood of nonbarrier method consistency, switching, and non-use. RESULTS At baseline, 453 of 1162 (39%) of respondents were using short-acting methods (pill, patch, ring, or injection), 113 of 1162 (9.7%) were using long-acting methods (implants or intrauterine devices [IUDs]), and 596 of 1162 (51.3%) reported using neither short- nor long-acting methods. Over a 9-month period, 22/33 (66.7%) of those using IUDs consistently used the method, which was a statistically greater frequency of consistency than individuals who selected other nonbarrier methods (270/530 [50.9%], aRR: 1.40; 95% CI: 1.11, 1.77). Implant users had rates of method consistency similar to users of other nonbarrier methods (aRR: 1.11; 95% CI: 0.89, 1.38). Factors independently associated with method consistency included being older, having never been pregnant, having greater perceived risk of pregnancy, and greater contraceptive knowledge. CONCLUSION Sexually active Latina adolescents attending California SRH centers who were not trying to become pregnant maintained consistent contraceptive use more frequently when using an IUD. Using a patient-centered approach, contraceptive counseling for Latina adolescents can describe the combined efficacy and contraceptive stability offered by IUDs should patients desire it. IMPLICATIONS This study addressees gaps in knowledge about U.S. Latina adolescents' contraceptive use patterns. We demonstrate that IUD users, and not implant users, appear more likely to consistently use their method than those using non-LARC methods. Patient-centered contraceptive counseling for Latina adolescents can describe the greater contraceptive stability that IUDs may offer.
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Kumar MM, Borzutzky CR. Restricting abortion access in the USA: implications for child and adolescent health. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:83-85. [PMID: 36423655 DOI: 10.1016/s2352-4642(22)00285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Maya M Kumar
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA 92123, USA.
| | - Claudia R Borzutzky
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Auerbach SL, Coleman-Minahan K, Alspaugh A, Aztlan EA, Stern L, Simmonds K. Critiquing the Unintended Pregnancy Framework. J Midwifery Womens Health 2023; 68:170-178. [PMID: 36637112 DOI: 10.1111/jmwh.13457] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 01/14/2023]
Abstract
The unintended pregnancy framework, a central tenet of sexual and reproductive health care delivery and research, has been depicted as an adverse outcome that should be prevented. There is growing criticism of the inadequacies of this framework, although little modification in public health guidelines, measurement, or clinical practice has been seen. This article critically reviews the literature on unintended pregnancy to encourage reflection on how this framework has negatively influenced practice and to inspire the advancement of more patient-centered care approaches. We begin by outlining the historical origins of the unintended pregnancy framework and review how this framework mischaracterizes patients' lived experiences, fails to account for structural inequities, contributes to stigma, and is built upon weakly supported claims of a negative impact on health outcomes. We close with a discussion of the relationship between health care provision and unintended pregnancy care and the implications and recommendations for realigning clinical practice, research, and policy goals.
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Affiliation(s)
| | - Kate Coleman-Minahan
- College of Nursing, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Amy Alspaugh
- College of Nursing, University of Tennessee, Knoxville, Tennessee
| | | | - Lisa Stern
- Coalition to Expand Contraceptive Access, San Francisco, California
| | - Katherine Simmonds
- Roux Institute, Bouvé College of Health Sciences, Northeastern University, Portland, Maine
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Puri MC, Raifman S, Daniel S, Karki S, Maharjan DC, Ahlbach C, Diamond-Smith N, Foster DG. Denial of legal abortion in Nepal. PLoS One 2023; 18:e0282886. [PMID: 36943824 PMCID: PMC10030013 DOI: 10.1371/journal.pone.0282886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 02/25/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION In Nepal, abortion is legal on request through 12 weeks of pregnancy and up to 28 weeks for health and other reasons. Abortion is available at public facilities at no cost and by trained private providers. Yet, over half of abortions are provided outside this legal system. We sought to investigate the extent to which patients are denied an abortion at clinics legally able to provide services and factors associated with presenting late for care, being denied, and receiving an abortion after being denied. METHODS We used data from a prospective longitudinal study with 1835 women aged 15-45. Between April 2019 and December 2020, we recruited 1,835 women seeking abortions at 22 sites across Nepal, including those seeking care at any gestational age (n = 537) and then only those seeking care at or after 10 weeks of gestation or do not know their gestational age (n = 1,298). We conducted interviewer-led surveys with these women at the time they were seeking abortion service (n = 1,835), at six weeks after abortion-seeking (n = 1523) and six-month intervals for three years. Using descriptive and multivariable logistic regression models, we examined factors associated with presenting for abortion before versus after 10 weeks gestation, with receiving versus being denied an abortion, and with continuing the pregnancy after being denied care. We also described reasons for the denial of care and how and where participants sought abortion care subsequent to being denied. Mixed-effects models was used to accounting clustering effect at the facility level. RESULTS Among those recruited when eligibility included seeking abortion at any gestational age, four in ten women sought abortion care beyond 10 weeks or did not know their gestation and just over one in ten was denied care. Of the full sample, 73% were at or beyond 10 weeks gestation, 44% were denied care, and 60% of those denied continued to seek care after denial. Nearly three-quarters of those denied care were legally eligible for abortion, based on their gestation and pre-existing conditions. Women with lower socioeconomic status, including those who were younger, less educated, and less wealthy, were more likely to present later for abortion, more likely to be turned away, and more likely to continue the pregnancy after denial of care. CONCLUSION Denial of legal abortion care in Nepal is common, particularly among those with fewer resources. The majority of those denied in the sample should have been able to obtain care according to Nepal's abortion law. Abortion denial could have significant potential implications for the health and well-being of women and their families in Nepal.
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Affiliation(s)
- Mahesh C Puri
- Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal
| | - Sarah Raifman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Sara Daniel
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Sunita Karki
- Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal
| | - Dev Chandra Maharjan
- Center for Research on Environment, Health and Population Activities (CREHPA), Kathmandu, Nepal
| | - Chris Ahlbach
- School of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Nadia Diamond-Smith
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Diana Greene Foster
- Department of Obstetrics, Gynecology, Reproductive Sciences, Advancing New Standards in Reproductive Health, University of California, San Francisco, California, United States of America
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Ethical Care for Patients with Self-Managed Abortion After Roe. Am J Nurs 2023; 123:38-44. [PMID: 36546386 DOI: 10.1097/01.naj.0000911524.68698.ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT The 2022 Supreme Court decision leaving the regulation of abortion to the states is sure to result in a complex regulatory environment for patients and nurses. In states where abortion is illegal, patients may self-manage abortions using medications they obtain through the mail or by other means. Nurses may care for these patients in multiple settings and may wonder about their own legal and ethical obligations. This article reviews patient privacy as it relates to self-managed abortion, ethical reporting requirements for nurses, and best practices for treating complications of self-managed abortion using a harm reduction framework, with a focus on protecting patients' rights. Recommendations for ethical patient care are also provided.
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Downey MMB, Patteson Poehling C, O'Connell S. Measurement and Operationalization of the Social Determinants of Health and Long-Acting Reversible Contraception Use in the U.S.: A Systematic Scoping Review. AJPM FOCUS 2022; 1:100032. [PMID: 37791245 PMCID: PMC10546546 DOI: 10.1016/j.focus.2022.100032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction The objective of this review was to conduct a systematic evaluation of the measurement and operationalization of the social determinants of health in research on long-acting reversible contraception use in the U.S. To contribute to the ongoing refinement of the quality of social determinants of health and long-acting reversible contraception use research, this systematic scoping review examines how social determinants of health are measured and operationalized in studies that examine long-acting reversible contraception initiation and usage at the patient level. Methods A detailed search of 5 electronic databases (PubMed, Embase, Web of Science, CINAHL, and PsycINFO) was conducted between December 2020 and January 2021 according to PRISMA guidelines. Determinants were assessed using the Dahlgren and Whitehead model. The protocol and data extraction template were developed a priori. Results A total of 27 articles representing 26 studies were included in our study. A total of 12 studies were retrospective and cross-sectional in design; the remaining studies were a combination of designs. Healthcare services and health insurance were identified as the most frequently researched categories of determinants. There was wide variation in reported operationalization of race and ethnicity, limited engagement with sexuality, and uneven geographic representation across studies. Discussion This systematic scoping review is the first, to the best of our knowledge, to focus on the measurement and operationalization of social determinants of health and on current long-acting reversible contraception use research. Future research on the impact of social determinants of health on long-acting reversible contraception use must explore the full range of factors shaping contraceptive decision making and use and focus on equity-informed data collection methods and reporting.
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Affiliation(s)
| | - Catherine Patteson Poehling
- School of Social Work, College of Education and Human Sciences, the University of Southern Mississippi, Hattiesburg, Mississippi
| | - Samantha O'Connell
- Tulane University Office of Academic Affairs & Provost, New Orleans, Louisiana
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Dickey MS, Mosley EA, Clark EA, Cordes S, Lathrop E, Haddad LB. "They're forcing people to have children that they can't afford": a qualitative study of social support and capital among individuals receiving an abortion in Georgia. Soc Sci Med 2022; 315:115547. [PMID: 36427479 DOI: 10.1016/j.socscimed.2022.115547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Abortion is common but highly stigmatized in the United States, and the overturning of Roe v. Wade severely restricted abortion access in many states across the nation. Data reveal that maternal morbidity and mortality are already increasing, and research suggests existing inequities in abortion access across racial/ethnic and socioeconomic groups will be exacerbated. Research has shown that social support (perceived and received aid from one's social network) and social capital (resources accessed through those social connections) can improve access to health services and decrease barriers to care. Given the escalating barriers to abortion, including longer travel distances, it is imperative to better understand the roles of social support and social capital within abortion access, especially for people living on lower incomes and people of color. Our team conducted in-depth interviews with post-abortion patients (n = 18) from an urban abortion clinic in Georgia in 2019 and 2020, shortly after a six-week gestational age abortion limit had been passed but before it was enacted. We examined how people described their social support and social capital - or lack thereof - when making decisions about their pregnancy and their ability to access abortion. We found that social support and social capital - economic support in particular - were key facilitators of both abortion access and parenting, but participants often experienced barriers to economic support within their social networks due to poverty, unstable partnerships, structural inequality, and abortion stigma. Women experienced constraints to their reproductive autonomy, wherein they had no alternatives but abortion. Our findings suggest that increased economic support and de-stigmatization of abortion are needed to improve reproductive autonomy. Our findings also indicate that restricting and outlawing abortion services is significantly detrimental to the well-being of pregnant people, their families and networks, and their communities by perpetuating cycles of poverty and deepening socioeconomic and racial/ethnic inequities.
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Affiliation(s)
- Madison S Dickey
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Elizabeth A Mosley
- The Center for Reproductive Health Research in the Southeast (RISE), Rollins School of Public Health, Emory University, 250 East Ponce De Leon Avenue, Decatur, GA, 30030, USA
| | - Elizabeth A Clark
- Emory University School of Medicine, Department of Gynecology and Obstetrics, 49 Jesse Hill Jr Drive, Atlanta, GA, 30303, USA
| | - Sarah Cordes
- Emory University School of Medicine, Department of Gynecology and Obstetrics, 49 Jesse Hill Jr Drive, Atlanta, GA, 30303, USA
| | - Eva Lathrop
- Emory University School of Medicine, Department of Gynecology and Obstetrics, 49 Jesse Hill Jr Drive, Atlanta, GA, 30303, USA
| | - Lisa B Haddad
- Emory University School of Medicine, Department of Gynecology and Obstetrics, 49 Jesse Hill Jr Drive, Atlanta, GA, 30303, USA; The Population Council, Center for Biomedical Research, 1230 York Avenue, New York, NY, 10065, USA
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Ford CL, Walker V, Crear-Perry J, Gipson JD. Maternal and Infant Health Inequities, Reproductive Justice and COVID Addressed in RACE Series. Ethn Dis 2022; 32:351-356. [PMID: 36388862 PMCID: PMC9590602 DOI: 10.18865/ed.32.4.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Ethn Dis. 2022;32(4):351-356; doi:10.18865/ed.32.4.351
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Affiliation(s)
- Chandra L. Ford
- Center for the Study of Racism, Social Justice & Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Valencia Walker
- Center for the Study of Racism, Social Justice & Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Nationwide Children’s Hospital, The Ohio State University, Columbus, OH
| | | | - Jessica D. Gipson
- UCLA Bixby Center on Population and Reproductive Health, UCLA Fielding School of Public Health, Los Angeles, CA
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Disi ES, Okpaise OO, Akpanobong MAU, Eyinfunjowo SO, Ukwandu SA, Alabintei MO. Effects and Proposed Countermeasures of Abortion Bans and Restrictions on People With Uteruses and Society. Cureus 2022; 14:e29906. [PMID: 36348848 PMCID: PMC9632542 DOI: 10.7759/cureus.29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
With the recent overturning of Roe V. Wade by the Supreme Court, access to abortions in many regions across the United States will become very limited as laws regarding fetal termination will be determined by state legislators rather than on a federal level. This article highlights the effects of Roe V. Wade's abolishment on individuals that can get pregnant, how unwanted pregnancies will affect society in general, and reasonable steps forward following the ban. We conducted an electronic search using PubMed, Google, and Google Scholar. The search was retrospective, and the preliminary results focused on articles about the rationale behind pregnancy termination and the overall effects of abortion and the ban. Review papers, original papers, and newspaper articles were eligible for use. Sample size and region of publication were not exclusionary criteria. Each author independently reviewed and extracted data to write up each assigned section, and group collaborations occurred to create the final draft. Out of the 93 resources reviewed, 32 sources were deemed eligible and used in this article. These resources included 23 journal articles, eight websites, and one book.. The data gathered showed that while abortions have many potential complications even when performed under regulated conditions, taking away the choice of those with a uterus is also not without consequence. The economic, familial, and societal implications should be considered moving forward as safety nets will need to be implemented for people with uterus and children involved.
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Affiliation(s)
- Efe S Disi
- College of Medicine, Madonna University, Elele, NGA
- Biology, University of Kentucky, Lexington, USA
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Rivera Rodriguez G, Tamayo Acosta J, Sosa Gomez AE, Marcucci Rodriguez RE, Rodriguez Cintron GA, Acosta M. The Medical and Financial Burden of Illegal Abortion. Cureus 2022; 14:e30514. [PMID: 36415416 PMCID: PMC9675393 DOI: 10.7759/cureus.30514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
More than a heated debate subject, abortion is a matter that has been present in human history for a very long time. As our society evolves and advances in medicine and socioeconomic systems are made, the subject of the medical procedure known as abortion appears to be a differentiator in our behaviors as a society. This article highlights the known effects and medical complications of illegal abortion and the financial impact of the procedure's legal status. A retrospective search using EBSCO, PubMed/Medline, Cochrane, EMBASE: Excerpta Medica Database, and DARE electronic databases was conducted, focused on detailing the risks of illegal abortion, the financial cost of complications, the socioeconomic impact of unwanted progeny, and the rationale behind seeking the procedure, legally or otherwise. Each author independently reviewed and extracted data to write up each assigned section, and group collaborations occurred to create the final draft. Out of the 87 resources reviewed, 16 sources were deemed eligible for this article, and their data are herein outlined.
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Affiliation(s)
- Grecia Rivera Rodriguez
- General Internal Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
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Abstract
Although teenage pregnancy rates have decreased over the past 30 years, many adolescents become pregnant every year. It is important for pediatricians to have the ability and the resources to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental counseling that includes the full range of pregnancy options. Counseling includes an unbiased discussion of the adolescent's options to continue or terminate the pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. It is important for pediatricians to be familiar with laws and policies impacting access to abortion care, especially for minor adolescents, as well as laws that seek to limit health care professionals' provision of unbiased pregnancy options counseling and referrals, either for abortion care or continuation of pregnancy in accordance with the adolescent's choice. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling that includes the full range of pregnancy options. Pediatricians should be aware of and oppose policies that restrict their ability to provide pregnant adolescents with unbiased counseling that includes the full range of pregnancy options. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue.
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Foster DG. New Abortion Bans Will Increase Existing Health and Economic Disparities. Am J Public Health 2022; 112:1276-1277. [PMID: 35969828 PMCID: PMC9382161 DOI: 10.2105/ajph.2022.306993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Diana Greene Foster
- Diana Greene Foster is with Department of Obstetrics, Gynecology & Reproductive Sciences and the Advancing New Standards in Reproductive Health program at the University of California, San Francisco
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Paltrow LM, Harris LH, Marshall MF. Beyond Abortion: The Consequences of Overturning Roe. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:3-15. [PMID: 35652910 DOI: 10.1080/15265161.2022.2075965] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The upcoming U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization has the potential to eliminate or severely restrict access to legal abortion care in the United States. We address the impact that the decision could have on abortion access and its consequences beyond abortion care. We posit that an abortion ban would, in effect, mean that anyone who becomes pregnant, including those who continue a pregnancy and give birth to healthy newborns and those with pregnancy complications or adverse pregnancy outcomes will become newly vulnerable to legal surveillance, civil detentions, forced interventions, and criminal prosecution. The harms imposed by banning or severely restricting abortion access will disproportionately affect persons of color and perpetuate structural racism. We caution that focusing on Roe as a decision that only protects ending a pregnancy ignores the protection that the decision also affords people who want to continue their pregnancies. It overlooks the ways in which overturning Roe will curtail fundamental rights for all those who become pregnant and will undermine their status as full persons meriting Constitutional protections. Such a singular focus inevitably obscures the common ground that people across the ideological spectrum might inhabit to ensure the safety, health, humanity, and rights of all people who experience pregnancy.
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Adynski GI, Bravo L, Harris M, Adynski HR, Zaragoza S, Ikharo E, Harris LK, Lackey C. Global implications of Dobbs vs. Jackson Women's health Organization for Nurses as a historically gendered profession. Int J Nurs Stud 2022; 135:104342. [DOI: 10.1016/j.ijnurstu.2022.104342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022]
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Affiliation(s)
- Daniel Grossman
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | | | - Deborah Grady
- Department of Medicine, University of California, San Francisco.,Deputy Editor, JAMA Internal Medicine
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47
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Seymour JW, Thompson TA, Milechin D, Wise LA, Rudolph AE. Potential Impact of Telemedicine for Medication Abortion Policy and Programming Changes on Abortion Accessibility in the United States. Am J Public Health 2022; 112:1202-1211. [PMID: 35830676 PMCID: PMC9342822 DOI: 10.2105/ajph.2022.306876] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 11/04/2022]
Abstract
Objectives. To quantify the impact of telemedicine for medication abortion (TMAB) expansion or ban removal on abortion accessibility. Methods. We included 1091 facilities from the 2018 Advancing New Standards in Reproductive Health facility database and Planned Parenthood Web site, among which 241 did not offer abortion as sites for TMAB expansion. Accessibility was defined as the proportion of reproductive-aged women living within a 30-, 60-, or 90-minute drive time from an abortion-providing facility. We calculated accessibility differences between 3 scenarios: (1) facilities offering abortion in 2018 (reference), (2) the reference scenario in addition to all facilities in states without TMAB bans (TMAB expansion), and (3) all facilities (TMAB ban removal). We also stratified by state and urban-rural status. Results. In 2018, 65%, 81%, and 89% of women lived within a 30-, 60-, or 90-minute drive time from an abortion-providing facility, respectively. Expansion and ban removal expanded abortion accessibility relative to the current accessibility scenario (range: 1.25-5.66 percentage points). Women in rural blocks experienced greater increases in accessibility than those in urban blocks. Conclusions. TMAB program and policy changes could expand abortion accessibility to an additional 3.5 million reproductive-aged women. Public Health Implications. Our findings can inform where to invest resources to improve abortion accessibility. (Am J Public Health. 2022;112(8):1202-1211. https://doi.org/10.2105/AJPH.2022.306876).
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Affiliation(s)
- Jane W Seymour
- Jane W. Seymour is with the Department of Epidemiology, School of Public Health, Boston University, Boston, MA, and Ibis Reproductive Health, Cambridge, MA. Terri-Ann Thompson is with Ibis Reproductive Health. Dennis Milechin is with Research Computing Services, Information Services and Technology, Boston University. Lauren A. Wise is with the Department of Epidemiology, School of Public Health, Boston University. Abby E. Rudolph is with the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
| | - Terri-Ann Thompson
- Jane W. Seymour is with the Department of Epidemiology, School of Public Health, Boston University, Boston, MA, and Ibis Reproductive Health, Cambridge, MA. Terri-Ann Thompson is with Ibis Reproductive Health. Dennis Milechin is with Research Computing Services, Information Services and Technology, Boston University. Lauren A. Wise is with the Department of Epidemiology, School of Public Health, Boston University. Abby E. Rudolph is with the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
| | - Dennis Milechin
- Jane W. Seymour is with the Department of Epidemiology, School of Public Health, Boston University, Boston, MA, and Ibis Reproductive Health, Cambridge, MA. Terri-Ann Thompson is with Ibis Reproductive Health. Dennis Milechin is with Research Computing Services, Information Services and Technology, Boston University. Lauren A. Wise is with the Department of Epidemiology, School of Public Health, Boston University. Abby E. Rudolph is with the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
| | - Lauren A Wise
- Jane W. Seymour is with the Department of Epidemiology, School of Public Health, Boston University, Boston, MA, and Ibis Reproductive Health, Cambridge, MA. Terri-Ann Thompson is with Ibis Reproductive Health. Dennis Milechin is with Research Computing Services, Information Services and Technology, Boston University. Lauren A. Wise is with the Department of Epidemiology, School of Public Health, Boston University. Abby E. Rudolph is with the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
| | - Abby E Rudolph
- Jane W. Seymour is with the Department of Epidemiology, School of Public Health, Boston University, Boston, MA, and Ibis Reproductive Health, Cambridge, MA. Terri-Ann Thompson is with Ibis Reproductive Health. Dennis Milechin is with Research Computing Services, Information Services and Technology, Boston University. Lauren A. Wise is with the Department of Epidemiology, School of Public Health, Boston University. Abby E. Rudolph is with the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
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Affiliation(s)
- M Antonia Biggs
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Corinne Rocca
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
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Gordon MR, Coverdale J, Chervenak FA, McCullough LB. Undue burdens created by the Texas Abortion Law for vulnerable pregnant women. Am J Obstet Gynecol 2022; 226:529-534. [PMID: 34954218 DOI: 10.1016/j.ajog.2021.12.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
The new Texas abortion law requires the physician to determine whether a fetal heartbeat is present and prohibits abortion after a heartbeat has been documented. An exception is allowed when a "medical emergency necessitated the abortion." These and other provisions of the statute are to be enforced through "civil actions" brought by private citizens. This article identifies 3 populations of vulnerable women who will experience undue burdens created by the Texas abortion law. We begin with an account of the concept of undue burden in the jurisprudence of abortion, as expressed in the 1992 US Supreme Court case, Planned Parenthood v. Casey of Southeastern Pennsylvania. We then provide an evidence-based account of the predictable, undue burdens for 3 populations of vulnerable women: pregnant women with decreased freedom of movement; pregnant minors; and pregnant women with major mental disorders and cognitive disabilities. The Texas law creates an undue burden on these 3 populations of vulnerable women by reducing or even eliminating access to abortion services outside of Texas. The Texas law also creates an undue burden by preventably increasing the risks of morbidity, including loss of fertility, and mortality for these 3 populations of vulnerable women. For these women, it is indisputable that the Texas law will create undue burdens and is therefore not compatible with the jurisprudence of abortion as set forth in Planned Parenthood v. Casey because a "significant number of women will likely be prevented from obtaining an abortion." Federal courts should therefore strike down this law.
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Toscano M, Wood J, Spielman S, Ferri R, Whaley N, Seligman NS. Prenatal care utilization in pregnant women who consider but do not have abortions. BMC Pregnancy Childbirth 2022; 22:53. [PMID: 35062913 PMCID: PMC8780296 DOI: 10.1186/s12884-021-04343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Over half of all pregnancies in the United States are unintended, and 18% result in termination of pregnancy (TOP). Some women seek TOP, but ultimately continue their pregnancy. Data are limited about their utilization of prenatal care and their perinatal outcomes. Our primary outcome was to investigate differences in guideline-based prenatal care utilization in women who consider but do not have an abortion.
Methods
Retrospective cohort study of patients having obstetrical dating ultrasound (US) from 2011–2018 at a single academic medical center that offers TOP. Contemplators completed US with intention of TOP but instead continued the pregnancy to live birth. A 2:1 group of non-contemplators completed US and continued to live birth. A prenatal care utilization scoring system was used to compare groups. Secondary outcomes investigated differences in adverse pregnancy outcomes and postpartum care.
Results
There were 94 contemplators and 183 non-contemplators. Inadequate prenatal care utilization initially was more common in contemplators than non-contemplators (62.8% vs 85.8%, p < 0.01) but was not significant after adjustment (aOR 1.0, 95% CI 0.40 – 2.56). There were no differences in adverse obstetric or neonatal outcomes. Contemplators were significantly more likely to have a postpartum contraceptive method (PPCM) upon hospital discharge (aOR 4.8, 95% CI 1.16 – 20.0) and significantly more likely to use a highly-effective PPCM (aOR 6.4, 95% CI 2.34 – 17.4).
Conclusions
Reversal of intention for TOP is not associated with differences in prenatal care utilization, but is associated with increased uptake of postpartum contraceptive method.
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