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Verma N, Goedken P, Cwiak C, Kottke M. Perspectives on an early abortion ban in a restrictive US state: A qualitative exploration. Contraception 2023; 123:110025. [PMID: 36948436 DOI: 10.1016/j.contraception.2023.110025] [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: 08/01/2022] [Revised: 02/07/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES To gain a deeper understanding of perspectives on abortion and early abortion bans in a restrictive US state. STUDY DESIGN We conducted a qualitative study using semistructured Zoom interviews with residents of the US state Georgia's 6th Congressional District. Potential participants first completed a screening tool to recruit people who held "middle-of-the-spectrum" views on abortion based on two abortion questions on a 5-point Likert scale. The interviews focused on participants' thoughts and feelings on abortion and Georgia's early abortion ban. We transcribed, coded, and analyzed the interviews, and present a subset of themes. RESULTS We interviewed 28 people from March to May 2020. Participants often described holding complex views on abortion shaped by a range of lived experiences, values, and identities. They lamented the "black-and-white" nature of the national abortion discussion, which they felt oversimplified the issue and did not represent their views. Participants discussed the importance of experiences that allowed them to empathize with people who choose abortion, even when they personally felt they would make a different decision in a similar situation. Based on these experiences, many participants emphasized the importance of separating their own views on abortion from what needed to be regulated for others. However, participants often demonstrated a lack of understanding about the extent to which HB481 makes abortion inaccessible in Georgia. CONCLUSIONS Our results indicate that, even in states traditionally labeled as restrictive or hostile towards abortion, many people express an openness to understand others' experiences and hold complex and multifaceted views. IMPLICATIONS Our laws and policies at the state level profoundly affect the practice of medicine and access to care. Our study furthers our understanding of how a sample of people in a restrictive US state think and feel about abortion and early abortion bans. These results can be used to support educational efforts, policies, and communication practices that better reflect the complex views of the public.
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Affiliation(s)
- Nisha Verma
- Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Peggy Goedken
- Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Carrie Cwiak
- Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Melissa Kottke
- Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
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Tirado V, Ekström AM, Orsini N, Hanson C, Strömdahl S. Knowledge of the abortion law and key legal issues of sexual and reproductive health and rights among recently arrived migrants in Sweden: a cross-sectional survey. BMC Public Health 2023; 23:551. [PMID: 36959645 PMCID: PMC10035217 DOI: 10.1186/s12889-023-15399-z] [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] [Received: 06/08/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
Background Sexual and reproductive health and rights (SRHR), including access and information on the laws and policies related to abortion, varies considerably between countries. Migrants may have limited knowledge of SRHR and related resources in their new country. This study investigates migrants’ knowledge of the right to safe and legal abortion and other associated factors including the recent law on sexual consent, the legal age for sexual consent and age to marry in Sweden. Methods We conducted a cross-sectional study from 2018 to 2019 among recent migrants attending high schools or Swedish language schools. Descriptive statistics were computed on the knowledge of the Swedish abortion law and other legal aspects. Univariable and multivariable logistic regression analyses were conducted to assess if migrants’ socio-demographic characteristics were associated with knowledge (i.e. correct/incorrect) of the Swedish abortion law and other key SRHR-related legal issues. Results Of the total 6,263 participants, 3,557 (57%) responded about whether it is legal to have an induced abortion in Sweden, and of these, 2,632 (74%) answered incorrectly. While more than half (61%) of the respondents knew the sexual consent law, nearly half (48%) did not know that sexual consent is also required for married couples. About 90% correctly responded that it is illegal to have sex with a minor (under the age of 15) and were aware of the legal age (18 years) to marry in Sweden. Incorrect knowledge of the Swedish abortion law was associated with being religious (adjusted odds ratio (AOR), 2.12; 95% confidence interval (CI), 1.42–3.15), not having previous sexual health education (AOR, 1.68; 95% CI, 1.38–2.05), coming from a country with predominantly restrictive abortion laws (AOR, 1.46; 95% CI, 1.16–1.84), low level of education (AOR, 1.29; 95% CI, 1.04–1.61) and having a temporary residence permit (AOR, 1.27; 95% CI, 1.02–1.57). Conclusion We found a substantial lack of knowledge among migrants of reproductive age in Sweden regarding important laws and policies of SRHR, particularly the right to abortion. SRHR-related programmes and comprehensive sexual health education for recently arrived migrants could include components to increase knowledge of legal and safe abortions and other laws concerning SRHR. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-023-15399-z.
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Affiliation(s)
- Veronika Tirado
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mia Ekström
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- grid.416648.90000 0000 8986 2221Department of Infectious Diseases, Venhälsan, Södersjukhuset, Stockholm, Sweden
| | - Nicola Orsini
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Claudia Hanson
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- grid.8991.90000 0004 0425 469XLondon School of Hygiene and Tropical Medicine, London, UK
| | - Susanne Strömdahl
- grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden
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Coleman-Minahan K, Alspaugh A. Abortion Knowledge Among Advanced Practice Clinicians in Colorado. Womens Health Issues 2022; 32:461-469. [PMID: 35738986 PMCID: PMC9532373 DOI: 10.1016/j.whi.2022.04.006] [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] [Received: 09/10/2021] [Revised: 04/05/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Our objective was to quantify abortion law and care knowledge among Colorado advanced practice clinicians. METHODS We conducted a stratified random survey of advanced practice clinicians, oversampling women's health and rural clinicians. We assessed sample characteristics, positions on abortion legality, and knowledge of abortion law and care. Mean knowledge scores were compared by sample characteristics. Survey responses were compared by provision of pregnancy options counseling and positions on abortion legality. Linear regression models were used to examine knowledge scores. RESULTS A total of 513 participants completed the survey; the response rate was 21%. Abortion law knowledge questions (mean score, 1.7/7.0) ranged from 12% (physician-only law) to 45% (parental consent law) correct. For five of seven questions, "I don't know" was the most frequently chosen response. Abortion care knowledge questions (mean score, 2.8/8.0) ranged from 19% (abortion prevalence) to 60% (no elevated risk of breast cancer) correct. For four of eight questions, "I don't know" was the most frequently chosen response. Practicing in all other areas (e.g., family practice) was associated with lower abortion law and care knowledge than practicing in women's health. Providing options counseling was positively associated with abortion knowledge (law, β = 0.44; 95% confidence interval [CI], 0.10-0.78; care, β = 0.52; 95% CI, 0.08-0.95). Compared with participants who believe abortion should be legal in all circumstances, those who believe abortion should be illegal in all circumstances had similar abortion law knowledge (β = -0.03; 95% CI, -0.65 to 0.59), but lower abortion care knowledge (β = -1.85; 95% CI, -2.34 to -1.36). CONCLUSIONS Abortion knowledge is low among Colorado advanced practice clinicians and education is needed.
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Affiliation(s)
- Kate Coleman-Minahan
- University of Colorado College of Nursing, Aurora, Colorado; University of Colorado Population Center, Boulder, Colorado.
| | - Amy Alspaugh
- University of Tennessee College of Nursing, Knoxville, Tennessee; ACTIONS Program, University of California, San Francisco, San Francisco, California
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Barr-Walker J, DePiñeres T, Ossom-Williamson P, Mengesha B, Berglas NF. Countering Misinformation About Abortion: The Role of Health Sciences Librarians. Am J Public Health 2021; 111:1753-1756. [PMID: 34529495 PMCID: PMC8561200 DOI: 10.2105/ajph.2021.306471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Jill Barr-Walker
- Jill Barr-Walker is with ZSFG Library, University of California, San Francisco, and the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Teresa DePiñeres is with Innovations in Reproductive Health, Miami, FL. Peace Ossom-Williamson is with the UTA Libraries, University of Texas at Arlington. Biftu Mengesha is with the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Nancy F. Berglas is with Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA
| | - Teresa DePiñeres
- Jill Barr-Walker is with ZSFG Library, University of California, San Francisco, and the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Teresa DePiñeres is with Innovations in Reproductive Health, Miami, FL. Peace Ossom-Williamson is with the UTA Libraries, University of Texas at Arlington. Biftu Mengesha is with the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Nancy F. Berglas is with Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA
| | - Peace Ossom-Williamson
- Jill Barr-Walker is with ZSFG Library, University of California, San Francisco, and the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Teresa DePiñeres is with Innovations in Reproductive Health, Miami, FL. Peace Ossom-Williamson is with the UTA Libraries, University of Texas at Arlington. Biftu Mengesha is with the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Nancy F. Berglas is with Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA
| | - Biftu Mengesha
- Jill Barr-Walker is with ZSFG Library, University of California, San Francisco, and the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Teresa DePiñeres is with Innovations in Reproductive Health, Miami, FL. Peace Ossom-Williamson is with the UTA Libraries, University of Texas at Arlington. Biftu Mengesha is with the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Nancy F. Berglas is with Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA
| | - Nancy F Berglas
- Jill Barr-Walker is with ZSFG Library, University of California, San Francisco, and the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Teresa DePiñeres is with Innovations in Reproductive Health, Miami, FL. Peace Ossom-Williamson is with the UTA Libraries, University of Texas at Arlington. Biftu Mengesha is with the Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco. Nancy F. Berglas is with Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA
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Differences in abortion-related knowledge among women involved in the criminal legal system in three US cities. Contraception 2021; 104:606-611. [PMID: 34461135 DOI: 10.1016/j.contraception.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We examined if abortion-related knowledge among women with criminal legal system involvement differed in three U.S. cities in states with varying abortion policies. STUDY DESIGN Respondents were self-identified women with criminal legal system involvement. Data come from a cross-sectional baseline survey of 381 women in three U.S. cities: Oakland, California, Kansas City, Kansas/Missouri, and Birmingham, Alabama. The primary outcome, high abortion-related knowledge, was based on a 10-item scale dichotomized into low vs high abortion-related knowledge. We used descriptive statistics, bivariable associations, and logistic regression to assess the association between high abortion-related knowledge, city of residence, and other possible related factors. RESULTS Respondents in Kansas City, KS/MO and Birmingham, AL had lower odds of high abortion-related knowledge compared to respondents in Oakland, CA (OR: 0.19, 95% CI: 0.10-0.38 and OR: 0.17, 95% CI: 0.11-0.28, respectively). In adjusted analysis, the association remained after controlling for race/ethnicity, insurance status, and community supervision past year. CONCLUSIONS Findings underscore the need for communicating clear and accurate information about abortion care, especially in states where laws and ongoing political challenges make it difficult to access both reliable information and services. IMPLICATIONS Efforts to disseminate accurate information regarding abortion care, particularly among marginalized people, should utilize multiple venues in addition to traditional healthcare information sources. Reproductive justice advocates should connect with jails and probation offices to reach people with criminal legal system involvement and foster increased knowledge of reproductive rights and services.
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Swartz JJ, Rowe C, Truong T, Bryant AG, Morse JE, Stuart GS. Comparing Website Identification for Crisis Pregnancy Centers and Abortion Clinics. Womens Health Issues 2021; 31:432-439. [PMID: 34266709 DOI: 10.1016/j.whi.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/21/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Crisis pregnancy centers (CPCs) seeking to dissuade women from abortion often appear in Internet searches for abortion clinics. We aimed to assess whether women can use screenshots from real websites to differentiate between CPCs and abortion clinics. METHODS We conducted a cross-sectional, nationally representative online study of English- and Spanish-speaking women aged 18-49 years in the United States. We presented participants with screenshots from five CPCs and five abortion clinic websites and asked if they thought an abortion could be obtained at that center. We scored correct answers based on clinic type. Outcomes included ability to correctly identify CPCs and abortion clinics as well as risk factors for misidentification. The survey also included five questions about common abortion myths and a validated health literacy assessment. RESULTS We contacted 2,223 women, of whom 1,057 (48%) completed the survey and 1,044 (47%) were included in the analysis. The median score for correctly identifying CPCs as facilities not performing abortion was 2 out of 5 (Q:1 0, Q:3 4). The median score for correctly identifying abortion clinics as facilities performing abortion was 5 out of 5 (Q:1 3, Q:3 5). Those less likely to endorse abortion myths had higher odds of correctly identifying CPCs (adjusted odds ratio, 2.43; 95% confidence interval, 1.78-3.32). A low health literacy score was associated with decreased odds of correct identification of CPCs (adjusted odds ratio, 0.39; 95% confidence interval, 0.25-0.59). CONCLUSIONS Websites of CPCs were more difficult for women to correctly identify than those of abortion clinics. Women with limited knowledge about abortion and low health literacy may be particularly susceptible to misidentification of CPC websites.
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Affiliation(s)
- Jonas J Swartz
- Division of Women's Community and Population Health, Department of OBGYN, Duke University Medical Center, Durham, North Carolina; Division of Family Planning, Department of OBGYN, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
| | - Carly Rowe
- Division of Family Planning, Department of OBGYN, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Tracy Truong
- Department of Biostatistics & Bioinformatics, Duke University of Medical Center, Dueham, North Carolina
| | - Amy G Bryant
- Division of Family Planning, Department of OBGYN, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jessica E Morse
- Division of Family Planning, Department of OBGYN, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Gretchen S Stuart
- Division of Family Planning, Department of OBGYN, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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