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Zhu DT, Zhao L, Alzoubi T, Shenin N, Baskaran T, Tikhonov J, Wang C. Public health and clinical implications of Dobbs v. Jackson for patients and healthcare providers: A scoping review. PLoS One 2024; 19:e0288947. [PMID: 38551970 PMCID: PMC10980209 DOI: 10.1371/journal.pone.0288947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/05/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION On June 24, 2022, the U.S. Supreme Court's decision in Dobbs v. Jackson reversed the precedent set forth by Roe v. Wade, empowering individual states to regulate abortion care. This aftermath of this ruling has given rise to widespread bans, limiting the accessibility of abortion services for patients and impeding providers' ability to deliver a comprehensive spectrum of reproductive health services. Of particular concern is the disproportionate impact on medically underserved groups, further heightening existing social and structural disparities in reproductive health. METHODS We conducted a scoping review to broadly evaluate the clinical and public health impact of Dobbs on patients' access to abortion care and related reproductive health services, in addition to the training and clinical practice of healthcare providers. We searched eight bibliographic databases (PubMed, Scopus, Embase, PsycINFO, Google Scholar, Science Direct, JSTOR, and Web of Science) and three preprint servers (medRxiv, bioRxiv, and Europe PMC) using various combinations of keywords related to 'abortion', 'Dobbs', and 'Roe' on March 22, 2023. Four reviewers independently screened the studies based on pre-specified eligibility criteria and one reviewer performed data extraction for pre-identified themes. The search was conducted based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. RESULTS Eighteen studies, comprising 12 peer-reviewed articles and 6 study abstracts, met the inclusion criteria. The studies demonstrated that Dobbs increased demand for contraception, magnified existing travel- and cost-related barriers to access, further polarized views on abortion and complex family planning on social media (e.g., Twitter), and evoked substantial concerns among medical trainees regarding their scope of practice and potential legal repercussions for providing abortion care. CONCLUSION In the wake of Dobbs v. Jackson, further public health and clinical interventions are urgently needed to bridge disparities in abortion care and reproductive health, mitigating the deleterious consequences of this emerging public health crisis.
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Affiliation(s)
- David T. Zhu
- Medical Scientist Training Program, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Lucy Zhao
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Tala Alzoubi
- Faculty of Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Novera Shenin
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Julia Tikhonov
- School of Interdisciplinary Sciences, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Catherine Wang
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Rahman M, King C, Saikaly R, Sosa M, Sibaja K, Tran B, Tran S, Morello P, Yeon Seo S, Yeon Seo Y, Jacobs RJ. Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review. Cureus 2024; 16:e55785. [PMID: 38586685 PMCID: PMC10999118 DOI: 10.7759/cureus.55785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Intrauterine devices (IUDs) are considered a reliable contraceptive option for women, but they can come with side effects. There is a disconnect in standard guidelines for IUD insertion within and without the U.S. The objective of this review was to address a gap in the literature regarding official procedures for pain management during IUD implantation. This scoping review was initiated using keywords to extract relevant articles from multiple databases: U.S. National Library of Medicine National Institutes of Health (PubMed), MEDLINE (Ovid), and Excerpta Medica dataBASE (EMBASE, Ovid). Initially, 457 articles were identified and after a rigorous screening and selection process, 37 articles were chosen to be further assessed to ascertain if they met the study's inclusion criteria. Those 37 articles were further evaluated fully to check for relevancy. From that process, 19 articles were chosen for the review, and all passed quality assessment evaluations using the JB Appraisal Tools. To best address the research question, the data from the 19 articles were divided into three categories: 1) circumstantial factors, 2) non-pharmacological methods, and 3) pharmacological methods. Circumstantially, women with previous vaginal deliveries experienced the lowest pain during the procedure, and nulligravid (never pregnant) women experienced the most pain. Lower pain scores were reported by lactating women compared to non-lactating. Black women experienced the most anticipated pain compared to other races. Regarding non-pharmacological methods, different insertion techniques, tools, and the use of a cold compress were found to not affect the level of pain during IUD insertion. Lastly, it was shown that pharmacological methods such as lidocaine gel, lidocaine paracervical block, and lidocaine combined with either diclofenac or prilocaine decreased pain scores at different time stamps of the procedure. Also, oral ketorolac and a vaginal combination of misoprostol and dinoprostone helped reduce pain. Findings from this scoping review revealed a lack of uniformity across practices when performing IUD insertions, possibly due to differences in procedures across circumstantial factors, non-pharmacological methods, and pharmacological methods. More research is needed to investigate the intricacies of pain with IUD insertion. Moving forward, especially following a potential increase in the use of IUDs after the reversal of Roe v. Wade, establishing this gap may lead to a more refined standardized protocol to mitigate pain with IUD insertions.
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Affiliation(s)
- Mayisah Rahman
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Connor King
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Rosie Saikaly
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Maria Sosa
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Kristel Sibaja
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Brandon Tran
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Simon Tran
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Pamella Morello
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Se Yeon Seo
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Yi Yeon Seo
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Robin J Jacobs
- Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
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Mosley EA, Zite N, Dehlendorf C, Deal A, O'Leary R, Achilles S, Barnato AE, Hall D, Borrero S. Development of My Decision/Mi Decisión, a web-based decision aid to support permanent contraception decision making. PEC INNOVATION 2023; 3:100203. [PMID: 37693728 PMCID: PMC10483066 DOI: 10.1016/j.pecinn.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
Objective To develop a patient-centered, web-based decision aid to support informed and value-concordant decision making among Medicaid enrollees considering tubal sterilization. Methods We used the Ottawa Decision Support Framework and the International Patient Decision Aids Standards (IPDAS) to guide systematic development of our decision aid. We interviewed 15 obstetrician-gynecologists and 40 women, who had considered or were considering tubal sterilization. A Steering Committee-comprising healthcare providers, social scientists, reproductive health and justice advocates, and people with lived experience-provided feedback and direction. We developed English and Spanish prototypes, which were beta tested with 24 women. Results The resulting web-based My Decision/Mi Decisión tool (English/Spanish) includes written and video information about tubal sterilization procedures; an interactive table of contraception options; values clarification exercises; reflection and deliberation; knowledge checks; and a summary report to share with one's provider. Users found the decision aid to be informative, engaging, easy to use, and helpful in informing contraception decision making. Conclusion My Decision/Mi Decisión is a scalable tool that could be implemented widely to support informed decision making about tubal sterilization. Innovation This is a novel and timely web-based decision tool for tubal sterilization, when demand for permanent contraception is rapidly increasing post-Dobbs. While designed for Medicaid enrollees, further investigation will explore more generalized use.
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Affiliation(s)
- Elizabeth A. Mosley
- Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Center for Innovative Research on Gender Health Equity, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Nikki Zite
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920, USA
| | - Christine Dehlendorf
- Departments of Family & Community Medicine, Obstetrics, Gynecology & Reproductive Sciences, Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Ashley Deal
- Dezudio, Pittsburgh, PA 15221, USA
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Raelynn O'Leary
- Dezudio, Pittsburgh, PA 15221, USA
- Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Sharon Achilles
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Bill and Melinda Gates Foundation, Seattle, WA 98102, USA
| | - Amber E. Barnato
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Daniel Hall
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
- Department of Surgery, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15213, USA
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15213, USA
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15213, USA
| | - Sonya Borrero
- Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Center for Innovative Research on Gender Health Equity, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Sarkar A, Panneer S, Vanya V, Wadhawan I. A Prospective Quality Improvement Initiative to Address the Barriers to Postpartum Tubal Ligation Among Multiparous Women. Cureus 2022; 14:e29641. [DOI: 10.7759/cureus.29641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
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