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Stowers P, Heck R, Csiszar K, Kaneshiro B. Corrigendum to "Just world beliefs and community-level abortion stigma: An exploratory survey" [Contraception 2023;122:109979]. Contraception 2024; 130:110341. [PMID: 38016885 PMCID: PMC10898363 DOI: 10.1016/j.contraception.2023.110341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Paris Stowers
- Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States.
| | - Ronald Heck
- College of Education, University of Hawaii, Honolulu, Hawaii, United States
| | - Katalin Csiszar
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States
| | - Bliss Kaneshiro
- Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, United States
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Pearlman Shapiro M, Stowers P, Raidoo S. Contraception After Abortion. Clin Obstet Gynecol 2023; 66:749-758. [PMID: 37750667 DOI: 10.1097/grf.0000000000000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
After a spontaneous or induced abortion, people may desire to delay or prevent a future pregnancy and many desire to use contraceptive methods to do so. Contraception counseling and provision at the time of abortion care are important components to improve contraceptive access and convenience for people undergoing abortion care. The majority of hormonal and barrier contraceptive methods may be safely initiated at the time of medication or procedural abortion or shortly thereafter, although delayed initiation may be necessary in certain circumstances. A patient-centered approach to contraceptive counseling can identify patients' priorities and mitigate provider coercion or pressure.
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Affiliation(s)
- Marit Pearlman Shapiro
- Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Paris Stowers
- Department of Obstetrics, Gynecology, and Women's Health, University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, Hawaii
| | - Shandhini Raidoo
- Department of Obstetrics, Gynecology, and Women's Health, University of Hawaii at Manoa John A. Burns School of Medicine, Honolulu, Hawaii
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Stowers P, Fontanilla T, Elia J, Salcedo J, Kaneshiro B, Tschann M, Soon R. A qualitative study of perspectives on research participation among individuals who recently experienced an abortion in Hawai'i. Contraception 2023; 126:110107. [PMID: 37390947 DOI: 10.1016/j.contraception.2023.110107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The United States Code of Federal Regulations mandates extra protections for research involving pregnant participants seeking abortions. This study aims to understand the perspectives of abortion patients regarding recruitment, decision-making, and participation in research. STUDY DESIGN We recruited adults in Hawai'i who reported at least one induced abortion in the previous 6 months. Recruitment strategies included online advertisements and flyers posted in reproductive health clinics. We conducted in-person, semistructured interviews exploring research preferences. The authors collaboratively reviewed the resulting transcripts and created a code dictionary. We reviewed, organized, condensed, and diagrammed the resulting data to identify dominant themes. RESULTS Between February and November 2019, we interviewed 25 participants aged 18-41 years who had medication (n = 14) or procedural (n = 11) abortions. Interviews ranged from 32 to 77 minutes (mean = 48 minutes). Four themes emerged: (1) people having abortions are capable of making informed decisions about research participation, (2) abortion-related stigma influences research decision-making, (3) people having abortions prefer to learn about study opportunities early and through participant-driven recruitment methods, and (4) the ideal role of the abortion provider in research is unclear. CONCLUSIONS Abortion patients in this study want to be informed of research opportunities and feel capable of deciding about participation in research studies. Current federally mandated protections and common research practices could be revisited and revised to better reflect these preferences. IMPLICATIONS Revision of federal regulations and optimization of recruitment methods may allow researchers to improve the research experience for patients having an abortion.
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Affiliation(s)
- Paris Stowers
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States.
| | - Tiana Fontanilla
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Jennifer Elia
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Jennifer Salcedo
- School of Medicine, Department of Obstetrics and Gynecology, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Bliss Kaneshiro
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Mary Tschann
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
| | - Reni Soon
- John A Burns School of Medicine, Department of Obstetrics, Gynecology, & Women's Health, University of Hawai'i, Honolulu, HI, United States
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Stowers P, Heck R, Csiszar K, Kaneshiro B. Just-word beliefs and community-level abortion stigma: An exploratory survey. Contraception 2023; 122:109979. [PMID: 36804051 PMCID: PMC10149599 DOI: 10.1016/j.contraception.2023.109979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVES This study aimed to evaluate whether belief in a just world is associated with community-level abortion stigma. STUDY DESIGN From December 2020 to June 2021, we conducted a national U.S. survey of 911 adults using Amazon Mechanical Turk. Survey respondents completed both the Community-Level Abortion Stigma Scale and Global Belief in a Just World Scale. We used linear regression to evaluate the association between just-world beliefs, demographic characteristics, and community-level abortion stigma. RESULTS The mean Global Belief in a Just World Scale score was 25.8. The mean Community-Level Abortion Stigma Scale score was 2.6. The strength of just-world beliefs (β = 0.7), male gender (β = 4.1), a history of a previous pregnancy (β = 3.1), post college education (β = 2.8), and strength of religious beliefs (β = 0.3) were associated with higher community-level abortion stigma. Asian race was associated with lower community-level abortion stigma (β = -7.2). CONCLUSIONS After controlling for demographic characteristics, strong just-world beliefs were associated with higher community-level abortion stigma. IMPLICATIONS Understanding just-world beliefs may provide a potential target for stigma-reduction strategies.
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Affiliation(s)
- Paris Stowers
- University of Hawaii, John A. Burns School of Medicine, Department of Obstetrics, Gynecology & Women's Health, 82 Puuhonu Place #205, Hilo, HI, USA.
| | - Ronald Heck
- University of Hawaii, College of Education, 1776 University Avenue Wist Hall Rm 220, Honolulu, HI, USA
| | - Katalin Csiszar
- University of Hawaii, John A. Burns School of Medicine, Department of Quantitative Health Sciences, 651 Ilalo Street, Medical Education Building, Suite 411, Honolulu, HI, USA
| | - Bliss Kaneshiro
- University of Hawaii, John A. Burns School of Medicine, Department of Obstetrics, Gynecology & Women's Health, 1356 Lusitana St. Ste 514, Honolulu, HI, USA
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Raidoo S, Kaneshiro B, Stowers P. Guam: The US territory where America's day begins but abortion access is still in the dark. Contraception 2021; 104:33-35. [DOI: 10.1016/j.contraception.2021.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022]
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Kerestes C, Murayama S, Tyson J, Natavio M, Seamon E, Raidoo S, Lacar L, Bowen E, Soon R, Platais I, Kaneshiro B, Stowers P. Provision of medication abortion in Hawai'i during COVID-19: Practical experience with multiple care delivery models. Contraception 2021; 104:49-53. [PMID: 33789080 PMCID: PMC8005318 DOI: 10.1016/j.contraception.2021.03.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/03/2022]
Abstract
Objective To demonstrate the effectiveness of medication abortion with the implementation of telemedicine and a no-test protocol in response to the COVID-19 pandemic. Study design This is a retrospective cohort study of patients who had a medication abortion up to 77 days gestation at the University of Hawai‘i between April and November 2020. Patients had the option of traditional in clinic care or telemedicine with either in clinic pickup or mailing of medications. During this time, a no-test protocol for medication abortion without prior labs or ultrasound was in place for eligible patients. The primary outcome was the rate of successful medication abortion without surgical intervention. Secondary outcomes included abortion-related complications. Results A total of 334 patients were dispensed mifepristone and misoprostol, 149 (44.6%) with telemedicine with in-person pickup of medications, 75 (22.5%) via telemedicine with medications mailed, and 110 (32.9%) via traditional in person visits. The overall rate of complete medication abortion without surgical intervention was 95.8%, with success rates of 96.8, 97.1, and 93.6% for the clinic pickup, mail, and clinic visit groups, respectively. Success for those without an ultrasound performed prior to the procedure was 96.6%, compared to 95.5% for those with ultrasound. We obtained follow-up data for 87.8% of participants. Conclusions Medication abortion was safe and effective while offering multiple modes of care delivery including telemedicine visits without an ultrasound performed prior to dispensing medications. Implications Incorporating telemedicine and a no-test protocol for medication abortion is safe and has the potential to expand access to abortion care. All care models had low rates of adverse events, which contradicts the idea that the Risk Evaluation and Mitigation Strategyincreases the safety of medication abortion.
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Affiliation(s)
- Courtney Kerestes
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.
| | - Sarah Murayama
- John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Jasmine Tyson
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Melissa Natavio
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Elisabeth Seamon
- John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Shandhini Raidoo
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Lea Lacar
- John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Emory Bowen
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Reni Soon
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | | | - Bliss Kaneshiro
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Paris Stowers
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
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Stowers P, Kameoka A, Raidoo S. P29 Abortion narratives on Twitter: A mixed methods study. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Stowers P, Thannickal A, Wojtowycz M, Wallis J, Reiss ZV. National survey of attitudes towards pregnancy termination procedures among anaesthesiology residents in the US. Sex Health 2019; 15:477-479. [PMID: 30244689 DOI: 10.1071/sh18022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 06/06/2018] [Indexed: 11/23/2022]
Abstract
Anaesthesiologists are vital to abortion access in the US. An online survey of 215 anaesthesiology residents assessed attitudes towards abortion. Among the surveyed residents, first-trimester abortion was more acceptable than second-trimester abortion (P<0.001). Few respondents objected to abortion in cases of fetal anomalies or maternal health indications. Further, 77.3% of surveyed residents reported past participation in abortion procedures, including 77.8% of residents with objections to abortion in some circumstances. Anaesthesiology residents who are female, childless and non-religious were more likely to find first-trimester abortion acceptable.
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Affiliation(s)
- Paris Stowers
- State University of New York Upstate Medical University, Department of Obstetrics and Gynecology, 750 East Adams Street, Room 2602, Syracuse, NY 13210, USA
| | - Aneesa Thannickal
- State University of New York Upstate Medical University, College of Medicine, 750 East Adams Street, Room 2602, Syracuse, NY 13210, USA
| | - Martha Wojtowycz
- State University of New York Upstate Medical University, Department of Public Health and Preventive Medicine, 760 Irving Avenue, 2263 Weiskotten Hall, Syracuse, NY 13210, USA
| | - Jodi Wallis
- State University of New York Upstate Medical University, Department of Obstetrics and Gynecology, 750 East Adams Street, Room 2602, Syracuse, NY 13210, USA
| | - Zevidah V Reiss
- Northland Family Planning Centers, 35000 Ford Road, Westland, MI 48185, USA
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Abstract
OBJECTIVE Levonorgestrel (LNG) emergency contraception (EC) may have decreased efficacy for women with body mass indices (BMI)≥26kg/m2. This study aims to evaluate the prevalence of LNG EC use and EC counseling among overweight women. METHODS The 2013-2015 dataset from the National Survey of Family Growth was analyzed to determine the proportion of women with BMI≥26kg/m2 who report recent use of LNG EC and EC counseling. RESULTS Overall, 2.4% of respondents reported recent use of LNG EC. Among women using oral LNG for EC, 29.8% of survey participants reported BMI≥26kg/m2. Additionally, 40.2% of women with BMI≥26kg/m2 using oral LNG EC reported having a doctor or medical provider talk to them about emergency contraception within the last 12 months, compared to 18.3% of LNG EC users with BMI<26kg/m2 (p<0.001). CONCLUSIONS Despite recent counseling from clinicians and concerns for decreased efficacy, a significant number of overweight women continue to use LNG for EC. Clinicians should counsel women with BMI≥26kg/m2 on the potential limitations of oral LNG for EC and offer more effective EC methods, including the copper intrauterine device and oral ulipristal acetate.
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Affiliation(s)
- Paris Stowers
- State University of New York Upstate Medical University, Department of Obstetrics and Gynecology, Syracuse, NY, USA.
| | - Renee Mestad
- State University of New York Upstate Medical University, Department of Obstetrics and Gynecology, Syracuse, NY, USA.
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Stowers P. A reply to "Hormonal contraception, depression, and academic performance among females attending college in the United States". Psychiatry Res 2018; 270:1184. [PMID: 30447819 DOI: 10.1016/j.psychres.2018.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Paris Stowers
- Department of Obstetrics, Gynecology, and Women's Health, John A. Burns School of Medicine, University of Hawaii at Manoa, 1319 Punahou St, Suite 824, Honolulu 96826, United States.
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