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Foregrounding pain in self-managed early medication abortion: a qualitative study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-09-18 Carrie Purcell, Victoria Louise Newton, Fiona Bloomer, Lesley Hoggart
Objective To explore experiences of pain in the context of early medical abortion (EMA) in the UK and to guide best practice around anticipatory guidance on pain. Methods From late 2020 to early 2021, we recruited individuals from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and
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A post-abortion contraception text-and-call service to support patients to access effective contraception after telemedicine abortion BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-09-13 John Joseph Reynolds-Wright, Sharon T Cameron
Background Most abortions in Scotland are conducted at home before 12 weeks’ gestation using telemedicine. The volume of information given at a pre-abortion consultation may feel overwhelming and contraception may not be prioritised. Telemedicine limits immediate provision of some methods. Pathways to improve access to post-abortion contraception (PAC) are needed. Methods We piloted a PAC ‘text-and-call’
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Celebrating 50 years of our Journal BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-09-13 Sam Rowlands
The Journal has been in existence for 50 years and this semicentennial issue celebrates this special occasion. The evolution and development of the Journal mirrors that of the medical specialty of sexual and reproductive health (SRH) in the UK. Over this half century, the complexity of SRH has been reflected in the content of the Journal, with the richness of qualitative methodology joining well-established
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Abortion patients’ perspectives on enhancing a telemedicine model of post-abortion contraception: a qualitative study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-09-04 Nicola Boydell, Sophie Buijsen, John Joseph Reynolds-Wright, Sharon T Cameron, Jeni Harden
Background Access to post-abortion contraception (PAC) is critical for reducing unintended pregnancies and supporting reproductive decision-making. Patients often face challenges in identifying, accessing and initiating their preferred contraceptive methods post-abortion. This may be particularly so with telemedicine models of care with absence of in-person appointments, and reduced opportunities to
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COVID-19 pandemic exacerbation of disparities in access to public abortion services in Mexico BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-29 Elizabeth Kravitz, Biani Saavedra-Avendaño, Blair G Darney
Background We describe clients in Mexico City’s public abortion programme, Interrupción Legal de Embarazo (ILE), during the COVID-19 pandemic and test whether the pandemic exacerbated inequities in access. Methods We conducted a cohort study of all abortions in the ILE programme from 1 January 2019 to 30 June 2022. We compared patients from within and outside the Mexico City Metropolitan area (ZMVM)
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Local anaesthesia for pain control in surgical abortion before 14 weeks of pregnancy: a systematic review BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-29 Regina Renner, Madeleine Ennis, Adrienne McKercher, Jillian T Henderson, Alison Edelman
Background Abortions are common and associated with procedural pain. We aimed to evaluate benefits and harms of local anaesthesia given for pain control during surgical abortion at less than 14 weeks' gestation. Methods We searched a systematic review on local anaesthesia for pain control for surgical abortion at less than 14 weeks' gestation using uterine aspiration. We searched multiple databases
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Management of breast engorgement after second-trimester abortion or loss: a survey of current practice patterns BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-23 Andrea Henkel, Kate A Shaw
Breast engorgement and milk leakage following second-trimester perinatal loss and abortion is common and can cause both physical pain and emotional distress.1 2 Currently, there is limited clinical guidance regarding counselling or available treatment modalities.3 Therefore, we aimed to characterise current practice patterns in anticipatory guidance and use of non-pharmacological or pharmacological
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Digital training for self-injectable contraceptives: a feasibility and acceptability pilot study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-19 Rhiana Mills, Rapha Krong, Fiona Kithinji, Paula Baraitser
Background Self-injectable contraceptives, namely subcutaneous depot medroxyprogesterone acetate 104 mg micronised formulation delivered via uniject system, reduce the need to travel to a facility for contraceptive access, but the initial, in-person, training may be a barrier to starting this method. This article reports on a small, exploratory pilot in Kenya to test the feasibility and acceptability
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The case for integrating sexual and reproductive health services in Pacific Island countries BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-15 Kirsten I Black, Titilola Duro-Aina, Deborah Bateson
The Pacific Islands region is a geographic area of the Pacific Ocean made up of hundreds of scattered islands that form 15 independent countries. These archipelago nations are among the tiniest, most dispersed and most isolated countries in the world. All face significant ongoing threats of natural disasters associated with the impacts of climate change. The populations are young (half are under the
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Sexual and reproductive health clinical consultations: preconception care BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-08-08 Amy Hough, Jayne Kavanagh, Neha Pathak
Sofia, aged 32 years, wants another child. She has used a contraceptive implant for contraception for 2 years and attends her local sexual health clinic to have it removed. Before starting the removal the healthcare professional (HCP) asks about her general health and obstetric history. She is well and does not take regular medication. Her body mass index (BMI) is 33 kg/m2 and her last cervical screening
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The state of sexual health services in England BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-31 Sarah Harris
The current provision of sexual health services in England is disjointed, difficult to manage, and does not provide safe and effective care for all patients. Sexual health services are an important aspect of public health and primary care provision1. Effective sexual health services ensure reduction in communicable diseases and unwanted pregnancies, and promote good health in communities1. Investment
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Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: findings from the EXTEND-PREFER study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-18 Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib
Background Young Australian women from culturally and linguistically diverse (CALD) backgrounds are vulnerable to unwanted pregnancy. We aimed to assess whether an online educational video, co-designed with young CALD women, can increase their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC). Methods Online advertising was used to recruit young CALD
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Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006–2010 versus 2017–2019 BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-16 Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw
Objective Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have
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Double dosing ulipristal acetate emergency contraception for individuals with obesity: a randomised crossover trial BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-14 Alison Edelman, Jon D Hennebold, Kise Bond, Jeong Y Lim, Ganesh Cherala, Steven W Blue, Shawn P Kraft, David W Erikson, David Archer, Jeffery Jensen
Objective To determine whether increasing the dose of ulipristal acetate (UPA)-containing emergency contraception (EC) improves pharmacodynamic outcomes in individuals with obesity. Study design We enrolled healthy, regularly-cycling, confirmed ovulatory, reproductive-age individuals with body mass index (BMI) >30 kg/m2 and weight >80 kg in a randomised crossover study. We monitored participants with
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Self-performed Rh typing: a cross-sectional study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-14 Divya Dethier, Mary Tschann, Meliza Roman, John J Chen, Reni Soon, Bliss Kaneshiro
Objective To evaluate whether patients are capable and willing to self-administer and interpret an EldonCard test to determine their Rh status. Methods This was a cross-sectional study in Honolulu, HI, USA of pregnancy-capable people aged 14–50 years who did not know their blood type and had never used an EldonCard. Participants independently completed EldonCard testing, determined their Rh type and
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What do Australian primary care clinicians need to provide long-acting reversible contraception and early medical abortion? A content analysis of a virtual community of practice BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-02 Sonia Srinivasan, Sharon Maree James, Joly Kwek, Kirsten Black, Angela J Taft, Deborah Bateson, Wendy V Norman, Danielle Mazza
Background Uptake of long-acting reversible contraception (LARC) is lower in Australia compared with other high-income countries, and access to early medical abortion (EMA) is variable with only 11% of general practitioners (GPs) providing EMA. The AusCAPPS (Australian Contraception and Abortion Primary Care Practitioner Support) Network is a virtual community of practice established to support GPs
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Association between COVID-19 vaccination and menstruation: a state of the science review BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Laura A Payne, Lauren A Wise, Amelia K Wesselink, Siwen Wang, Stacey A Missmer, Alison Edelman
Introduction Menstrual health is a key patient-reported outcome beyond its importance as a general indicator of health and fertility. However, menstrual function was not measured in the clinical trials of COVID-19 vaccines. The purpose of this review was to synthesise the existing literature on the relationship between COVID-19 vaccination and menstrual health outcomes. Methods A PubMed search to 31
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Developing an accessible audiovisual animation to provide information about postpartum contraception BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Michelle Cooper, Hannah Robinson, Leanne Hughes, Karen McCabe, Janine Simpson, Sharon Cameron
The postpartum period is a high-risk time for unintended pregnancy and abortion.1 Short inter-pregnancy intervals are associated with an increased risk of most obstetric complications2 but accessing appointments to discuss and initiate contraception can be difficult for new parents after leaving the maternity unit.1 The antenatal period offers a unique opportunity to discuss and provide information
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Japan initiates a groundbreaking market test of over-the-counter emergency contraceptive pills with pharmacies as a first access point BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Hayase Hakariya, Takanao Hashimoto, Yosuke Suzuki, Tamae Hamaki, Tetsuya Tanimoto
On 28 November 2023, the Japanese Ministry of Health, Labor and Welfare (MHLW) initiated a market test to allow designated pharmacies to sell emergency contraceptive pills (ECPs), levonorgestrel (approved in 2011 in Japan) or its generic product, behind the pharmacy counter without a prescription.1 The test, commissioned by the MHLW and conducted by the Japan Pharmaceutical Association, will run until
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French Parliament ratifies the inclusion in the French Constitution of “guaranteed freedom” for abortion: but does this really prevent future restrictions? BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Philippe Faucher
The two French Parliamentary chambers met on 4 March 2024 in the Congress of Versailles and voted in favour of the constitutional bill to include abortion as a fundamental right in law. Deputies and senators overwhelmingly approved the constitutional revision with 780 votes ‘for’ of 852 votes cast (72 ‘against’). This evolution of the French Constitution completes a process initiated in reaction to
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Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Zohra S Lassi, Komal Abdul Rahim, Alexandra Maria Stavropoulos, Lareesa Marie Ryan, Jyoti Tyagi, Bisi Adewale, Jaameeta Kurji, Soumyadeep Bhaumik, Salima Meherali, Moazzam Ali
Introduction The evidence on adolescent empowerment, which involves access to personal and material resources for reproductive autonomy and economic equity, is limited. This systematic review assesses the use of contraceptives in empowering and strengthening the agency and vice versa among adolescents and young women. Methods We ran the searches in six electronic databases: Cochrane Database of Systematic
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Patient experiences of undergoing abortion with and without an ultrasound scan in Britain BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Rebecca Blaylock, Patricia A Lohr, Lesley Hoggart, Pam Lowe
Background Routine ultrasound scanning to determine gestational age and pregnancy location has long been part of pre-abortion assessment in Britain, despite not being legally required or recommended in national clinical guidelines. To support implementation of fully telemedical abortion care (implemented in Britain in April 2020), the Royal College of Obstetricians and Gynaecologists (RCOG) issued
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Preconception health risk factors documented in general practice electronic medical records BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Nishadi Nethmini Withanage, Jessica R Botfield, Kirsten Black, Danielle Mazza
Background Documenting medical and lifestyle preconception health risk factors in electronic medical records (EMRs) could assist general practitioners (GPs) to identify those reproductive-aged women who could most benefit from preconception care (PCC). However, it is unclear to what extent PCC risk factors are identifiable in general practice records. This study aimed to determine the extent to which
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Seeking support for abortion online: a qualitative study of women’s experiences BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Rachel Victoria Wilson-Lowe, Carrie Purcell, Ruth Lewis, Lisa McDaid
Introduction Social support can mitigate the impact of stress and stigma before or after an abortion. However, stigma anticipation can limit access to in-person support. Informal online spaces can offer opportunities to address unmet support needs including supplementing in-person support lacking within stigmatised contexts. While earlier studies have explored content of posts comprising personal accounts
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Self-managed medication abortion trajectories: results from a prospective observational study in Argentina, Nigeria and Southeast Asia BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-07-01 Elizabeth A Pleasants, Ruvani T Jayaweera, Ijeoma Egwuatu, Sybil Nmezi, Ika Ayu Kristianingrum, Ruth Zurbriggen, Belén Grosso, Chiara Bercu, Relebohile Motana, Caitlin Gerdts, Heidi Moseson
Objectives Time is a crucial factor in abortion-seeking because options for care change with pregnancy duration, and most people prefer to access abortion care early in pregnancy. We aimed to collect data on the timing of steps in accompanied self-managed abortion-seeking experiences in legally restrictive settings. Methods In this prospective, observational, cohort study we recruited callers from
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Consequences of ‘medical exceptions’ in restrictive abortion legislation: caesarean scar ectopic pregnancy and beyond BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-20 Natalie DiCenzo, Adam Elwood, Ruby Lin, Lily Bayat, Todd Rosen
After the 2022 Supreme Court decision Dobbs v. Jackson Women’s Health Organization to revoke federal abortion rights, many restrictive state abortion laws took effect.1 2 Most legislation limits abortion under almost all circumstances, with exceptions for ‘life-threatening emergency’ –an ill-defined term. Pregnancy even without comorbidities can be life-threatening, particularly in the United States
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Seeking abortion accompaniment: experiences and self-managed abortion preferences of hotline callers after abortion legalisation in Argentina BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-18 Brianna Keefe-Oates, Sofia Filippa, Elizabeth Janiak, Ruth Zurbriggen, Belén Grosso, Jarvis T Chen, Caitlin Gerdts, Barbara Gottlieb
Background Until the legalisation of abortion in Argentina in 2021, the Socorristas en Red, a network of feminist collectives, provided support and information (‘accompaniment’) to people self-managing their abortion with medications. Following legalisation, the Socorristas continued accompanying people self-managing or accessing abortion through the healthcare system. We conducted a cross-sectional
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‘Direct booking’ for intrauterine contraception appointments: a better way of working? BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-13 Kate Foster, Rebecca Strauss, Madeleine Crow
Many women in the UK find it difficult to access the contraceptive services they need.1 Long-acting reversible contraception (LARC) has been highlighted as a key area for improvement, with the recommendation to introduce evidence-based technologies as a way of improving accessibility.2 In 2022/2023, LARC comprised 55% of contraception appointments at Integrated Sexual Health Services. Of these, the
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Pain experiences during intrauterine device procedures: a thematic analysis of tweets BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-11 Neda Taghinejadi, Helene-Mari van der Westhuizen, Francis Ifeanyi Ayomoh, Wasim Ahmed, Trisha Greenhalgh, Anne-Marie Boylan
Introduction In June 2021, high-profile testimonials in the media about pain during intrauterine device (IUD) procedures in the UK prompted significant discussion across platforms including Twitter (subsequently renamed X). We examined a sample of Twitter postings (tweets) to gain insight into public perspectives and experiences. Methods We harvested tweets posted or retweeted on 21–22 June 2021 which
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Demanding doctorability for abortion on request: a conversation analysis of pre-abortion counselling in public hospitals in the Eastern Cape, South Africa BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-10 Ryan du Toit, Catriona Ida Macleod
Background Research on abortion counselling generally uses retrospective interviewing regarding providers’ and users’ experiences. In this article we explore how requests for abortion are made and received in real time in (officially non-mandatory) pre-abortion counselling conducted by nurses and counsellors in South African public abortion clinics. Methods To capture turn-by-turn interactions, we
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Challenging misleading information about ‘abortion reversal’ BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-04 Joseph Vernon Turner
The increasing literature on early pregnancy mifepristone antagonisation by progesterone is encouraging, as we seek to better serve women in this difficult situation. Nevertheless, there are ongoing examples of misleading information regarding scientific and clinical aspects of ‘abortion reversal’. The recent review by Stifani and Lavelanet claimed that clinicians “should be cautious about providing
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Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-04 Jesse D Thacher, Andreas Vilhelmsson, Annelise J Blomberg, Lars Rylander, Anna Jöud, Lone Schmidt, Charlotte Ørsted Hougaard, Eva Elmerstig, Ditte Vassard, Kristina Mattsson
Background Pandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Skåne, Sweden. Methods Using the Skåne Healthcare Register
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Utilising fruits to enhance first-trimester abortion simulation: can we do better than a papaya? BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-06-04 Sarah Nicole Owens, Simranvir Kaur, Andrea Henkel
As access to reproductive healthcare decreases in the United States, there is increasing reliance on simulation to help trainees achieve proficiency in uterine aspiration. While this procedure has traditionally been simulated on a papaya,1 2 we sought to identify if there was an alternative fruit that was similar or superior in key procedural components of first-trimester uterine aspiration. We selected
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Vernacular knowledge about contraception: an interdisciplinary perspective on myths, misperceptions and lived experience BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-05-24 Victoria Louise Newton
Recent research points to social media as a driver in the rise of contraceptive misconceptions and misinformation. An attitudinal change towards hormonal contraception has also been documented, coupled with rising distrust of clinicians in favour of peer influencers,1 a narrative that has been echoed in mainstream media.2 However, the circulation of contraceptive narratives is not a new phenomenon
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Oral contraception prescribing trends in Scottish general practices between 2016 and 2023 BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-05-24 Elliot Johnson-Hall
A number of restrictions on daily life accompanied the COVID-19 pandemic. One such restriction was the change towards remote consultations, such as telephone triage and video-based telehealth appointments in general practices. The changes in oral contraceptive prescribing in Scottish general practices from January 2016 to January 2023 were examined. While the effects of COVID-19 on contraceptive prescribing
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Impact of an early medical abortion at home pack of medicines in Scotland BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-05-22 Nathan Burley, Kirsten Cameron, Audrey Brown, Christine Black
Abortion care involves the provision of up to seven medicines: abortifacients,1 analgesia, an antiemetic, contraception2 and occasionally an antibiotic. This is a large volume of pharmaceuticals supplied and is similar to the amount of medicines supplied after a heart attack. More medicines per intervention carries greater complexity and associated problems.3 Legislation changes during the COVID-19
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Provision of care to diverse populations: results from the 2019 Canadian Abortion Provider Survey BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-05-10 Madeleine Ennis, Regina Renner, Bimbola Olure, Stephanie Begun, Wendy V Norman, Sarah Munro
The WHO highlighted the importance of providing culturally safe, high-quality healthcare,1 emphasising that services should be welcoming to diverse populations, including “youth and people from sexual and gender minorities, people living with disabilities, and all groups in vulnerable and marginalised situations”. We conducted the 2019 Canadian Abortion Provider Survey (CAPS), collecting demographics
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Longitudinal trends in uptake of hormonal long-acting reversible contraception devices throughout the COVID-19 pandemic: an Australian population-based study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-05-07 Tahlee Blade Stevenson, Alice R Rumbold, Vivienne Moore, Kelly Hall, Jenni Ilomaki, Danielle Mazza, Deborah Bateson, Luke E Grzeskowiak
Background Little is known about the degree to which the COVID-19 pandemic, and associated restrictions and disruptions to health services, impacted the accessibility of hormonal long-acting reversible contraception (LARC) devices within Australia. Here, we explore longitudinal patterns of dispensing of the contraceptive implant and hormonal intrauterine devices (IUDs) within Australia, before and
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Abortion rates in UK servicewomen BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-03 Victoria Elizabeth Kinkaid, Ruth Guest, Tracy-Louise Appleyard
The number of women in the United Kingdom (UK) armed forces (AF) is rising each year, with women currently representing 11.7% of the regular military; people who work full-time for the AF.1 The UK Government has set ambitious targets to increase this to 30% by 2030 in the wake of the Atherton Report, which highlighted that the military is “still a man’s world”.2 Servicewomen are a population that are
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BSACP Conference abstract BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 British Medical Journal Publishing Group
These oral abstracts were presented at the 2023 British Society of Abortion Care Providers (BSACP) Annual Conference on 10 November 2023 titled: ‘Excellence in Abortion Care Together: Coming together as a supportive community to improve patient care’. The oral abstract titled "Complications associated with mifepristone use for dilation and evacuation abortion procedures between 22- and 24-weeks’ gestation"
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What is new in breast cancer and contraception? A statement from the Faculty of Sexual & Reproductive Healthcare (FSRH) BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Ellen Adams, Katie Boog, Sarah Margaret Hardman
Breast cancer (BC) is the most common cancer in women worldwide. Although it is more common in older women, it is increasingly being diagnosed in premenopausal women.1 During BC treatment and some time after treatment is complete, avoiding pregnancy is recommended. BC outcomes could be adversely affected by pregnancy itself or by delayed treatment due to pregnancy, and treatment could be teratogenic
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Sexual and reproductive health clinical consultations: domestic abuse BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Melissa Gardner, Jayne Kavanagh
Zeynep, a 24-year-old beautician, sees her general practice nurse about contraception. She starts the consultation by saying, “My husband wants to start having babies now, but I want to wait a bit”. The practice nurse discusses her contraceptive options and Zeynep opts to start the combined hormonal contraceptive pill. The nurse is curious about Zeynep’s initial statement and asks about her relationship
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Women’s experiences of postpartum contraceptive services when elective caesarean section is the method of birth: a qualitative study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Karin Lichtenstein Liljeblad, Helena Kopp Kallner, Jan Brynhildsen, Helena Kilander
Background The unmet need for postpartum contraception is a global challenge. Postpartum placement of an intrauterine device (IUD) within 48 hours of vaginal delivery is available in many settings worldwide, but is not routinely practised in Sweden. To improve contraceptive services and facilitate the informed choice of IUD placement at the time of a caesarean section (CS), we performed this study
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Patient and public involvement in abortion research: reflections from the Shaping Abortion for Change (SACHA) Study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Rebecca Blaylock, Maria Lewandowska, Charlotte Kelly, Becky Gunn, Rebecca Meiksin, Rachel H Scott, Melissa J Palmer, Kaye Wellings, Patricia A Lohr, Rebecca S French, The SACHA Study Team N/A
Patient and public involvement (PPI) is limited within abortion-related research. Possible reasons for this include concerns about engaging with a stigmatised patient group who value confidentiality and may be reluctant to re-engage with services. Structural barriers, including limited funding for abortion-related research, also prevent researchers from creating meaningful PPI opportunities. Here,
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A systematic review and critical appraisal of menopause guidelines BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Chandima Hemachandra, Sasha Taylor, Rakibul M Islam, Ensieh Fooladi, Susan R Davis
Objective and rationale To identify and appraise current national and international clinical menopause guidance documents, and to extract and compare the recommendations of the most robust examples. Design Systematic review. Data sources Ovid MEDLINE, EMBASE, PsycINFO and Web of Science Eligibility criteria for selecting studies Practice guidance documents for menopause published from 2015 until 20
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Scaling postpartum family planning services in the Democratic Republic of Congo: outcomes and lessons learned BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Rita Kabra, Komal Preet Allagh, Brigitte Nsiku Kini, Robert Mulunda Kanke, James Kiarie
Maternal, neonatal and infant mortality rates in the Democratic Republic of Congo (DRC) are among the highest in the world. Although the maternal mortality rate has decreased since 2000, there were still a total of 16 000 maternal deaths reported in 2017 from the DRC.1 In 2020, the maternal mortality rate in DRC increased to 547 deaths per 100 000 live births, a 16% increase from 2017.2 Additionally
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Opt-in versus universal codeine provision for medical abortion up to 10 weeks of gestation at British Pregnancy Advisory Service: a cross-sectional evaluation BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Neda Taghinejadi, Hannah McCulloch, Michał Krassowski, Amelia McInnes-Dean, Katherine C Whitehouse, Patricia A Lohr
Objective To assess patient experiences of pain management during medical abortion up to 10 weeks’ gestation with opt-in versus universal codeine provision. Methods We invited patients who underwent medical abortion up to 10 weeks of gestation to participate in an online, anonymous, English-language survey from November 2021 to March 2022. We performed ordinal regression analyses to compare satisfaction
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Women’s experiences of the consenting process for pregnancy remains disposal following early miscarriage BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Susie Kilshaw
Background and methodology UK clinical practices around managing pregnancy remains after pregnancy loss involve a process of documenting consent. Women are typically offered options for disposal, which may include cremation, burial, releasing for private arrangements, releasing to a funeral director and, in some cases, sensitive incineration. A single researcher conducted 20 months of ethnographic
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Challenges for cervical screening in people experiencing homelessness BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Katie Eirian Hawkins, Kyra Gourlay, Kate Cuschieri
There are over 3000 new cases of cervical cancer each year across the UK, most being associated with persistent infection with human papillomavirus (HPV). Cervical screening greatly reduces the risk of cancer and is offered in Scotland to women and individuals with a cervix aged 25–64 years. Cervical screening has been based on HPV testing since 2020. Two of the main risk factors for the development
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Factors affecting female sexual well-being: a 5-year follow-up of a randomised clinical trial on post-abortion contraception BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Janina Bosas, Elena Toffol, Elina Pohjoranta, Maarit J Mentula, Ritva Hurskainen, Satu Suhonen, Oskari Heikinheimo
Introduction Sexual well-being is associated with general well-being. Several factors, such as overweight, infertility, anxiety and sex hormones, also play a role, but the effects of hormonal contraception remain a point of debate. We characterised the factors associated with sexual well-being in fertile-aged women following induced abortion. Methods A 5-year follow-up of a nested, longitudinal, cohort
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Associations between the COVID-19 pandemic and women’s fertility intentions: a multi-country, cross-sectional (I-SHARE) study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Min Zhao, Caitlin Alsandria O'Hara, Norhafizah Bte Sahril, Huijun Liu, Kaiyan Pei, Olena Ivanova, Elin C Larsson, Simukai Shamu, Eneyi Kpokiri, Amanda Cleeve, Joseph D Tucker, Kristien Michielsen, Wei-Hong Zhang
Introduction The COVID-19 pandemic, together with the subsequent social distancing measures, could lead to shifts in family and fertility planning. This study aimed to explore the associations between the COVID-19 pandemic and changes in fertility intentions among an international sample of reproductive-aged women. Methods A multi-country, cross-sectional study based on data from 10 672 women aged
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Contraception prescribing in England during the COVID-19 pandemic BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-04-01 Tanha Begum, Emer Cullen, Malcolm Moffat, Judith Rankin
Background National lockdowns in England due to COVID-19 resulted in rapid shifts in healthcare provision, including in primary care where most contraceptive prescriptions are issued. This study aimed to investigate contraception prescribing trends in primary care during the pandemic and the impact of socioeconomic deprivation. Methods Prescribing data were accessed from the English Prescribing Dataset
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Understanding the impact of COVID-19 on women’s access to and experiences of contraceptive services in England: a qualitative study BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-03-19 Lauren McMillan, Erica Gadsby, Rebecca Howell, Michael Ussher, Kate Hunt, Allison Ford
Background The COVID-19 pandemic response prompted rapid changes to how contraceptive services were delivered in England. Our aim was to examine women’s experiences of accessing contraceptive services since March 2020 and to understand any inequalities of access. Methods We conducted telephone interviews with 31 women aged 17–54 years who had accessed contraceptive services in England since March 2020
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Interconnections between unintended pregnancy, alcohol and other drug use, and pregnancy, birth, infant, childhood and socioeconomic outcomes: a scoping review BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-03-12 Kelly A McNamara, Bridin Murnion, Penelope Fotheringham, Mishka Terplan, Nicholas Lintzeris, Ju Lee Oei, Diana M Bond, Natasha Nassar, Kirsten I Black
Background Unintended pregnancy (UIP) and substance use disorder share underlying root causes with similar impacts for women and their offspring in pregnancy, birth and beyond. Furthermore, intoxication with alcohol and other drugs (AOD) increases the risk of UIP. Objectives To assess the available evidence on associations between UIP and health, social and economic outcomes, in women who use AOD.
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Initiating medical abortion in an emergency department in the United States BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-02-16 Carl Preiksaitis, Monica Saxena, Andrea Henkel
Objectives The primary objective of this study was to assess the feasibility of initiating medical abortions in a large, academic emergency department (ED) in the United States. Methods A retrospective case series analysis was conducted to evaluate a protocol for initiating medical abortion in the ED implemented from January 2020 to October 2023 at an academic, tertiary care hospital in California
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Sexual and reproductive health clinical consultations: abortion in non-specialist community-based clinics BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-01-01 Corrina Horan, Pollyanna Cohen, Jayne Kavanagh
Sam, aged 31, attends her local sexual health clinic requesting a pregnancy test after a split condom with her regular partner 4 weeks ago. She took oral emergency contraception the following morning. However, she has not had a period for 6 weeks and her breasts are more tender than usual. Her menstrual cycle is usually regular and monthly. Before the pregnancy test, the healthcare provider (HCP) asks
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Reversal of medication abortion with progesterone: a systematic review BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-01-01 Bianca Maria Stifani, Antonella Francheska Lavelanet
Background We sought to determine whether there is evidence to recommend progesterone for individuals not wishing to complete a medication abortion after taking mifepristone. Methods We undertook an updated systematic review including a primary search for studies in which individuals received progesterone to reverse the effects of mifepristone, and a secondary search for studies in which individuals
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Correspondence on ‘Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding’ by DeLoughery et al BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-01-01 Parmis Vafapour, Roda Awil Mohammed, Poppy Elizabeth Sullivan
Dear Editor, We have reviewed the article by DeLoughery et al ,1 and express our gratitude for the findings as medical students passionate about women’s health. The study reviewed a range of menstrual products and worked to quantify their absorbency. The study’s experimental design accounted for the functional differences inherent in different menstrual products. Testing protocols were tailored for
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Client-reported quality of facility-managed medication abortion compared with pharmacy-sourced self-managed abortion in Bangladesh BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-01-01 Laura E Jacobson, Sarah E Baum, Erin Pearson, Rezwana Chowdhury, Nirali M Chakraborty, Julia M Goodman, Caitlin Gerdts, Blair G Darney
Objective We used the newly developed Abortion Care Quality Tool (ACQTool) to compare client-reported quality of medication abortion care by source (facility-managed vs pharmacy-sourced self-managed abortion (SMA)) in Bangladesh. Methods We leveraged exit and 30-day follow-up surveys collected to develop and validate the ACQTool collected at nongovernmental organisation (NGO)-supported or -operated
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Contraceptive efficacy and global licensing of 52 mg levonorgestrel intrauterine devices: does a Mirena last longer in New York than York? BMJ Sexual & Reproductive Health (IF 3.4) Pub Date : 2024-01-01 Zachary Nash, Annette Thwaites
There is significant discrepancy between licensed durations for contraceptive efficacy of 52 mg levonorgestrel intrauterine devices (LNG-IUDs) across different countries and between UK licences and national recommendations (table 1). This is confusing and unhelpful for both clinicians and users. View this table: Table 1 Licensed durations for contraceptive efficacy of 52 mg levonorgestrel intrauterine