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Sexual and reproductive health clinical consultations: domestic abuse BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-03-13 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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Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-03-13 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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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 3.3) 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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Foregrounding pain in self-managed early medication abortion: a qualitative study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-03-01 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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Preconception health risk factors documented in general practice electronic medical records BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-23 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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A systematic review and critical appraisal of menopause guidelines BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-22 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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Women’s experiences of postpartum contraceptive services when elective caesarean section is the method of birth: a qualitative study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-16 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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Initiating medical abortion in an emergency department in the United States BMJ Sexual & Reproductive Health (IF 3.3) 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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Patient experiences of undergoing abortion with and without an ultrasound scan in Britain BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-16 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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Patient and public involvement in abortion research: reflections from the Shaping Abortion for Change (SACHA) Study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-09 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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Seeking support for abortion online: a qualitative study of women’s experiences BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-02-09 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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Scaling postpartum family planning services in the Democratic Republic of Congo: outcomes and lessons learned BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-30 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 3.3) Pub Date : 2024-01-30 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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Associations between the COVID-19 pandemic and women’s fertility intentions: a multi-country, cross-sectional (I-SHARE) study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-22 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 3.3) Pub Date : 2024-01-22 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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Women’s experiences of the consenting process for pregnancy remains disposal following early miscarriage BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-05 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 3.3) Pub Date : 2024-01-05 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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Sexual and reproductive health clinical consultations: abortion in non-specialist community-based clinics BMJ Sexual & Reproductive Health (IF 3.3) 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 3.3) 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 3.3) 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 3.3) 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 3.3) 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
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Going with the flow: the emergence of menstrual science BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-01 Nichole Tyson, Olga Kciuk, Paul D Blumenthal
Menstruation is a universal human experience from menarche to menopause. It is estimated that approximately 26% of the global population menstruates, with approximately 800 million individuals menstruating each day.1 While menstruation is considered a healthy vital sign and physiological process within the reproductive age group, it is often associated with stigma and normalisation of pain. These factors
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Understanding pre-residency abortion training pathways and career choices in the United States: a qualitative study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-01 Rebecca Henderson, Valeria Barreto, Molly Nyren, Olivia Moumne, Tory Finley, Sharon Byun, Alexandra Monaco, Jody Steinauer
Background Many factors contribute to the decision to provide abortion in the United States. We aim to describe pre-residency experiences and decisions that contribute to choosing a career as an abortion provider in the United States. Methods We conducted 60-min semi-structured telephone interviews with 34 current abortion care providers about their career trajectories, decision-making and planning
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Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-01 Alayna Carrandi, Claudia Bull, Yanan Hu, Luke E Grzeskowiak, Helena Teede, Kirsten Black, Emily Callander
Background Short birth intervals and unintended pregnancy are associated with poorer maternal and infant outcomes. There is a risk of pregnancy during the immediate postpartum period unless contraception is initiated. This retrospective cohort study aimed to capture the current patterns of hormonal contraceptive provision within 12 months postpartum in a high-income country. Methods We used a linked
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Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2024-01-01 Rebecah MacGilleEathain, Tamsin Smith, Isabel Steele
Background It has been identified that rural young people face barriers to accessing support for their sexual well-being such as availability and transport, knowing healthcare staff personally, and fear of being judged negatively within their community. These factors may contribute to widening health inequalities and expose young people living in rural areas to increased risk of poor sexual well-being
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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 3.3) Pub Date : 2023-10-31 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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Time to treat the climate and nature crisis as one indivisible global health emergency BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-25 Chris Zielinski
Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and
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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 3.3) Pub Date : 2023-10-19 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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Improving access to medicines for early medical abortion: learning from experiences of medicines licensing and service delivery BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Sam Rowlands, Mira Harrison-Woolrych
Governments worldwide have an obligation to ensure that reproductive health information, supplies and services are available, accessible, acceptable and of good quality.1 The WHO advises that everyone has the right to access safe and effective abortion care.2 However, in 2023, there remain many factors working against people’s access to such care.3 4 This Editorial discusses two key areas which continue
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Co-produced patient pathway for sexual health follow-up with children and young people using a paediatric sexual assault referral centre (SARC): facilitating elements of self-care and self-testing BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Jane Meyrick, Rachel Adams, Michelle Cutland
Childhood sexual abuse (CSA) is increasingly recognised and the impact often lifelong.1 At least 15% of girls/young women and 5% of boys/young men experience some form of sexual abuse before the age of 16 years,2 after which they may be offered sexual health follow-up (SHFU) from a paediatric sexual abuse referral centre (SARC). For children and young people (CYP) and their carers, the visit may be
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Priority indicators for sexual and reproductive health self-care: recommendations from an expert working group BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Claire W Rothschild, GIlda Sedgh, Martha Brady, Holly McClain Burke, Jane Cover, Andrea Cutherell, Austen El-Osta, Kelsey Holt, Dinesh Kumar, Fredrick Makumbi
Self-care has been lauded as a strategy to advance universal health coverage by placing users at the centre of health systems, supporting equitable access to health services, and improving health system resilience.1 Because self-care is by its nature often practised outside of the formal health system, self-care monitoring and evaluation (M&E) is challenging and requires novel approaches. The WHO has
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Self-care for abortion activists and providers: lessons of law and risk from Argentina BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Raquel Irene Drovetta, Cordelia Freeman, Agustina Rúa
In 2022, the Argentinean organisation Socorristas en Red celebrated its tenth anniversary. This celebration reaffirmed the group’s commitment to safe abortion across Argentina, to providing information on safe abortions, and to supporting the termination of pregnancies for those who request it.1 2 The Socorristas’ activism and provision of abortion care therefore precedes Law 27.610, which in December
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You’re invited: welcome to the dynamic world of quality improvement and implementation science BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Lisa M Goldthwaite, Cati G Brown-Johnson
As defined by the WHO, postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth.1 Access to postpartum contraception supports both individual reproductive goals and population health outcomes, and much is known about the safety and efficacy of various contraceptive methods in the postpartum period. In the
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Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID) BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Andrew J Baxter, Rebecca S Geary, Emily Dema, Raquel Bosó Pérez, Julie Riddell, Malachi Willis, Anne Conolly, Laura L Oakley, Andrew J Copas, Jo Gibbs, Christopher Bonell, Pam Sonnenberg, Catherine H Mercer, Soazig Clifton, Nigel Field, Kirsten Mitchell
Background Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic. Methods Natsal-COVID Wave 2 surveyed 6658 adults aged 18–59 years between March and April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants
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Pharmacy dispensing of abortion pills in Ghana: experiences of pharmacy workers and users BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Mercy Nana Akua Otsin, Kirsten Black, Leesa Hooker, Angela J Taft
Background Self-managed medical abortions are generally safe; however, pharmacy provision of abortion pills is against the Ghanaian abortion law. Nevertheless, evidence shows increasing numbers of women use it. An understanding of the influence of the law on pharmacies dispensing abortifacients and women who needed hospital care after using these pills is lacking. This study aimed to address this gap
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A prospective, comparative study of clinical outcomes following clinic-based versus self-use of medical abortion BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Nathalie Kapp, Bunsoth Mao, Jamie Menzel, Elisabeth Eckersberger, Vonthanak Saphonn, Tung Rathavy, Erin Pearson
Background To determine whether clinical outcomes differ among women accessing a combined medical abortion regimen from a health clinic when compared with those accessing it from a pharmacy. Methods We conducted a multicentre, prospective, comparative, non-inferiority study of participants aged ≥15 years seeking medical abortion from five clinics and five adjacent pharmacy clusters in three provinces
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Reproductive and sexual health of Australian adolescents exposed to family and domestic violence BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Carol Orr, Erin Kelty, Melissa O'Donnell, Colleen M Fisher, Rebecca Glauert, David B Preen
Background There is a dearth of research investigating sexually transmitted infections (STIs) in children exposed to family and domestic violence (FDV). Further, there is no research on terminations of pregnancy in children exposed to FDV. Methods This retrospective cohort study used linked administrative data from Western Australia to investigate whether exposure to FDV is associated with a risk of
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Improving postpregnancy contraceptive method choice and long-acting reversible contraception provision in Botswana: a quality improvement pilot BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 G Justus Hofmeyr, Rebecca Jane Ryan, Aamirah Mussa, Bame Bame, Sifelani Malima, Thabo Moloi, Rebecca Luckett, Ndiwo B Memo, Badani Moreri-Ntshabele, Mercy Nkuba Nassali, Modimowame Jamieson, Kyungu M Kime, Chelsea Morroni
#### Key messages The most impactful and cost-effective strategy to reduce maternal and perinatal mortality is to enable women to avoid unintended pregnancy. Provision of immediate postpartum contraception, promoted by the WHO, can avert more than 30% of maternal deaths and 10% of child mortality.1–3 In Botswana, the maternal mortality ratio is 166.3 deaths per 100 000 live births, unsafe abortion
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Women’s needs for lifestyle risk reduction engagement during the interconception period: a scoping review BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Sharon James, Jessica E Moulton, Anisa Assifi, Jessica Botfield, Kirsten Black, Mark Hanson, Danielle Mazza
Background Unhealthy lifestyle is responsible for many chronic conditions, and antenatal engagement with women about lifestyle behaviours can be too late to prevent some adverse pregnancy outcomes and subsequent childhood risks. To reduce the risk of future adverse outcomes, the interconception period is an opportunity to implement positive health changes. The aim of this scoping review was to explore
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Understanding barriers to using long-acting reversible contraceptives (LARCs) in primary care: a qualitative evidence synthesis BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Emma Linton, Rebecca Mawson, Victoria Hodges, Caroline Anne Mitchell
Background Long-acting reversible contraceptives (LARCs) are highly effective. In primary care, LARCs are prescribed less frequently than user-dependent contraceptives despite higher efficacy rates. Unplanned pregnancies are rising in the UK, and LARCs may have a role in reducing these through and redressing inequitable contraceptive access. To provide contraceptive services that offer maximal choice
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Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-10-01 Elizabeth Chloe Romanis, Jordan A Parsons
Background Telemedical early medical abortion (TEMA) was introduced in England and Wales as a temporary measure in 2020 and was made permanent in 2022. While there are considerable data showing the safety, efficacy, and acceptability of TEMA for patients, there have been objections raised to TEMA based on safeguarding—particularly for people under 18 years of age. Little is known about abortion care
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Scaling-up post-pregnancy family planning services: experiences and challenges from Afghanistan BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Rita Kabra, Paata Chikvaidze, Adela Mubasher, Komal Preet Allagh, Karima Gholbzouri, James Kiarie
In Afghanistan, modern contraceptive prevalence (mCPR) is low among women of reproductive age at 16%,1 while the unmet need for family planning (FP) is high at 25% among women of reproductive age.2 The Ministry of Public Health (MoPH) committed to increase the mCPR to 30% and reduce the unmet need to 10%, by 2030.3 The mCPR at 1 month postpartum is 6%, and at 6 months postpartum is 22%.1 One in two
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Predictors of post-vasectomy semen analysis completion BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 John Ernandez, Alexandra J Berger, Brittany D Berk, Catherine Gu, Alexander P Cole, Martin Kathrins
The 2012 American Urological Association (AUA) Vasectomy Guidelines recommended cessation of alternate forms of contraception after demonstration of azoospermia, rare non-motile sperm (RNMS), or ≤100 000 non-motile sperm on a single post-vasectomy semen analysis (PVSA) performed 8–16 weeks after vasectomy.1 Despite these criteria being less restrictive than prior practice, patient completion of PVSAs
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Intrauterine devices: a summary of new guidance BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Ashley Jefferies, Katie Boog
The Faculty of Sexual & Reproductive Healthcare (FSRH) Clinical Effectiveness Unit (CEU) has recently published an updated intrauterine device (IUD) guideline, incorporating new evidence-based recommendations alongside refreshed established guidance.1 IUDs are effective and popular long-acting reversible contraception (LARC) used by approximately 159 million users worldwide2 and by approximately 21%
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Sexual and reproductive health clinical consultations: emergency contraception BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Jayne Kavanagh, Pollyanna Cohen, Corrina Horan
Jaz, aged 28 years, works as a marketing manager for a clothing company. It is her day off and she attends the walk-in service at her local sexual health clinic on a Monday morning. She requests emergency contraception (EC). She normally uses condoms with her partner of 6 months but did not use one when she had sex last Wednesday (5 days ago). The app Jaz uses to track her period tells her that her
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Exploring and promoting the role of health visitors in postnatal contraception: a ‘test and learn’ project BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Victoria Gilroy, Katherine Louise Gilmore, Annette Thwaites
The antenatal and postnatal periods are ideal times to offer women information about contraception to support informed decision-making.1 The provision of timely advice and supported access to contraception aims to enable women to plan subsequent pregnancies and reduce unintended pregnancies and short interpregnancy intervals that are linked with poor pregnancy outcomes.2 Some 45% of pregnancies and
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Risk of thromboembolism in patients with COVID-19 who are using hormonal contraception: a Cochrane systematic review BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Katie Hansen, Megan A Cohen, Shaalini Ramanadhan, Robin Paynter, Alison Edelman, Jillian T Henderson
Background The coronavirus disease COVID-19 is associated with an increased risk of thrombotic events. Individuals with COVID-19 using hormonal contraception could be at additional risk for thromboembolism, but evidence is sparse. Methods We conducted a systematic review on the risk of thromboembolism with hormonal contraception use in women aged 15–51 years with COVID-19. We searched multiple databases
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Interest in advance provision of abortion pills: a national survey of potential users in the USA BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Klaira Lerma, Paul D Blumenthal
Objective To assess interest in clinician-administered advance provision of abortion pills among potential users in the USA. Methods Using social media advertisements, we recruited people living in the USA who were aged 18–45 years and assigned female at birth, who were not pregnant or planning pregnancy, for an online survey on reproductive health experiences and attitudes. We explored interest in
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Is contragestion the future? BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Sharon Cameron, Hang Wun Raymond Li, Kristina Gemzell-Danielsson
In the 1980s, the term ‘contragestion’ was coined by French scientists investigating progesterone receptor modulators (PRMs). Contragestion refers to a method that works after ovulation and throughout luteal phase and beyond.1 A contragestive could prevent or disrupt implantation, which may be politically controversial. On the other hand, a strategy to avoid abortion has been the concept of ‘menstrual
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Accessing abortion in a highly restrictive legal regime: characteristics of women and pregnant people in Malta self-managing their abortion through online telemedicine BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Andreana Dibben, Isabel Stabile, Rebecca Gomperts, James Kohout
Objective To examine the numbers and characteristics of women and pregnant people in Malta seeking at-home medical abortion using online telemedicine from 2017 to 2021. Design Population-based study. Setting Republic of Malta Participants Between 1 January 2017 and 31 December 2021, 1090 women and pregnant people requested at-home medical abortion through one online telemedicine provider (Women on
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Desire to Avoid Pregnancy scale: clinical considerations and comparison with other questions about pregnancy preferences BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Jennifer Anne Hall, Geraldine Barrett, Judith M Stephenson, Natalie Lois Edelman, Corinne Rocca
Background Clinicians and women of reproductive age would benefit from a reliable way to identify who is likely to become pregnant in the next year, in order to direct health advice. The 14-item Desire to Avoid Pregnancy (DAP) scale is predictive of pregnancy; this paper compares it with other ways of assessing pregnancy preferences to shortlist options for clinical implementation. Methods A cohort
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French women’s experiences and opinions with in-country versus cross-border abortion travel: a mixed-methods paper BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Laura Rahm, Silvia De Zordo, Joanna Mishtal, Giulia Zanini, Camille Garnsey, Derek Clougher, Caitlin Gerdts
Objectives This is the first study contrasting the experience of women residing in France and travelling for abortion services inside and outside their country of residence. We compare travel reasons and costs as well as our study participants’ opinions of abortion legislation. The article documents legal and procedural barriers related to accessing local and timely abortions and provides policy recommendations
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Evaluation of the psychometric properties of the Reproductive Autonomy Scale for use in the UK BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Eleanor Riches, Geraldine Barrett, Jennifer Anne Hall
Background Reproductive autonomy—control over outcomes including contraceptive use and childbearing—is a human right and vital to women’s empowerment. Those whose reproductive autonomy is threatened by the structures and relationships in their lives are at risk of coercion and unplanned pregnancy and could benefit from additional services. The Reproductive Autonomy Scale (RAS) was developed in the
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Understanding the experiences and needs of LGBTIQA+ individuals when accessing abortion care and pregnancy options counselling: a scoping review BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Sally Bowler, Kari Vallury, Ernesta Sofija
Background Safe, accessible, and inclusive abortion care and pregnancy options counselling are essential components of sexual and reproductive health and rights. Research has documented LGBTIQA+ people are as likely, or more than likely, as the general population to experience an abortion in their lifetime yet face significant barriers to accessing abortion and related care, which undermines well-being
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Integrating pre-exposure prophylaxis of HIV infection into family planning services: a scoping review BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-07-01 Caroline I Gotsche, Petrus S Steyn, Manjulaa Narasimhan, Michelle Rodolph, Rachel Baggaley, James N Kiarie
Introduction The aim of this review was to map evidence of integrating pre-exposure prophylaxis (PrEP) for HIV prevention into family planning services. A comprehensive package, using a combination of PrEP and contraceptive delivery, could reduce the number of new HIV infections and/or unintended pregnancies for at-risk women and adolescent girls. Methods A scoping literature search was conducted between
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Understanding women’s views of and preferences for accessing postpartum contraception: a qualitative evidence synthesis BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-04-01 Grace J Freeman-Spratt, Jessica R Botfield, Grace Soeun Lee, Prithi Rajiv, Kirsten I Black
Background Nearly half of women experience unintended pregnancies. These are associated with increased risk of poor maternal physical and psychosocial health outcomes. Many pregnancies in the first year postpartum are unintended, further increasing risks of poor outcomes and complications. We undertook a qualitative evidence synthesis to evaluate qualitative research on women’s views and preferences
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Words matter: perforation… or transmural migration? BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-04-01 Stephanie Irene Amaya, Andrea Henkel, Paul D Blumenthal
The intrauterine device (IUD) is a safe and highly effective form of reversible contraception, and IUD use is increasing globally.1 The paper published in this edition is a credible and comprehensive review of early postpartum IUD (PPIUD) experiences.2 In summary, the authors show that PPIUDs decrease unintended pregnancy rates and short-interval pregnancies, lessen economic burden, and are safe for
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Cross-national differences in the use of contraception and abortion services between England, Wales, and Scotland BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-04-01 Bernice Kuang, Ann Berrington
Dear Editor, Overall levels of childbearing are significantly higher in England and Wales (total fertility rate of 1.62 and 1.49, respectively, in 2021) than in Scotland (1.31), but few studies have investigated the role of abortion or contraception as proximate determinants of fertility, leaving a key gap in knowledge. This is largely due to a paucity of continuously collected comparable data, since
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Utilisation, effectiveness, and safety of immediate postpartum intrauterine device insertion: a systematic literature review BMJ Sexual & Reproductive Health (IF 3.3) Pub Date : 2023-04-01 Kristina Rosa Bolling, Yesmean Wahdan, Neal Warnock, Jason Lott, Juliane Schoendorf, Federica Pisa, Evelyn Gomez-Espinosa, Kristin Kistler, Brett Maiese
Background Intrauterine devices (IUDs) are highly effective contraception. IUDs inserted directly following delivery provide immediate birth control and may decrease unintended pregnancies, including short-interval pregnancies, thereby mitigating health risks and associated economic burden. Methods This systematic literature review included published global data on the utilisation, effectiveness, and