M Ruggles, BT Edmonds, J Peipert, R Evans, M Fernandez, K Wendholt, SS Bhamidipalli, TA Wilkinson, C Bernard
{"title":"CHANGES IN CONTRACEPTIVE METHOD CHOICES FOLLOWING DOBBS IN A STATEWIDE CONTRACEPTIVE ACCESS INITIATIVE: PATH4YOU","authors":"M Ruggles, BT Edmonds, J Peipert, R Evans, M Fernandez, K Wendholt, SS Bhamidipalli, TA Wilkinson, C Bernard","doi":"10.1016/j.contraception.2024.110645","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>The <em>Dobbs v Jackson Women’s Health Organization</em> decision significantly impacted abortion access, and Indiana was the first state to legislate an abortion ban in August 2022. The objective of this study was to evaluate changes in contraceptive method choice among participants using our statewide contraceptive access initiative, PATH4YOU. Our hypothesis was that more people would choose contraceptive methods with higher effectiveness due to concern for lack of abortion access in case of unintended pregnancy.</div></div><div><h3>Methods</h3><div>We analyzed programmatic data of 1,224 reproductive-aged people receiving care through PATH4YOU from September 2021 to September 2023, including 178 pre-<em>Dobbs</em> and 1,034 post-<em>Dobbs</em>. All participants received pregnancy intention screening, comprehensive contraceptive counseling/decision support, and same-day, free reversible method access. We analyzed the study population via age and zip code, including the social deprivation index (SDI), and the method mix before and after the <em>Dobbs</em> decision.</div></div><div><h3>Results</h3><div>The average age of participants was 28 years; 77% received care in-person, 23% via telehealth. Based on zip code, 88% were urban and were evenly split among the SDI quartiles (22% in the most vs 26% in the least deprived quartiles). Overall, participants chose 35% LARC, 31% pill/patch/ring, 12% injectable, 3% barrier/EC, and 11% other/none. After the <em>Dobbs</em> decision, significantly more participants chose more effective methods, including LARC (37% vs 24%, <em>p<0.001</em>) and injectables (13% vs 5%, <em>p=0.003</em>), while fewer chose pill/patch/ring (29% vs 41%, <em>p=0.03</em>).</div></div><div><h3>Conclusions</h3><div>The <em>Dobbs</em> decision and concerns about abortion access appear to have influenced contraceptive method choice for participants in PATH4YOU.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contraception","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0010782424003408","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
The Dobbs v Jackson Women’s Health Organization decision significantly impacted abortion access, and Indiana was the first state to legislate an abortion ban in August 2022. The objective of this study was to evaluate changes in contraceptive method choice among participants using our statewide contraceptive access initiative, PATH4YOU. Our hypothesis was that more people would choose contraceptive methods with higher effectiveness due to concern for lack of abortion access in case of unintended pregnancy.
Methods
We analyzed programmatic data of 1,224 reproductive-aged people receiving care through PATH4YOU from September 2021 to September 2023, including 178 pre-Dobbs and 1,034 post-Dobbs. All participants received pregnancy intention screening, comprehensive contraceptive counseling/decision support, and same-day, free reversible method access. We analyzed the study population via age and zip code, including the social deprivation index (SDI), and the method mix before and after the Dobbs decision.
Results
The average age of participants was 28 years; 77% received care in-person, 23% via telehealth. Based on zip code, 88% were urban and were evenly split among the SDI quartiles (22% in the most vs 26% in the least deprived quartiles). Overall, participants chose 35% LARC, 31% pill/patch/ring, 12% injectable, 3% barrier/EC, and 11% other/none. After the Dobbs decision, significantly more participants chose more effective methods, including LARC (37% vs 24%, p<0.001) and injectables (13% vs 5%, p=0.003), while fewer chose pill/patch/ring (29% vs 41%, p=0.03).
Conclusions
The Dobbs decision and concerns about abortion access appear to have influenced contraceptive method choice for participants in PATH4YOU.
期刊介绍：
Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.
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