Pub Date : 2026-01-01Epub Date: 2025-10-03DOI: 10.1016/j.contraception.2025.111245
Alexandra Wollum , Symone Harmon , Terri-Ann Thompson
Objective
Young people face greater barriers to accessing abortion care than adults including parental involvement laws which require those without parental/guardian notification or consent to seek judicial bypass. This study sought to assess whether the implementation of remote judicial bypass hearings was associated with an increase in access to judicial bypass.
Study design
We conducted a retrospective observational study comparing a county that implemented remote judicial bypass hearings (“treatment county”) to a county in the same state that maintained in-person judicial bypass hearings (“control county”). We examined the number of judicial bypass clients who lived in or sought abortion care in the two study counties from July 2018 to April 2023. The judicial bypass clients were all represented by one of two legal organizations. We used a difference in differences approach to model monthly judicial bypass clients.
Results
We estimated a higher number of judicial bypass requests in the county that implemented remote judicial bypass after its implementation in March 2020. The change in the number of judicial bypass requests from before to after the implementation of remote judicial bypass in the treatment county was 2.8 times the change in the control county (95% CI: 1.9–4.2, p < 0.001). In the control county, there was a 46% decrease (95% CI: 31–58%) from before to after the implementation of remote judicial bypass compared to a 53% increase in the treatment county (95% CI: 13–107%).
Conclusion
Offering remote judicial bypass for minors seeking abortion may expand access to judicial bypass hearings.
Implications
Remote judicial bypass hearings may be able to facilitate greater access to legal procedures for minors seeking abortion care.
{"title":"Do remote judicial bypass hearings increase access for minors seeking abortion care?: A quasi-experimental study, 2018–2023","authors":"Alexandra Wollum , Symone Harmon , Terri-Ann Thompson","doi":"10.1016/j.contraception.2025.111245","DOIUrl":"10.1016/j.contraception.2025.111245","url":null,"abstract":"<div><h3>Objective</h3><div>Young people face greater barriers to accessing abortion care than adults including parental involvement laws which require those without parental/guardian notification or consent to seek judicial bypass. This study sought to assess whether the implementation of remote judicial bypass hearings was associated with an increase in access to judicial bypass.</div></div><div><h3>Study design</h3><div>We conducted a retrospective observational study comparing a county that implemented remote judicial bypass hearings (“treatment county”) to a county in the same state that maintained in-person judicial bypass hearings (“control county”). We examined the number of judicial bypass clients who lived in or sought abortion care in the two study counties from July 2018 to April 2023. The judicial bypass clients were all represented by one of two legal organizations. We used a difference in differences approach to model monthly judicial bypass clients.</div></div><div><h3>Results</h3><div>We estimated a higher number of judicial bypass requests in the county that implemented remote judicial bypass after its implementation in March 2020. The change in the number of judicial bypass requests from before to after the implementation of remote judicial bypass in the treatment county was 2.8 times the change in the control county (95% CI: 1.9–4.2, <em>p</em> < 0.001). In the control county, there was a 46% decrease (95% CI: 31–58%) from before to after the implementation of remote judicial bypass compared to a 53% increase in the treatment county (95% CI: 13–107%).</div></div><div><h3>Conclusion</h3><div>Offering remote judicial bypass for minors seeking abortion may expand access to judicial bypass hearings.</div></div><div><h3>Implications</h3><div>Remote judicial bypass hearings may be able to facilitate greater access to legal procedures for minors seeking abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111245"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-10DOI: 10.1016/j.contraception.2025.111255
Brandon Wagner , Jennifer Huh
Objectives
To describe retail sales of over-the-counter (OTC) birth control pills (BCP) in their first year on the market in the U.S.
Study design
We estimate OTC BCP pill sales using retail scan data aggregating grocery stores, drug stores, mass merchandisers, club stores, dollar stores, military outlets, and convenience stores.
Results
Despite initial increase, sales of OTC BCP have been relatively static in 2025, with approximately 4700 3-month packs and 17,000 1-month packs sold per week.
Conclusions
Limited sales suggest challenges to broader adoption of OTC BCP for those at risk of pregnancy in the U.S.
{"title":"One year of Opill: Retail sales of over-the-counter birth control pills in the United States","authors":"Brandon Wagner , Jennifer Huh","doi":"10.1016/j.contraception.2025.111255","DOIUrl":"10.1016/j.contraception.2025.111255","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe retail sales of over-the-counter (OTC) birth control pills (BCP) in their first year on the market in the U.S.</div></div><div><h3>Study design</h3><div>We estimate OTC BCP pill sales using retail scan data aggregating grocery stores, drug stores, mass merchandisers, club stores, dollar stores, military outlets, and convenience stores.</div></div><div><h3>Results</h3><div>Despite initial increase, sales of OTC BCP have been relatively static in 2025, with approximately 4700 3-month packs and 17,000 1-month packs sold per week.</div></div><div><h3>Conclusions</h3><div>Limited sales suggest challenges to broader adoption of OTC BCP for those at risk of pregnancy in the U.S.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111255"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-09-24DOI: 10.1016/j.contraception.2025.111237
Suzanne Veldhuis , Hazal Atay , Marcela Trocha , Weronika Majek , Jennifer R. Fishman
Objective
Advance provision of medication abortion involves providing abortion pills before pregnancy. This study describes motivations, feelings, and opinions related to advance provision in Poland.
Study design
This exploratory study analyzed 648 advance provision consultations and follow-up surveys (response rates: survey 1 = 36.4%, survey 2 =17.2%) received by Women on Web from Poland in 2022–2023.
Results
Common motivations included legal restrictions, limited access to pills, and the comfort of at-home abortion. Three overarching themes emerged: avoiding access problems; gaining peace of mind, control, safety, and security; and community use.
Conclusions
Our results suggest that advance provision can enhance autonomy and well-being in abortion care.
{"title":"“Now that I have pills at home, I feel less trapped”: Advance provision of abortion pills in Poland","authors":"Suzanne Veldhuis , Hazal Atay , Marcela Trocha , Weronika Majek , Jennifer R. Fishman","doi":"10.1016/j.contraception.2025.111237","DOIUrl":"10.1016/j.contraception.2025.111237","url":null,"abstract":"<div><h3>Objective</h3><div>Advance provision of medication abortion involves providing abortion pills before pregnancy. This study describes motivations, feelings, and opinions related to advance provision in Poland.</div></div><div><h3>Study design</h3><div>This exploratory study analyzed 648 advance provision consultations and follow-up surveys (response rates: survey 1 = 36.4%, survey 2 =17.2%) received by Women on Web from Poland in 2022–2023.</div></div><div><h3>Results</h3><div>Common motivations included legal restrictions, limited access to pills, and the comfort of at-home abortion. Three overarching themes emerged: avoiding access problems; gaining peace of mind, control, safety, and security; and community use.</div></div><div><h3>Conclusions</h3><div>Our results suggest that advance provision can enhance autonomy and well-being in abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111237"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-09DOI: 10.1016/j.contraception.2025.111251
Pauline De Corte, Moritz Klinghardt, Anja Bauerfeind , Tanja Boehnke, Klaas Heinemann
Objective
We assessed the risk of venous thromboembolism (VTE) risk of chlormadinone acetate (CMA) 2 mg/ethinylestradiol (EE) 30 µg as opposed to levonorgestrel (LNG) 0.15 mg/EE 30 µg.
Study design
We pooled data from four comparable, large, observational studies in a dataset comprising new users of combined oral contraceptives (COC). Individuals with a personal history of VTE were excluded. Incidence rates of confirmed VTE were summarized. Cox models were performed to calculate crude and adjusted hazard ratios (HRs).
Results
We identified 31,379 COC users exposed to either CMA 2 mg/EE 30 µg or LNG 0.15 mg/EE 30 µg, contributing to 59,167 women-years. Sixty VTE were reported. VTE incidence rates were comparable between CMA- and LNG-cohorts (9.8/10,000 woman-years [WY]; 95% confidence interval [CI]: 6.36–14.50 vs. 10.38/10,000 WY; 95% CI: 7.23–14.44, respectively). The HR was 1.25 (95% CI: 0.72–2.14) after adjusting for age, BMI, family history of VTE and current duration of use.
Conclusion
Within the general limitations of observational research, we conclude that this study and its contributing studies provide a robust basis to compare the risk of VTE in users of CMA 2 mg/EE 30 µg to those of LNG 0.15 mg/EE 30 µg. While we found an HR > 1 for CMA 2 mg/EE 30 µg compared to LNG 0.15 mg/EE 30 µg, the increase was non-significant, and the absolute risk increase remained small and in line with previous studies.
Implications
No significant differences were found regarding the risk of VTE between users of CMA- and LNG-containing COCs. Incidence rates of VTE were in line with previous findings of VTE incidences across various COCs.
{"title":"Risk of venous thromboembolism associated with chlormadinone acetate- and levonorgestrel-containing combined oral contraceptives – Insights from the retrospective RIVET-RCS study","authors":"Pauline De Corte, Moritz Klinghardt, Anja Bauerfeind , Tanja Boehnke, Klaas Heinemann","doi":"10.1016/j.contraception.2025.111251","DOIUrl":"10.1016/j.contraception.2025.111251","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed the risk of venous thromboembolism (VTE) risk of chlormadinone acetate (CMA) 2 mg/ethinylestradiol (EE) 30 µg as opposed to levonorgestrel (LNG) 0.15 mg/EE 30 µg.</div></div><div><h3>Study design</h3><div>We pooled data from four comparable, large, observational studies in a dataset comprising new users of combined oral contraceptives (COC). Individuals with a personal history of VTE were excluded. Incidence rates of confirmed VTE were summarized. Cox models were performed to calculate crude and adjusted hazard ratios (HRs).</div></div><div><h3>Results</h3><div>We identified 31,379 COC users exposed to either CMA 2 mg/EE 30 µg or LNG 0.15 mg/EE 30 µg, contributing to 59,167 women-years. Sixty VTE were reported. VTE incidence rates were comparable between CMA- and LNG-cohorts (9.8/10,000 woman-years [WY]; 95% confidence interval [CI]: 6.36–14.50 vs. 10.38/10,000 WY; 95% CI: 7.23–14.44, respectively). The HR was 1.25 (95% CI: 0.72–2.14) after adjusting for age, BMI, family history of VTE and current duration of use.</div></div><div><h3>Conclusion</h3><div>Within the general limitations of observational research, we conclude that this study and its contributing studies provide a robust basis to compare the risk of VTE in users of CMA 2 mg/EE 30 µg to those of LNG 0.15 mg/EE 30 µg. While we found an HR > 1 for CMA 2 mg/EE 30 µg compared to LNG 0.15 mg/EE 30 µg, the increase was non-significant, and the absolute risk increase remained small and in line with previous studies.</div></div><div><h3>Implications</h3><div>No significant differences were found regarding the risk of VTE between users of CMA- and LNG-containing COCs. Incidence rates of VTE were in line with previous findings of VTE incidences across various COCs.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111251"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-01DOI: 10.1016/j.contraception.2025.111244
Amanda Nagle , Anitra Beasley , Klaira Lerma , Gracia Sierra , Gabriela Alvarez Pérez , Daniel Grossman , Kari White
Objective
In September 2021, Texas implemented Senate Bill 8 (SB8)- a law prohibiting abortion after detection of embryonic cardiac activity and was poised to ban all abortions with few exemptions if the US Supreme Court ended federal protections for abortion. Given restricted options for in-state facility-based care, we evaluated pregnant Texans’ preferences for other strategies to obtain abortion care and assessed social and economic factors associated with their interest.
Study Design
In June and July 2022, we recruited Texans ≥ 18 years of age attending the mandatory consultation and ultrasound visit at 8 in-state facilities for a survey about their interest in strategies to obtain an abortion if they could not do so in Texas. We asked about five strategies: out-of-state facility-based care; abortion on a ship off Texas’ coast; asynchronous non-US-based telehealth; synchronous US-based telehealth; or use of misoprostol from Mexico. We used 3-step latent class analysis to identify clusters (or classes) of abortion seekers with similar preferences and multinomial regression analysis to assess the relationship between resource constraints and class membership.
Results
Among 293 respondents with complete information, we identified four classes: amenable to most strategies (n = 209), amenable to in-person strategies (n = 39), amenable to at-home strategies (n = 20), and few strategies acceptable (n = 25). Class membership was related to care preferences, access to a reliable car, and concern about the legality and safety of abortion pills obtained online.
Conclusions
Most respondents were interested in all strategies, while those with transportation barriers and abortion modality concerns found fewer strategies acceptable.
Implications
Most Texans seeking abortion were interested in a variety of in-person and virtual strategies for obtaining abortion if they could not do so in Texas. Information about the safety and legality of options for abortion care and about financial and logistical-support resources could improve accessibility for those facing greater constraints.
{"title":"Preferred strategies for obtaining abortion care among pregnant Texans: A latent class analysis","authors":"Amanda Nagle , Anitra Beasley , Klaira Lerma , Gracia Sierra , Gabriela Alvarez Pérez , Daniel Grossman , Kari White","doi":"10.1016/j.contraception.2025.111244","DOIUrl":"10.1016/j.contraception.2025.111244","url":null,"abstract":"<div><h3>Objective</h3><div>In September 2021, Texas implemented Senate Bill 8 (SB8)- a law prohibiting abortion after detection of embryonic cardiac activity and was poised to ban all abortions with few exemptions if the US Supreme Court ended federal protections for abortion. Given restricted options for in-state facility-based care, we evaluated pregnant Texans’ preferences for other strategies to obtain abortion care and assessed social and economic factors associated with their interest.</div></div><div><h3>Study Design</h3><div>In June and July 2022, we recruited Texans ≥ 18 years of age attending the mandatory consultation and ultrasound visit at 8 in-state facilities for a survey about their interest in strategies to obtain an abortion if they could not do so in Texas. We asked about five strategies: out-of-state facility-based care; abortion on a ship off Texas’ coast; asynchronous non-US-based telehealth; synchronous US-based telehealth; or use of misoprostol from Mexico. We used 3-step latent class analysis to identify clusters (or classes) of abortion seekers with similar preferences and multinomial regression analysis to assess the relationship between resource constraints and class membership.</div></div><div><h3>Results</h3><div>Among 293 respondents with complete information, we identified four classes: <em>amenable to most strategies</em> (n = 209), <em>amenable to in-person strategies</em> (n = 39), <em>amenable to at-home strategies</em> (n = 20), and <em>few strategies acceptable</em> (n = 25). Class membership was related to care preferences, access to a reliable car, and concern about the legality and safety of abortion pills obtained online.</div></div><div><h3>Conclusions</h3><div>Most respondents were interested in all strategies, while those with transportation barriers and abortion modality concerns found fewer strategies acceptable.</div></div><div><h3>Implications</h3><div>Most Texans seeking abortion were interested in a variety of in-person and virtual strategies for obtaining abortion if they could not do so in Texas. Information about the safety and legality of options for abortion care and about financial and logistical-support resources could improve accessibility for those facing greater constraints.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111244"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-09-28DOI: 10.1016/j.contraception.2025.111240
Meesha Vullikanti , Adriana N. Vélez-Avilés , Sara Neill , Rose L. Molina
Objective
To assess differences in U.S.-based abortion fund messaging on social media in English and Spanish. Abortion funds are private philanthropic organizations that provide abortion seekers with direct funding and logistical support for abortion care.
Study design
This multi-methods study applied linguistic and content analysis of social media posts from the 95 abortion funds affiliated with the National Network of Abortion Funds (NNAF) between June 24, 2022 and January 1, 2025. All social media posts underwent large-scale linguistic analysis. All Spanish posts and a random sampling of 10% of English posts were selected for qualitative thematic analysis.
Results
Of 10,118 total posts, only three languages were represented: 10,051 posts were in English (>99%), 66 posts (<1%) were in Spanish, and one post was in Portuguese. Fifty-five percent of English posts include content about sexual health and well-being compared to 13% of Spanish posts. English posts described abortion sociopolitical landscapes, while Spanish posts described access to abortion services. Many Spanish posts included poorly translated or culturally miscontextualized phrases.
Conclusions
Most abortion funds published posts in English only, and messaging varied by language and included low-quality translations. Future work should explore hidden assumptions and strategies behind these differences.
Implications
Private abortion funds are an essential player in the abortion access landscape and must make efforts to provide culturally responsive, accurate information about abortion in as many language as is feasible based on the linguistic diversity of the surrounding communities.
{"title":"Differences in abortion fund messaging in English and Spanish: A social media analysis","authors":"Meesha Vullikanti , Adriana N. Vélez-Avilés , Sara Neill , Rose L. Molina","doi":"10.1016/j.contraception.2025.111240","DOIUrl":"10.1016/j.contraception.2025.111240","url":null,"abstract":"<div><h3>Objective</h3><div>To assess differences in U.S.-based abortion fund messaging on social media in English and Spanish. Abortion funds are private philanthropic organizations that provide abortion seekers with direct funding and logistical support for abortion care.</div></div><div><h3>Study design</h3><div>This multi-methods study applied linguistic and content analysis of social media posts from the 95 abortion funds affiliated with the National Network of Abortion Funds (NNAF) between June 24, 2022 and January 1, 2025. All social media posts underwent large-scale linguistic analysis. All Spanish posts and a random sampling of 10% of English posts were selected for qualitative thematic analysis.</div></div><div><h3>Results</h3><div>Of 10,118 total posts, only three languages were represented: 10,051 posts were in English (>99%), 66 posts (<1%) were in Spanish, and one post was in Portuguese. Fifty-five percent of English posts include content about sexual health and well-being compared to 13% of Spanish posts. English posts described abortion sociopolitical landscapes, while Spanish posts described access to abortion services. Many Spanish posts included poorly translated or culturally miscontextualized phrases.</div></div><div><h3>Conclusions</h3><div>Most abortion funds published posts in English only, and messaging varied by language and included low-quality translations. Future work should explore hidden assumptions and strategies behind these differences.</div></div><div><h3>Implications</h3><div>Private abortion funds are an essential player in the abortion access landscape and must make efforts to provide culturally responsive, accurate information about abortion in as many language as is feasible based on the linguistic diversity of the surrounding communities.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111240"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-09-20DOI: 10.1016/j.contraception.2025.111231
Rana Barar , Ruvani Jayaweera
Objective
The purpose of this Research Practice Support is to provide an overview of basic concepts and a starting place for implementing different aspects of community-engaged research approaches, and share lessons learned, best practices, and resources from the community of academic sexual and reproductive health researchers. Our goal is to aid researchers who have not yet conducted research in a community-engaged way, as well as help researchers who have some experience with community engagement find a way to deepen their practice.
Study design
The principles and examples included in this paper are drawn from the expertise of the community of academic sexual and reproductive health researchers in the Research Implementation Special Interest Group within the Society of Family Planning.
Results
In this Research Practice Support, we present a model of a continuum of community engagement, from less engaged to full shared leadership. This Research Practice Support highlights key lessons including: tensions between academic and community priorities, the need for transparency and trust-building, the value of humility and compromise, and the resource- and time-intensive nature of meaningful engagement. Best practices include setting clear expectations, acknowledging power dynamics, involving community partners in decision-making, and budgeting appropriately for engagement.
Conclusion
Ultimately, responsible community-engaged research requires structural support from institutions and funders to overcome barriers to equitable participation.
{"title":"Society of Family Planning Research Practice Support: Implementation strategies and considerations for conducting community-engaged sexual and reproductive health research","authors":"Rana Barar , Ruvani Jayaweera","doi":"10.1016/j.contraception.2025.111231","DOIUrl":"10.1016/j.contraception.2025.111231","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this Research Practice Support is to provide an overview of basic concepts and a starting place for implementing different aspects of community-engaged research approaches, and share lessons learned, best practices, and resources from the community of academic sexual and reproductive health researchers. Our goal is to aid researchers who have not yet conducted research in a community-engaged way, as well as help researchers who have some experience with community engagement find a way to deepen their practice.</div></div><div><h3>Study design</h3><div>The principles and examples included in this paper are drawn from the expertise of the community of academic sexual and reproductive health researchers in the Research Implementation Special Interest Group within the Society of Family Planning.</div></div><div><h3>Results</h3><div>In this Research Practice Support, we present a model of a continuum of community engagement, from less engaged to full shared leadership. This Research Practice Support highlights key lessons including: tensions between academic and community priorities, the need for transparency and trust-building, the value of humility and compromise, and the resource- and time-intensive nature of meaningful engagement. Best practices include setting clear expectations, acknowledging power dynamics, involving community partners in decision-making, and budgeting appropriately for engagement.</div></div><div><h3>Conclusion</h3><div>Ultimately, responsible community-engaged research requires structural support from institutions and funders to overcome barriers to equitable participation.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111231"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-02DOI: 10.1016/j.contraception.2025.111243
Erin Pearson , Jamie Menzel , Bunsoth Mao , Caesar Agula , Samuel Antobam , Elisabeth Eckersberger , Ayaga Bawah , Vonthanak Saphonn , Nathalie Kapp
Objective
To understand differences in post-abortion contraceptive use between women accessing medication abortion (MA) in pharmacies compared to clinics.
Study design
We conducted secondary analysis of data from two non-randomized non-inferiority trials that compared MA outcomes for pharmacy and clinic clients in Cambodia (2018–2019) and Ghana (2019–2021). A total of 3791 MA clients (clinic: n = 1966, pharmacy: n = 1825) were recruited from 60 urban sites (24 clinics, 36 pharmacies). We used Poisson models to assess differences in post-abortion contraceptive use between pharmacy and clinic clients and mediation analyses to explore the mechanisms through which MA purchase location influences post-abortion contraceptive outcomes.
Results
Contraceptive use 30 days post-abortion was reported by approximately half of clinic clients (Cambodia: 51.9%; Ghana 41.3%) and somewhat fewer pharmacy clients (Cambodia: 43.0%; Ghana: 27.0%), but this difference was not statistically significant (Cambodia: adjusted risk difference [aRD] = −6.6%; 95% CI: −16.4% to 3.3%; Ghana: aRD = −10.1%; 95% CI: −23.4% to 3.2%). Though overall post-abortion contraceptive use was comparable, pharmacy clients used less effective contraceptive methods than clinic clients. Offer of contraceptive information and methods at the point of MA purchase were significantly higher in clinics, and mediation analyses demonstrated that this explained differences in post-abortion contraceptive outcomes between pharmacy and clinic clients.
Conclusions
Use of more effective post-abortion contraceptive methods may be facilitated by offering contraceptive information and methods in pharmacies at the point of MA purchase, but further research and monitoring is required to ensure that these interventions are client-centered and not coercive.
Implications
Greater access to contraceptive information and methods in pharmacies at the point of MA purchase may facilitate use of effective post-abortion contraceptive methods for those self-managing their abortions via pharmacy purchase of MA.
{"title":"Post-abortion contraceptive use among women purchasing medication abortion from pharmacies vs. clinics: Evidence from Cambodia and Ghana","authors":"Erin Pearson , Jamie Menzel , Bunsoth Mao , Caesar Agula , Samuel Antobam , Elisabeth Eckersberger , Ayaga Bawah , Vonthanak Saphonn , Nathalie Kapp","doi":"10.1016/j.contraception.2025.111243","DOIUrl":"10.1016/j.contraception.2025.111243","url":null,"abstract":"<div><h3>Objective</h3><div>To understand differences in post-abortion contraceptive use between women accessing medication abortion (MA) in pharmacies compared to clinics.</div></div><div><h3>Study design</h3><div>We conducted secondary analysis of data from two non-randomized non-inferiority trials that compared MA outcomes for pharmacy and clinic clients in Cambodia (2018–2019) and Ghana (2019–2021). A total of 3791 MA clients (clinic: <em>n</em> = 1966, pharmacy: <em>n</em> = 1825) were recruited from 60 urban sites (24 clinics, 36 pharmacies). We used Poisson models to assess differences in post-abortion contraceptive use between pharmacy and clinic clients and mediation analyses to explore the mechanisms through which MA purchase location influences post-abortion contraceptive outcomes.</div></div><div><h3>Results</h3><div>Contraceptive use 30 days post-abortion was reported by approximately half of clinic clients (Cambodia: 51.9%; Ghana 41.3%) and somewhat fewer pharmacy clients (Cambodia: 43.0%; Ghana: 27.0%), but this difference was not statistically significant (Cambodia: adjusted risk difference [aRD] = −6.6%; 95% CI: −16.4% to 3.3%; Ghana: aRD = −10.1%; 95% CI: −23.4% to 3.2%). Though overall post-abortion contraceptive use was comparable, pharmacy clients used less effective contraceptive methods than clinic clients. Offer of contraceptive information and methods at the point of MA purchase were significantly higher in clinics, and mediation analyses demonstrated that this explained differences in post-abortion contraceptive outcomes between pharmacy and clinic clients.</div></div><div><h3>Conclusions</h3><div>Use of more effective post-abortion contraceptive methods may be facilitated by offering contraceptive information and methods in pharmacies at the point of MA purchase, but further research and monitoring is required to ensure that these interventions are client-centered and not coercive.</div></div><div><h3>Implications</h3><div>Greater access to contraceptive information and methods in pharmacies at the point of MA purchase may facilitate use of effective post-abortion contraceptive methods for those self-managing their abortions via pharmacy purchase of MA.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111243"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-09-12DOI: 10.1016/j.contraception.2025.111210
Sarah J. Pogge , Alice Y. Cai , Amelia Llerena , Megan L. Young , William S. Havron IV , Sarah Horvath , Cheryl Godcharles , Nikki Zite , Rachel Flink-Bochacki
Objectives
To compare the volume of female permanent contraceptive procedures before and after the Supreme Court Dobbs decision, and to assess the impact of political factors on patient decision-making.
Study design
We conducted a multicenter retrospective study of interval permanent female contraceptive procedures at four academic medical centers in New York, Pennsylvania, Florida, and Tennessee, comparing a pre-Dobbs (July 1, 2021–June 30, 2022) and post-Dobbs cohort (July 1, 2022–June 30, 2023). The primary outcome was a change in procedure volume, with secondary outcomes including differences in patient characteristics and decision-making. We performed descriptive statistics, Student t tests, and χ2 tests in Stata SE.
Results
There were 445 procedures in the year pre-Dobbs and 674 in the year post-Dobbs. Total average monthly procedure volume increased (mean 9.3 to 14.0, p < 0.001), with individual institution increases ranging from 28-129%. Patients post-Dobbs were more often under age 30 (37.0% vs 30.3%, p = 0.024) and nulliparous (21.2% vs 10.2%, p < 0.001). Decision-making documentation was recorded for 96 post-Dobbs patients in New York and Pennsylvania and was similar between sites, with one-fifth of patients considering future access to permanent contraception, reversible contraception, and abortion in their decisions. At both sites, 47% of patients said their decision was somewhat or very related to current political events.
Conclusions
There was an increase in permanent female contraception in the year post-Dobbs at four academic medical centers with different state abortion policies, particularly in younger and nulliparous patients. Fear of losing access to future reproductive options is integrated into reproductive decision-making, illustrating the wide-reaching impact of political interference in patient autonomy.
Implications
Patients are increasingly seeking permanent contraception following the Dobbs decision, countering pronatalist policies by preventing any possibility of future childbearing. Residing in an abortion-protective state does not prevent the fear that arises from legislative control over reproductive health decisions, which threatens reproductive justice and patient autonomy.
{"title":"Changes in female permanent contraception at academic medical centers following the Dobbs decision","authors":"Sarah J. Pogge , Alice Y. Cai , Amelia Llerena , Megan L. Young , William S. Havron IV , Sarah Horvath , Cheryl Godcharles , Nikki Zite , Rachel Flink-Bochacki","doi":"10.1016/j.contraception.2025.111210","DOIUrl":"10.1016/j.contraception.2025.111210","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the volume of female permanent contraceptive procedures before and after the Supreme Court <em>Dobbs</em> decision, and to assess the impact of political factors on patient decision-making.</div></div><div><h3>Study design</h3><div>We conducted a multicenter retrospective study of interval permanent female contraceptive procedures at four academic medical centers in New York, Pennsylvania, Florida, and Tennessee, comparing a pre-<em>Dobbs</em> (July 1, 2021–June 30, 2022) and post-<em>Dobbs</em> cohort (July 1, 2022–June 30, 2023). The primary outcome was a change in procedure volume, with secondary outcomes including differences in patient characteristics and decision-making. We performed descriptive statistics, Student <em>t</em> tests, and χ<sup>2</sup> tests in Stata SE.</div></div><div><h3>Results</h3><div>There were 445 procedures in the year pre-<em>Dobbs</em> and 674 in the year post-<em>Dobbs</em>. Total average monthly procedure volume increased (mean 9.3 to 14.0, <em>p</em> < 0.001), with individual institution increases ranging from 28-129%. Patients post-<em>Dobbs</em> were more often under age 30 (37.0% vs 30.3%, <em>p</em> = 0.024) and nulliparous (21.2% vs 10.2%, <em>p</em> < 0.001). Decision-making documentation was recorded for 96 post-<em>Dobbs</em> patients in New York and Pennsylvania and was similar between sites, with one-fifth of patients considering future access to permanent contraception, reversible contraception, and abortion in their decisions. At both sites, 47% of patients said their decision was somewhat or very related to current political events.</div></div><div><h3>Conclusions</h3><div>There was an increase in permanent female contraception in the year post-<em>Dobbs</em> at four academic medical centers with different state abortion policies, particularly in younger and nulliparous patients. Fear of losing access to future reproductive options is integrated into reproductive decision-making, illustrating the wide-reaching impact of political interference in patient autonomy.</div></div><div><h3>Implications</h3><div>Patients are increasingly seeking permanent contraception following the <em>Dobbs</em> decision, countering pronatalist policies by preventing any possibility of future childbearing. Residing in an abortion-protective state does not prevent the fear that arises from legislative control over reproductive health decisions, which threatens reproductive justice and patient autonomy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111210"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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