Reproductive Health最新文献

Background: Sexual and reproductive health (SRH) is essential for public health. COVID-19 led to major disruptions in the provision of essential services including SRH services. Within the context of a multi-country project, this study aimed to explore individual and service-level impacts on contraceptive and sexual health services during the COVID-19 pandemic and recovery phase in England.

Methods: A longitudinal, mixed-methods design was implemented, collecting data in two phases, approximately 9 months apart (November 2021 and July 2022). The study comprised in-depth interviews with staff (n = 4) and clients (n = 20) of a sexual health and contraceptive clinical service in the Southeast of England. Over the same timeframe, a quantitative service availability and readiness assessment (SARA) was completed, based on World Health Organization validated tools.

Results: Sexual health and contraceptive services continued to operate throughout the pandemic, however measures taken to prevent COVID-19 transmission and staff capacity issues (due to staff redeployment, staff sickness) impacted on patient choice (e.g. how the service could be accessed, methods of contraception available) and patient experience (e.g. delays in accessing healthcare). Despite disruptions, staff described how in-person provision remained available almost continuously for urgent/vulnerable cases. SARA data confirmed service availability, and qualitative data indicate how this was managed. For example, postal home self-sampling for STIs/HIV was expanded and contraceptive counselling by telephone was introduced to reduce clinic visits, and was retained due to popularity. At Time 2, services were running close to normal.

Conclusions: COVID-19 disrupted sexual health and contraceptive services in England. Compared to pre-pandemic, more elements of these services were delivered remotely. Readiness to adapt was aided by the pre-pandemic direction-of-travel towards greater use of digital and telemedicine services. Innovations require robust evaluation to ensure optimisation for public health benefit both in the pandemic and post-pandemic context.

Background: Adolescence is a formative period in which self-concept and sexual identity are developed. Unintended teenage pregnancies represent a sensitive and stigmatized issue, often associated with major psychosocial challenges. The aim of this study is to explore the lived experiences of women with unintended teenage pregnancies in Germany, with a particular focus on adverse childhood experiences (ACE) and Teen Dating Violence (TDV).

Methods: The analysis is based on five biographical narrative interviews conducted within the ELSA project (November 2020-April 2024), which aimed to investigate how unintended pregnancies are managed and to identify needs for counseling and care. Using the documentary method, we reconstructed the meaning of communicative and conjunctive knowledge in adolescents' narratives and compared these orientations across four comparative dimensions: childhood biography, handling of the unintended pregnancy, construction of intimate relationships, and construction of minority.

Results: Two contrasting orientation types were reconstructed across the dimensions, shaped by how adolescents processed external framings. Type 1 (subordinated, resigned orientation) was characterized by communicative deficit narratives and conjunctive patterns of resignation, dependency, and restricted agency. Type 2 (reflexive, pro-active orientation) demonstrated communicative acknowledgment of burdens but conjunctive practices of resilience, negotiation, and self-assertion. Unintended pregnancies were frequently constructed as existential crises, in which personal needs and emotions were suppressed. Minority status intensifies these challenges, while ACE -related patterns of behavior were reproduced in the context of pregnancy and intimate relationships.

Conclusions: The study provides valuable insights into the complex realities and decision-making processes of female adolescents with unintended pregnancies. The findings highlight the need for specific support services that strengthen girls' empowerment and agency in order to promote sexual and reproductive health and rights. Outdated role models that ascribe contraceptive responsibility solely to women should be replaced by gender-equitable sexual education. In addition, legal regulations and counseling services should be better aligned with the often precarious family and partnership situations of young pregnant women.

Background: Unplanned pregnancy remains a critical reproductive health and social equity issue in the United States, disproportionately affecting women of color. In the U.S. South, where cultural conservatism and restrictive reproductive policies are prevalent, these experiences are further shaped by intersecting systems of race, gender, and power. Despite extensive public health focus on prevention and behavior, limited attention has been given to how women of color in higher education interpret and navigate unplanned pregnancy within these racialized and gendered contexts. This study explores how college women of color experience unplanned pregnancy and how intersecting social dynamics influence their perceptions, emotions, and decision-making.

Methods: This qualitative study used a phenomenological design to capture the lived experiences of eleven self-identified college women of color who experienced an unplanned pregnancy while enrolled in undergraduate programs in the U.S. South. Guided by the Social-Ecological Model, semi-structured interviews were conducted via a secure video-conferencing platform. Transcripts were analyzed using Braun and Clarke's six-phase thematic analysis. Research rigor was ensured through triangulation, reflexive bracketing, and collaborative coding.

Results: Four key themes emerged: (1) Emotional and gendered burdens-participants described fear, shame, and stigma rooted in moral and gender norms; (2) Gendered contraceptive responsibility-contraception and prevention were viewed as women's duty, with minimal partner accountability; (3) Partner influence and power in pregnancy decisions-relationships often reflected unequal emotional and decision-making dynamics; and (4) Cultural and racialized expectations-religious beliefs, family reputation, and community respectability shaped silence and internal conflict. Collectively, these experiences reflected intersecting gendered and racialized pressures that limited autonomy and support.

Conclusion: Unplanned pregnancy among college women of color in the U.S. South is shaped by intertwined gendered and racialized burdens that constrain reproductive agency. These findings highlight the need for universities to implement culturally responsive, equity-centered reproductive health policies and support services that actively address stigma, power imbalances, and structural barriers affecting pregnant students.