Sexual and Reproductive Health Matters最新文献

Testimonies of abortion experiences are largely silenced in many contexts around the world, including Poland, and stigma affects how abortion is represented. Pro-choice initiatives, which support abortion rights, aim to challenge stigma through the sharing of personal abortion experiences (i.e. abortion storytelling). However, these initiatives may simultaneously construct normative hierarchies of abortion and stigmatise abortion stories which do not fit context-specific, politicised norms. This study draws on data purposefully sampled from a pro-choice abortion storytelling initiative in Poland, conducted between 2020 and 2021, and organised by the Abortion Dream Team (ADT; Aborcyjny Dream Team), an influential Polish organisation campaigning for abortion access and rights. By conducting a qualitative document analysis of 73 first-person abortion stories shared in this initiative, I explored how abortion was represented, and whether, and how, these representations challenged abortion stigma and its manifestation in normative hierarchies of abortion. Using reflexive thematic analysis, I identified four main themes. My findings show that abortion is represented as a valid decision, both a positive and challenging experience, and an embodied process. The stories shared in the ADT storytelling initiative challenge stigma and deconstruct normative hierarchies of abortion by representing abortion as a complex experience imbued with multiple, and often contradictory, meanings. This study highlights the existence of positive and non-stigmatising representations of abortion in Poland and shows that abortion storytelling can challenge dominant narratives around abortion. These findings therefore have broader significance, as they suggest that abortion storytelling may serve as an effective tool to destigmatise abortion and advance abortion rights. DOI:10.1080/26410397.2025.2535835.

In Chile, despite important advances in access to contraception and a steady reduction in unplanned pregnancy, longstanding barriers for young people to access sexual and reproductive health (SRH) and rights - rooted in a conservative and religious background - have been highlighted by recent socio-political movements, including the feminist student wave of 2018 and the social uprising of 2019. The COVID-19 pandemic further strained access, leading to the suspension of many in-person services. In this context, we conducted a qualitative study between 2020 and 2023 to explore young women's perceptions of sexuality and SRH, their interactions with the formal healthcare system, and the diverse resources they engage with to access support and care. 23 in-depth interviews were carried out with heterosexual and non-heterosexual women aged 18-25 in Chile's Metropolitan Region. The findings reveal a mismatch between young women's holistic understanding of sexuality - which includes emotional, biological, and political dimensions - and the healthcare system's reductionist, heteronormative, and risk-based approach, which became more visible after these societal upheavals. As a result, young women may use biomedical SRH services strategically for prescriptions and testing, while seeking more comprehensive support outside the formal system through virtual platforms, health professionals giving online support, and civil society organisations. The study concludes that systemic changes in the health system are needed to bridge these divides and uphold the sexual and reproductive rights of young women in Chile, especially those who identify as non-heterosexual. DOI: 10.1080/26410397.2025.2558272.

Reproductive coercion (RC) and intimate partner violence (IPV) threaten women's health and reproductive agency globally. The Addressing Reproductive Coercion in Health Settings (ARCHES) intervention integrates screening for RC and IPV, covert contraceptive options, IPV referrals, and an educational booklet into family planning (FP) services. This study examines client and provider perspectives on ARCHES in Nairobi, Kenya. A qualitative study was conducted in the three private clinics implementing ARCHES. Data were collected through 35 in-depth client interviews and 12 provider interviews three months post-intervention. Participants were purposively sampled based on age and RC/IPV experience. Thematic content analysis was used. Clients reported greater reproductive autonomy through increased knowledge of covert contraception, IPV services, and reproductive rights. Providers reported gaining confidence to address RC and IPV and building stronger relationships with clients. Barriers included stigma around IPV referrals and limited counselling time. Screening for RC/IPV was widely accepted, with some clients recognising abuse for the first time. The compact educational booklet improved knowledge retention and community outreach. Perspectives on male partner engagement were mixed due to concerns about safety and confidentiality. ARCHES was well-received by clients and providers, enhancing FP care and addressing critical gaps in RC and IPV support. Future adaptations should address barriers to IPV referral uptake and provider first-line IPV support, and carefully track implementation to ensure continued client-centred counselling. These findings support ARCHES as a scalable model for integrating FP and violence prevention interventions in Kenya and similar contexts.

Elite athletes routinely undertake strenuous training routines, which often involve high-intensity sessions. However, there are knowledge gaps in how they experience training during pregnancy and subsequent return to sport. Combined with inadequate financial and contractual safety, female athletes may jeopardise their careers when starting families. This study aimed to describe female athletes' experiences and perspectives related to pregnancy and motherhood within the context of elite sports in Norway. We interviewed five world-class athletes between October 2022 and April 2023, using a descriptive qualitative approach. Full interview transcripts were analysed based on a reflexive thematic analysis model. Five overarching themes were identified: (1) uncertainty, (2) lack of supportive networks, (3) physical capacity, (4) the impact of postpartum return to sports on maternal health, and (5) combining motherhood and elite sports. Our findings emphasise the challenges that Norwegian pregnant and postpartum athletes face in balancing motherhood with successful careers, highlighting the importance of providing adequate support systems to ensure their health and the well-being of their child.

The advent of planned oocyte cryopreservation (planned OC) represents a pivotal transition from reactive infertility treatments to proactive fertility preservation, providing a contemporary solution for women aiming to synchronise their career aspirations with future fertility plans. While numerous developed Western nations have liberalised access to planned OC for diverse individuals, including opposite-sex married couples, same-sex married couples, and unmarried individuals, mainland China maintains stringent prohibitions, permitting it solely for medical reasons, due to medical, cultural, and ethical considerations. In contrast, Hong Kong, a major urban city in China, has adopted a more permissive approach, allowing access to planned OC for non-medical reasons among unmarried individuals. This article will delve into the evolving landscape of public attitudes, fertility-seeking behaviour, and regulatory governance in Hong Kong. It will reflect on the practices and challenges associated with implementing a more permissive policy on planned OC, aiming to extract valuable lessons for the broader Chinese context.

A roundtable on gynaecological health in South Asia engaged speakers from four countries to share insights on the current context, challenges and priorities for action in the region. Women's gynaecological needs beyond maternal health are overlooked in most settings, with common ailments underdiagnosed or untreated. While over-medicalisation and a lack of data and evidence are two common challenges, midwife-led programmes, investment in primary health care and nationwide data collection on gynaecological health are promising initiatives. The key priorities for evidence generation are to: understand gynaecological health and its interlinked determinants; examine impacts on quality of life; and design approaches that address women's health through the life course.

The WHO recommends two medication abortion regimens, either misoprostol used with mifepristone or misoprostol-only. Both regimens are recognised as safe and effective, but in the United States (US) most abortions are completed using mifepristone and misoprostol. Given current political hostility to abortion, restrictions on mifepristone, and the long-term legal strategy to restrict nationwide access to the combined mifepristone and misoprostol regimen, more people in the US may use misoprostol-only regimens. Globally research has documented experiences with misoprostol-only abortions, but what are the experiences among people living in the US? We conducted a thematic analysis of 31 in-depth interviews with people who self-managed their abortion using misoprostol acquired from a mail-order or retail pharmacy between May and June 2020. We examine the acceptability of using misoprostol for medication abortion across three domains: the medication regimen, the mode of delivery of medications, and the overall model of care. We find that individual perceptions of misoprostol were shaped by both prior and informed knowledge. Picking up misoprostol from a retail pharmacy fostered familiarity, and having a prescription legitimised the service as an authentic medication provider. Receiving medications from the mail-order delivery model met preferences for privacy and anonymity. In reflections on the overall model, satisfaction was high across participants, but those who were adolescents at the time of their abortion had a distinct unmet need for emotional support compared to older participants. These results contribute to a growing evidence base on the acceptability of misoprostol-only regimens and mail-order and retail pharmacy service delivery models.

As sexual and reproductive rights (SRR) face mounting threats globally, Catalonia's National Strategy for Sexual and Reproductive Rights showcases how democratic governments can expand SRR through feminist policymaking and governance. Building on the region's robust public health infrastructure, systemic inequalities have been addressed and care standards improved with innovative policies. Grounded in intersectional feminism and a rights-based approach that prioritises bodily autonomy, universality, accessibility and participation, SRR have been embedded not only into health policies but also into education, workplaces and community frameworks. Key lessons from this experience highlight the importance of feminist expertise and leadership in driving impactful change. Framing SRR as human rights broadens their scope and facilitates collaboration across cabinet portfolios, while institutionalising policies within extant frameworks and services seeks to ensure their sustainability beyond political cycles. Furthermore, transformative SRR policies need not be cost-prohibitive; redesigning public services and training health professionals to deliver empathetic care can also yield significant results. Public engagement and participatory policymaking empower citizens and stakeholders, fostering accountability and a culture of advocacy. Catalonia's bold and inclusive model, coupled with robust responses to the anti-gender movement, offers a blueprint for governments and advocacy organisations worldwide. [192].

Self-managed abortion (SMA) is prevalent in the United States (US) and has become increasingly common since the 2022 Supreme Court ruling in Dobbs v. Jackson Women's Health Organization that allowed states to enact early abortion bans. Although SMA is legal in nearly every US state, the number of people who have been arrested for alleged participation in SMA has continued to grow in recent years. Reproductive justice advocates have identified news media portrayals of these cases as a likely contributor to adverse legal outcomes for criminalised individuals; however, researchers have not yet investigated this. Therefore, we aimed to qualitatively assess the ways in which national news media outlets depict instances of SMA criminalisation. We identified 41 articles published by the top five national newspapers between 2000 and 2023 and conducted a reflexive thematic analysis. Our analysis revealed concerning patterns in news media coverage, in which journalists frequently personified the fetus as a victim while vilifying the criminalised person, undermined the character of the criminalised person through selected personal histories, and promoted the presumption of guilt by treating biased police statements as objective accounts. These findings contribute to the literature by describing the ways in which reproductive injustice is legitimised through news media and provide empirical support for reproductive justice advocates' calls for more responsible journalism in news media coverage of SMA criminalisation.

Changing sexual behaviours among Chinese youth have emerged along with China's rapid socioeconomic transition. In the context of enduring Confucian traditions and limited formal sexuality education, there is an increasing demand from Chinese youth for accessible and inclusive sexuality education. This research explores how young people in China seek out and engage with sexual knowledge within this shifting cultural landscape. While previous studies indicate that a lack of knowledge in sexual and reproductive health (SRH) is associated with risky sexual behaviours, investigations on how Chinese youth access SRH knowledge and its impact on their behaviours remain unclear. Based on the survey data collected in 2019-20, this cross-sectional study of 52,256 Chinese youth highlighted how young people access and apply sexual knowledge. Boys were more likely to learn from media (primarily pornography), while girls tended to rely on school-based education and parental communication. Mediation analyses were performed to explore the association between sources of sexual knowledge and sexual and reproductive health with a mediator of sexual knowledge scores. The results show that youth who acquired SRH knowledge from the media were more likely to engage in sexual intercourse and experience early sexual debut, while youth gaining SRH knowledge from school were less likely to have sexual intercourse and early debut. Sexual knowledge acquisition occurs not only in one setting but across various settings in young people's lives. This study provides insights for future sexuality education improvement through different learning sources and emphasises how young people's learning experiences impact their sexual behaviour.