Womens Health Issues最新文献

{"title":"Texas' Abortion Ban Conflicts With Person-Centered Health Care: Experiences of Texans With Medically Complex Pregnancies.","authors":"Lauren Thaxton, Whitney Arey, Gabriela Alvarez Pérez, Pritika Paramasivam, Klaira Lerma, Kari White","doi":"10.1016/j.whi.2025.10.003","DOIUrl":"https://doi.org/10.1016/j.whi.2025.10.003","url":null,"abstract":"<p><strong>Introduction: </strong>Starting in 2021, the Texas law referred to as Senate Bill 8 (SB8) sharply restricted abortion care, with an exception for medical emergencies. As a result, many pregnant Texans with medically complex conditions are being denied abortion care. The purpose of this study was to evaluate the perspectives of Texans with medically complex pregnancies after SB8.</p><p><strong>Materials and methods: </strong>Texans who were pregnant in the 12 months before or after the study start date (October 2021), and received a diagnosis that indicated a pregnancy risk, engaged in semi-structured interviews exploring their health care experiences. Interviewers asked participants how they learned about complications with their pregnancy, counseling they received about medical complexity pregnancy options (including abortion care and/or other medical interventions), their decision-making process, how abortion laws impacted their options and access to care, and their reflections on the care they received. Interviews were recorded and transcribed and reviewed by five research team members. We conducted a thematic analysis using inductive and deductive coding. We used the World Health Organization framework to inform data interpretation about quality-of-care metrics.</p><p><strong>Results: </strong>We enrolled 25 participants with a range of maternal, fetal, or pregnancy-related medical conditions; half of participants received abortion care. Participants reported that information about pregnancy conditions and abortion options was ambiguous, leaving them to learn more on their own; they had limited autonomy to pursue abortion care given their unique medical concerns and found it challenging to engage their care team; and they lacked emotional support across their journey due to abortion stigma, fear of legal risks to others, and overall lack of mental health resources.</p><p><strong>Discussion: </strong>Pregnant Texans with medically complex conditions described major gaps in quality of care after SB8. Where abortion care cannot be provided by law, health systems can better meet patients' needs by providing effective transitions of care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574653","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}

{"title":"Invisible Tethers: The Role of Social Networks in Intimate Partner Violence and Mental Health Among Adult Women","authors":"Marina Katague MPH ,&nbsp;Trace Kershaw PhD ,&nbsp;Laurel Sharpless MPH ,&nbsp;Kamila A. Alexander PhD, MPH, RN ,&nbsp;Tiara C. Willie PhD, MA","doi":"10.1016/j.whi.2025.09.001","DOIUrl":"10.1016/j.whi.2025.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Intimate partner violence (IPV) is associated with high rates of posttraumatic stress disorder (PTSD) and depression, and women experiencing IPV often face social isolation that may exacerbate mental health concerns. This study examines the relationship among IPV, social networks, and mental health outcomes in women. It aims to understand how social network characteristics relate to the presence of PTSD and depression among women with and without experiences of IPV.</div></div><div><h3>Methods</h3><div>We collected data on IPV experiences, participants’ social networks, and PTSD and depression symptomatology from women aged 18–35 in Connecticut who reported risk indicators for pre-exposure prophylaxis candidacy (N = 204). Multivariable logistic regression models were used to assess the relationship between IPV and mental health, while adjusting for demographic factors and covariates. We also examined whether social network characteristics moderated this relationship.</div></div><div><h3>Results</h3><div>Women experiencing IPV had fewer men in their networks, more network members who had experienced IPV, and more network members with violence-acceptable attitudes compared with women without IPV experiences. IPV experience was also significantly associated with higher PTSD symptomatology. IPV moderated two associations between network characteristics and depression: among women experiencing IPV, greater network closeness was associated with less severe depression symptoms, whereas among women without IPV experience, a higher percentage of men in the network was associated with less severe depression symptoms.</div></div><div><h3>Conclusion</h3><div>There are significant differences in social network characteristics among women with and without IPV experiences. Trauma-informed interventions and services should acknowledge how network members might influence depression when engaging with women experiencing IPV.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 493-502"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276127","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}

{"title":"Black Women Benefit From Psychotherapies for Insomnia, but Experience Adherence Challenges: Results of a Comparative Effectiveness Trial in Women Veterans","authors":"Kimiko J. May PsyD ,&nbsp;Alexander J. Erickson PhD ,&nbsp;Gwendolyn C. Carlson PhD ,&nbsp;Monica R. Kelly PhD ,&nbsp;Yeonsu Song PhD, RN, FNP ,&nbsp;Kaddy Y. Revolorio PsyD ,&nbsp;Michael N. Mitchell PhD ,&nbsp;Donna L. Washington MD, MPH ,&nbsp;Elizabeth M. Yano PhD, MSPH ,&nbsp;Cathy A. Alessi MD ,&nbsp;Sarah Kate McGowan PhD ,&nbsp;Constance H. Fung MD, MSHS ,&nbsp;Jennifer L. Martin PhD","doi":"10.1016/j.whi.2025.08.003","DOIUrl":"10.1016/j.whi.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Black women and veterans experience disproportionally high rates of insomnia. Few studies have examined how treatment adherence and outcomes vary by racial identity. We found that cognitive behavioral therapy for insomnia (CBT-I) and an acceptance and commitment therapy (ACT)-based insomnia treatment similarly improve sleep outcomes for women veterans, and this analysis examined differences in adherence and outcomes of these treatments based on racial identity groups.</div></div><div><h3>Purpose</h3><div>Analyses examined differences in adherence and treatment outcomes in Black compared with white women veterans who engaged in CBT-I or an ACT-based insomnia treatment (i.e., acceptance and the behavioral changes to treat insomnia [ABC-I]).</div></div><div><h3>Methods</h3><div>As part of a larger clinical trial (NCT02076165), 40 Black and 51 white women veterans with insomnia disorder completed five sessions of CBT-I or ABC-I. The Insomnia Severity Index (ISI) and sleep diaries were completed at baseline, posttreatment, and 3-month follow-up. The Credibility and Expectancy Questionnaire was completed at the end of the first treatment session. Multiple and fractional regression models were used to evaluate the association between race group and change in ISI, sleep diary sleep efficiency, and adherence to weekly sleep schedule prescriptions in CBT-I and ABC-I.</div></div><div><h3>Results</h3><div>Treatment benefits were comparable between Black and white women veterans; however, Black women had transiently lower adherence to sleep restriction time in bed recommendations in the week immediately after sleep restriction therapy was introduced in both treatments. There were no other differences between the groups.</div></div><div><h3>Conclusions</h3><div>Future research is needed to understand potential barriers to early adherence to recommendations experienced by Black women veterans and to identify treatment adaptations to meet their needs.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 467-474"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294096","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}

{"title":"Incidence of Ectopic Pregnancy and Diagnostic Accuracy of Ectopic Pregnancy Screening Criteria Among People Seeking Versus Not Seeking Abortion: A Retrospective Case-Control Study","authors":"M. Antonia Biggs PhD ,&nbsp;Mary Anne Armstrong MA ,&nbsp;Lue-Yen Tucker BA ,&nbsp;Shelly Kaller MPH ,&nbsp;Juleon Rabbani DrPH ,&nbsp;Justine W. Lee MD ,&nbsp;Giulia Chillemi MSc ,&nbsp;Daniel Grossman MD","doi":"10.1016/j.whi.2025.08.006","DOIUrl":"10.1016/j.whi.2025.08.006","url":null,"abstract":"<div><h3>Objectives</h3><div>We estimated the incidence of ectopic pregnancy, associated risk factors, and accuracy of three history-based screening criteria for medication abortion (history of ectopic pregnancy, tubal surgery, and intrauterine device [IUD] in place) in detecting ectopic pregnancies among people seeking versus not seeking abortion.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective case-control study by reviewing electronic health records of a random sample of 2,201 ectopic and 1,153 intrauterine pregnancies of people enrolled at Kaiser Permanente Northern California (2016–2021). After classifying pregnancies as those to people seeking or not seeking abortion, we used logistic regression weighted to the total sample of pregnancies (N = 385,081) to estimate the incidence of ectopic pregnancies, associated risk factors, and accuracy of three history-based screening criteria.</div></div><div><h3>Results</h3><div>The adjusted incidence of ectopic pregnancy was significantly lower for people seeking abortion (.39%; 95% confidence interval [CI] [.30%, .47%]) than for people not seeking abortion (1.74%; 95% CI [1.55%, 1.94%]). People seeking abortion received ectopic pregnancy treatment earlier in pregnancy than those not seeking abortion (53 vs. 55 days’ gestation, <em>p</em> = .04). Among people seeking abortion, combined history of IUD use, ectopic pregnancy, and tubal surgery had low sensitivity (17.6%; 95% CI [12.4%, 23.8%]), high specificity (93.5%; 95% CI [90.2%, 96.0%]), and a low area under the receiver operating characteristic curve value (55.5%; 95% CI [52.5%, 58.6%]).</div></div><div><h3>Conclusions</h3><div>The incidence of ectopic pregnancy among people seeking abortion is extremely low and lower than among people not seeking abortion. The three history-based screening criteria we evaluated had very low sensitivity and performed poorly in accurately identifying ectopic pregnancies, suggesting they may have limited clinical utility and may create barriers to access to no-test abortion. Further research is needed to refine protocols to better identify, evaluate, and monitor people for possible ectopic pregnancies in the context of no-test provision of medication abortion.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 475-484"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245644","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}

{"title":"Examining the Acceptability and Feasibility of a Doula Intervention Program for Veterans Receiving VA Maternity Care Benefits","authors":"Kristin M. Mattocks PhD, MPH ,&nbsp;Lael Ngangmeni PhD ,&nbsp;Valerie Marteeny MS ,&nbsp;Lorrie Walker MA ,&nbsp;Karen M. Goldstein MD, MSPH ,&nbsp;Stephanie Condon-Perry PA-C ,&nbsp;Kathryn Berrien RN, BSN, MS ,&nbsp;Danielle Weber RN ,&nbsp;Lisa L. Shenette MS ,&nbsp;Kate Wallace MPH ,&nbsp;Aimee Kroll-Desrosiers PhD","doi":"10.1016/j.whi.2025.10.002","DOIUrl":"10.1016/j.whi.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to assess the feasibility and acceptability of a community-based doula care pilot program for pregnant veterans receiving Department of Veterans Affairs (VA)-purchased obstetric care.</div></div><div><h3>Methods</h3><div>This study was conducted at two VA medical centers (Durham, North Carolina, and New Orleans, Louisiana) in partnership with local community-based doula agencies. Certified doulas provided prenatal education as well as continuous labor support and postpartum follow-up. Telephone-based surveys were administered at baseline (∼20 weeks’ gestation) and ∼4 weeks postpartum. Acceptability was assessed using the validated 4-item Acceptability of Intervention Measure (AIM; 5-point Likert scale) and participant-reported experiences. Maternal and infant health outcomes were assessed following childbirth.</div></div><div><h3>Results</h3><div>Of the 39 veterans referred, 74% (<em>n</em> = 29) enrolled, and 59% (<em>n</em> = 23) completed both assessments, comprising the final analytic sample. Participants were predominantly Black (74%) and multiparous (61%), with high rates of service-connected disability (91%), military sexual trauma (70%), and elevated prenatal depressive symptoms (44%). All veterans received prenatal doula support; 61% received intrapartum support and 57% received postpartum support. The overall cesarean birth rate was 17%, and 87% of participants rated their childbirth experience positively. The mean AIM score was 4.3 (SD = 1.2), indicating a high level of perceived acceptability and feasibility of the doula intervention. Most participants (70%) expressed interest in using doula services in future pregnancies.</div></div><div><h3>Conclusions</h3><div>Community-based doula care was feasible and highly acceptable among perinatal veterans, particularly those with elevated psychosocial and obstetric risk. These findings support integrating doula services into VA maternity care to enhance culturally responsive, trauma-informed support for veterans of color.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 458-466"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582676","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}

{"title":"Mistrust Limits Possibilities for Patient-Provider Discussions Regarding Cannabis Use During Pregnancy","authors":"Heather Gould MPH ,&nbsp;Claudia Zaugg MPH ,&nbsp;Karen A. Scott MD, MPH, FACOG ,&nbsp;Sarah C.M. Roberts DrPH","doi":"10.1016/j.whi.2025.09.002","DOIUrl":"10.1016/j.whi.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Recent changes in cannabis policy and use among pregnant people have prompted recommendations that health care providers discuss cannabis use with pregnant patients. We explored pregnant people's perceptions of their interactions with health care providers regarding cannabis use during pregnancy.</div></div><div><h3>Methods</h3><div>We conducted in-depth interviews with 34 individuals who were either pregnant or had been pregnant within the past 2 years and who used cannabis before or during their pregnancy. The interviews explored people's experiences with and perspectives on communication with health care providers about cannabis use during pregnancy.</div></div><div><h3>Results</h3><div>Most participants reported an absence of provider-initiated inquiries about cannabis use and few disclosed their cannabis use to a provider. Participants expressed distrust in providers as sources of accurate cannabis information, as they understood providers as grouping cannabis with alcohol and other drugs, which they saw as conflicting with their perception of a lack of conclusive scientific evidence about health effects of cannabis use during pregnancy. They worried about providers judging and reporting them to child welfare if providers learned about their cannabis use. Participants described using cannabis for medical reasons, but only rarely recalled experiencing providers talking with them about risks and benefits of cannabis versus other treatments.</div></div><div><h3>Conclusions</h3><div>Although many pregnant people use cannabis as a medicine to manage pregnancy symptoms or health conditions, they perceive providers as viewing and treating cannabis as a harmful recreational drug. This disconnect, along with their fears of provider judgment and of providers reporting them to child welfare, appears to be limiting effective, person-focused discussions regarding risks and benefits of different approaches to treating the symptoms and health conditions for which pregnant people use cannabis.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 450-457"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276123","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}

{"title":"Contribution of Maternal Age to Increasing Severe Maternal Morbidity During Birth and Up to 1 Year Postpartum","authors":"Samuel H. Nyarko PhD ,&nbsp;Lucy T. Greenberg MS ,&nbsp;Scott A. Lorch MD ,&nbsp;Jeannette Rogowski PhD ,&nbsp;Jeffrey S. Buzas PhD ,&nbsp;Ciaran S. Phibbs PhD ,&nbsp;George R. Saade MD ,&nbsp;Molly Passarella MS ,&nbsp;Nansi S. Boghossian MPH, PhD","doi":"10.1016/j.whi.2025.08.005","DOIUrl":"10.1016/j.whi.2025.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>We examined whether increasing severe maternal morbidity (SMM) rates are driven by changes in maternal age distribution or age-specific SMM rates.</div></div><div><h3>Methods</h3><div>In a retrospective cohort study across three states, we analyzed data from two time points (2008–2009 to 2019–2020). We used Kitagawa decomposition analysis to determine the contributions of changes in maternal age distribution and age-specific SMM rates to SMM rates both with and without transfusion during birth and up to 1 year postpartum, stratified by race/ethnicity. We examined the following racial/ethnic groups: non-Hispanic white, non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander.</div></div><div><h3>Results</h3><div>Between 2008–2009 and 2019–2020, SMM and non-transfusion SMM rates increased from 213.6 to 260.5 and from 109.6 to 154.8 per 10,000 births, respectively. Across all racial and ethnic groups, the proportion of younger birthing individuals (&lt;25 years) decreased and the proportion of older individuals (≥30 years) increased. The decomposition analysis showed that increases in SMM and non-transfusion SMM were primarily due to increases in age-specific SMM rates (100.0% and 94.6%, respectively), particularly among younger birthing individuals. Changes in maternal age distribution had a minimal overall contribution. However, when stratified by race/ethnicity, changes in maternal age distribution had a greater contribution to SMM (28.9%) and non-transfusion SMM (22.7%) rates among non-Hispanic Black individuals, with little to no contribution observed in the other groups.</div></div><div><h3>Conclusion</h3><div>The increasing rates of birth-related and postpartum SMM rates stem from increasing rates of SMM in every age group rather than shifts in maternal age distribution.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 442-449"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208049","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}

{"title":"Factors Associated With Guideline-Concordant Cervical Cancer Screening Exit: A Mixed Methods Study","authors":"Abigael Olson MD ,&nbsp;Lindsay Fuzzell PhD ,&nbsp;Naomi C. Brownstein PhD ,&nbsp;Holly B. Fontenot PhD, RN/NP ,&nbsp;Alexandra Michel PhD, RN/CNM ,&nbsp;Paige Lake MPH ,&nbsp;Susan T. Vadaparampil PhD ,&nbsp;Rebecca B. Perkins MD, MSc","doi":"10.1016/j.whi.2025.07.006","DOIUrl":"10.1016/j.whi.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>More than 20% of cervical cancers are diagnosed in women older than 65 years. Guidelines recommend screening exit at age 65 for average-risk patients only if certain criteria are met, yet most women aged 64–66 years in the United States are inadequately screened. In this mixed methods study, we explored clinician knowledge of exit criteria.</div></div><div><h3>Methods</h3><div>We explored factors associated with clinician-reported guideline-concordant screening exit, as well as facilitators and barriers to appropriate cervical cancer screening exit. Guideline concordance required that clinicians be aware that patients can exit screening if they have received a hysterectomy for benign reasons or had either three consecutive negative Pap tests or two consecutive negative human papilloma virus tests—and that they should not exit screening if they have a history of precancer treatment in the prior 25 years.</div></div><div><h3>Results</h3><div>In 2021, a national sample of 1,251 clinicians completed surveys; a subset (<em>n</em> = 55) completed qualitative interviews. Although most (&gt;70%) correctly identified criteria related to hysterectomy and prior negative screening requirements, only 35% of participants (<em>n</em> = 434) responded correctly to all screening exit items. In logistic regression models, male clinicians, OB/GYNs, and those in academic or hospital-based practices were more likely to respond correctly. Interview responses indicated variable understanding of the nuances of exit criteria. Those who continued screening patients past age 65 cited concerns related to new sexual partners and missing cancers. Several providers noted difficulty accessing adequate records.</div></div><div><h3>Conclusions</h3><div>Clinicians who routinely perform cervical cancer screening have knowledge gaps around exit criteria and also describe difficulty applying the criteria in practice. As fewer women undergo hysterectomy and life expectancy increases, the number of individuals older than 65 at risk for cervical cancer will continue to rise. Adjusting guidelines to decrease the complexity of exit criteria should be considered.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 415-423"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030837","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}

{"title":"Reproductive Health Services in Abortion-Providing Clinics: A Scoping Review of Provision and Policy Contexts","authors":"Katherine M. Mahoney BA ,&nbsp;Licia Bravo BS ,&nbsp;Arden McAllister MPH ,&nbsp;Kacie Bogar MS ,&nbsp;Sean Hennessy PharmD, PhD ,&nbsp;Courtney A. Schreiber MD, MPH ,&nbsp;Alice Abernathy MD, MSHP","doi":"10.1016/j.whi.2025.07.007","DOIUrl":"10.1016/j.whi.2025.07.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Abortion-providing clinics often offer preventive reproductive health services. We conducted a scoping review to characterize provision of contraceptive care, sexually transmitted infection (STI) testing and/or treatment, and cervical cancer prevention and/or screening at U.S. abortion-providing clinics and to highlight policy drivers of variation in access to and provision of these services at the time of abortion by abortion-providing clinics.</div></div><div><h3>Data Sources</h3><div>Researchers screened articles and extracted data from PubMed, Embase, Scopus, and CINAHL from inception through March 2023.</div></div><div><h3>Methods of Study Selection</h3><div>Articles were eligible for review if they related contraceptive care, STI testing and/or treatment, or cervical cancer prevention and/or screening to abortion access, demand, or provision. Within these articles, we closely examined any discussion of health policy, conceptualized broadly based on existing literature describing policy associations with reproductive health care to identify policy drivers of reproductive health care provision in abortion care settings.</div></div><div><h3>Tabulation, Integration, and Results</h3><div>A total of 5,359 articles were screened; 74 were included in the review. Sixty-five were about contraceptive care, seven on STI testing and/or treatment, and two on cervical cancer prevention and/or screening. Drivers of variation in provision of preventive reproductive health services included insurance and billing policies and regulatory requirements on abortion-providing facilities and clinicians. Existing data on the association between policies that restrict or protect abortion access and provision of preventive health services by abortion-providing clinics on a national scale are limited.</div></div><div><h3>Conclusion</h3><div>Abortion-providing clinics are an access point for reproductive health services. Legislative trends to constrain abortion access may have spillover effects on provision of preventive reproductive health care such as contraceptive care, STI testing and/or treatment, and cervical cancer prevention and/or screening.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 424-441"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974309","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}

{"title":"Social Media Descriptions of Pain and Pain Management During Intrauterine Device Insertion: “Women's Pain is Not Taken Seriously”","authors":"Gabrielle Schweitzer MD ,&nbsp;Azza Elrashid ,&nbsp;Lakshmi Sundaresan MD ,&nbsp;Kathleen Mehari MD ,&nbsp;Lauren Owens MD, MPH ,&nbsp;Lauren D. Oshman MD, MPH","doi":"10.1016/j.whi.2025.08.002","DOIUrl":"10.1016/j.whi.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Intrauterine devices (IUDs) are a highly effective and safe method of contraception, yet IUD insertion can be painful. Social media is a trusted source of health information for reproductive-age adults and accounts of painful and traumatic insertion are prevalent on social media. The aim of this study was to explore the experiences of social media users with pain, trauma, and pain management during IUD insertion.</div></div><div><h3>Methods</h3><div>We identified common IUD-related hashtags or search terms on TikTok, Instagram, and Twitter; identified the top posts (defined as the posts at the top of each search) and their comments for each hashtag or search term on each platform; performed directed qualitative content analysis; and summarized code frequency under each theme with descriptive statistics.</div></div><div><h3>Results</h3><div>Analysis of a total of 214 total posts and comments identified three major themes describing user experiences: 1) Severe pain experiences were more common than tolerable or mild experiences, 2) some participants shared traumatic and negative emotional responses, and 3) negative or dismissive health care professional responses to painful IUD insertion were more frequent than positive and supportive responses.</div></div><div><h3>Conclusion</h3><div>Health care professionals should be aware of common narratives on social media and provide trauma-informed pain management to ensure that all patients have appropriate counseling for IUDs.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 6","pages":"Pages 485-492"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132223","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}