August 2021: Power Updates Edition
There are plenty of articles, publications, and stories published every month. In an effort to help you distinguish fact from fiction, save time in your already busy day, and share news you may not have otherwise seen, here are eight stories from the last month we thought you might find interesting:
In many places a second visit to a provider is necessary to place an IUD or birth control implant. This study looked at nearly 1,200 patients who received a prescription for an IUD or implant. A full 68% of orders were placed on the second visit, which took place around 22 days after the first visit. Of the 32% of patients who did not return for a second visit and placement, 41% stated that this was due to the logistics of making a second appointment and 28% became pregnant prior to the end of the study period.
In recent years, some states have begun to enact laws that restrict abortion care access after a specified gestational age (known as “gestational age limit laws”). Using data from 2005-2017, which included 16,232,133 births in states that enacted a gestational age limit abortion law and 36,472,309 births in states that did not, researchers found that gestational age limit laws were associated with an increase in infant mortality rates.
OB/GYN physicians make up a large percentage of abortion providers, particularly at later gestational ages, and receive most of their abortion training during their residency years. However, the availability and quality of this training varies depending on the residency program itself. In this study, the authors asked current resident OB/GYN physicians to report on what kind of abortion training was offered by their programs as well as their general satisfaction with their abortion training. Sixty percent of respondents indicated that abortion training was routine “opt-out” training, 18% reported that their abortion training was optional with a clear process for arranging training, 11% reported that their abortion training was optional without a clear process, and 8% reported no training at all. In a sensitivity analysis, routine training and optional training with a clear process were associated with higher levels of reported satisfaction with training.
Pregnancy and Birth
With more than a decade’s worth of date from the Pregnancy Risk Assessment Monitoring System, the authors of this study set out to discover whether changes to Medicaid’s eligibility requirements impacted first-time parents use of health care services, their pregnancy intentions, and risk factors. They found that expanding Medicaid coverage significantly increases insurance coverage and prenatal care while also significantly decreasing unintended pregnancy and stress from health care bills.
National data from nearly 75,000 women who gave birth in 2016-2017 shows that nearly 41% of pregnancies were unintended and substance use was significantly associated with having an unintended pregnancy. “Nearly 57% of participants reported alcohol consumption during the preconception period, with 32% indicating binge drinking, 17% reported preconception smoking, and 10% cannabis use.”
Sexual and Reproductive Health
The CDC has released updated clinical guidelines for the treatment of sexually transmitted infections (STIs). The previous guidelines were released in 2015. This edition includes new answers to key questions around treatment and clinical management. Among other topics, the guidelines cover HIV, chlamydia, and gonococcal infections, viral hepatitis, and STI detection among special populations.
Researchers wanted to know if people who were eligible for HPV vaccination, but a part of an under-immunized population, would find an abortion care visit an acceptable opportunity to receive vaccination. Results were varied with 50 participants accepting the first vaccine of the series and 51 declining. Only seven of the 50 completed the full series. However, most patients regardless of their final decision indicated a willingness to accept other services and had never previously been offered an HPV vaccine.
Previous research has shown culturally sensitive and relevant health care improves outcomes among people of many races and ethnicities. This study evaluated Native STAND, a comprehensive sexual health curriculum, which was designed for American Indian and Alaska Native high school students. Implemented in 48 communities between 2014 and 2019, the curriculum focuses on STIs, HIV, and teen pregnancy prevention, as well as intimate partner violence, drug and alcohol abuse, and suicide. It was found to be effective in a variety of settings with a significantly higher percentage of participants reporting having had a serious conversation about sex with their friends and thinking about and sharing the lessons learned after participating in Native STAND.