December 2022: Power Updates Edition
There are plenty of articles, publications, and stories published every month. 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 10 stories from the last month we thought you might find interesting:
Birth Control
Power to Decide CEO, Raegan McDonald-Mosley, and Senior Director, Research and Evaluation, Riley Steiner, published this commentary in Contraception highlighting over-the-counter (OTC) oral contraception as an important and safe strategy to increase access to birth control. They present survey data collected as part of Power to Decide’s annual Thanks, Birth Control campaign showing that 50% of young adults think it will be very (17%) or somewhat (33%) hard in the future. Moreover, when asked if the “the Supreme Court’s decision in June [that] allows states to set their own abortion laws” has changed their “opinion about how easy or hard it will be for people to get birth control in the future” the majority of respondents (57%) reported that they think it will be harder to access birth control. They note, “Availability [of a progestin-only pill] OTC has the potential to increase access to this specific method, particularly for people who face systemic barriers to accessing clinic-based care, such as adolescents and young adults and people of color. More broadly, such approval would signal the use of science to inform innovative service delivery strategies and hopefully pave the way for subsequent regulatory decisions that further expand contraceptive access.”
Trends in Postpartum Contraceptive Use in 20 U.S States and Jurisdictions
Using data collected from 20 sites participating in the Pregnancy Risk Assessment Monitoring System, this study analyzed trends in postpartum contraceptive method use from 2015 to 2018 and differences by key characteristics. Overall, while there was an increase in LARC use during the study period, there was also an increase in the use of no contraceptive method; use of short-acting reversible methods decreased over time. In 2018, those without insurance were less likely to use a permanent, long-acting reversible, or short-acting reversible method of birth control compared to people with private insurance. However, there were no differences in contraceptive use by these method categories between people with private insurance and individuals with public insurance. Those living in rural areas were more likely to use any method of birth control than those living in urban areas.
Pregnancy and Birth
This literature review synthesized previously published studies that examine associations between unintended pregnancy and maternal and infant health outcomes during pregnancy and postpartum. Findings from 36 included studies indicate that compared to people who have an intended pregnancy, people with an unintended pregnancy were significantly more likely to experience depression (23.3% vs 13.9%) and interpersonal violence (14.6% vs 5.5%) during pregnancy as well as have a preterm birth (9.4% vs 7.7%) and an infant with low birth weight (7.3% vs 5.2%).
Abortion
Abortion Incidence and Service Availability in the United States, 2020
This study presents findings from the Guttmacher Institute’s 2019-2020 Abortion Provider Census, which collects data on abortion from all known healthcare facilities that provide abortion care in the U.S. Data were compared with the 2017 census. In 2020, 930,160 abortions were provided in clinical settings, which represented an 8% increase in abortion from 2017. There were 492,210 medication abortions in 2020, a 45% increase from 2017. Overall, the total number of clinics providing abortion care did not change but there were increases in the Midwest and the West and declines in the Northeast and South.
Abortion Surveillance - United States, 2020
This report presents findings from CDC’s routine surveillance of abortions in the United States. For 2020, 49 areas voluntarily provided data. Overall, 620,327 abortions were reported, a decrease of 2% from 2019 and a decrease of 15% since 2011. More than half of all abortions (57.2%) occurred among women in their 20s whereas only 0.2% of abortions were among adolescents <15 years. However, abortion ratios were highest among those under 20 years of age. A little over half (51%) of abortions were medication abortions performed at 9 weeks of gestation or earlier and another 40% were surgical abortions that occurred at 13 weeks gestation or earlier.
Intimate Relationships After Receiving Versus Being Denied an Abortion
This analysis from the Turnaway Study assessed the impact of receiving compared with being denied a wanted abortion on women’s intimate partnerships, up to 5 years after seeking an abortion. The authors found no differences in the likelihood of the intimate relationship with the person involved in the pregnancy lasting. However, compared to those who received an abortion, women denied abortion care were twice as likely to be in a poor intimate relationship with a partner 2-5 years after they sought an abortion.
Sexual and Reproductive Health
This randomized controlled trial tested the efficacy of the “2gether” intervention in increasing use of dual protection strategies and preventing pregnancy and STI transmission among young, Black women. Over one year, 685 sexually active 14–19-year-olds participated in the study, receiving either standard of care or the “2gether” intervention, which included an interactive multimedia program, a structured counseling session with a clinical provider, and a structured health education and counseling session with a nurse educator. Participants in the intervention were more likely to report using a condom with an IUD or implant in the prior 3 months. Findings also suggest that the intervention reduced risk for the primary biologic outcome examined--chlamydia, gonorrhea, trichomonas, or pregnancy.
Crush: A Randomized Trial to Evaluate the Impact of a Mobile Health App on Adolescent Sexual Health
This randomized controlled trial evaluated Crush, a phone app designed to promote use of sexual and reproductive health services and birth control, among 1,210 young women 14-18 years of age. Compared to a control group that received a wellness app, after a three-month check in Crush users had improvements in knowledge, attitudes, and self-efficacy related to SRH services and birth control at 3 and 6 months after baseline. However, the study found no difference was found between the two groups in actual use of sexual and reproductive health care services.
Researchers interviewed administrators and providers regarding their experiences integrating Title X services within a Georgia primary care network whose community health center sites are primarily federally qualified health centers. Findings indicate that grantee and sub-grantee organization were able to successfully implement Title X-funded services and expand access to sexual and reproductive health services among people with lower incomes and other underserved populations. Clinical training that addressed IUD and implant provision and counseling and administrative training for reporting along with reporting template were identified as factors important to successful integration.
Using data from nearly 29,500 females and more than 24,600 males between aged 15-44 years participating in the National Survey of Family Growth, this study analyzed changes in sexual behaviors and STI screening to better understand rising gonorrhea and chlamydia infections in the US over the past decade. Any STI testing and chlamydia testing in the past year increased among females and for both males, there were declines in mean number of female partners in the past year and having multiple partners at the same time. However, the percent of males who reported having ever had sex with another male increased. Additionally, significant declines were found among both males and females for condom use at last vaginal sex as well as the proportion of condom-protected sex acts in the prior four weeks.
