January 2021: Power Updates Edition
In a survey of more than 250 young people (mostly between the ages of 15-17), the authors found the majority had heard of oral emergency contraception (EC), and that of those who were sexually active, more than a quarter had used EC. Less than half reported knowing that EC could be bought over the counter irrespective of age and of gender, and only 27% knew that minors could purchase EC without parental consent.
Social media provides a useful forum for discussion about contraception and reproductive choice, but few studies that have examined the relationship between social media and patient preferences. The authors of this study reviewed almost 1 million tweets about contraception between 2006 and 2019. Their analysis found an increasing number of tweets about contraception overall, with both positive and negative sentiments. Overall, their findings suggest that social media may play an increasingly important part of patients’ contraceptive preferences, and knowledge about these platforms could allow providers to provide more effective counseling.
Pregnancy and Birth
The authors of this paper posit that the idea of the preconception health framework must evolve to focus on race equity and to acknowledge the historical and social inequities that currently impact reproductive health care for people of color. After meeting with a diverse group of partners and experts, they created an outline of principles for a new framework that include, “centering the needs of and redistributing power to communities, having clinical and public health systems acknowledge historical and ongoing harms related to reproductive and sexual health, and addressing root causes of inequities.”
The study’s authors were interested in exploring whether preconception health care for women of low income increased if states expanded Medicaid eligibility. Looking at statistics from 2011-2017, they found that expanding Medicaid did not translate to preconception care and also did not reduce the rate of adverse birth outcomes such as preterm birth.
The results of this study confirmed those of the study above; Medicaid expansion does not necessarily translate to improved preconception, pregnancy, and postpartum health outcomes. The authors recommend Medicaid policy begin to incorporate a framework of reproductive autonomy that focuses not just on pregnancy, but patient-centered reproductive health.
Results of this study found that nearly 13,000 in-person clinic visits would be avoided every month if restrictive laws that require clinical visits were repealed. It also found that more than 31,000 clinic visits would be avoided every month if all four common types of abortion restriction policies were repealed.
Sexual and Reproductive Health
Through a literature review, the authors of this paper concluded that state-level legislation could significantly affect the type of accessible reproductive health care women receive. They call for more rigorous research in this area to better understand the association with health outcomes.
This policy analysis defines work requirements in the Medicaid program; relates the history of Azar v. Gresham, which will be heard by the Supreme Court in the spring 2021; explains how work requirements can be detrimental and why Medicaid coverage is so important to people of low income; and recommends priorities for the Biden-Harris administration to protect Medicaid.
In hopes of understanding current inequities in the world of reproductive health, this commentary quantifies national data for important health measures, such as contraceptive use, Pap tests, mammograms, and unintended pregnancy rates. Based on the data, the authors conclude that “the disproportionate risk for women of color for reproductive health access and outcomes expand beyond individual-level risks and include social and structural factors.” They advise that real change will require diverse and committed partnerships that include people of color.
Women age 18-25 have the highest rate of unplanned pregnancy and STIs of all age groups. However, there is little research on the unique sexual and reproductive health needs of this specific group. The authors list recommendations for all providers, but especially nurses, on personalized care for women age 18-25.