October 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 10 stories from the last month we thought you might find interesting:
Adolescents and young adults have high rates of unintended pregnancy, which is often related to lack of access to information about contraception, or irregular method use. This study’s authors examined 10 existing decision aids aimed at young people to understand their effectiveness. They found that each helps to build contraceptive knowledge, at least in the short term. However, they noted that further research is needed to better understand the long term outcomes of these decision aids.
Long-acting reversible contraception (LARC) such as the implant and IUDs are high effective birth control methods that require little ongoing user input and allow users to return quickly to their original fertility after removal. However, uptake of these methods is low in the US, particularly among adolescents and young adult women. This study examined how the social networks of patients in this age group could potentially impact their choices to use LARCs. It found that while health care providers had an important impact on young patients’ LARC-related decisions; family and peers also had influence as potential sources of negative or misleading information for patients. The authors urge providers to embrace their roles as trusted sources of information and to consider directly addressing inaccurate information that may come from a patient’s social network.
SpeakOut is an intervention aimed at encouraging young people to share their IUD and implant experiences with peers in the hopes of improving teen birth control usage. This study found that in a group of more than 1,000 the intervention did not increase conversations about contraception, knowledge of birth control methods, or usage of contraception.
This study looked at the effects of a 2015 law passed in Tennessee requiring women to wait at least 48 hours after seeing a health care provider for an abortion before obtaining abortion care. Results showed that the mandatory waiting period was responsible for a 53-69% increase in second trimester abortions as well as a small, but not insignificant reduction in abortion rates overall.
Pregnancy and Birth
By analyzing nearly 3,800 pregnancy-related deaths in the US between 2011-2016, this study concluded that 52% occurred in large, urban counties while 7% happened in rural counties. However, disparities in maternal mortality increased in rural areas with women age 35-44 having a mortality rate three times higher than their urban peers. Regardless of where a person lived, Black women and American Indian or Alaska Native women had mortality rates two to three times higher than their white peers.
By analyzing data from 2016-2017 vital statistics mortality data that included the cause of death as listed on the death certificate, these researchers confirmed that Black women have a maternal mortality rate 3.55 times than white women. The leading causes of death for Black women were eclampsia, preeclampsia, and postpartum cardiomyopathy. Black women died from these conditions at a rate of five times that of their white peers. The authors caution that more attention should be paid by providers to heart-related conditions among pregnant and postpartum Black women in particular.
Sexual and Reproductive Health
While primary care providers can discuss patients’ reproductive goals, evidence show that they may not be because of a lack of training, time constraints, or reimbursement concerns. Among veterans—a group which includes a large population of reproductive-age people—surveys have shown that very few people have discussed their reproductive goals with a provider. This study found that a new tool, MyPath, effectively provided veterans with new information on contraception and a significantly larger proportion of people spoke to their provider about reproductive issues after using the tool.
Using data from multiple sources, this study complied a database of all providers that offer contraceptive care (aka the contraceptive workforce) for six types of highly effective birth control (IUD, implant, shot, pills, patch, and ring). As a result of the database’s construction, researchers determined that more than 73% of OBGYNs and 72% of nurse-midwives prescribed the pill, patch, or ring while only 51% of family medicine physicians, 32% of pediatricians, and 19% of internal medicine physicians do the same. The number of physicians prescribing birth control varied dramatically across states among all of the types of providers tracked.
This study confirmed that the COVID-19 pandemic has made access to birth control more complicated, especially for already marginalized people. The authors surveyed more than 3,000 people about their contraceptive experiences during the pandemic and found that 51.5% of those who looked for birth control came up against a barrier in July 2020 and 55.3% reported the same six months later in January 2021. Many reported not using their preferred method, but those who had lost income or reported problems with hunger were more likely to than others to say that they would prefer to use another method.
The sexually transmitted infection (STI) rate in the US has continued to rise over the last decade. Research has identified the US military as a group with high STI rates and in need of special attention to control and prevent the continuing spread. This report, written by the National Academies of Sciences, Engineering, and Medicine, details a comprehensive plan to address STI risk, prevention, delivery, and treatment for active-duty service members.