September 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:
Incarcerated women often have limited access to birth control. However, there is a lack of research into their feelings around making long-acting reversible contraceptive (LARC) methods, such as IUDs and the implant, available. Learning more about their desires is especially important considering the long history of reproductive coercion that has taken place in U.S. correctional institutes. Sixty-four percent of those surveyed did not support beginning a LARC method while incarcerated; in addition to distrusting the qualifications of medical personnel associated with the facility, many also cited the cleanliness of their detention facility as a factor in their decision. However, participants supported making more forms of birth control available to incarcerated people, even when they were not interested in specifically offering LARC methods.
In 2013, the U.S. Selected Practice Recommendations for Contraceptive Use (US SPR) released its first recommendation around the provision of emergency contraception (EC). This study surveyed providers to see if they followed the clinical recommendations laid out by the US SPR and to chart any changes from immediately after its release to 2019. Study results showed that compared to 2013-2014, in 2019, providers were more likely to prescribe contraception at the same time as EC. However, even in 2019, only 16% of providers frequently wrote a prescription for EC in advance of any need for it. More research is needed to understand the barriers providers face in implementing the US SPR’s recommendations around EC.
To better understand people’s preference for abortion procedures, sometimes called surgical abortion, versus medication abortion—and in the hopes that total anonymity will lead to greater honesty, these researchers analyzed recent posts to the social network Reddit. Four themes emerged from the posts about decision-making on type of abortion: emotional experiences, process-specific concerns, and structural barriers. The authors believe that their results further indicate the importance of easily accessible, evidence-based information about abortion care online.
The effects of legal restrictions on abortion care rates have been well documented, as has the unequal way people are affected by restrictions. But less is known about how COVID-19 has impacted access. This study compared demographic information and travel characteristics of patients receiving abortion care at four facilities in Arkansas, Kansas, and Oklahoma before and during the pandemic. Results shed light on a variety of changes, including:
- A 35.2% increase in patients having medication abortions.
- Patients traveling more miles to receive abortion care.
- More non-monogamous patients were more likely to begin a LARC method after their abortion.
Using data from 22 state prison systems, all Federal Bureau of Prisons sites, and six county jails, this study found that only 11 state prisons allowed abortion in the first and second trimester, 14% did not allow abortion at all, and 19 prisons required the incarcerated person to pay for their abortion. Four county jails allowed abortion in the first and second trimester, and a quarter required the incarcerated person to pay for their abortion. Only 1.4% of pregnancies in those incarcerated in prisons ended in abortion, while 18% of pregnancies of those in jail ended in abortion. Although it was not possible to assess pregnancy intention, these low rates and difficulty in access raise concerns for the presence of reproductive coercion. There is a clear need for further reproductive access and equity for incarcerated individuals.
As more states attempt to limit abortion earlier in pregnancy, it is important to understand why it may take longer for some people to realize they are pregnant. Of the nearly 1,000 women surveyed, most of those who sought abortion care in their second trimester did not realize they were pregnant until more than eight weeks after their last period. Those who had not given birth before or who used a method of hormonal birth control in the month they got pregnant were more likely to already be more than 13 weeks after their last period before realizing they were pregnant. The majority reported a lack of symptoms commonly associated with pregnancy or symptoms that they ascribed to something other than pregnancy as the main reason they had a delayed realization.
Pregnancy and Birth
Preliminary numbers show a decrease in the birth rate throughout the COVID-19 pandemic. But little research has occurred around pregnancy intention, especially among those living in areas greatly affected by COVID-19. This study surveyed more than 1,000 mothers of young children living in New York City and found that 49.2% of women who had been actively trying to conceive had stopped, and 37.2% of those who had been planning to conceive were no longer planning. Many cited increased stress levels and financial insecurity because of the pandemic as reasons behind their shifting pregnancy intentions.
In line with the current opioid use disorder (OUD) epidemic, there has been an increase in utero opioid exposure. Nearly 140 women being treated for OUD and at risk for unplanned pregnancy participated in this study. One-third received usual care, one-third onsite birth control services and six months of follow-up visits, and one-third received the same onsite services with a financial incentive for attending follow-up visits. Results show that compared to those who received usual care, both those who received onsite birth control services with follow-up were more likely to correctly and consistently use birth control methods. However, financial incentives resulted in the highest number of people who wanted to prevent an unplanned pregnancy doing so through birth contraceptive coverage.
Sexual and Reproductive Health
When young people age 19 or younger have more than one child, it increases the chances that they will experience adverse medical, socioeconomic, educational, and parental outcomes. And many adolescents who have had a child do not use birth control or use a less effective method. The results of this study show that consistent, optimal provider interconception care that links pediatric and maternal health care makes it more likely that young women will not become pregnant again and will begin using a birth control method to prevent unplanned pregnancy.
Women with OUD are highly likely to experience an unplanned pregnancy. In this small study, 119 women received a peer-led intervention that provided both education about and a link to family planning services. The results indicated that the intervention may be an effective way to support family planning needs for those in OUD treatment as 90% said that the topics covered were important, 76% said that the information provided was new to them, and 82% said working with a peer was helpful.