Reproductive Services Research Articles

Youths with disabilities: Utilization and predictors of Youths Friendly Reproductive Health Services in Dessie City Administration, North East Ethiopia, 2021: A cross‐sectional study

AbstractBackground and AimsYounger generations with disabilities are more likely to be affected and have severe difficulties receiving specific services. Ethiopia is no exception to the global trend of poverty‐stricken countries with a higher frequency of illness or disability. This study aimed to assess the utilization of Youths Friendly Reproductive Health Services (YFRHS) and predictors among youths with disabilities in Dessie City, North East, Ethiopia, 2021.MethodsA community‐based, cross‐sectional study was conducted. Data were collected from the literature using questionnaires. Bivariable analysis was performed for each independent variable with a p < 0.25 on the data imported to multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) at a 5% level of significance has measured the strength of association between utilization of youth‐friendly reproductive services among disabilities and independent variables.ResultsOf 423 participants, 91% responded. About 42% of participants had used YFRHS. Youths in the age group of 20–24 years were 2.8 times more likely to use such services than 15–19‐year‐olds (AOR = 2.8, 95% CI: [1.04, 7.44]). Disabled youths living alone were 3.6 times more likely to use the services than those with parents (AOR = 3.6, 95% CI: [1.36, 9.35]). Youths with a visual impairment were 80% less likely to use the services than youths with hearing impairments (AOR = 0.2, 95% CI: [0.18, 0.30]), and disabled youths with poor knowledge were 90% less likely to use the services than participants with good knowledge (AOR = 0.1, 95% CI: [0.01, 0.61]) were statistically significant.ConclusionThe utilization of YFRHS among youths with disabilities in Dessie Town was low. Participants aged 20–24 years, who lived alone, had visual impairment, and had poor knowledge, were found to be significantly associated.

Rebuilding a Reproductive Future Informed by Disability and Reproductive Justice.

Rebuilding a Reproductive Future Informed by Disability and Reproductive Justice.

Digital Disruption in the Sperm Industry: Analyzing the Societal Implications of Technological Innovations in Reproductive Services

Digital Disruption in the Sperm Industry: Analyzing the Societal Implications of Technological Innovations in Reproductive Services

P-462 The current status of female reproductive health and preconception behaviour in the UK: cross-sectional data from over 135,145 Hertility users

Abstract Study question We sought to characterise the reproductive health of a large cohort of UK-based women to assess the lifestyle of those who were trying to conceive Summary answer The vast majority were experiencing one or more symptoms and a substantial number of women who were trying to conceive were leading an unfavourable lifestyle. What is known already Data regarding the prevalence of female reproductive health conditions within the UK is outdated, heterogeneous and often collected from cohorts unrepresentative of the current background population. Recent evidence suggests 31% of UK-based women experience at least one severe reproductive health symptom annually (Public Health England, 2018), however this data was also collected from a small population. Furthermore, although guidance regarding the optimisation of fertility in those trying to conceive (TTC) is available, the uptake of lifestyle changes to preconception behaviour regarding smoking, recreational drug use, alcohol consumption, body weight and physical activity is unknown. Study design, size, duration A cross-sectional study was conducted on 135,145 women who were >18 years old and completed a health assessment for Hertility, an at-home women’s health testing service available in the UK, between September 2020 and January 2023. Participants/materials, setting, methods Data was collected from women who completed a free virtual health assessment (VHA) on Hertility’s website consisting of up to 24 questions assessing the user’s demographics, lifestyle and medical history. The number of questions presented to the user differed depending on their archetype and only the most recent VHA data was analysed from registered users who completed it multiple times. Counts, means and percentages of completed VHAs were calculated using R software. Main results and the role of chance Of 135,145 users, the most common pre-existing reproductive health conditions reported were polycystic ovary syndrome (12.0%, n = 16,181), endometriosis (4.0%, n = 5,393), fibroids or uterine polyps (3.0%, n = 4,092), pelvic inflammatory disease (1.8%, n = 2,387) and premature ovarian insufficiency (0.2%, n = 311). The majority of all users (80.5%, n = 108,833) reported currently experiencing one or more symptoms indicative of an underlying reproductive or thyroid health condition, most commonly: fatigue (48.5%, n = 65,593), irritability (35.1%, n = 47,426), acne (30.4%, n = 41,071), feeling cold often (30.4%, n = 41,071) and irregular periods (26.7%, n = 36,108). Of the 26.2% (n = 35,352) who reported they were actively TTC, 45.6% (n = 12,920) were consuming alcohol on a weekly basis, 28.1% (n = 9,667) were regular or occasional smokers and 8.4% (n = 2,876) were regular or occasional recreational drug users. Additionally, 3.9% (n = 1,351) and 38.9% (n = 13,541) had a body mass index (BMI) of < 18.5 or > 30 kg/m2 respectively and 12.1% (n = 4279) were not physically active. Limitations, reasons for caution As all data was self-reported, there is a risk of recall bias and false reporting. As the users who completed the VHA were seeking a reproductive healthcare service, there is likely a bias in the selection criteria of study participants. Additionally, users were given limited answer options to select from. Wider implications of the findings UK-based women are receiving inadequate symptom management and preconception counselling, evidenced by the majority of users experiencing one or more active symptoms of a reproductive or thyroid health condition and a substantial number TTC who have BMIs and/or lifestyle behaviour(s) associated with decreased conception and live birth rates. Trial registration number not applicable

O-116 Benefits

Abstract The World Health Organization’s Sustainable Development Goal 3.7 covers sexual and reproductive health to ensure universal access to sexual and reproductive health care services, including family planning, information & education and the integration of reproductive health into national strategies. Globally, infertility is one of the most frequent chronic diseases among men and women of reproductive age. Infertility is associated with a number of different risk factors from medical diseases some being congenital; various infections like tuberculosis, sexually transmitted infections like chlamydia; health-behaviour like smoking, obesity, use of cannabis, advanced age; unsafe abortions; insufficient access to good quality pregnancy care and delivery care; and reproductive risk factors at workplaces and in the environment. In many cases infertility is preventable by reducing risk factors. In order to prevent infertility, national strategies are needed on an individual and societal level. One of the important strategies is to raise fertility awareness for everyone – this includes increased fertility awareness for young adults, their parents, health care staff, teachers and others who are in contact with young adults, but also politicians and stakeholders who have a huge impact on how to organize our societies including sufficient access to safe reproductive care to support people to have the children they desire (or to stay childfree if they prefer). On a global level, surveys and interview studies have repeatedly shown that a high proportion of people have insufficient knowledge regarding fertility and risk factors for infertility, and they falsely believe that medically assisted reproduction is nearly always successful. The studies also show that many people are aware of their limited knowledge. Recent studies find that young adults express a need for being better educated in this field and many prefer a course in sexual education including fertility knowledge when they are undergoing their youth education. Study participants prefer to have fertility knowledge in advance in order better to take care of their fertility potential when they desire to have children. It is also of importance to increase fertility awareness among parents, as a proportion of young adults talk to their parents about when to have children. Parents especially in high-income countries could encourage their children to postpone family building to ages where it could be difficult for their sons and daughters to have sufficient time to have the number of children they desire. Other studies show that also health care professionals like doctors and nurses outside of the fertility field have limited fertility knowledge and hence could give their patients poor advice when it comes to reducing infertility risk factors and when to seek medically assisted reproduction. There are several benefits of globally raising fertility awareness for everyone: 1) to ensure that people are able to make well-informed decision-making regarding their own family building. 2) To prevent infertility and reduce the proportion of people in need of medically assisted reproduction. 3) To be able to organize societies to become family friendly. 4) To support NGOs and others to fight for universal access to safe sexual and reproductive health care including access to contraception, safe abortions and safe pregnancy and delivery care. 5) To secure sufficient access to high-quality medically assisted reproduction for those in need of treatment to become parents. 6) To stop using harmful substances that impact fertility at workplaces and in the environment.

Experiences of women of childbearing age regarding Implanon provision in South Africa.

The World Health Organization has stated that millions of women of childbearing age in developing countries who are not planning to be pregnant are not utilising modern contraceptives such as long-term contraceptives, including Implanon. South Africa had a high rate of women of childbearing age who used Implanon as one of long-term contraception methods from its introduction in 2014. Familiar reasons for women to not use modern contraceptives involved a lack of healthcare facilities, supplies and trained healthcare workers in their area to provide effective contraceptive services in South Africa. This study aimed to explore and describe the experiences of women of childbearing age regarding Implanon provision. The study was conducted in primary health care facilities of Ramotshere Moiloa subdistrict, South Africa. Qualitative, descriptive phenomenological approach was used in this study. Twelve women of childbearing age were purposively sampled. Childbearing age refers to woman in their reproductive ages who will not be regarded as high risk for pregnancy. Semi-structured interviews were utilised to collect data and five Colaizzi's steps of data analysis were used. Data were collected from 12 of 15 selected women of childbearing age who had experience in utilising Implanon contraceptive device. Data saturation was reached after interviewing 12 participants as the information was coming out, repeatedly. Three themes with subthemes emerged from the study, namely period of Implanon use, experiences of obtaining information regarding Implanon and healthcare experiences related to Implanon. It was evident that a lack of effective pre- and post-counselling, eligibility screening and poor management of severe side effects are contributory factors that led to early removal and decline in uptake of the said method. There is also a lack of effective comprehensive Implanon training to some of reproductive service providers.Contribution: It may increase the number of women who still want to use Implanon as a reliable method.

The Role of Doulas in Addressing Disparities, Barriers, and Potential Solutions to Navigating Reproductive Loss

Reproductive loss can take many forms. Common experiences include abortions, stillbirths, or miscarriages. Especially in a post-Roe time and space, the health disparities and stigmas that exist surrounding reproductive loss and those experiencing pregnancy loss have become even more apparent. Health disparities continue to exist through sociodemographic factors such as ethnicity, gender, race, and socioeconomic status. As found in existing literature on individuals’ experiences with reproductive health care, each person’s experiences strongly correlate with their identities. The level of reproductive care and compassion received vary dramatically as a result, with people of color and lower socioeconomic statuses receiving lower quality of care when seeking it out. Trends in unintended pregnancies and access to support resources also reinforce the idea that health disparities are at play. Additionally, intersectionality, or the overlapping of an individual’s multiple identities, plays an important role in the disparities seen within reproductive healthcare as discrimination and other structural factors are designed to benefit certain groups of individuals while putting others at disadvantages. Studies and surveys of individuals who have experienced pregnancy loss have addressed the existence of these inequalities within reproductive health care. Through a reproductive justice perspective, this literature review aims to bring attention to the disparities present in reproductive healthcare and how the work of reproductive loss doulas, which are full-spectrum doulas who honor all reproductive experiences, may address these disparities with sensitive and compassionate care. While addressing nationwide disparities in pregnancy loss, this literature review uses the state of Michigan to also analyze the current legislative efforts designed to expand access to critical reproductive health care services.

Gender norms and access to sexual and reproductive health services among women in the Marrakech-Safi region of Morocco: a qualitative study

IntroductionImproving access to sexual and reproductive health remains a public health challenge, especially for women, whose access is affected by several determinants, such as gender inequality, which is the underlying barrier to all other determinants. Many actions have been carried out, but much remains to be done before all women and girls can exercise their rights. This study aimed to explore how gender norms influence access to sexual and reproductive health services.MethodA qualitative study was conducted from November 2021 to July 2022. The inclusion criteria were women and men aged over 18 years old, living in the urban and rural areas of the Marrakech-Safi region in Morocco. A purposive sampling method was used to select participants. Data were obtained through semi-structured interviews and focus groups with selected participants. The data were coded and classified using thematic content analysis.ResultsThe study highlighted inequitable, restrictive gender norms that lead to stigmatization and affect the sexual and reproductive healthcare-seeking behavior and access of girls and women in the Marrakech-Safi region. These most common gender norms for women include parental refusal, stigmatization, and social exclusion of girls from sexual and reproductive health education services; strong decision-making power of family members over contraceptive use and women’s adherence to pregnancy monitoring and access to supervised delivery; and culturally constructed role allocation, assigning a reproductive role to women and making them responsible for the health of new-borns.ConclusionSexual and reproductive health projects must strive to be gender sensitive. Gender-blind projects are missed opportunities to improve health outcomes and advance gender equality.

Reworking Emergency Medicine Resident Education Post-Dobbs v Jackson Women's Health Organization.

Reworking Emergency Medicine Resident Education Post-Dobbs v Jackson Women's Health Organization.

Non-partner Violence During Pregnancy and Utilisation of Reproductive Healthcare Services by Women in India: An Application of the Andersen–Newman Behavioural Model

Women’s abuse is a global health problem that erodes their self-esteem and saps their energy. Research evidence for India mainly focusses on use of reproductive healthcare services by women based on their experience of intimate partner violence during pregnancy. We hypothesise that non-partner violence during pregnancy can be equally detrimental for women and their children’s well-being. As this aspect remains unexplored, we investigate the relationship between physical non-partner violence (PNPV) faced by women during pregnancy in India and utilisation of three reproductive healthcare services by them, namely antenatal care, institutional delivery and postnatal checks. Using data from the fourth round of the National Family Health Survey and employing binary multivariable logistic regression models under the framework of the Andersen–Newman Behavioural Model of health services utilisation, we find that women who experience PNPV during pregnancy are significantly more likely to give birth in a medical facility but less likely to make use of postnatal care services. Thus, recognising the connection between violence during pregnancy and the utilisation of maternal health services can enable healthcare and other social support organisations to identify the unique needs of pregnant women experiencing abuse and help in reducing such violence from happening in the first place.

Social determinants of health and their relationships to reproductive outcomes.

The medical community has begun to focus on factors that impact not only health but also wellness for both mainstream and disadvantaged communities. Public health initiatives have evaluated nonmedical factors to determine whether they have a broader influence on physical health than traditional medicine, especially in reproductive care. These factors, referred to as social determinants of health (SDOH), affect a variety of medical conditions, have an impact on medical strategies, and suggest that traditional medicine may be more limited than commonly thought. The purpose of this article, therefore, is threefold: First, it will offer a general review of selected components of current SDOH that act as nonmedical factors in health and behavioral wellness. Second, it will present specific SODH and their impact on contraceptive and prenatal care. Finally, it will highlight SODH policies that either enhance or impede the ability of health systems to deliver innovative reproductive services to underserved populations.

Attitudes toward Reproductive Tourism and Cross border reproductive care (CBRC): Legal, Economic, Ethical issues and dilemmas, possibilities and limitations

The goal of the present study is to discuss the issue of Cross-Border Reproductive Care known as CBRC and Reproductive Tourism. The subject is of great interest as this type of tourism has been flourishing in recent years, without, however, being thoroughly researched, regarding the very important, health, quality of medical care, financial, ethics, legality and transparency or illegality, aspects concerning the processes that are carried out for the desired result of human reproduction. In addition, one of the sharpest-increasing types of Cross-Border Reproductive Care is international surrogacy. Thousands of interested people travel abroad for IVF and ICSI treatment, or with the aim to employ the paid services of foreign surrogates. The search for solutions has made CBRC a global industry. It is a multibillion-euro international industry introducing unique legal, financial, ethical, and risk-management challenges and disputes.
 The current study addressed this gap by examining Greek citizens’ attitudes toward Reproductive Tourism and Cross border reproductive and their legal, financial, ethical, consequences. To test the research hypotheses, a survey was conducted on 652 Greek citizens, who answered a questionnaire, which was distributed electronically in the format of a Google form. For the data analysis the study used the multiple correspondence analysis – MCA of sphere of multivariate data analysis.
 The results discuss, as far as the legal dimensions are concerned, the restriction on specific reproductive treatments in the country of residence. IVF and ICSI are allowed in almost all countries but there are legal restrictions regarding the age of the woman or the couple, unmarried couples, single woman, gay, transgender and same-sex couples. As far as the financial dimension of the CBRC is concerned, the study discusses the lack of financial data that is a natural consequence of the lack of both national and global registers. The cost of infertility treatment seems to be one of the most basic reasons for those interested to seek assisted reproductive services outside the borders of their country of origin and residence, and the commercialization of health is an ethical issue that deserves further study in relation to the country of destination. In addition, the study discusses main ethical issues regarding donors and surrogate mothers, among others, which have to do with their exploitation, their moral and physical harm, possible child abuse, parental rights and the sale of babies which are considered of a major importance. Donor or surrogate mothers may suffer from serious and even life-threatening complications. Donor or surrogate mothers from low and economic backgrounds do not have the possibility of legal support and coverage and cannot claim parental rights. Additionally, the study debates the high cost of treatments, health and care benefits, the economic exploitation of women from countries with weak economies, the instrumentalization of women, the legal issues and rights of descendants born in destination countries and in terms of their repatriation, the correct information and informed consent for the medical procedures to be performed, as well as many others because the list is long.
 According to the study the need that is obvious, due to the great impact of the CBRC, concerns the creation of a universal protocol through the European Council and the College of Obstetrics and Gynaecology (EBCOG) as well as the American College of Obstetrics and Gynaecology (ACOG) to remove all the above mentioned issues , issues and moral dilemmas that above all will guarantee the good of health, justice, non-harm, the good of justice, autonomy and self-determination and finally, human rights.

“If I Control Your Body, I Can Fully Control You”: Interpersonal and Structural Violence Findings from the Georgia Medication Abortion Project

Access to medication abortion—the use of medications rather than a surgical procedure for pregnancy termination—is an essential reproductive healthcare service. Following the overturn of Roe v. Wade and federal abortion protections in the United States, medication abortion and telemedicine for abortion are increasingly vital. Black, Latinx, and lower-income women in the United States already experience disproportionate barriers to abortion care and interpersonal and structural violence—interconnected, social systems that police bodily autonomy. This current study examined qualitative data from a larger community-led, reproductive justice project on medication abortion perspectives among Black and Latinx women in a large, urban center in Georgia. We used thematic analysis to examine interviews ( N = 82) with key informants ( n = 20) and interviews ( n = 32) and focus groups ( n = 30) with Black and Latinx women ages 18–51 years. Four violence-related themes were identified: (a) sexual assault and intimate partner violence as reasons for abortion; (b) reproductive coercion by partners and family members; (c) reproductive coercion by predominantly White providers; and (d) abortion bans, the legacy of enslavement, immigration enforcement, and poverty as structural violence. Shifting family planning care to be patient- and community-centered, in conjunction with policy advocacy to change oppressive systems, is critical.

General and reproductive healthcare experiences of formerly incarcerated women in the United States: a qualitative study

PurposeThe US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.Design/methodology/approachAfter obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.FindingsThe authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.”Originality/valueWomen face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

Evidence for "Whole Family Approach" in accelerating uptake of COVID-19 and routine immunizations among integrated primary health services in Nigeria.

The family is the simplest unit but possesses the strongest bond in society. These qualities - bond and proximity - that exist both within and across neighboring families, according to our research, can be instrumental in shaping a new kind of health promotion strategy that can transform health behaviors in communities. The Whole Family Approach (WFA) is a government-sanctioned approach to increase uptake of COVID-19 vaccines in Nigeria. The approach entails leveraging the high family-based demand for some primary health services, such as malaria, diabetes, hypertension, and reproductive services, to generate demand for COVID-19 and routine immunizations. However, since the announcement in 2021, there has been no available evidence to show the impact of the approach on COVID-19 vaccine uptake, though global literature generally favors family-centered health approaches. This study tests the effectiveness of the approach in increasing the utilization of target services in a Nigerian community and further provides a theoretical framework for the strategy. Two primary healthcare facilities were selected in two communities located in Abuja in a quasi-experimental design. After a small-sample landscape assessment of the communities and the facilities, family-targeting health promotion activities were facilitated in the intervention community (integrated health education by trained community health influencers) and facility (opportunistic health promotion through in-facility referrals) for one month. Anonymized service utilization data were acquired from both facilities over a period of four months to analyze their respective month-by-month service utilization trends. Time trend analysis was conducted and revealed that WFA significantly increased service utilization (N = 5870; p < 0.001, α = 0.01, 99% CI) across all the package services provided at the intervention facility. A supplementary Pearson's correlation analysis further presented a positive relationship (r = 0.432-0.996) among the services which favored the result. It can therefore be concluded that the "Whole Family Approach" of health promotion is efficacious in accelerating uptake of priority health services such as COVID-19 and routine immunizations. While there is more to be understood about this interesting approach, we recommend the improvement of communication and capacity gaps in Nigeria's primary healthcare system to ensure that promising strategies such as the WFA are adequately implemented at the community and facility levels.

Optimizing Care for Military Women: The Value of the Dual-Certified Family and Women's Health Nurse Practitioner.

The number of women in the military has more than tripled over the past 50 years, increasing from 5% in the 1970s to 17% in 2023, making them essential for global health engagement and military operations. Provider competence and confidence are barriers to the consistent availability of preventive, gynecologic, and reproductive services for women across service locations and duty platforms. The Defense Health Board recommends standardizing services and improving the availability and scope of services for women at every point of care. In direct conflict with these recommendations, however, is a congressional call for a drawdown of medical forces, which creates a need for operationally trained clinicians with a broad skill set including comprehensive care for women. Advanced practice registered nurses, such as family and women's health nurse practitioners, are key assets to fill this gap on military medical health-care teams. At the request of the U.S. Air Force, the Graduate School of Nursing at the Uniformed Services University began offering a Women's Health Nurse Practitioner (WHNP) program in 2014. The WHNP curriculum was layered onto the existing Family Nurse Practitioner program so that Family Nurse Practitioner students receive enhanced education in women's health and WHNP students are prepared to meet the holistic, primary care needs of patients across the lifespan in addition to caring for women with obstetric and urogenital health concerns. This article highlights the value of dual-certified Family Nurse Practitioners and WHNPs in the military health-care system. These Uniformed Services University alumni are uniquely prepared to provide comprehensive primary and specialty care for female warfighters across the lifecycle from stable, well-resourced duty stations to austere, operational settings or deployment platforms.

Prospects for Regulating the Right to Posthumous Reproduction in the Context of War in Ukraine: Foreign Experience and Formation of Legal Support for the Realisation of Reproductive Rights of Military Personnel

Background: This article focuses on the analysis of posthumous reproduction regulation perspectives in Ukraine through the lens of war risks, considering how the reproductive rights of male and female military personnel could be best guaranteed. In particular, the peculiarities of different legal and ethical problems, like formal requirements for the disposal of reproductive biological material and embryos in case of death, as well as issues of inheritance and establishment of paternity/maternity, are disclosed. The problem of posthumous reproduction legal regulation unification in the application of technology of posthumous reproduction is considered. Attention is also focused on the possibility of reproductive tourism for the sake of posthumous reproduction. Methods: The methodological framework of the study was a range of philosophical, general, and legal methods. The-dialectical method of cognition made it possible to investigate the problem’s social and ethical content and legal form and conduct a systematic theoretical and legal analysis of the applying posthumous reproduction in practice, especially under the scope of risks for health and life, which are conditioned by war in Ukraine. Thanks to the comparative method, the diversity of posthumous reproduction regulation models worldwide was investigated and compared with current Ukrainian draft Laws, particularly considering which of the models listed could best fit the Ukrainian law and moral traditions and the current situation in our country. With the help of a formal-legal approach, the content and peculiarities of contractual and legal practice were analysed. Results and Conclusions: It was comprehensively considered that posthumous reproduction should be allowed and regulated in the special law of Ukraine, which must perform the clear and justified legal framework to protect the rights of all participants of these sensitive relationships: consumers and performers of these reproductive services, as well as so-called postmortal children.

Provision of Postpartum Contraception Before and After the Start of the COVID-19 Pandemic in Maine.

Preliminary findings from selected health systems revealed interruptions in reproductive health care services due to the COVID-19 pandemic. We estimated changes in postpartum contraceptive provision associated with the start of the COVID-19 pandemic in Maine. We used the Maine Health Data Organization's All Payer Claims Database for deliveries from October 2015 through March 2021 (n = 45 916). Using an interrupted time-series analysis design, we estimated changes in provision rates of long-acting reversible contraception (LARC), permanent contraception, and moderately effective contraception within 3 and 60 days of delivery after the start of the COVID-19 pandemic. We performed 6- and 12-month analyses (April 2020-September 2020, April 2020-March 2021) as compared with the reference period (October 2015-March 2020). We used Poisson regression models to calculate level-change rate ratios (RRs) and 95% CIs. The 6-month analysis found that provision of LARC (RR = 1.89; 95% CI, 1.76-2.02) and moderately effective contraception (RR = 1.51; 95% CI, 1.33-1.72) within 3 days of delivery increased at the start of the COVID-19 pandemic, while provision of LARC (RR = 0.95; 95% CI, 0.93-0.97) and moderately effective contraception (RR = 1.08; 95% CI, 1.05-1.11) within 60 days of delivery was stable. Rates of provision of permanent contraception within 3 days (RR = 0.70; 95% CI, 0.63-0.78) and 60 days (RR = 0.71; 95% CI, 0.63-0.80) decreased. RRs from the 12-month analysis were generally attenuated. Disruptions in postpartum provision of permanent contraception occurred at the beginning of the COVID-19 pandemic in Maine. Public health policies should include guidance for contraceptive provision during public health emergencies and consider designating permanent contraception as a nonelective procedure.

Reproductive slavery: Historical and present-day discussions of the Black female body as a condition of confinement

From history to present day, various territories have utilized both socio-political systems and compulsory powers to place restrictions on reproductive information, healthcare, supplies, procedures, and services pertaining to birth control, sterilization, emergency contraception, and abortion. Quintessentially, these restrictions have uniquely impacted African American women, limiting reproduction for some, and mandating it others. This article takes a comparative historical approach and examines reproductive slavery in the United States during the Atlantic Slave Trade (1619–1865), as well as reproductive restrictions implemented over the last fifty years (1970–2022). This article asserts that the events and policies that occurred in the latter era are an extension of colonial reproductive slavery. Further, this article includes a discussion on the critical importance of intersectional feminist perspectives in discussions of reproductive policies, bodily autonomy, and labor markets.

Research Priorities to Support Women Veterans' Reproductive Health and Health Care Within a Learning Health Care System.

Research Priorities to Support Women Veterans' Reproductive Health and Health Care Within a Learning Health Care System.