Lauren Ralph 2021 Headshot

Lauren Ralph, PhD, MPH

Associate Professor and Epidemiologist

Lauren Ralph, PhD, MPH, is an Epidemiologist at UCSF’s Advancing New Standards in Reproductive Health, and Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences. Her research focuses on young people’s access to abortion and factors influencing their overall reproductive health and well-being. She is an expert on parental involvement requirements for abortion, having led novel research on the impact of these laws. She has published extensively on abortion, including the effectiveness and safety of telehealth medication abortion, accuracy of abortion patients’ self-determination of eligibility for medication abortion, pregnancy decision-making and people’s level of certainty about their pregnancy decisions, the impact of different types of abortion restrictions on people’s ability to access abortion care, and, most recently, on the frequency of abortions taking place outside the formal health care system (self-managed abortion). 

Her research has been cited extensively by national media outlets including the New York Times and Washington Post, and in ongoing legal and advocacy efforts to support young people’s access to reproductive healthcare against an increasingly restricted landscape.  

Dr. Ralph is a former UCSF-Kaiser BIRCWH K12 scholar and completed her PhD and MPH at the University of California, Berkeley. 

For Dr. Ralph’s contact information and full list of publications, click here.

Citations
  • Merz-Herrala AA, Biggs MA, Ehrenreich K, Kaller S, Ralph LJ, Scott KA, Kapp N, Kromenaker T, Perritt J, Kari White, Grossman D. Examining the association between prior medical mistreatment and interest in and support for over-the-counter medication abortion among people seeking in-person abortion in the United States. BMC Health Services Research. April 2026; https://doi.org/10.1186/s12913-026-14505-2.
  • Baba F, Ralph LJ, Biggs MA, McNicholas C, Miller AH, Grossman D. Satisfaction with and Feasibility of No-Test Telehealth Medication Abortion vs In-Person Care with Ultrasound in the United States. Contraception. April 2026; https://doi.org/10.1016/j.contraception.2026.111459.
  • Ralph LJ, Baba F, Ehrenreich K, Natalie Morris, MPH, Biggs MA, Blanchard K, Hernández E, Kapp N, Kromenaker T, Perritt J, Raymond EG, Kari White, Grossman D. Accuracy of Self-Selection for Medication Abortion Using a Prototype Drug Facts Label. JAMA Internal Medicine. April 2026; https://doi.org/10.1001/jamainternmed.2026.0298.
  • Ehrenreich K, Biggs MA, Kaller S, Ralph LJ, Blanchard K, Bustamante CK, Cervantes M, Hauser D, Hernández E, Kapp N, Kromenaker T, Moayedi G, Perritt J, Raymond EG, Kari White, Grossman D. Development of a consumer information leaflet for a prototype over-the-counter mifepristone and misoprostol medication abortion product. Contraception. January 2026; https://doi.org/10.1016/j.contraception.2025.111361.
  • Bryson AE, Oberman M, Lehmann LS, Ralph LJ, Brindis CD, Raymond-Flesch M. Navigating a new frontier: An exploratory study of clinicians’ confidence in their ability to help adolescents access abortion post-Dobbs. Contraception. October 2025; https://doi.org/10.1016/j.contraception.2025.111041.
  • Watson K, Grossman D, Ehrenreich K, Biggs MA, Ralph LJ. Assessing Comprehension of Informed Consent in Abortion Research. Contraception. August 2025; https://doi.org/10.1016/j.contraception.2025.111051.
  • Biggs MA, Baba F, Ralph LJ, Schroeder R, McNicholas C, Miller AH, Grossman D. Psychosocial burden when accessing medication abortion when using no-test telehealth care compared to in-person care with ultrasound. Contraception. March 2025; https://doi.org/10.1016/j.contraception.2025.110894.
  • Biggs MA, Ralph LJ, Ehrenreich K, Kaller S, Blanchard K, Hauser D, Kapp N, Kromenaker T, Moayedi G, Perritt J, Raymond EG, Kari White, Grossman D. No-Test Screening Protocols May Disproportionately Exclude Structurally Oppressed Communities Who Could Benefit from Accessing Medication Abortion. Health Equity. March 2025; https://doi.org/10.1089/heq.2024.0128.
  • Schroeder R, Ralph LJ, Kaller S, Biggs MA. Attitudes regarding the safety of in-clinic and self-managed abortion methods among the US general public in early 2022. Culture Health & Sexuality. February 2025; https://doi.org/10.1080/13691058.2025.2469274.
  • Coleman-Minahan K, Galvez Seminario M, Ralph LJ. Exploring Adolescents' and Young Adults' Abortion Disclosure and Adolescents' Experiences Navigating Colorado's Parental Notification Law. Journal of Adolescent Health. January 2025; https://doi.org/10.1016/j.jadohealth.2024.12.013.
  • Biggs MA, Schroeder R, Kaller S, Grossman D, Scott KA, Ralph LJ. Changes in Support for Advance Provision and Over-the-Counter Access to Medication Abortion. Jama Network Open. January 2025; https://doi.org/10.1001/jamanetworkopen.2024.54767.
  • Ralph LJ, Ehrenreich K, Kaller S, Gurazada T, Biggs MA, Blanchard K, Hauser D, Kapp N, Kromenaker T, Moayedi G, Gil JP, Perritt J, Raymond EG, Taylor D, Kari White, Valladares ES, Williams S, Grossman D. Accuracy of survey-based assessment of eligibility for medication abortion compared with clinician assessment. American Journal of Obstetrics & Gynecology. January 2025; https://doi.org/10.1016/j.ajog.2025.01.008.
  • Wasser O, Ralph LJ, Kaller S, Biggs MA. Catastrophic Health Expenditures for In-State and Out-of-State Abortion Care. Jama Network Open. November 2024; https://doi.org/10.1001/jamanetworkopen.2024.44146.
  • Rocca CH, Gould H, Elizabeth Gonzalez, Foster DG, Isabel Muñoz, PhD, Miriam Parra, RN, Ralph LJ. Cohort profile: the ADAPT study, a prospective study of pregnancy preferences, pregnancy, and health and well-being in the southwestern USA. BMJ Open. September 2024; https://doi.org/10.1136/bmjopen-2024-085372.
  • Adler A, Biggs MA, Kaller S, Schroeder R, Prata N, Scott KA, Ralph LJ. The association of experiences of medical mistrust and mistreatment and ever considering self-managing an abortion. Contraception. August 2024; https://doi.org/10.1016/j.contraception.2024.110697.
  • Ralph LJ, Schroeder R, Kaller S, Grossman D, Biggs MA. Self-Managed Abortion Attempts Before vs After Changes in Federal Abortion Protections in the US. Jama Network Open. July 2024; https://doi.org/10.1001/jamanetworkopen.2024.24310.
  • Krems JM, Grossman D, Ehrenreich K, Ralph LJ. Money and place: Quantifying the types of obstacles associated with seeking an abortion after 10 weeks’ gestation, 2019–2020. Contraception. July 2024; https://doi.org/10.1016/j.contraception.2024.110476.
  • Ralph LJ, Baba F, Biggs MA, McNicholas C, Miller AH, Grossman D. Comparison of No-Test Telehealth and In-Person Medication Abortion. JAMA. June 2024; https://doi.org/10.1001/jama.2024.10680.
  • Wasser O, Ralph LJ, Kaller S, Biggs MA. Experiences of delay-causing obstacles and mental health at the time of abortion seeking.. Contraception: X. March 2024; https://doi.org/10.1016/j.conx.2024.100105.
  • Biggs MA, Becker A, Schroeder R, Kaller S, Scott KA, Grossman D, Raifman S, Ralph LJ. Support for criminalization of self-managed abortion (SMA): A national representative survey. Social Science & Medicine. December 2023; https://doi.org/10.1016/j.socscimed.2023.116433.
  • Biggs MA, Schroeder R, Casebolt TM, Laureano BI, Wilson-Beattie RL, Ralph LJ, Kaller S, Adler A, Gichane MW. Access to Reproductive Health Services Among People With Disabilities. Jama Network Open. November 2023; https://doi.org/10.1001/jamanetworkopen.2023.44877.
  • Kaller S, Upadhyay UD, Ralph LJ, Schroeder R, Biggs MA. Awareness of medication abortion among a nationally representative U.S. sample, 2021-2022. Contraception. September 2023; https://doi.org/10.1016/j.contraception.2023.110078.
  • Ralph LJ, Hasselbacher L. Adolescents and Abortion Restrictions: Disproportionate Burdens and Critical Warnings. Journal of Adolescent Health. July 2023; https://doi.org/10.1016/j.jadohealth.2023.05.002.
  • Ralph LJ, Biggs MA, Ehrenreich K, Grossman D. Accuracy of Self-assessment of Gestational Duration Among Adolescents Seeking Abortion Using Information in Addition to Date of Last Menstrual Period. JAMA Pediatrics. April 2023; https://doi.org/10.1001/jamapediatrics.2023.0483.
  • Adler A, Biggs MA, Kaller S, Schroeder R, Ralph LJ. Changes in the Frequency and Type of Barriers to Reproductive Health Care Between 2017 and 2021. Jama Network Open. April 2023; https://doi.org/10.1001/jamanetworkopen.2023.7461.
  • Kaller S, Ralph LJ, Wingo E, Biggs MA. Abortion terminology preferences: a cross-sectional survey of people accessing abortion care. BMC Women's Health. January 2023; https://doi.org/10.1186/s12905-022-02152-8.
  • Biggs MA, Driver M, Kaller S, Ralph LJ. Unwanted abortion disclosure and social support in the abortion decision and mental health symptoms: A cross-sectional survey. Contraception. October 2022; DOI: 10.1016/j.contraception.2022.10.007.
  • Ralph LJ, Ehrenreich K, Kaller S, Biggs MA. A cross-sectional study examining consideration of self-managed abortion among people seeking facility-based care in the United States. Reproductive Health. August 2022; DOI: 10.1186/s12978-022-01486-8.
  • Rocca CH, Miriam Parra, RN, Isabel Muñoz, PhD, Foster DG, Boscardin WJ, Ralph LJ. Comparison of Pregnancy Preferences Preceding vs Year 1 of the COVID-19 Pandemic. Jama Network Open. July 2022; DOI:10.1001/jamanetworkopen.2022.20093.
  • Biggs MA, Ehrenreich K, Natalie Morris, MPH, Blanchard K, Bustamante CK, Choimorrow SY, Hauser D, Hernandez Y, Kapp N, Kromenaker T, Moayedi G, Perritt J, Ralph LJ, Raymond EG, Valladares ES, Kari White, Grossman D. Comprehension of an Over-the-Counter Drug Facts Label Prototype for a Mifepristone and Misoprostol Medication Abortion Product. Obstetrics & Gynecology. May 2022; DOI: 10.1097/AOG.0000000000004757.
  • Ralph LJ, Foster DG, Barar RE, Rocca CH. Home pregnancy test use and timing of pregnancy confirmation among people seeking health care. Contraception. March 2022; DOI: 10.1016/j.contraception.2021.10.006.
  • Biggs MA, Ralph LJ, Natalie Morris, MPH, Ehrenreich K, Perritt J, Kapp N, Blanchard K, Kari White, Barar RE, Grossman D. A cross-sectional survey of U.S. abortion patients’ interest in obtaining medication abortion over the counter. Contraception. January 2022; DOI: 10.1016/j.contraception.2022.01.010.
  • Ralph LJ, Ehrenreich K, Barar RE, Biggs MA, Natalie Morris, MPH, Blanchard K, Kapp N, Moayedi G, Perritt J, Raymond EG, Kari White, Grossman D. Accuracy of self-assessment of gestational duration among people seeking abortion. American Journal of Obstetrics & Gynecology. December 2021; doi: 10.1016/j.ajog.2021.11.1373.
  • Ralph LJ, Foster DG, Barar RE, Rocca CH. Home pregnancy test use and timing of pregnancy confirmation among people seeking healthcare. Contraception. November 2021; DOI: 10.1016/j.contraception.2021.10.006.
  • Raifman S, Ralph LJ, Biggs MA, Grossman D. “I’ll just deal with this on my own”: a qualitative exploration of experiences with self-managed abortion in the United States. Reproductive Health. May 2021; 2021; 18:91.
  • Raifman S, Biggs MA, Ralph LJ, Ehrenreich K, Grossman D. Exploring attitudes about the legality of self managed abortion in the US: Results from a nationally representative survey. Journal of Sexuality Research and Social Policy. March 2021; [Epub ahead of print].
  • Jovel IJ, Cartwright AF, Ralph LJ, Upadhyay UD. Abortion waiting periods and decision certainty among people searching online for abortion care. Obstetrics & Gynecology. March 2021; [Epub ahead of print].
  • Wingo E, Ralph LJ, Kaller S, Biggs MA. Abortion method preference among people presenting for abortion care. Contraception. December 2020; 103(4):269-275.
  • Ralph LJ, Foster DG, Biggs MA, Samari G, Upadhyay UD, Gerdts C, Grossman D. Prevalence of self-managed abortion among women of reproductive age in the United States. JAMA. December 2020; 3(12):e2029245.
  • Biggs MA, Neilands TB, Kaller S, Ralph LJ. Developing and validating the Psychosocial Burden among people Seeking Abortion Scale (PB-SAS). PLOS One. December 2020; 15(12):e0242463.
  • Rowland B, Rocca CH, Ralph LJ. Certainty and intention in pregnancy decision-making: An exploratory study. Contraception. November 2020; j.contraception.2020.11.003.
  • Ralph LJ, Chaiten L, Werth E, Daniel S, Brindis CD, Biggs MA. Reasons for and logistical burdens of judicial bypass for abortion in Illinois. Journal of Adolescent Health. October 2020; S1054-139X(20)30508-5.
  • Ralph LJ, Foster DG, Rocca CH. Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women. Perspectives on Sexual and Reproductive Health. March 2020; 52(1):39-48.
  • Gollub EL, van de Wijgert JHHM, Jones H, Ralph LJ, Padian NS. ECHO: context and limitations. The Lancet. February 2020; 395(10222):E24.
  • Jewell BL, Smith JA, Padian NS, van de Wijgert JHHM, Gollub EL, Jones HE, Ralph LJ, Hallet TB. ECHO: context and limitations. The Lancet. February 2020; 395(10222):E25-26.
  • Samari G, Foster DG, Ralph LJ, Rocca CH. Pregnancy preferences and contraceptive use among US women. Contraception. January 2020; 101(2):79-85.
  • Ralph LJ, Mauldon J, Biggs MA, Foster DG. A Prospective Cohort Study of the Effect of Receiving versus Being Denied an Abortion on Educational Attainment. Women's Health Issues. November 2019; 29(6):455-464.
  • Gollub EL, Jones HE, Ralph LJ, van de Wijgert JHHM, Padian N, Stein Z. The Need for Policy Change Regarding Progestin-Only Injectable Contraceptives. Journal of Women's Health. September 2019; 28(9):1180-1184.
  • Ralph LJ, Schwarz EB, Grossman D, Foster DG. Self-reported Physical Health of Women Who Did and Did Not Terminate Pregnancy After Seeking Abortion Services: A Cohort Study. Annals of Internal Medicine. June 2019; 171(4):238-247.
  • McCarthy KJ, Gollub EL, Ralph LJ, van de Wijgert JHHM, Jones HE. Hormonal contraceptives and the acquisition of sexually transmitted infections: an updated systematic review. Sexually Transmitted Diseases. May 2019; 46(5):290-296.
  • Biggs MA, Ralph LJ, Foster DG, Grossman D. Support for and interest in alternative models of medication abortion provision among a national probability sample of U.S. women. Contraception. February 2019; 99(2):118-124.
  • Rocca CH, Ralph LJ, Wilson M, Gould H, Foster DG. Psychometric Evaluation of an Instrument to Measure Prospective Pregnancy Preferences: The Desire to Avoid Pregnancy Scale. Medical Care. February 2019; 57(2):152-158.
  • Nance N, Ralph LJ, Padian N, Cowan F, Buzdugan R, Mushavi A, Mahomva A, McCoy SI. Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe. BMC Women's Health. November 2018; 18(1):193.
  • Ralph LJ, Belusa E, Foster DG, Brindis CD, Biggs MA. The Impact of a Parental Notification Requirement on Illinois Minors' Access to and Decision-Making Around Abortion. Journal of Adolescent Health. March 2018; 62(3):281-287.
  • Foster DG, Biggs MA, Ralph LJ, Gerdts C, Roberts SCM, Glymour MA. Socioeconomic Outcomes of Women Who Receive and Women Who Are Denied Wanted Abortions in the United States. American Journal of Public Health. January 2018; 108(3):407-413.
  • Roberts SCM, Belusa E, Turok DK, Combellick S, Ralph LJ. Do 72-Hour Waiting Periods and Two-Visit Requirements for Abortion Affect Women's Certainty? A Prospective Cohort Study. Women's Health Issues. July 2017; 27(4):400-406.
  • Ralph LJ, Foster DG, Kimport K, Turok DK, Roberts SCM. Measuring decisional certainty among women seeking abortion. Contraception. March 2017; 95(3):269–278.
  • Sisson G, Ralph LJ, Gould H, Foster DG. Adoption Decision Making among Women Seeking Abortion. Women's Health Issues. March 2017; 27(2):136-144.
  • Roberts SCM, Ralph LJ, Sharon C. Wilsnack, Foster DG. Which women are missed by primary health-care based interventions for alcohol and drug use?. Addict Behav. April 2016; 55:32-7.
  • Ralph LJ. Hormonal contraceptive use and women's risk of HIV acquisition: priorities emerging from recent data.. Current Opinion in Obstetrics and Gynecology. December 2015; 27(6):487-95.
  • Ralph LJ, Gollub EL, Jones HE. Hormonal contraceptive use and women's risk of HIV acquisition: priorities emerging from recent data. Current Opinion in Obstetrics and Gynecology. December 2015; 27(6):487-95.
  • Ralph LJ, Gould H, Baker A, Foster DG. The Role of Parents in Minor’s Decisions to Have an Abortion and Anticipated Coping After Abortion. Journal of Adolescent Health. April 2014; 54(4):428-34.
  • Minnis AM, Marchi K, Ralph LJ, Biggs MA, Combellick S, Arons A, Brindis CD, Braveman P. Limited Socioeconomic Opportunities and Latina Teen Childbearing: a Qualitative Study of Family and Structural Factors Affecting Future Expectations.. J Immigr Minor Health. April 2013.
  • Foster DG, Biggs MA, Ralph LJ, Arons A, Brindis CD. Family Planning and Life Planning: Reproductive Intentions Among Individuals Seeking Reproductive Health Care. Women's Health Issues. September-October 2008; 18:351-359.

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April 13, 2026

Examining the association between prior medical mistreatment and interest in and support for over-the-counter medication abortion among people seeking in-person abortion in the United States

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