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News from ANSIRH

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Women have varied motivations for adopting emergency contraception pills vs the copper IUD as emergency contraception

We explored why young women choose a particular method of emergency contraception (EC), whether EC pills or the copper IUD. We found that women had varied reasons for preferring each type of EC method, and that some young people were unable to access the IUD as EC and felt stigma around repeated use of EC pills. Our findings suggest the need to support women’s decisions to use either EC method, to destigmatize repeat use of EC pills, and to improve access of the IUD as EC.

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Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

Although abortion in the U.S. is very common, it remains highly stigmatized. As part of the Turnaway Study, we assessed perceptions of abortion stigma among people who obtained an abortion near a facility’s gestational limit and compared them to people who were denied abortion because they were past the facility’s gestational limit. We followed both groups over five years. We found that most people seeking abortion perceived abortion stigma both from people close to them and people in their community, and levels of abortion stigma were higher among those who obtained an abortion than among those denied an abortion. Perceptions of abortion stigma soon after seeking an abortion was associated with psychological distress years later.

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Being denied abortion can lead to financial distress that lasts at least 5 years

In recent years, many states have increased their efforts to pass legislation that restricts access to abortion and little was known about the economic and financial consequences these laws have on women and families. In this study, we used Turnaway Study data and examined participants’ credit history three years before they became pregnant and five years after to determine the impact of being denied a wanted abortion.

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Abortion restrictions can make obtaining an abortion impossible for people with complex life situations

States across the U.S. have enacted restrictive abortion laws, and many of those states have multiple restrictive laws in place. We examined how these laws have impacted women who considered, but did not have, an abortion. We found that, for people dealing with complex life situations, including dealing with economic insecurity, mental health, and substance use, restrictive abortion laws can make obtaining abortion care impossible.

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An overwhelming majority of women who have an abortion say the decision was right for them 5 years later

Many states justify laws restricting abortion – like mandatory waiting periods and ultrasound viewing – by claiming that women will come to regret their decisions. We conducted a longitudinal study of women across the country and found that 97.5% of them felt that having an abortion was the right decision one week after obtaining one and 99% felt it was the right decision five years afterward. Women had a full range of emotions, from relief to sadness, but our study found that those emotions decreased over time.

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Scientific evidence is less important than stories in shaping state legislators’ abortion policy decisions

Although research shows that abortion is very safe, many U.S. states have passed laws restricting abortion claiming a concern for patient safety. We interviewed lawmakers in three states about their abortion policy decision-making, and found that stories and the views of trusted intermediaries carried more weight than scientific evidence.

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ANSIRH Research Highlights 2019

Welcome to ANSIRH's accomplishments for 2019. We are proud to share our major achievements from the past year, including publications, media mentions, op-eds, awards, legal and legislative briefs, and other highlights.

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Abortion on TV in 2019

We documented forty-three instances of abortion disclosures or discussions onscreen in 2019, more than we’ve ever observed in a single year. Unlike 2018, the majority of characters featured in abortion plotlines were white, contrary to reality: the majority of people who have abortions are people of color. Other notable trends include multiple depictions of self-managed abortion, portrayed inaccurately as both ineffective and unsafe, as well as slightly more characters portrayed as raising children at the time of their abortion than in previous years.

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Contraceptive counseling should address multiple considerations, not just desire to avoid pregnancy

To provide patient-centered contraceptive counseling and care, providers should consider both patients’ pregnancy preferences and the features that matter to them in a birth control method. Our study with Columbia University used the Desire to Avoid Pregnancy scale, a new instrument that captures the ranges of feelings women might have about a potential pregnancy. The research showed that most women – including those with a high preference for avoiding pregnancy and women who are open to a pregnancy –used contraception. And women with a stronger desire to avoid pregnancy did not use more effective methods. Healthcare providers should consider the features of contraception outside of how effective the method is a preventing pregnancy that can shape patient’s contraceptive decision-making. 

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Receiving versus being denied a wanted abortion is not associated with graduating or dropping out of school over five years

Prior research has been unclear about whether people attain lower levels of education as a result of unintended childbearing itself or as a result of other factors that limit their socioeconomic opportunities. We did not find a difference in graduation or drop-out rates between women who received a wanted abortion compared to women who were denied an abortion. However, among those that graduated, women who received a wanted abortion more often finished a post-secondary (post high school) degree compared to women who were denied a wanted abortion and went on to parent.

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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