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News from ANSIRH

ANSIRH News

Some prenatal care patients feel uncertain about their pregnancy

Most women are sure of their decision to continue a pregnancy or have an abortion before meeting with a clinician. This study found that a subset of women entering prenatal care, about 1 in 10, want to discuss their pregnancy options with their provider. Women living in states with restrictive abortion policies and women facing socioeconomic hardships, including food insecurity, were especially interested in talking about their options. Clinicians should be prepared to offer unbiased, non-directive counseling and referrals to patients in need.

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Women with higher levels of reproductive autonomy appear to experience lower levels of abortion stigma

Our study finds that women who have higher levels of reproductive autonomy may experience lower levels of abortion stigma following an abortion. Stigma following the event of an abortion can affect a woman’s emotional well-being.  Women who have an abortion can face judgment from others, shame or guilt. However, an increased sense of reproductive autonomy, or the power a woman has over her reproductive decisions, may reduce stigma felt after an abortion. Thus, stigma-reduction interventions aimed at increasing reproductive autonomy may be helpful for women who have an abortion.

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New methods to include LGBTQ people in pregnancy risk research

There is little research about the needs and experiences of LGBTQ people in relation to abortion, contraception, and pregnancy.  To address this gap, we created a survey with existing and new measures to assess sexual behavior and reproductive anatomy. We assessed the appropriateness of these questions through 39 cognitive interviews with people assigned female at birth who identified as LGBTQ. Participants responded positively to the questions, and gave constructive feedback about pregnancy intention measures. This study provides crucial guidance on how to evaluate the inclusion of LGBTQ people in abortion and contraception research.

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Mandatory ultrasound viewing laws limit decisional autonomy

Research on mandatory pre-abortion ultrasound viewing laws has focused on whether they dissuade women from abortion, finding only a very small effect. In this study, we examined whether these laws affect women’s decisional autonomy by compelling viewing, finding evidence that they change women’s viewing decision making, substantially increasing rates of viewing.  Moreover, this effect differs by race, with larger impacts on the viewing behavior of black women compared with white women.  Findings call for renewed attention at a macro level to the coercive power of laws regulating abortion.

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Research roadmap seeks to expand access to medication abortion in safe, effective and user-friendly ways

Our research roadmap seeks to understand self-manage abortion and to generate critical evidence to remove unnecessary restrictions and provide medication abortion in user-friendly and accessible ways, with a focus on two complementary goals.

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Laws targeting drug use in pregnancy have become more punitive

States are increasingly regulating drug use in pregnant women, yet little is known about these laws. We analyzed over 40 years of state-level policy in this arena and found that the number of states with one or more policies targeting drug use during pregnancy has increased substantially, and that these policies have become more punitive. We compared policies targeting alcohol use during pregnancy and drug use during pregnancy, and found that, with the exception of Mandatory Warning Signs, drug-related policies and alcohol-related policies almost entirely overlap.

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Abortion safety does not differ depending on facility type

Thirteen states have laws that require abortion clinics to meet the standard of Ambulatory Surgical Centers (ASCs). This is the first study to directly investigate the safety of abortions performed in ASCs compared to office-based settings. There was no significant difference in rates of complications after having an abortion in an ASC compared to having an abortion in an office-based setting.  Laws that mandate that abortions be performed in ASCs do not increase the safety of abortions.

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State policies targeting alcohol use in pregnancy result in worse birth outcomes

Using data from over 148 million births over 50 years, we found that most state-level policies do not improve birth outcomes, and that several policies are associated with poorer birth outcomes, such as low birthweight, premature birth, and a low APGAR score. Even policies that are meant to be supportive of pregnant women, such as policies that require mandatory warning signs related to alcohol use during pregnancy, were associated with adverse birth outcomes and decreased prenatal care utilization.

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Study finds abortion-related emergency department visits are extremely rare

We analyzed data from nearly 200 million emergency department (ED) visits between 2009 and 2013 by women of reproductive age and found that among all visits, only about 0.01% (1 in every 10,000) were abortion-related. Previous research on abortion-related ED visits has been conducted at the state level only; this study is the first to use this extensive data set to explore the topic on a national scale.

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California university students face barriers to accessing medication abortion off campus; it would be feasible for student health centers to provide care

We assessed potential demand for medication abortion among California public university students and current barriers to accessing care. We also evaluated the capacity of University of California (UC) and California State University (CSU) student health centers to provide medication abortion on campus.

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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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