Potential demand for and access to medication abortion among North Carolina college students.

Objective: To estimate demand for medication abortion (MAB) among North Carolina (NC) college students and describe access to nearest clinics offering MAB to each campus.

Methods: We calculated demand using 2019-2020 campus demographics and NC abortion statistics. We used a mystery client technique to gather MAB cost and appointment wait times at the closest clinics and calculated travel distances and times.

Single-Visit Long-Acting Reversible Contraception Initiation Among Adolescents Before and During COVID-19.

Purpose: Single-visit long-acting reversible contraception (LARC) is cost-effective and convenient. Our objective was to compare incidence of single-visit LARC placement and associated factors during the year before the COVID-19 pandemic (March 15, 2020) and the first year of the pandemic.

Methods: This retrospective cohort study analyzed electronic health records from a large healthcare system.

Distance Traveled for Abortion at a North Carolina Tertiary Care Center Following Restrictive Legislation.

Background: North Carolina enacted 5 statutes restricting abortion between 2011 and 2016. Our objective was to compare the proportion of women who traveled more than 25 miles to a Southern tertiary care center during 2 distinct time periods (2011 and 2017).

Methods: We conducted a time-series retrospective cohort study of women who obtained an abortion at University of North Carolina hos-pitals in 2011 and 2017.

Single-visit insertion of long-acting reversible contraception in a single health system.

Objective: To identify patient and practice characteristics associated with single-visit placement of long-acting reversible contraception (LARC) across the University of North Carolina Health system.

Study Design: We conducted a retrospective observational study using existing electronic health records. We abstracted data from charts of individuals ages 15-50 years who received a LARC device between March 15, 2019, and March 14, 2021.

Unfulfilled Requests for Postpartum Tubal Ligation at a Southern Tertiary Care Center.

Nationally, multiple barriers lead only 50% of women who request postpartum tubal ligation to receive it prior to discharge. We aimed to identify characteristics associated with unfulfilled requests for postpartum tubal ligation at a tertiary medical center in the South. We conducted a retrospective chart review of all women delivering a live infant with a documented desire for postpartum sterilization between September 1, 2018, and November 30, 2018.

Comparing Website Identification for Crisis Pregnancy Centers and Abortion Clinics.

Background: Crisis pregnancy centers (CPCs) seeking to dissuade women from abortion often appear in Internet searches for abortion clinics. We aimed to assess whether women can use screenshots from real websites to differentiate between CPCs and abortion clinics.

Methods: We conducted a cross-sectional, nationally representative online study of English- and Spanish-speaking women aged 18-49 years in the United States.

Pregnancy Medicaid Improvements in a Nonexpansion State After the Affordable Care Act.

One-half of women in the United States use Medicaid during pregnancy. Women living in states that did not expand Medicaid under the Patient Protection and Affordable Care Act (ACA) are at risk of losing coverage post partum. We analyzed Medicaid claims and vital statistics for the state of North Carolina for the period 2011 to 2017.

Women's knowledge of their state's abortion regulations. A national survey.

Objectives: States vary significantly in their regulation of abortion. Misinformation about abortion is pervasive and propagated by state-mandated scripts that contain abortion myths. We sought to investigate women's knowledge of abortion laws in their state.

The Impact of a 72-hour Waiting Period on Women's Access to Abortion Care at a Hospital-Based Clinic in North Carolina.

In 2015, North Carolina became the 5th state to pass legislation requiring women to undergo state-mandated counseling 72 hours prior to abortion. Whether this legislation has changed the timing of abortion decision-making or receipt of care is not known. This is a cross-sectional study using anonymous survey data from women presenting for abortion at a hospital-based abortion clinic in North Carolina.

Risk-Reducing Salpingectomy Versus Standard Tubal Sterilization: Lessons From Offering Women Options for Interval Sterilization.

Objectives: In women receiving sterilization, the removal of the entire fallopian tube, a procedure referred to as a risk-reducing salpingectomy (RRS), reduces subsequent ovarian cancer risk compared with standard tubal sterilization procedures. There are limited data on which surgical procedure women will choose when educated about the benefits of an RRS. Our objective was to study the proportion of women desiring sterilization that would choose an RRS.

What Is New in Global Women's Health? (Part 2): Best Articles From the Past Year.

This month we focus on current research in women's global health. Drs. Stuart and Ramsey discuss five recent publications, which are concluded with a "bottom line" that is a take-home message.

What Is New in Global Women's Health? (Part 1): Best Articles From the Past Year.

This month we focus on current research in global women's health. Drs. Ramsey and Stuart discuss four recent publications, which are concluded with a "bottom line" that is a take-home message.

Interval Female Sterilization.

Female sterilization is relied on by nearly one in three women aged 35-44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician-gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion.

Medical abortion reversal: science and politics meet.

Medical abortion is a safe, effective, and acceptable option for patients seeking an early nonsurgical abortion. In 2014, medical abortion accounted for nearly one third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible.

Amenorrhea rates and predictors during 1 year of levonorgestrel 52 mg intrauterine system use.

Objective: The objective was to evaluate amenorrhea patterns and predictors of amenorrhea during the first year after levonorgestrel 52 mg intrauterine system (IUS) placement.

Study Design: This cohort analysis includes 1714 nulliparous and parous women who received a Liletta® levonorgestrel 52 mg IUS in a multicenter trial to evaluate efficacy and safety for up to 8 years. Participants maintained a daily diary with bleeding information.

Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study.

Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended pregnancy and HIV infection. We evaluated the association of HIV status with dual method use in a cohort of postpartum women. Women completed baseline surveys in the postpartum ward and telephone surveys about contraceptive use 3, 6, and 12 months later.

Management of Intrauterine Contraception in Early Pregnancy.

Objectives: Women with rare intrauterine contraception (IUC) failures are advised to have their IUC removed because of the risk of poor obstetric outcomes with a retained IUC. Specifics regarding IUC removal in early pregnancy including techniques for removal, rates of success, and immediate pregnancy outcomes following removal are not well described, however. The objective of this study was to identify women with an IUC in early pregnancy examined at a tertiary care center with the primary objective of describing IUC removal attempts, IUC removal successes, and pregnancy outcomes at 20 weeks following IUC removal.

Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion.

Objective: To evaluate whether contraceptive insurance coverage for women who present for an abortion is associated with obtaining long-acting reversible contraception or depot medroxyprogesterone acetate (DMPA) on the day the abortion is completed.

Methods: We conducted a prospective cohort study of women presenting for medical or surgical abortion at a single health center in North Carolina. Eligible women were 18 years or older and fluent in English or Spanish.

Patterns of Contraceptive Adoption, Continuation, and Switching after Delivery among Malawian Women.

Women who report use of postpartum family planning may not continue their initial method or use it consistently. Understanding the patterns of method uptake, discontinuation, and switching among women after delivery is important to promote uptake and continuation of effective methods of contraception. This is a secondary analysis of 634 Malawian women enrolled into a prospective cohort study after delivery.

Drug interactions between hormonal contraceptives and antiretrovirals.

Objective: To summarize published evidence on drug interactions between hormonal contraceptives and antiretrovirals.

Design: Systematic review of the published literature.

Methods: We searched PubMed, POPLINE, and EMBASE for peer-reviewed publications of studies (in any language) from inception to 21 September 2015.

Etonogestrel-Releasing Contraceptive Implant for Postpartum Adolescents: A Randomized Controlled Trial.

Study Objective: To compare immediate postpartum insertion of the contraceptive implant to placement at the 6-week postpartum visit among adolescent and young women.

Design: Non-blinded, randomized controlled trial.

Setting And Participants: Postpartum adolescents and young women ages 14-24 years who delivered at an academic tertiary care hospital serving rural and urban populations in North Carolina.

Two-week postpartum intrauterine contraception insertion: a study of feasibility, patient acceptability and short-term outcomes.

Objective: To determine the feasibility and acceptability of inserting the levonorgestrel intrauterine system, LNG 52 mg IUS (LNG IUS), at 2 weeks postpartum.

Study Design: This prospective study of feasibility and patient acceptability recruited women interested in a postpartum LNG IUS and placed the LNG IUS under ultrasound guidance on days 14-20 postpartum. We determined feasibility by our ability to recruit and insert the LNG IUS in our predetermined sample size of 50 women.

Association between contraceptive implant knowledge and intent with implant uptake among postpartum Malawian women: a prospective cohort study.

Background: Long-acting reversible contraception (LARC) can assist women with birth spacing and reduce unintended pregnancies. Sub-Saharan Africa has low uptake of the two available methods of LARC, the subdermal implant and intrauterine contraception (IUC). Our primary objectives were to: 1) calculate the incidence of LARC use among postpartum Malawian women, and 2) assess if LARC knowledge and intent to use LARC were associated with LARC uptake.

Reasons for Intrauterine Device Use, Discontinuation and Non-Use in Malawi: A Qualitative Study of Women and their Partners.

The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Malawi. A unique cohort of women who had enrolled in a trial of postpartum IUD use one year earlier gave insights into reasons for using, discontinuing, or not using the IUD. We conducted in-depth interviews with 18 women one year after they participated in a pilot study of a randomized controlled trial of postpartum IUD insertion, and 10 of their male partners.