Background: Access to safe abortion is declining in the US—especially in the Southeast—and Black, Latinx, and/or lower income women experience disproportionate barriers to abortion care and increased risk for unintended pregnancy, HIV/AIDS, and maternal mortality. Medication abortion has the potential to improve access for marginalized and high-risk women. SisterLove, Inc., a community-based reproductive justice organization ...Read more >

Background: Expanding the pool of trained, competent medication abortion providers is necessary to fill gaps in access to safe abortion in the US. The scope of practice for advanced practice clinicians (APCs), including nurse practitioners (NPs), certified nurse midwives (CNMs) and physician assistants (PAs), extends well beyond the skills required to safely manage medication abortion ...Read more >

Background: Medical abortion with mifepristone and misoprostol is highly effective; however, continuing pregnancy can still occur, especially as gestation advances. Even after completing treatment, some women with continuing pregnancies change their mind. Legislators began to focus on women who change their mind after mifepristone administration following a 2012 report of “medical abortion reversal” in which ...Read more >

Background: Women are seeking abortion at increasingly earlier gestations which increases the likelihood that providers will have difficulty visualizing the pregnancy on ultrasound, the current standard of care in most abortion clinics in the US. Women with no gestational sac visualized on ultrasound have a pregnancy of unknown location (PUL). The most serious risk of ...Read more >

Background: New strategies are needed to help people overcome barriers to abortion and achieve greater reproductive autonomy. Demedicalized models for medication abortion care have the potential to greatly expand access to abortion, particularly for those most affected by distance and cost barriers. Methods: The study is a patient-centered, clinically supported, prospective observational study among people ...Read more >

Despite its critical importance in reproductive health, access to safe abortion care in the US and globally continues to be impaired by laws and policies based on religious, political, or other ideologies. Although there is substantial anecdotal evidence about specific beliefs and rationales for opposing abortion provision, identifying specific attitudes, and exploring how those attitudes ...Read more >

Young transgender men (including young people who are transmasculinizing) face disparities in the provision of reproductive health care including contraception, despite their biologic capacity for pregnancy and evidence that this population has a need and desire for these critical services. There is a paucity of evidence describing the contraceptive preferences of transmasculine patients, with almost ...Read more >

Black women in the US are more likely to experience unintended and short-interval pregnancies, which are associated with increased risk of adverse birth outcomes for mothers and infants. Long-acting reversible contraception (LARC), including the placement of intrauterine devices (IUDs) or implants, is the most effective contraceptive method for reducing unintended and short-interval pregnancies; however, Black ...Read more >

Motivation for contraceptive use hinges on the user’s assumption that they are fertile—capable of conceiving or impregnating. The idea of infertility carries anxiety and stigma for many and, with no way to validate fertility other than attempting pregnancy, may cause people to doubt their reproductive capacity and need for contraception even though they have no ...Read more >

Provision of long-acting reversible contraceptives (LARCs) before women leave the delivery hospital can be difficult for health care systems to achieve due to the high costs of devices and insertion. In response to challenges with the global fee for labor and delivery services, 37 states since 2012 have established mechanisms to provide appropriate reimbursement for ...Read more >