This is a prospective cohort study. We will identify women who present to Planned Parenthood League of Massachusetts (PPLM) with pregnancy of unknown location (PUL) who desire medication abortion. For the purposes of this study, PUL will be defined as no intrauterine gestational sac visualized on ultrasound. Women with PUL who are eligible for immediate ...Read more >

We conducted a prospective cohort study exploring a broadened use of ulipristal acetate as a pharmacologic cervical preparation agent with adjunct misoprostol prior to second trimester surgical abortion procedures between 16 – 18 6/7 weeks. We enrolled 13 participants. All procedures were completed in the expected time frame with no complications. We found that ulipristal ...Read more >

Abortion stigma is pervasive in the United States. This study focuses on individual-level abortion stigma, defined as the way in which stigma is internalized and experienced as guilt and shame. While abortion itself does not cause mental illness, abortion stigma, which induces secrecy, thought suppression, and isolation, may worsen psychological responses to the procedure. Few ...Read more >

Crisis pregnancy centers (CPCs) provide pregnancy-related services with the intent of dissuading people from seeking abortions. Half of states support CPCs through funding or mandatory referrals. Our study has two aims: (1) to spatially map the distribution and concentration of CPCs and abortion facilities (AFs) in states that do and do not support CPCs, and ...Read more >

The Department of Health and Human Services’ (HSS) 45 Code of Federal Regulations (CFR) part 46 requires extra protections for vulnerable populations in clinical research. Subpart B of this document categorizes pregnant women as a vulnerable population. This restrictive categorization has been criticized based on the lack of evidence that pregnant women, including women seeking ...Read more >

We do not know when oxytocin receptor (OXTR) expression increases during gestation above non-pregnant levels or when the myometrium becomes responsive to oxytocin. Oxytocin is the most effective pharmacologic prophylaxis of hemorrhage in term deliveries, but utility in second trimester abortion is unknown. Prior research has indicated there is minimal oxytocin receptor expression in early ...Read more >

Dilation and evacuation at 16 to 20 weeks’ gestation is generally performed as a two-day procedure in which cervical dilation is achieved with overnight preparation. When cervical preparation and dilation and evacuation can be performed on the same day, women are spared a multi-day procedure and access to abortion is increased. The Society of Family ...Read more >

No clear guideline currently exists for best practices involving cervical preparation for women planning dilation and evacuation at 20 weeks and greater. I plan to perform a pilot, randomized, double-blind, placebo-controlled trial. On day 1, 66 women will receive mifepristone 200 mg orally or placebo 18-24 hours prior to osmotic dilator (Dilapan-S 4-mm) placement (day ...Read more >

Objective: Black race is associated with higher rates of poor pregnancy outcomes, including pregnancy loss and perinatal depression. However, the association between race and adverse mental health outcomes in an early pregnancy loss (EPL) population is not well described. This study aimed to examine the relationship between race and psychometric variables among participants in an ...Read more >

Background: Ulipristal acetate 30 mg (UPA) became available as a Schedule 1 prescription-only emergency contraception (EC) in British Columbia, Canada in September 2015. UPA has been found to be superior in overweight women relative to levonorgestrel (LNG). Canadian data on UPA use is lacking. Objectives: This will be the first study of current EC use ...Read more >