在美国联邦堕胎保护变化之前与之后的自我管理堕胎尝试
Lauren Ralph1, Rosalyn Schroeder1, Shelly Kaller1
1Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland.
JAMA network open
|July 30, 2024
概括
自主流产 (SMA) 在失去联邦保护后增加. 边缘化群体,特别是年轻人,使用SMA方法效率较低,强调需要更安全的堕胎护理.
科学领域:
- 生殖健康 生殖健康
- 公共卫生政策 公共卫生政策
- 卫生社会学 卫生社会学
背景情况:
- 在美国,减少对以设施为基础的堕胎的机会,需要了解自我管理堕胎 (SMA) 的趋势.
- 2022年6月联邦堕胎保护的推翻创造了一个不断变化的政策格局,影响了生殖选择.
- 之前的研究没有在这种不断变化的背景下检查SMA患病率的变化.
研究的目的:
- 为了估计2022年6月最高法院裁决之前和之后美国普通人口中SMA患病率的变化.
- 为了确定与SMA使用相关的人口因素.
- 为了预测终身SMA患病率.
主要方法:
- 在美国从2021年12月到2023年7月进行的连续横截面调查.
- 包括说英语或西班牙语的参与者在出生时被分配为女性,年龄在18-49岁 (或15-17岁,如果适用).
- 用离散时间事件历史模型分析自我报告的SMA尝试,相关因素和预计的终身流行率.
主要成果:
- 曾经尝试过SMA的个人的加权调整比例从2021-2022年的2.4%增加到2023年的3.4%.
- 在非西班牙裔黑人和性/性别少数群体参与者中,SMA的经历更高.
- 很大一部分SMA尝试 (约40%) 发生在20岁之前,经常使用草药,物理方法或物质.
结论:
- 在失去联邦堕胎保护后,观察到SMA使用量的增加.
- 调查结果表明,在边缘化群体中,SMA使用率较高,经常采用不太有效的方法.
- 迫切需要扩大获得安全有效的堕胎护理模式的机会,并保护寻求SMA后医疗护理的个人.
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