Does abortion reduce self-esteem and life satisfaction?

PurposeThis study aims to assess the effects of obtaining an abortion versus being denied an abortion on self-esteem and life satisfaction.MethodsWe present the first 2.5 years of a 5-year longitudinal telephone-interview study that follows 956 women who sought an abortion from 30 facilities across the USA. We examine the self-esteem and life satisfaction trajectories of women who sought and received abortions just under the facility's gestational age limit, of women who sought and received abortions in their first trimester of pregnancy, and of women who sought abortions just beyond the facility gestational limit and were denied an abortion. We use adjusted mixed effects linear regression analyses to assess whether the trajectories of women who sought and obtained an abortion differ from those who were denied one.ResultsWomen denied an abortion initially reported lower self-esteem and life satisfaction than women who sought and obtained an abortion. For all study groups, except those who obtained first trimester abortions, self-esteem and life satisfaction improved over time. The initially lower levels of self-esteem and life satisfaction among women denied an abortion improved more rapidly reaching similar levels as those obtaining abortions at 6 months to one year after abortion seeking. For women obtaining first trimester abortions, initially higher levels of life satisfaction remained steady over time.ConclusionsThere is no evidence that abortion harms women's self-esteem or life satisfaction in the short term

Men can see hormonal contraception as a joint responsibility with their partners

For now, hormonal contraception is available only to women. But to what extent to men help to manage this contraceptive method alongside their partners? In new research, Ann Fefferman and Ushma D. Upadhyay find that despite literature which suggests men can often be absent or coercive in contraceptive management, they are often active partners in this area, even while facing difficult circumstances which can constrain their choices

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion.

BackgroundTo estimate the proportion of pregnant women in Louisiana who do not obtain abortions because Medicaid does not cover abortion.MethodsTwo hundred sixty nine women presenting at first prenatal visits in Southern Louisiana, 2015-2017, completed self-administered iPad surveys and structured interviews. Women reporting having considered abortion were asked whether Medicaid not paying for abortion was a reason they had not had an abortion. Using study data and published estimates of births, abortions, and Medicaid-covered births in Louisiana, we projected the proportion of Medicaid births that would instead be abortions if Medicaid covered abortion in Louisiana.Results28% considered abortion. Among women with Medicaid, 7.2% [95% CI 4.1-12.3] reported Medicaid not paying as a reason they did not have an abortion. Existing estimates suggest 10% of Louisiana pregnancies end in abortion. If Medicaid covered abortion, this would increase to 14% [95% CI 12, 16]. 29% [95% CI 19, 41] of Medicaid eligible pregnant women who would have an abortion with Medicaid coverage, instead give birth.ConclusionsFor a substantial proportion of pregnant women in Louisiana, the lack of Medicaid funding remains an insurmountable barrier to obtaining an abortion. Forty years after the Hyde Amendment was passed, lack of Medicaid funding for abortion continues to have substantial impacts on women's ability to obtain abortions

Prevalence, Awareness, Treatment, and Control of High LDL Cholesterol in New York City, 2004

IntroductionLow-density lipoprotein (LDL) cholesterol is a major contributor to coronary heart disease and the primary target of cholesterol-lowering therapy. Substantial disparities in cholesterol control exist nationally, but it is unclear how these patterns vary locally.MethodsWe estimated the prevalence, awareness, treatment, and control of high LDL cholesterol using data from a unique local survey of New York City's diverse population. The New York City Health and Nutrition Examination Survey 2004 was administered to a probability sample of New York City adults. The National Health and Nutrition Examination Survey 2003-2004 was used for comparison. High LDL cholesterol and coronary heart disease risk were defined using National Cholesterol Education Program Adult Treatment Panel III (ATP III) guidelines.ResultsMean LDL cholesterol levels in New York City and nationally were similar. In New York City, 28% of adults had high LDL cholesterol, 71% of whom were aware of their condition. Most aware adults reported modifying their diet or activity level (88%), 64% took medication, and 44% had their condition under control. More aware adults in the low ATP III risk group than those in higher risk groups had controlled LDL cholesterol (71% vs 33%-42%); more whites than blacks and Hispanics had controlled LDL cholesterol (53% vs 31% and 32%, respectively).ConclusionHigh prevalence of high LDL cholesterol and inadequate treatment and control contribute to preventable illness and death, especially among those at highest risk. Population approaches - such as making the food environment more heart-healthy - and aggressive clinical management of cholesterol levels are needed

Effects of relationship context on contraceptive use among young women

OBJECTIVES: To understand how relationship status influences contraceptive use among young people. STUDY DESIGN: Data were collected as part of a longitudinal study on hormonal contraception among unmarried adolescent and young women who wanted to avoid pregnancy for at least one year, recruited at family planning clinics in the San Francisco Bay area. Follow-up surveys were completed at 3, 6, and 12 months. Longitudinal analysis was used to examine whether relationship characteristics, including type and length of sexual relationship are associated with current use of effective contraception. RESULTS: Among women with a partner at baseline, 78%, 70%, and 61% had the same partner at 3, 6, and 12 months follow up, respectively. Women in casual relationships were less likely to use effective contraceptive methods, compared to women in consistent relationships (AOR=0.67, p<0.01). Women in new relationships (0–3 months) were less likely to use effective contraceptive methods (AOR=0.60, p<0.001) compared to women in relationships more than one year in length. Younger women (AOR=0.76, p<0.05), black women (AOR=0.67, p<0.05) and Latina women (AOR=0.73, p<0.05) were also significantly less likely to use effective contraception. These effects remained even after controlling for condom use. CONCLUSIONS: Relationship type and length are independently significantly associated with current effective contraceptive use among adolescent and young women. Women in casual relationships and new relationships were significantly less likely to use effective contraceptive methods. IMPLICATIONS: Family planning providers should discuss women’s relationship context and association with contraceptive use in order to help women think of contraception as a long term personal strategy. Since relationship status affects contraceptive use, providers and programs that aim to reduce unintended pregnancy can consider strategies to create a paradigm shift around contraceptive use that focuses on the woman’s reproductive goals, current life stage, and life goals