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*Editors' Note: As of January 2017, the Monthly Women's Health Research Review has been discontinued. Below are archived articles for your reference.

Review Identifies Effective Teen Pregnancy, STI Prevention Programs

May 29, 2014

Although many reviews have assessed programs designed to reduce the risk of teen pregnancy, sexually transmitted infections and associated sexual risk behaviors, there is a need for a "comprehensive, updated assessment" of individual programs' effectiveness, according to researchers from Mathematica and Child Trends. The researchers identified 88 high- and moderate-quality studies on 78 such programs, 31 of which demonstrated evidence of effectiveness.

Shared Decision-Making Among Best Practices for Counseling Pregnant Women With Prior C-Section

May 29, 2014

Kim Cox of the University of New Mexico provides "evidence-based guidance on the essential elements" for providers to consider when counseling pregnant women who have had prior cesarean sections about options for mode of birth, including a trial of labor after cesarean (TOLAC) and elective repeat cesarean delivery. Cox recommends a shared decision-making model that incorporates both the provider's and the woman's perspectives. Although not all providers can offer TOLAC, "[g]iven the evidence in favor of [it] as a safe option, women should not continue to be forced to undergo unneeded and unwanted surgery to safely give birth," Cox concludes.

Study Examines Association Between HIV Status, Unintended Pregnancy in Sub-Saharan Africa

May 29, 2014

To better understand the associations between HIV and unintended pregnancy, researchers analyzed data from surveys of women in Nigeria and Zambia about their HIV status, contraceptive use, and abortion and pregnancy history. They found that HIV-positive and HIV-negative women had similar rates of unintended pregnancy and abortion but that HIV-positive women were more likely to have been using contraception when they conceived an unintended pregnancy. The researchers also noted a high unmet need for contraception in the region, concluding that new efforts are needed to improve access to effective methods, especially for HIV-positive women.

Few Details on Abortion Coverage Available To Consumers in ACA's Marketplaces

April 24, 2014

Activists and policymakers on both sides of the abortion-rights debate have expressed frustration with the lack of nationwide standards for the disclosure of abortion coverage information in health plans sold through the Affordable Care Act's insurance marketplaces. To determine how health plans are approaching the issue, the Guttmacher Institute reviewed information available online to consumers through states' marketplaces and the federal HealthCare.gov website. The "vast majority" of plan documents were "silent" about abortion coverage, but guidance from the Obama administration directing plans to list the information could rectify the issue, Guttmacher concludes.

Exercise During Pregnancy Reduces Chance of Cesarean Births, Study Suggests

April 24, 2014

Through a meta-analysis of 16 randomly controlled trials on physical activity during pregnancy, researchers concluded that a structured physical exercise program reduces a woman's chances of a cesarean section delivery by 15% and maternal weight gain by about 1 kilogram, on average. The researchers encourage doctors to advise pregnant patients to follow the American College of Obstetricians and Gynecologists' recommendations to exercise 30 minutes on most days of the week.

Study Examines Role of Parents, Partners in Minors' Abortion Decisions

April 24, 2014

To assess the role of parents and partners in minors' abortion decisions, researchers compared minors' abortion experiences with those of adult women at the same clinic. They found that minors largely experience abortion in similar ways as adults and, for the most part, involve their mothers and partners in their abortion decisions. However, among the minority who felt pressure or a lack of support for their abortion decision, there was an increased likelihood of anticipating poor coping after the procedure. The findings suggest that state-mandated parental involvement requirements, which do not account for individual circumstances, could be harmful for minors' well-being.

Immediate Postpartum Contraceptive Implant Insertion for Adolescents Highly Cost-Effective

April 24, 2014

Researchers from the University of Colorado's Anschutz Medical Campus created an observational study to evaluate the cost-effectiveness of immediate postpartum contraceptive implant insertion for adolescent mothers through a hypothetical state-funded program. They found that repeat pregnancy rates were substantially lower among adolescents who received the implants compared with a control group. Although offering such coverage through Colorado's Medicaid program would increase costs upfront, it would generate savings by 12 months post-insertion, resulting in savings of $6.50 for every dollar spent on implant insertion by 36 months, the study found.

HIV Prevention Strategies Must Involve Women, Address Structural Barriers, Integrate Services

April 24, 2014

Historically, the U.S. response to HIV has focused on men and individual behavior, rather than the "social, cultural, and economic factors" that affect HIV risk, especially for marginalized women, according to Anna Forbes and colleagues. They review the current landscape of HIV prevention strategies and care for women, recommending a new approach that involves women living with HIV in the development of HIV programs, removes "structural barriers to access for women," and integrates service delivery for sexual and reproductive health care, HIV prevention and treatment, and violence intervention.

Reproductive Justice Approach Also Applies to LARC, Commentary Argues

March 28, 2014

In a commentary, Jenny Higgins of the University of Wisconsin highlights the "promise and potential" of long-acting reversible contraception (LARC), as well as its potential "drawbacks." She urges advocates and providers to "integrate a reproductive justice approach into our reproductive health toolkit" by not only improving the affordability and accessibility of LARC but by "respect[ing] women's decisions not to use LARC, their ability to have LARC removed when they wish and their ability to have the children they want to have."

Study Examines STI Prevalence, Risk Among Sexually Minority Women

March 28, 2014

Researchers examined gonorrhea and chlamydia diagnoses at walk-in clinics to assess the prevalence of the sexually transmitted infections (STIs) among women who reported having sex with women. They also assessed sexual risk behaviors, including substance use, finding that sexual minority women were much more likely than heterosexual women to report recent substance use. All of the women diagnosed with gonorrhea and chlamydia had recently had sex with men, including those who identified as lesbian, suggesting that all women who have sex with men should be screened for STIs regardless of sexual identity.

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