The ability to make informed decisions about reproductive health is a cornerstone principle of the practice of prenatal medical genetics. Unfortunately, these reproductive health decisions have become entangled in the current, contentious political climate. This debate reached an inflection point in 2022 with Dobbs v. Jackson when the Supreme Court of the United States (SCOTUS) overturned the national right to abortion previously established in Roe v. Wade. This decision prompted a reassessment of the opinions of medical students on reproductive health and abortion. Our study focused on a medical school in Alabama, a conservative state that enacted a restrictive abortion ban following the Dobbs ruling. Two surveys, conducted in 2015 and 2022, explored students\' viewpoints on reproductive health topics, including abortion. The comparison revealed a significant shift toward more pro-choice perspectives among medical students. Notably, religious affiliation did not consistently align with opinions, as many Christian students supported pro-choice views. Our results suggest that medical students\' reproductive health opinions at our institution have shifted to a more pro-choice position over the last decade.

Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = -14.77, p < 0.001; upward coercion: t[1160] = -18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist\'s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.

BACKGROUND: Reproductive health and mental health are intertwined, but studies investigating family planning needs and desire for children in mental healthcare are scarce.
METHODS: We studied the experiences of (former) patients, those with close relationships with the (former) patients (close ones) and mental health professionals (MHP) on discussing family planning and desire for children in mental healthcare. We combined quantitative (two nationwide surveys) and qualitative data (four focus groups) in a mixed-methods approach with sequential analytical design.
RESULTS: Combined data from focus groups (n = 19 participants) and two surveys (n = 139 MHPs and n = 294 (former) patients and close ones) showed that a considerable group of MHPs (64.0%), patients (40.9%) and close ones (50.0%) found that family planning should be discussed by a psychiatrist. However, several obstacles impeded a conversation, such as fear of judgment, lack of time and knowledge and limited opportunity for in-depth exploration of life themes in therapeutic relationships.
CONCLUSIONS: To increase the autonomy of patients in discussing family planning, we suggest MHPs explore the desire to discuss family planning with all patients in the reproductive phase of life, prior to discussing contraceptive care. MHPs should receive education about psychiatric vulnerability in relation to family planning and desire for children, and patients and close ones should be empowered to initiate a conversation themselves.

Generally, man plays a more significant role in population health in developing countries like Nigeria, as most of them show no interest in contraceptive use. Hence, to achieve the desired population control in a developing country like Nigeria, men must step up the modern use of contraceptives. The objective of the study was to examine the effect of family planning counselling and media messages about reproductive health on men\'s acceptance of contraceptives. Precisely, the study sought to determine if the use of counselling and radio messages on family planning could enhance the acceptance of contraceptive usage among men in developing countries like Nigeria. The researchers sourced the data for the study from the Nigerian Demographic and Health Survey conducted in 2018 and used the Logit regression method for the data analysis. Results from the analysis showed that counselling at health facilities and radio messages on modern contraceptive use have positive and significant effects on men\'s acceptance of contraceptives. Based on the findings, the study recommended that the best way to increase contraceptive use among men in Nigeria and some other developing countries is to compel pregnant women attending antenatal care services to come with their husbands to the health facility once a month, during which the men could be counselled on the importance of modern contraceptives usage.
De manière générale, l’homme joue un rôle plus important dans la santé de la population dans les pays en développement comme le Nigéria, car la plupart d’entre eux ne manifestent aucun intérêt pour l’utilisation de contraceptifs. Par conséquent, pour parvenir au contrôle démographique souhaité dans un pays en développement comme le Nigéria, les hommes doivent intensifier l’utilisation moderne des contraceptifs. L\'objectif de l\'étude était d\'examiner l\'effet des conseils en matière de planification familiale et des messages médiatiques sur la santé reproductive sur l\'acceptation des contraceptifs par les hommes. Plus précisément, l\'étude cherchait à déterminer si le recours aux conseils et aux messages radio sur la planification familiale pouvait améliorer l\'acceptation de l\'utilisation de la contraception chez les hommes dans les pays en développement comme le Nigeria. Les chercheurs ont extrait les données de l’étude de l’Enquête démographique et de santé nigériane menée en 2018 et ont utilisé la méthode de régression Logit pour l’analyse des données. Les résultats de l\'analyse ont montré que les conseils dispensés dans les établissements de santé et les messages radio sur l\'utilisation des contraceptifs modernes ont des effets positifs et significatifs sur l\'acceptation des contraceptifs par les hommes. Sur la base des résultats, l\'étude recommande que la meilleure façon d\'augmenter l\'utilisation des contraceptifs chez les hommes au Nigeria et dans certains autres pays en développement est d\'obliger les femmes enceintes qui fréquentent les services de soins prénatals à venir avec leur mari à l\'établissement de santé une fois par mois, pendant lequel les les hommes pourraient être conseillés sur l’importance de l’utilisation des contraceptifs modernes.

Though tertiary students studying health-related programs are assumed knowledgeable about family planning, this does not always translate to increased use of family planning services. In a cross-sectional survey, this study assessed 411 nursing, midwifery and allied health students\' knowledge of family planning, contraceptive use, perceptions, and factors affecting the utilisation of family planning services. Each student completed a 24-itemised questionnaire in a Computer-Assisted Personal Interviewing Survey. The data was analysed with Stata /IC version 16. Statistical significance was set at p<0.05. Overall knowledge of family planning was 99.7%, commonly gained in school (51.8%), followed by clinics and hospitals (41.4%). Only 21.7% of the students used family planning services. Menstrual cramps (57.9%), infertility (33.1%), and weight gain (32.5%) were the commonly perceived side effects of contraceptive use. The high proximity of participants to family planning service providers and lack of community, family, and partner acceptance of modern contraceptives were associated with underutilisation. Despite the high level of knowledge of family planning, the student\'s utilisation of family planning services was poor. To boost family planning service uptake among tertiary health students, it is essential to tackle barriers related to community, family, and partner acceptance. This can be achieved through educational programs that involve men in family planning discussions and by enhancing service accessibility.
Même si les étudiants du supérieur qui étudient dans des programmes liés à la santé sont censés connaître la planification familiale, cela ne se traduit pas toujours par une utilisation accrue des services de planification familiale. Dans le cadre d\'une enquête transversale, cette étude a évalué les connaissances de 411 étudiants en soins infirmiers, obstétricaux et paramédicaux en matière de planification familiale, d\'utilisation des contraceptifs, de perceptions et de facteurs affectant l\'utilisation des services de planification familiale. Chaque étudiant a rempli un questionnaire en 24 points dans le cadre d\'une enquête par entretien personnel assisté par ordinateur. Les données ont été analysées avec Stata/IC version 16. La signification statistique a été fixée à p<0,05. La connaissance globale de la planification familiale était de 99,7 %, généralement acquise à l\'école (51,8 %), suivie par les cliniques et les hôpitaux (41,4 %). Seulement 21,7% des étudiants ont utilisé les services de planification familiale. Les crampes menstruelles (57,9 %), l\'infertilité (33,1 %) et la prise de poids (32,5 %) étaient les effets secondaires couramment perçus de l\'utilisation de contraceptifs. La grande proximité des participants avec les prestataires de services de planification familiale et le manque d\'acceptation des contraceptifs modernes par la communauté, la famille et les partenaires étaient associés à la sous-utilisation. Malgré le niveau élevé de connaissances en matière de planification familiale, l\'utilisation des services de planification familiale par les étudiants était faible. Pour stimuler le recours aux services de planification familiale parmi les étudiants de l\'enseignement supérieur en santé, il est essentiel de s\'attaquer aux obstacles liés à l\'acceptation par la communauté, la famille et les partenaires. Cet objectif peut être atteint grâce à des programmes éducatifs qui impliquent les hommes dans les discussions sur la planification familiale et en améliorant l\'accessibilité des services.

BACKGROUND: In Mexico, anemia prevalence among women of reproductive age (WRA) decreased from 16.4% in 2006 to 11.6% in 2012, only to increase to 18.3% in 2016. The factors associated with this fluctuation are uncertain.
OBJECTIVE: We conducted a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in Mexico between 2006 and 2018.
METHODS: Using multivariate stepwise linear regression, we analyzed Mexico\'s Encuesta Nacional de Salud y Nutrición (ENSANUT) surveys from 2006, 2012, and 2018 to identify determinants of WRA anemia. We also conducted a review of anemia-relevant programs and policies, including financing documents, and conducted in-depth interviews and focus group discussions with key stakeholders in Mexico.
RESULTS: Among non-pregnant women (NPW) 15-49 years, mean hemoglobin (Hb) increased from 13.8 g/dL in 2006 to 14.0 g/dL in 2012, decreasing to 13.2 g/dL in 2018 (p<0.001). Inequities by geographical region and household wealth persisted throughout this period, with household wealth, urban residence and gravidity emerging as significant predictors of Hb among NPW. Qualitative analyses generally supported these findings. The most discussed program was Progresa-Oportunidades-Prospera (POP), where most resources for health were invested and most participants acknowledged that its cancellation in 2019 would lead to worsening in health and nutrition among the poor. Financing analyses showed a drop of funding for nutrition-related programs between 2014 and 2018. Cultural norms around gender roles were still prevalent, along with increasing rates of teenage pregnancy.
CONCLUSIONS: Anemia prevention efforts need to refocus on poverty alleviation, continuity of adequate coverage and financing of nutrition programs, especially with safety nets, and increase in uptake of family planning, especially among adolescent girls.

BACKGROUND: In Senegal, anemia prevalence among women of reproductive age (WRA) decreased from 59% in 2005 to 54% in 2017. However, determinants of reduction in disease burden under challenging public health conditions have not been studied.
OBJECTIVE: To conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia reduction among WRA in Senegal between 2005 and 2017.
METHODS: Standard Exemplars in Global Health methodology was used for quantitative analyses using Senegal\'s Demographic and Health Surveys. Qualitative analyses included a systematic literature review, program/policy analysis, and interviews with key stakeholders. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors.
RESULTS: Among non-pregnant women (NPW), mean hemoglobin (Hb) increased from 11.4 g/dL in 2005 to 11.7 g/dL in 2017 (p<0.0001), corresponding to a 5%-point decline in anemia prevalence (58% to 53%). However, inequities by geographical region, household wealth, women\'s educational attainment, urban compared to rural residence, and antenatal care (ANC) during last pregnancy continue to persist. During this time period, several indirect nutrition programs were implemented, with stakeholders acknowledging the importance of these programs, but agreeing there needs to be more consistency, evaluation, and oversight for them to be effective. Our OBDA explained 59% of the observed change in mean Hb, with family planning (25%), malaria prevention programs (17%), use of iron and folic acid (IFA) during last pregnancy (17%), and improvement in women\'s empowerment (12%) emerging as drivers of anemia decline, corroborating our qualitative and policy analyses.
CONCLUSIONS: Despite a reduction in anemia prevalence, anemia remains a severe public health problem in Senegal. To protect the gains achieved to date, as well as accelerate reduction in WRA anemia burden, focused efforts to reduce gender and social disparities, and improve coverage of health services, such as family planning, IFA, and antimalarial programs, are needed.

BACKGROUND: Anemia prevalence among women of reproductive age (WRA) in the Philippines was 25% in 2000, decreasing to 13% in 2018. To date, an in-depth assessment of the determinants associated with this decline has not been conducted.
OBJECTIVE: To conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in the Philippines between 2008 and 2018.
METHODS: Employing standard Exemplars methodology, we conducted quantitative analyses using the Philippines\' National Nutrition Survey, the Expanded National Nutrition Survey, and the Philippines National Demographic and Health Surveys. Qualitative analyses included a comprehnsive literature review, program/policy analysis, and interviews with stakeholders to understand country-level enablers and barriers to WRA anemia decline in the Philippines. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors.
RESULTS: Among non-pregnant women (NPW), mean hemoglobin (Hb) increased from 12.7 g/dL in 2008 to 13.1 g/dL in 2018 (p<0.01), corresponding to an 11%-point decline in anemia prevalence (23% to 12%). Inequities by geographical region, household wealth, and women\'s educational attainment narrowed considerably during this time. Important direct and indirect nutrition programs were introduced during our study period, including universal healthcare and food fortification. Country experts interviewed credited programs focused on alleviating micronutrient deficiencies and poverty, and improvements in women\'s health and well-being, for the country\'s extraordinary success. OBDA explained ∼50% of the observed change in mean Hb among NPW, with family planning (35%), household socio-demographics (29%), and improvement in women\'s nutrition (23%) emerging as critical drivers of anemia decline, corroborating our qualitative and policy analyses.
CONCLUSIONS: To protect these gains, WRA anemia prevention efforts in the Philippines should continue to focus on universal healthcare access, women\'s empowerment, and poverty alleviation.

Assisting women in attaining their reproductive goals is crucial for improving the well-being of families and children. As the first point of contact for healthcare, general practitioners (GPs) are ideal for family planning (FP) and preconception care (PCC). However, primary care interventions\' efficacy is unclear. The aim of this study was to examine GPs\' knowledge, attitudes, and perspectives on FP and PCC service management. Most GPs were aware of FP and PCC services and held a firm conviction that they should be primarily accountable together with obstetrician-gynaecologists. However, it is worth noting that less than 50% of respondents reported receiving thorough and comprehensive knowledge of their respective specialities. Those with general medicine qualifications demonstrated a high level of commitment to providing such services. The women\'s GPs and those with training in general medicine prescribed birth control pills and emergency contraception three times more frequently than the other doctors who suggested condoms or traditional methods or referred patients to another specialist (p < 0.05). In conclusion, PCC is of the utmost importance, and its effective implementation demands the collaboration of policymakers, healthcare providers, and individuals. GPs are essential in managing FP and PCC. They must incorporate more in-depth PCC into their clinical practice.

UNASSIGNED: Contraceptive switching from a more effective to a less effective method is a concern, especially in developing countries with high unmet needs for family planning. Indeed, the lack of understanding regarding the reasons behind contraceptive switching behavior in the study area poses a significant challenge in effectively addressing this issue.
UNASSIGNED: This study aimed to assess the magnitude and factors associated with long-acting contraceptive switching in Mizan-Aman town, southwest Ethiopia.
UNASSIGNED: A community-based cross-sectional study was conducted, involving 345 women randomly selected from the population of married women in their reproductive age group. Data collection was conducted through interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were employed to ascertain factors linked with contraceptive method switching status. Statistical significance was determined at a P-value of less than .05.
UNASSIGNED: Out of the 345 participants interviewed, the prevalence of switching from long-acting to short-acting contraceptives was 28.4%, 95% CI (13.6%, 33.2%). Upon adjusting for confounding variables, factors significantly associated with contraceptive switching included women aged 31-35 [adjusted odds ratio (AOR) = 0.58; 95% CI (0.36, 0.74)] and aged 41-49 [AOR = 0.54; 95% CI (0.48, 0.82)], those with formal education [AOR = 0.79; 95% CI (0.52, 0.87)], those desiring future pregnancy [AOR = 2.12; 95% CI (1.98, 3.38)], experiencing complications from previous method use [AOR = 3.67; 95% CI (2.57, 7.40)], and encountering stockouts of their preferred contraceptive choice [AOR = 2.01; 95% CI (1.39, 3.24)].
UNASSIGNED: The study area exhibited a notable prevalence of switching from long-acting contraceptives. Complications arising from prior method use and the unavailability of preferred contraceptive options emerged as significant factors influencing this switching behavior. Thus, it underscores the importance of providing counseling and ongoing support to women, ensuring access to safer and more effective modern contraceptive methods.