Publisher: BMJ Publishing Group   (Total: 62 journals)   [Sort by number of followers]

Showing 1 - 62 of 62 Journals sorted alphabetically
Acupuncture in Medicine     Hybrid Journal   (Followers: 16, SJR: 0.702, CiteScore: 1)
Annals of the Rheumatic Diseases     Hybrid Journal   (Followers: 34, SJR: 7.699, CiteScore: 8)
Archives of Disease in Childhood     Hybrid Journal   (Followers: 75, SJR: 1.322, CiteScore: 2)
Archives of Disease in Childhood - Education and Practice Edition     Hybrid Journal   (Followers: 20, SJR: 0.652, CiteScore: 1)
Archives of Disease in Childhood - Fetal and Neonatal Edition     Hybrid Journal   (Followers: 72, SJR: 1.837, CiteScore: 3)
BMJ     Hybrid Journal   (Followers: 1702)
BMJ Case Reports     Hybrid Journal   (Followers: 24, SJR: 0.213, CiteScore: 0)
BMJ Global Health     Open Access   (Followers: 8)
BMJ Innovations     Hybrid Journal   (Followers: 5, SJR: 0.491, CiteScore: 1)
BMJ Leader     Hybrid Journal  
BMJ Nutrition, Prevention & Health     Open Access   (Followers: 8)
BMJ Open     Open Access   (Followers: 46, SJR: 1.372, CiteScore: 3)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 29, SJR: 1.128, CiteScore: 2)
BMJ Open Gastroenterology     Open Access   (Followers: 7)
BMJ Open Ophthalmology     Open Access   (Followers: 9)
BMJ Open Quality     Open Access   (Followers: 21)
BMJ Open Respiratory Research     Open Access   (Followers: 7, SJR: 1.188, CiteScore: 2)
BMJ Open Science     Open Access   (Followers: 1)
BMJ Open Sport & Exercise Medicine     Open Access   (Followers: 18)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65, SJR: 2.679, CiteScore: 4)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 1)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 41, SJR: 0.878, CiteScore: 1)
BMJ Surgery, Interventions, & Health Technologies     Open Access   (Followers: 1)
British J. of Ophthalmology     Hybrid Journal   (Followers: 63, SJR: 2.173, CiteScore: 3)
British J. of Sports Medicine     Hybrid Journal   (Followers: 78, SJR: 3.232, CiteScore: 5)
Drug and Therapeutics Bulletin     Hybrid Journal   (Followers: 8, SJR: 0.117, CiteScore: 0)
Emergency Medicine J.     Hybrid Journal   (Followers: 53, SJR: 0.912, CiteScore: 1)
European J. of Hospital Pharmacy : Science and Practice (EJHP)     Hybrid Journal   (Followers: 5, SJR: 0.213, CiteScore: 0)
Evidence-Based Medicine     Hybrid Journal   (Followers: 29, SJR: 0.419, CiteScore: 0)
Evidence-Based Mental Health     Hybrid Journal   (Followers: 133, SJR: 0.839, CiteScore: 1)
Evidence-Based Nursing     Hybrid Journal   (Followers: 67, SJR: 0.125, CiteScore: 0)
Frontline Gastroenterology     Hybrid Journal   (Followers: 1, SJR: 0.39, CiteScore: 1)
General Psychiatry     Open Access   (Followers: 1)
Gut     Hybrid Journal   (Followers: 144, SJR: 7.44, CiteScore: 10)
Heart     Hybrid Journal   (Followers: 55, SJR: 2.853, CiteScore: 3)
Injury Prevention     Hybrid Journal   (Followers: 6, SJR: 1.03, CiteScore: 2)
Intl. J. of Gynecological Cancer     Hybrid Journal   (Followers: 25, SJR: 0.98, CiteScore: 2)
J. for ImmunoTherapy of Cancer     Open Access   (Followers: 7, SJR: 2.798, CiteScore: 6)
J. of Clinical Pathology     Hybrid Journal   (Followers: 13, SJR: 1.05, CiteScore: 2)
J. of Epidemiology & Community Health     Hybrid Journal   (Followers: 64, SJR: 1.932, CiteScore: 3)
J. of Family Planning and Reproductive Health Care     Hybrid Journal   (Followers: 10, SJR: 0.63, CiteScore: 1)
J. of Investigative Medicine     Hybrid Journal   (Followers: 3, SJR: 0.786, CiteScore: 2)
J. of Medical Ethics     Partially Free   (Followers: 32, SJR: 0.618, CiteScore: 1)
J. of Medical Genetics     Hybrid Journal   (Followers: 8, SJR: 3.304, CiteScore: 5)
J. of NeuroInterventional Surgery     Hybrid Journal   (Followers: 1, SJR: 1.551, CiteScore: 3)
J. of Neurology, Neurosurgery & Psychiatry     Hybrid Journal   (Followers: 51, SJR: 3.186, CiteScore: 5)
J. of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6, SJR: 0.303, CiteScore: 1)
Lupus Science & Medicine     Open Access   (Followers: 3, SJR: 1.625, CiteScore: 3)
Medical Humanities     Hybrid Journal   (Followers: 21, SJR: 0.321, CiteScore: 1)
Occupational and Environmental Medicine     Hybrid Journal   (Followers: 18, SJR: 1.913, CiteScore: 3)
Open Heart     Open Access   (Followers: 1, SJR: 1.281, CiteScore: 2)
Postgraduate Medical J.     Hybrid Journal   (Followers: 4, SJR: 0.813, CiteScore: 2)
Practical Neurology     Hybrid Journal   (Followers: 7, SJR: 0.63, CiteScore: 1)
RMD Open     Open Access   (Followers: 1, SJR: 2.169, CiteScore: 3)
Sexually Transmitted Infections     Hybrid Journal   (Followers: 5, SJR: 1.626, CiteScore: 2)
Stroke and Vascular Neurology     Open Access   (Followers: 2)
Student BMJ     Hybrid Journal   (Followers: 3)
The BMJ     Hybrid Journal   (Followers: 21, SJR: 2.893, CiteScore: 2)
Thorax     Hybrid Journal   (Followers: 36, SJR: 3.381, CiteScore: 4)
Tobacco Control     Hybrid Journal   (Followers: 16, SJR: 2.752, CiteScore: 3)
Veterinary Record     Hybrid Journal   (Followers: 26, SJR: 0.464, CiteScore: 0)
World J. of Pediatric Surgery     Open Access   (Followers: 4)
Similar Journals
Journal Cover
Journal of Family Planning and Reproductive Health Care
Journal Prestige (SJR): 0.63
Citation Impact (citeScore): 1
Number of Followers: 10  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1471-1893 - ISSN (Online) 2045-2098
Published by BMJ Publishing Group Homepage  [62 journals]
  • Defining counselling in contraceptive information and services: outcomes
           from an expert think tank

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      Authors: Ali, M; Tran, N. T.
      Pages: 79 - 81
      Abstract: As a global public health good, contraception is a core component of the Sustainable Development Goal 3.7 (universal access to sexual and reproductive healthcare services, including family planning). Fundamentally, access to contraceptive information and services is a human right that advances other human right aspects. Quality contraceptive information and services reinforce people’s freedom to determine the number and spacing of their children and offer a range of potential benefits encompassing women’s empowerment, economic development, education and improved health outcomes, including maternal and child health. However, in low- and middle-income countries, around 218 million women of reproductive age still have an unmet need for contraception in 2019 – meeting this need could drop annually an estimated 111 to 35 million unintended pregnancies, 35 to 10 million unsafe abortions, and 299 000 maternal deaths to 113 000.1 Many contraceptive users discontinue their methods or fail to use them optimally.
      Keywords: Open access
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201132
      Issue No: Vol. 48, No. 2 (2022)
       
  • Contraception after childbirth in the UK: beyond the COVID-19 pandemic

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      Authors: Cooper, M; Free, C. J, Cameron, S.
      Pages: 82 - 84
      Abstract: Due to the rapid return of fertility and sexual activity after delivery combined with increased difficulty accessing services, the postpartum period presents a particular risk for unintended pregnancy.1 Fractured commissioning of sexual and reproductive health (SRH) services in some regions of the UK, and more recently the COVID-19 pandemic, have further reduced community-based contraceptive access. The impact of this unmet contraceptive need can be seen in a number of ways. Studies indicate that up to 97% of women do not wish to become pregnant again in the year following childbirth.1 2 However, many women are unaware of how quickly they can conceive, and which contraceptive methods are safe to use at this time.2 Data from the UK suggests that at least 1 in 13 women access abortion services within the year after childbirth, and one in eight parous women conceive and continue...
      Keywords: COVID-19
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201310
      Issue No: Vol. 48, No. 2 (2022)
       
  • Perspectives of obstetricians and midwives on the provision of immediate
           postpartum intrauterine devices: a qualitative service evaluation

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      Authors: Boydell, N; Cooper, M, Cameron, S. T, Glasier, A, Coutts, S, McGuire, F, Harden, J.
      Pages: 85 - 92
      Abstract: BackgroundImmediate postpartum intrauterine device (PPIUD) insertion is safe and effective but largely unavailable in Europe. Data on maternity staff views on the provision and implementation of PPIUD services are limited. The objective of this qualitative evaluation was to explore the views and experiences of obstetricians and midwives providing PPIUD within a UK maternity setting, in order to identify areas for improvement and inform service provision in other areas.MethodsQualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (obstetricians n=8; midwives n=22) involved in PPIUD provision. Data were analysed thematically.ResultsMaternity staff were positive about the benefits of PPIUD for women. Midwives reported initial concerns about PPIUD safety, and the impact on workload; these views shifted following training, and as PPIUD was embedded into practice. Having a large pool of PPIUD-trained staff was identified as an important factor in successful service implementation. Having PPIUD ‘champions’ was important to address staff concerns, encourage training uptake, and advocate for the service to ensure continued resourcing.ConclusionsPPIUD in maternity services can help address unmet need for effective contraception in the immediate postpartum period. We emphasise the importance of widespread engagement around PPIUD among all healthcare professionals involved in the care of women, to ensure staff are informed and supported. Clinical champions and leaders play a key role in amplifying the benefits of PPIUD, and advancing organisational learning.
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201170
      Issue No: Vol. 48, No. 2 (2022)
       
  • Contraception in Person-Contraception Online (CiP-CO) cohort study

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      Authors: Rezel-Potts, E; Palmer, M. J, Free, C. J, McCulloch, H, Baraitser, P.
      Pages: 93 - 102
      Abstract: BackgroundOnline contraception services increasingly provide information, clinical assessment and home-delivered oral contraceptives (OCs). Evidence is lacking on the effects of online contraceptive service use on short-term contraceptive continuation.MethodsCohort study comparing contraceptive continuation between new users of a free-to-access online OC service in South East London with those from other, face-to-face services in the same area. Online questionnaires collected data on participants’ sociodemographic characteristics, motivations for OC access, service ratings, OC knowledge and contraceptive use. Contraceptive use in the 4-month study period was measured using health service records. Unadjusted and multivariable logistic regression models compared outcomes between the online service group and those using other services.ResultsOnline service-users (n=138) were more likely to experience short-term continuation of OCs compared with participants using other services (n=98) after adjusting for sociodemographic and other characteristics (adjusted OR 2.94, 95% CI 1.52 to 5.70). Online service-users rated their service more highly (mean 25.22, SD 3.77) than the other services group (mean 22.70, SD 4.35; p
      Keywords: Open access
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201168
      Issue No: Vol. 48, No. 2 (2022)
       
  • An observational study of patient experiences with a direct-to-patient
           telehealth abortion model in Australia

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      Authors: Thompson, T.-a; Seymour, J. W, Melville, C, Khan, Z, Mazza, D, Grossman, D.
      Pages: 103 - 109
      Abstract: BackgroundWhile abortion care is widely legal in Australia, access to care is often poor. Many Australians must travel long distances or interstate to access abortion care, while others face stigma when seeking care. Telehealth-at-home medical abortion is a potential solution to these challenges. In this study, we compared the experience of accessing an abortion via telehealth-at-home to accessing care in-clinic.MethodsOver a 20-month period, we surveyed patients who received medical abortion services at Marie Stopes Australia via the telehealth-at-home service or in-clinic. We conducted bivariate analyses to assess differences in reported acceptability and accessibility by delivery model.ResultsIn total, 389 patients were included in the study: 216 who received medical abortion services in-clinic and 173 through the telehealth-at-home service. Telehealth-at-home and in-clinic patients reported similarly high levels of acceptability: satisfaction with the service (82% vs 82%), provider interaction (93% vs 84%), and recommending the service to a friend (73% vs 72%). Only 1% of telehealth-at-home patients reported that they would have preferred to be in the same room as the provider. While median time between discovering the pregnancy to first contact with a clinic was similar between groups, median time from first contact to taking the first abortion medication was 7 days longer for telehealth-at-home patients versus in-clinic patients (14 days (IQR 9–21) vs 7 days (IQR 4–14); p
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201259
      Issue No: Vol. 48, No. 2 (2022)
       
  • Short interpregnancy interval: circumstance or choice'

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      Authors: Taylor, R. A. M; Yang, J. M, Cheney, K, Black, K.
      Pages: 110 - 116
      Abstract: IntroductionDespite the knowledge of pregnancy risks attributable to inadequate birth spacing, over one-third of pregnancies occur within 18 months of a preceding birth. In this qualitative study we sought to interview women with a short interpregnancy interval (sIPI) to explore their knowledge of contraception and birth spacing and their experience of counselling on these themes.MethodsWe conducted in-depth interviews with women with a sIPI (live-birth less than 18 months prior to conception of current pregnancy) at Royal Prince Alfred Hospital and Canterbury Hospital in Sydney, Australia. Women were recruited at the second antenatal visit or day 3 postpartum. Interviews were recorded and transcribed. The six-phase thematic analysis framework described by Braun and Clarke was used to perform qualitative data analysis.ResultsTwenty women were interviewed (IPI range: 3–18 months). The three central themes that arose were that perceptions of IPIs are shaped by individual circumstances, a lack of information from healthcare providers (HCPs) on IPI and contraception limited women’s ability to make informed decisions, and that reproductive life planning is an important element of pregnancy care.ConclusionsIn this study, women with a sIPI did not feel informed about birth spacing, had poor knowledge of reliable contraceptives, and remained at risk of further closely spaced pregnancies. There was a desire among women with a sIPI to receive clear and consistent education on these topics. HCPs need to do more to educate women in the antenatal and postnatal period to help them space their pregnancies appropriately.
      Keywords: Editor''s choice
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201269
      Issue No: Vol. 48, No. 2 (2022)
       
  • Acceptability of different mechanisms of action of contraception in women:
           a questionnaire survey

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      Authors: Tong, Y. W; Lo, S. S. T, Fung, B. W. K, Cameron, S. T, Ng, E. H. Y, Li, R. H. W.
      Pages: 117 - 122
      Abstract: BackgroundThe mechanism of action of a contraceptive method is an importantg consideration in a woman’s choice of contraception. For the development of new methods of contraception it is important to understand the acceptability of different contraceptive mechanisms within a population.MethodsWe recruited women attending contraceptive, termination of pregnancy or postnatal care services in Hong Kong for a questionnaire survey on their acceptability of the different ways in which contraceptive methods prevent pregnancy. Univariable and multivariable analyses were used to establish factors which may predict acceptability of the mechanism of action.ResultsA total of 1448 women completed the survey. The acceptability of contraceptive methods that act by preventing fertilisation ranked highest (78%), followed by those that inhibit ovulation (52%), disrupt implantation (43%) and dislodge an implanted embryo (30%). A history of termination of pregnancy was associated with greater acceptance of all posited contraceptive mechanisms. There was a very low degree of agreement between the declared acceptance of the various contraceptive mechanisms and the ever use of a method with the respective mechanism of action (Cohen’s kappa coefficient range 0.017–0.162).ConclusionsIn this population the acceptability of contraceptive methods that act by preventing fertilisation ranked highest, followed by those that inhibit ovulation, disrupt implantation and dislodge an implanted embryo. Women who had ever had a termination of pregnancy were more likely to accept all the posited contraceptive mechanisms.
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201110
      Issue No: Vol. 48, No. 2 (2022)
       
  • Novel use of menstrual blood for monitoring glycaemic control in patients
           with diabetes: a proof-of-concept study

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      Authors: Naseri, S; Brewster, R. C. L, Blumenthal, P. D.
      Pages: 123 - 127
      Abstract: BackgroundGlycated haemoglobin (HbA1c) is the diagnostic and prognostic standard for clinical management of diabetes mellitus (DM). Unfortunately, patient adherence to guidelines for routine testing can be poor and there are significant gender-based disparities in DM management and outcomes. Recent evidence suggests that menstrual blood may be comparable to systemic blood for monitoring of common biomarkers. The objective of the present study was to assess the concordance of HbA1c levels between menstrual and systemic blood in healthy women and women with diabetes of reproductive age.MethodsIn this prospective, observational cohort study, we enrolled healthy and diabetic (type 1 and type 2 DM) reproductive-age women (aged ≥18 and ≤45 years). Menstrual blood and venous systemic blood specimens were simultaneously obtained at time of menstruation, and analysed for HbA1c levels. Participants self-collected menstrual blood using a QPad, a novel, modified menstrual pad with an embedded dried blood spot strip.ResultsAmong 172 participants, 57.6% were healthy and 42.4% had a diagnosis of either type 1 or type 2 DM. There were no significant differences in mean HbA1c values in menstrual and systemic blood across the overall cohort or within the diabetic subgroup. Furthermore, HbA1c levels between blood sources were robustly correlated and demonstrated a significant linear relationship.ConclusionsThere is a strong concordance in HbA1c levels between menstrual and systemic blood. Empowered by self-collection technologies, these findings suggest that menstrual blood may serve as a reliable, non-invasive and potentially cost-effective alternative to serum for HbA1c monitoring among reproductive-age women with DM.
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201211
      Issue No: Vol. 48, No. 2 (2022)
       
  • Long-acting reversible contraception and satisfaction with structured
           contraceptive counselling among non-migrant, foreign-born migrant and
           second-generation migrant women: evidence from a cluster randomised
           controlled trial (the LOWE trial) in Sweden

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      Authors: Emtell Iwarsson, K; Larsson, E. C, Bizjak, I, Envall, N, Kopp Kallner, H, Gemzell-Danielsson, K.
      Pages: 128 - 136
      Abstract: ObjectiveThis trial aimed to evaluate effects of structured contraceptive counselling among non-migrants, foreign-born migrants and second-generation migrants.MethodsA cluster randomised controlled trial was conducted in 2017–2019 at abortion, youth and maternal health clinics in Stockholm, Sweden (the LOWE trial). Patients were eligible if they were 18 years or older, could understand Swedish or English (or if assisted by an interpreter), were sexually active or planning to be, and were seeking contraception for pregnancy prevention. We randomised clinics at a 1:1 allocation ratio to give either structured contraceptive counselling (intervention) or to maintain standard contraceptive counselling (control). Blinding was not deemed feasibile. A study-specific package for structured contraceptive counselling was used and comprised an educational video, an effectiveness chart, four key questions and a box with contraceptive models. Outcomes were effects of the intervention on long-acting reversible contraception (LARC) choice, initiation and use, and satisfaction with the intervention material among the participants.ResultsWe involved 14 clinics in each of the intervention and control groups, respectively. A total of 1295 participants were included: 1010 non-migrants, 169 foreign-born migrants and 116 second-generation migrants. Participants in the intervention group chose LARC to a higher extent than the control group (adjusted OR (aOR) 2.85, 95% CI 2.04–3.99), had higher LARC initiation rates (aOR 2.90, 95% CI 1.97 to 4.27) and higher LARC use within the 12-month follow-up period (aOR 2.09, 95% CI 1.47 to 2.96). The majority of the participants who received the intervention package found all the different parts to be supportive in contraceptive choice. The effectiveness chart was the only part of the package that a higher proportion of foreign-born migrants (58/84, 69%) and second-generation migrants (40/54, 74.1%) found supportive in contraceptive choice compared to non-migrants (259/434, 59.7%) (p = 0.048).ConclusionsStructured contraceptive counselling increased LARC choice, initiation and use, controlled for participants’ migration background. The effectiveness chart was found to be significantly more supportive among foreign-born migrants and second-generation migrants compared to non-migrants when choosing contraceptive methods.Trial registration number NCT03269357.
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201265
      Issue No: Vol. 48, No. 2 (2022)
       
  • Reducing the harms of unsafe abortion: a systematic review of the safety,
           effectiveness and acceptability of harm reduction counselling for pregnant
           persons seeking induced abortion

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      Authors: Stifani, B. M; Gill, R, Kim, C. R.
      Pages: 137 - 145
      Abstract: BackgroundGlobally, access to safe abortion is limited. We aimed to assess the safety, effectiveness and acceptability of harm reduction counselling for abortion, which we define as the provision of information about safe abortion methods to pregnant persons seeking abortion.MethodsWe searched PubMed, EMBASE, ClinicalTrials.gov, Cochrane, Global Index Medicus and the grey literature up to October 2021. We included studies in which healthcare providers gave pregnant persons information on safe use of abortifacient medications without providing the actual medications. We conducted a descriptive summary of results and a risk of bias assessment using the ROBINS-I tool. Our primary outcome was the proportion of pregnant persons who used misoprostol to induce abortion rather than other methods among those who received harm reduction counselling.ResultsWe included four observational studies with a total of 4002 participants. Most pregnant persons who received harm reduction counselling induced abortion using misoprostol (79%–100%). Serious complication rates were low (0%–1%). Uterine aspiration rates were not always reported but were in the range of 6%–22%. Patient satisfaction with the harm reduction intervention was high (85%–98%) where reported. We rated the risk of bias for all studies as high due to a lack of comparison groups and high lost to follow-up rates.DiscussionBased on a synthesis of four studies with serious methodological limitations, most recipients of harm reduction counselling use misoprostol for abortion, have low complication rates, and are satisfied with the intervention. More research is needed to determine abortion success outcomes from the harm reduction approach.FundingThis work did not receive any funding.PROSPERO registration numberWe registered the review in the PROSPERO database of systematic reviews (ID number: CRD42020200849).
      Keywords: Open access
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201389
      Issue No: Vol. 48, No. 2 (2022)
       
  • Making the case for supported self-managed medical abortion as an option
           for the future

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      Authors: Hoggart, L; Berer, M.
      Pages: 146 - 148
      Abstract: The use of misoprostol at home to induce abortion began in Brazil in the 1980s and spread rapidly to many parts of the globe. The combination of mifepristone plus misoprostol with safe and effective dosages and regimens rapidly became available through clinical provision and was included on the World Health Organization (WHO) complementary essential medicines list in 2005. In 2018, it was moved to the WHO core list of essential medicines and approved for self-managed abortion (SMA) at home up to 12 weeks’ gestation, based on substantial evidence of efficacy, safety and acceptability in legally permitted settings.1 Telemedicine counselling and long-distance provision of medical abortion pills for home use in legally restricted settings was begun in 2007 by Women on Web, a safe abortion hotline initiated by a feminist doctor. Access was greatly expanded when a second international hotline, Women Help Women, was...
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201181
      Issue No: Vol. 48, No. 2 (2022)
       
  • Are we prepared for change' The need for evidence on healthcare
           practitioner readiness for current and future trends in abortion provision
           in the UK

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      Authors: French, R. S; Shawe, J, Palmer, M. J, Reiter, J, Wellings, K, the SACHA Study Team, Aronsson, Baraitser, Cameron, Free, Keogh, Lewandowska, Lohr, Meiksin, Murphy, Norman, Scott, Sheldon, Wong
      Pages: 149 - 151
      Abstract: Significant changes are occurring in the landscape of abortion provision in the UK. More women are having medical abortions and self-managing these at home, resulting in an increase in the proportion of abortions performed before 10 weeks’ gestation.1 Since 2018, women in Britain have been able to take misoprostol, the second medication for medical abortion, at home provided they have attended a clinic to have it prescribed. The COVID-19 pandemic has accelerated the trend towards self-management. As an emergency and temporary measure due to concerns about reduced health service access for women with unwanted pregnancies during the pandemic, consultations about pregnancy options have occurred by telephone or video and, if women wish and are deemed clinically appropriate, a medical abortion pack of both mifepristone and misoprostol can be posted to their home (up to 9 weeks, 6 days’ gestation in England and Wales, and no restriction in...
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201243
      Issue No: Vol. 48, No. 2 (2022)
       
  • Missing strings following immediate postpartum IUD placement

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      Authors: Henkel, A; Blumenthal, P. D.
      Pages: 152 - 155
      Abstract: Key messages
      Non-visibility of IUD strings is more common following postplacental insertion after caesarean birth than vaginal birth.
      Since unrecognised expulsion or perforation is rare, missing IUD strings following postplacental insertion most likely indicates an intrauterine device.
      Where readily available, pelvic ultrasonography should be the first-line imaging modality to confirm intrauterine retention of IUD.
      In settings with limited ultrasound or radiography capacity, it is reasonable to recommend a trial of expectant management awaiting string descent with consideration of a secondary form of contraception. If strings are still not visualised after return of menses, consider an in-office removal, with concomitant insertion of a new IUD if desired. Case A 31-year-old gravida 3 para 3 presents for a scheduled postpartum follow-up 4 weeks following an uncomplicated spontaneous vaginal birth. Immediately following delivery, a postplacental copper intrauterine device (IUD) was placed for contraception. On...
      Keywords: SRH clinical consult
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201400
      Issue No: Vol. 48, No. 2 (2022)
       
  • Venus

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      Pages: 156 - 156
      Abstract: Offering self- or clinician-taken non-speculum sampling for cervical screening improves uptake among lapsed attenders aged 50+ years Cervical screening improves early detection and prevention of cancer. Vaginal speculum examination can be a barrier for patients either due to embarrassment or pain. This pragmatic multisite, randomised, controlled trial (RCT) among general practitioner (GP) practices in London, UK offered just under 800 women aged between 50 and 64 years, who had defaulted on cervical screening, the option of a self-taken or clinician-taken swab for high-risk human papillomavirus (hrHPV) testing compared with standard cervical cytology. At both 4 and 12 months following enrolment, significantly higher proportions of women (more than double) had engaged in screening in the intervention arm compared with the control arm. Of those screened using non-speculum methods, low numbers were hrHPV-positive and were linked to further care. This intervention clearly improves uptake, and in the era of COVID-19 where there...
      PubDate: 2022-04-08T01:03:25-07:00
      DOI: 10.1136/bmjsrh-2021-201374
      Issue No: Vol. 48, No. 2 (2022)
       
 
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