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Exploring potential interest in missed period pills in two US states

      Abstract

      Objective

      Missed period pills (MPP) are uterine evacuation medications used for treatment of delayed menses without prior pregnancy confirmation. This study explores potential interest in missed period pills in two US states.

      Study design

      We enrolled people seeking pregnancy test services at nine health centers in two US states between June 2015 and October 2017. Participants completed an anonymous questionnaire containing closed- and open-ended questions about background characteristics, reproductive practices, pregnancy feelings and intentions, abortion attitudes, and MPP interest. We used ordered logistic regression to identify factors associated with MPP interest and inductive content analysis to identify recurring qualitative themes related to MPP interest or disinterest.

      Results

      In all, 678 people completed the survey and 286/678 (42%) indicated interest in missed period pills. Interest was greatest (129/185 or 70%) among those who would be unhappy if pregnant. Variables associated with interest in the multivariate analyses were age ≥ 35, nulliparity, prior abortion and contraceptive use, recent use of emergency contraception, pregnancy feelings and intentions, and abortion attitudes (p < .05). Variables not associated with interest included state of residence, educational attainment, ethnicity, religious affiliation, and frequency of religious attendance. Key reasons for interest were to prevent, avoid or terminate pregnancy; and psychological or emotional benefits, including management of abortion stigma. Reasons for non-interest included concerns about safety or side effects, desire to be pregnant or have a baby, and not wanting to abort or hurt the fetus/baby.

      Conclusion

      If missed period pills were available in the United States, demand might be substantial and wide-ranging across demographic groups.

      Implications

      Our findings suggest that some people with missed periods do not desire pregnancy confirmation before taking medications that might disrupt a pregnancy. As a result, provision of missed period pills in the United States would expand reproductive service options and could improve the delivery of patient-centered care.

      Keywords

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      References

        • Bygdeman M.
        The possibility of using mifepristone for menstrual induction.
        Contraception. 2003; 68: 495-498
        • Xiao B.L.
        • von Hertzen H.
        • Zhao H.
        • Piaggio G.
        Menstrual induction with mifepristone and misoprostol.
        Contraception. 2003; 68: 489-494
      1. WHO Task Force on Post-Ovulatory Methods for Menstrual Regulation. Menstrual regulation by mifepristone plus prostaglandin: results from a multicentre trial. Hum Reprod 1995;10:308–14.

        • Grimes D.A.
        • Mishell D.R.
        • David H.P.
        A randomized clinical trial of mifepristone for induction of delayed menses: efficacy and acceptability.
        Contraception. 1992; 46: 1-10
        • Marlow H.M.
        • Biswas K.
        • Griffin R.
        • Menzel J.
        Women’s experiences with medication for menstrual regulation in Bangladesh.
        Cult Health Sex. 2016; 18: 349-360
        • Alam A.
        • Braken H.
        • Johnston H.B.
        • Raghavan S.
        • Islam N.
        • Winikoff B.
        • et al.
        Acceptability and feasibility of mifepristone-misoprostol for menstrual regulation in Bangladesh.
        Int Perspect Sex Reprod Health. 2013; 39: 79-87
      2. Hull TH, Sarwano SW, Widyantoro N. Induced abortion in Indonesia. Stud Fam Plann 199324:241–51.

        • Dixon-Mueller R.
        Innovations in reproductive health care: menstrual regulation policies and programs in Bangladesh.
        Stud Fam Plann. 1988; 19: 129-140
        • Finer L.B.
        • Zolna M.R.
        Declines in unintended pregnancy in the United States, 2008–2011.
        New Engl J Med. 2016; 374: 843-852
        • Smith W.
        • Turan J.M.
        • White K.
        • Stringer K.L.
        • Helova A.
        • Simpson T.
        • et al.
        Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama.
        Pers Sex Rep Hlth. 2016; 48: 73-81
        • Mollborn S.
        Predictors and consequences of adolescents’ norms against pregnancy.
        Sociol Q. 2010; 51: 303-328
        • Wiemann C.M.
        • et al.
        Are pregnancy adolescents stigmatized by pregnancy?.
        J Adolesc Health. 2005; 36 (352.ei–352.e7)
        • Ellison M.A.
        Authoritative knowledge and single women’s unintentional pregnancies, abortions, adoption, and single motherhood: social stigma and structural violence.
        Med Anthropol Q. 2003; 17: 322-347
        • Shellenberg K.M.
        • Tsui A.O.
        Correlates of perceived and internalized stigma among abortion patients in the USA: an exploration by race and Hispanic ethnicity.
        Int J Gynaecol Obstet. 2012; 118: S152-S159
        • Goffman E.
        Stigma: Notes on the Management of Spoiled Identity.
        Prentice-Hall, Englewood Cliffs, NJ1963
        • Cook R.J.
        • Dickens B.M.
        Reducing stigma in reproductive health.
        Int J Gynaecol Obstet. 2014; 125: 89-92
        • Major B.
        • Gramzow R.H.
        Abortion as stigma: cognitive and emotional aspects of concealment.
        J Pers Soc Psychol. 1999; 77: 735-745
        • Hanschmidt F.
        • Linde K.
        • Hilbert A.
        • Riedel-Heller S.G.
        • Kersting A.
        Abortion stigma: a systematic review.
        Perspect Sex Reprod Health. 2016; 48: 169-177
        • Cockrill K.
        • Nack A.
        ‘I’m not that type of person’: managing the stigma of having an abortion.
        Deviant Behavior. 2013; 34: 973-990
        • Shellenberg K.M.
        • Moore A.M.
        • Bankole A.
        • Juarez F.
        • Omideyi A.K.
        • Palomina N.
        • et al.
        Social stigma and disclosure about induced abortion: results from an exploratory study.
        Glob Public Health. 2011; 6: S111-S125
        • O’Donnell A.T.
        • O’Carroll T.
        • Toole N.
        Internalized stigma and stigma-related isolation predict women’s psychological distress and physical health symptoms post-abortion.
        Psychol Women Q. 2018; 42: 220-234
        • Steinberg J.R.
        • Tschann J.M.
        • Furgerson D.
        • Harper C.C.
        Psychosocial factors and pre-abortion psychological health: the significance of stigma.
        Soc Sci Med. 2016; 150: 67-75
        • Raymond E.G.
        • Coeytaux F.
        • Gemzell-Danielsson K.
        • Moore K.
        • Trussell J.
        • Winikoff B.
        Embracing post-fertilisation methods of family planning: a call to action.
        J Fam Plann Reprod Health Care. 2013; 39: 244-246
        • Dye H.M.
        • Stanford J.B.
        • Alder S.C.
        • Kim H.S.
        • Murphy P.A.
        Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use.
        BMC Womens Health. 2005; 5: 11
        • Grossman D.
        • Holt K.
        • Peña M.
        • Lara D.
        • Veatch M.
        • Córdova D.
        • et al.
        Self-induction of abortion among women in the United States.
        Reprod Health Matters. 2010; 18: 136-146
      3. Coeytaux F, Nichols V. Plan C: the safe strategy for a missed period when you don’t want to be pregnant, Rewire News, February 7, 2014. https://rewire.news/article/2014/02/07/plan-c-safe-strategy-missed-period-dont-want-pregnant/.

      4. Bazelon, E. The Dawn of the Post-Clinic Abortion, The New York Times, August 28, 2014.

      5. Hellerstein, E. The Rise of the DIY Abortion in Texas, The Atlantic, June 27, 2014.

        • Lopez-del Burgo C.
        • Mikolajczyk R.T.
        • Osorio A.
        • Errasti T.
        • de Irala J.
        Women’s attitudes towards mechanisms of action of birth control methods: a cross-sectional study in five European countries.
        J Clin Nurs. 2013; 22: 3006-3015
        • Winikoff B.
        Will a new kind of pill be the holy grail we seek?.
        Conscience. 2019; 2
        • Barry M.J.
        • Edgman-Levitan S.
        Shared decision making – the pinnacle of patient-centered care.
        N Engl J Med. 2012; 366: 780-781
        • Epstein R.M.
        • Street R.L.
        The values and value of patient-centered care.
        Ann Fam Med. 2011; 9: 100-102
        • Epstein R.M.
        • Fiscell K.
        • Lesser C.S.
        • Stange K.C.
        Why the nation needs a policy push on patient-centered health care.
        Health Aff (Millwood). 2010; 29: 1489-1495
        • Robinson J.H.
        • Callister L.C.
        • Berry J.A.
        • Dearing K.A.
        Patient-centered care and adherence: definitions and applications to improve outcomes.
        J Am Acad Nurse Pract. 2008; 20: 600-607
      6. Committee on Quality of Health Care in America. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press; 2001.