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The history of involuntary sterilisation brings reproductive justice into focus
Involuntary sterilisation has a dark history that remains relevant for contemporary medical and legal professionals. To learn from the past, we need to recognise historical injustices, and be aware of those that continue. In this editorial, Rowlands and Amy describe contexts in which sterilisations have been carried out without proper consent or under coercion. They consider the harm that has occurred, particularly to vulnerable populations, incarcerated peoples, and women of colour, and conclude that challenging the attitudes that underlie these human rights violations remains an important part of achieving reproductive justice. See page 239
Mifepristone effectiveness is not reduced by intramuscular DMPA given 24–48 hours later
Achieving effective contraception without delay following abortion is an important goal, but a randomised controlled trial in 2016 found an association between intramuscular depot medroxyprogesterone acetate (IM DMPA) given at the time of mifepristone administration for early medical abortion (EMA), and a slightly increased risk of continuing pregnancy compared with those not receiving it simultaneously. Reassuringly, a case-control study of almost 5000 women undergoing EMA reported here finds that those who received DMPA 24–48 hours after mifepristone were no more likely to experience continuing pregnancy than women receiving other methods of contraception, or none at all. A linked editorial (page 235) welcomes this new evidence, emphasising the importance of convenience and choice in contraception after abortion. See page 242
Might a user-informed video about the LNG-IUS reduce discontinuation and improve patient satisfaction?
Recognised side effects from the levonorgestrel intrauterine system (LNG-IUS) are common reasons given for discontinuation within the first 12 months of use. As anticipatory counselling regarding expected side effects may reduce method discontinuation and improve patient satisfaction, the authors describe the development of an educational video. They collaborated with clinicians and LNG-IUS users and plan to pilot the use of this video among patients on the day of their LNG-IUS insertion. See page 248
Ineffective postpartum contraception threatens adequate birth spacing in China
In China, unintended pregnancy rates among postpartum women are relatively high. An interview-based study …
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