Who does what? Reproductive responsibilities between heterosexual partners.

Managing fertility and sexual and reproductive health across the life course is associated with numerous responsibilities disproportionately experienced by women. This extends beyond dealing with the physical side effects of contraception and can include the emotional burden of planning conception and the financial cost of accessing health services. This scoping review aimed to map how reproductive responsibilities were defined and negotiated (if at all) between heterosexual casual and long-term partners during any reproductive life event. Original research in high-income countries published from 2015 onwards was sourced from Medline (Ovid), CINAHL and Scopus. In studies that focused on pregnancy prevention and abortion decision making, men felt conflict in their desire to be actively engaged while not wanting to impede their partner's agency and bodily autonomy. Studies identified multiple barriers to engaging in reproductive work including the lack of acceptable male-controlled contraception, poor sexual health knowledge, financial constraints, and the feminisation of family planning services. Traditional gender roles further shaped men's involvement in both pregnancy prevention and conception work. Despite this, studies reveal nuanced ways of sharing responsibilities - such as companionship during birth and abortion, ensuring contraception is used correctly during intercourse, and sharing the costs of reproductive health care.

Would men who have sex with men support less frequent screening for asymptomatic chlamydia and gonorrhoea to improve antibiotic stewardship? A qualitative study.

BACKGROUND: Men who have sex with men (MSM) taking pre-exposure prophylaxis (PrEP) are recommended to have screening for asymptomatic chlamydia and gonorrhoea every 3months with high rates of asymptomatic chlamydia and gonorrhoea detected. However, there is little evidence about the effectiveness of this screening interval and there is increasing concern about antibiotic consumption and its impact on antimicrobial resistance. There have been calls to reconsider this frequent screening for chlamydia and gonorrhoea. We conducted interviews with MSM to assess their attitudes to 3-monthly chlamydia and gonorrhoea screening. METHODS: Individual semi-structured interviews were conducted with MSM living in Victoria, Australia. Participants were aged 20-62years and had been taking PrEP for at least 6months. Interviews were audio-recorded and transcribed, and these data were investigated through reflexive thematic analysis. RESULTS: Thirteen interviews were conducted in August 2021. Participants were hesitant about reducing the screening frequency and reported that testing gave them a sense of security. While MSM recognised antimicrobial resistance was a concern, it did not impact their sexual behaviour, with many participants stating they would rather continue to take antibiotics to treat infections rather than adopt preventative measures such as condom use. Positive attitudes towards screening interval changes are more likely when PrEP patients are informed about the risks and benefits of sexual healthcare recommendations. CONCLUSION: While MSM on PrEP were initially hesitant to changes in screening frequency, changes may be acceptable if transparent communication, presenting the benefits and harms of screening and treatment, was delivered by a trusted healthcare professional.

Googling long-acting reversible contraception: A scoping review examining the information available online about intrauterine devices and contraceptive implants.

ISSUE ADDRESSED: The internet is an important source of health information, however, the quality of information about long-acting reversible contraception (LARC, including intrauterine devices (IUDs) and contraceptive implants) found online is largely unknown. METHODS: A scoping review of webpages returned in a Google search was conducted. The first three pages of results were included if they were written in English and contained information about LARC. Results were critically reviewed and assessed using the DISCERN quality of health information tool. RESULTS: Of 778 results, 306 pages met the eligibility criteria. While most webpages provided key information about LARC, including location in the body, benefits, side effects and risks, the information provided varied considerably. Only half mentioned efficacy and many webpages did not provide information about the cost of insertion and removal, how and where to access the devices or how they work. Despite side effects being mentioned in more than three-quarters of webpages, the depth and specificity of these varied considerably and were often contradictory across different webpages. CONCLUSIONS: Most webpages provided medically accurate information to consumers; however, many did not include key information such as cost or how they work. Descriptions of side effects varied between webpages, and this may inhibit informed decision-making. SO WHAT?: Most people make decisions about what contraceptive method they might like to use before visiting a health care provider, and most will get this information from the internet. Providing comprehensive, medically accurate and consistent information about both IUDs and contraceptive implants is vital to support informed decision-making.

"Tell us what's going on": Exploring the information needs of pregnant and post-partum women in Australia during the pandemic with 'Tweets', 'Threads', and women's views.

INTRODUCTION: The provision of maternity services in Australia has been significantly disrupted in response to the COVID-19 pandemic. Many changes were initiated quickly, often with rapid dissemination of information to women. The aim of this study was to better understand what information and messages were circulating regarding COVID-19 and pregnancy in Australia and potential information gaps. METHODS: This study adopted a qualitative approach using social media and interviews. A data analytics tool (TIGER-C19) was used to extract data from social media platforms Reddit and Twitter from June to July 2021 (in the middle of the third COVID-19 wave in Australia). A total of 21 individual semi-structured interviews were conducted with those who were, or had been, pregnant in Australia since March 2020. Social media data were analysis via inductive content analysis and interview data were thematically analysed. RESULTS: Social media provided a critical platform for sharing and seeking information, as well as highlighting attitudes of the community towards COVID-19 vaccines in pregnancy. Women interviewed described wanting further information on the risks COVID-19 posed to themselves and their babies, and greater familiarity with the health service during pregnancy, in which they would labour and give birth. Health providers were a trusted source of information. Communication strategies that allowed participants to engage in real-time interactive discussions were preferred. A real or perceived lack of information led participants to turn to informal sources, increasing the potential for exposure to misinformation. CONCLUSION: It is vital that health services communicate effectively with pregnant women, early and often throughout public health crises, such as the COVID-19 pandemic. This was particularly important during periods of increased restrictions on accessing hospital services. Information and communication strategies need to be clear, consistent, timely and accessible to reduce reliance on informal and potentially inaccurate sources.

Self-care interventions for preconception, antenatal, intrapartum and postpartum care: a scoping review.

OBJECTIVE: To identify current and emerging self-care interventions to improve maternity healthcare. DESIGN: Scoping review. DATA SOURCES: MEDLINE, Embase, EmCare, PsycINFO, Cochrane CENTRAL/CDSR, CINAHL Plus (last searched on 17 October 2021). ELIGIBILITY CRITERIA: Evidence syntheses, interventional or observational studies describing any tool, resource or strategy to facilitate self-care in women preparing to get pregnant, currently pregnant, giving birth or post partum. DATA EXTRACTION/SYNTHESIS: Screening and data collection were conducted independently by two reviewers. Self-care interventions were identified based on predefined criteria and inductively organised into 11 categories. Characteristics of study design, interventions, participants and outcomes were recorded. RESULTS: We identified eligible 580 studies. Many included studies evaluated interventions in high-income countries (45%) and during antenatal care (76%). Self-care categories featuring highest numbers of studies were diet and nutrition (26% of all studies), physical activity (24%), psychosocial strategies (18%) and other lifestyle adjustments (17%). Few studies featured self-care interventions for sexual health and postpartum family planning (2%), self-management of medication (3%) and self-testing/sampling (3%). Several venues to introduce self-care were described: health facilities (44%), community venues (14%), digital platforms (18%), partner/peer support (7%) or over-the-counter products (13%). Involvement of health and community workers were described in 38% and 8% of studies, who supported self-care interventions by providing therapeutics for home use, training or counselling. The most common categories of outcomes evaluated were neonatal outcomes (eg, birth weight) (31%), maternal mental health (26%) and labour outcomes (eg, duration of labour) (22%). CONCLUSION: Self-care interventions in maternal care are diverse in their applications, implementation characteristics and intended outcomes. Many self-care interventions were implemented with support from the health system at initial stages of use and uptake. Some promising self-care interventions require further primary research, though several are matured and up-to-date evidence syntheses are needed. Research on self-care in the preconception period is lacking.

"I never went to see that doctor again": A qualitative study examining Australian women's experiences requesting removal of LARC within 12 months of insertion.

OBJECTIVES: Removal or discontinuation of long-acting reversible contraception (LARC) requires cooperation of healthcare providers. The objective of this study was to explore young women's experiences when they request removal of LARC within 12 months of insertion. STUDY DESIGN: We conducted a qualitative study using individual semi-structured telephone interviews with women living in Victoria, Australia. We recruited participants using physical and online advertising flyers. We audio-recorded and transcribed interviews and thematically analyzed the data. RESULTS: Fifteen women participated in an interview. The experience of unacceptable side effects prompted "early" LARC removal in all cases. The non-autonomous nature of LARC removal was not considered by women pre-insertion and participants reported confidence in their ability to access LARC removal when requested. Although satisfaction was reported when LARC was removed on request, participants reported negative feelings towards their healthcare provider when there was perceived pressure to continue with LARC for longer than desired. This had implications for the patient-clinician relationship. Women experienced resistance to removal as a challenge to their bodily autonomy and this resulted in a loss of trust in health services. CONCLUSION: Resistance to removal of LARC can damage the patient-clinician relationship and be experienced as a challenge to women's autonomy and reproductive rights. IMPLICATIONS: Patients have confidence in their ability to get their LARC removed on request and autonomy is not largely considered prior to LARC initiation. Supportive removal services should be emphasized for women who request removal of LARC at any point after insertion in order to maintain trust in healthcare providers and health services.