Free, but at what cost? How US crisis pregnancy centres provide services.

In the USA, the most popular form of anti-abortion activism, crisis pregnancy centres (CPCs), provide a variety of services to prevent abortions. Moving beyond debate about misinformation and the ethics of CPCs, this study considers the services they provide and given their popularity among state legislatures, their connection to the state. Using interviews with ten CPC staff in Ohio (a state providing support to CPCs) and supplemental data from both state and CPC organisations, we find three relevant themes. First, CPC services reflect ideas about personal responsibility and Christianity held by the CPC staff. Second, we show that CPCs have assumed a variety of state duties (e.g. pregnancy testing and parenting classes), appealing to lawmakers in conservative states eager to transfer responsibility for disadvantaged residents to other entities. Finally, we consider the future direction of CPCs, highlighting tension between organisational goals (focusing on abortion prevention) and the on-the-ground experience of CPC staff (where non-pregnant clients need material aid). Drawing theoretical connections between CPC staff and social service workers sheds light on whose responsibility it is to address poverty in a post-welfare era.

Changing Educational Differentials in Female Sterilization.

CONTEXT: Female surgical sterilization is widely used in the United States. Educational differentials in sterilization are large, but poorly understood. Improved understanding of these differences is important to ensure that all women have access to the full range of contraceptive methods. METHODS: Data from the National Survey of Family Growth (1973-2015) from 8,100 women aged 40-44 were used to describe trends in sterilization and other contraceptive methods by educational attainment. Demographic standardization was employed to examine how compositional changes in marital status and age at first birth contribute to aggregate changes in sterilization prevalence. RESULTS: In 1982, women with a high school diploma and those with at least a bachelor's degree reported similar levels of sterilization use (38% and 32%, respectively), but by 2011-2015, prevalence had declined to 19% among college-educated women and had increased to 44% among those with a diploma. The trend among college graduates was largely attributable to delayed fertility; all other things being equal, if their age at first birth had not increased, the prevalence of sterilization would have declined by approximately 3% instead of 14% between 1982 and 2002. Increased use of sterilization among women with a high school diploma was only weakly related to changes in birth timing and marital status. CONCLUSIONS: Among women with a high school diploma, elements other than childbearing and marital status-such as contraceptive preferences and access-appeared to influence their contraceptive behavior. Sterilization differentials between high school and college graduates may reflect or exacerbate other socioeconomic disparities that affect women's health and well-being.

Understanding the experiences of youth living with sickle cell disease: a photovoice pilot.

A Photovoice pilot was conducted with youth living with sickle cell disease (SCD), in order to further understand their lived experience and examine the acceptability, feasibility, and utility of this method in this population. SCD is an inherited genetic condition whose primary symptom is severe pain. Youth were able to reflect on their experiences with SCD using Photovoice and the adapted SHOWeD method. Parents and youth found Photovoice to be valuable for children and adolescents with SCD. Emerging themes included the impact of SCD, the importance of everyday activities and interests, and the importance of family and support.