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Miscarriage and Abortion Among Women Attending Harm Reduction Services in Philadelphia: Correlations With Individual, Interpersonal, and Structural Factors
Journal article   Open access   Peer reviewed

Miscarriage and Abortion Among Women Attending Harm Reduction Services in Philadelphia: Correlations With Individual, Interpersonal, and Structural Factors

Joy D. Scheidell, Janna Ataiants and Stephen E. Lankenau
Substance use & misuse, v 57(6), pp 999-1006
24 Feb 2022
PMID: 35277115
url
https://surface.syr.edu/context/istpub/article/1199/viewcontent/Sharing_Historic_Costume_Collections_Online_Accepted_Manuscript.pdfView
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Life Sciences & Biomedicine Psychiatry Psychology Science & Technology Social Sciences Substance Abuse
Background: Reproductive health research among women who use drugs has focused on pregnancy prevention and perinatal/neonatal outcomes, but there have been few investigations of miscarriage and abortion, including prevalence and associated factors. Methods: Using cross-sectional data from a sample of non-pregnant women receiving harm reduction services in Philadelphia in 2016-2017 we examined lifetime miscarriage and abortion (n = 187). Separately for both outcomes, we used modified Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for associations with each correlate. We also explored correlates of reporting both miscarriage and abortion. Results: Approximately 47% experienced miscarriage, 42% experienced abortion, and 18% experienced both. Miscarriage correlates included: prescription opioid misuse (e.g., OxyContin PR 1.82, 95% CI 1.23, 2.69); 40% increase in prevalence associated with housing instability, 50% increase with survival sex, and two-fold increase with arrest. Abortion correlates included: mental health (e.g., depression PR 2.09, 95% CI 1.18, 3.71), stimulant use (e.g., methamphetamine PR 1.83, 95% CI 1.22, 2.74), and drug injection (PR 1.76, 95% CI 1.03, 3.02); partner controlling access to people/possessions, physical and emotional violence; and a two-fold increase associated with survival sex and arrest. Experiencing both reproductive outcomes was correlated with mental health, opioid and simulant use, housing instability, survival sex, and arrest. Conclusion: Miscarriage and abortion was common among women with history of drug misuse suggesting a need for expanded access to family planning, medication-assisted therapy, and social support services, and for the integration of these with substance use services. Future research in longitudinal data is needed.

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Collaboration types
Domestic collaboration
Web of Science research areas
Psychiatry
Psychology
Substance Abuse
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