Evidence map›Paper›PMID 39965989›Full record

ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health

Obstetrician-Gynecologist Perspectives and Counseling Practices on the U.S. Medicaid Waiting Period for Permanent Contraception.

Suzanna Larkin, Brooke W Bullington, Kristen A Berg, Kari White, Margaret Boozer, Tania Serna, Emily S Miller, Jennifer L Bailit, Kavita Shah Arora

Abstract read
In one paragraph

Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Suzanna LarkinDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Brooke W BullingtonDepartment of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina.
Kristen A BergCenter for Health Care Research and Policy, MetroHealth Medical System, Cleveland, Ohio.
Kari WhiteDepartment of Sociology, Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas; Resound Research for Reproductive Health, Austin, Texas.
Margaret BoozerDepartment of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
Tania SernaDepartment of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California.
Emily S MillerDepartment of Obstetrics and Gynecology, Brown University, Providence, Rhode Island.
Jennifer L BailitDepartment of Obstetrics and Gynecology, MetroHealth Medical System, Cleveland, Ohio.
Kavita Shah AroraDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: kavita_arora@med.unc.edu.

Funding

POPULATION STUDIEST32HD007168 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ELIZABETH A FRANKENBERG · 1985 to 2026
$13.8M
Research Services CoreP2CHD050924 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KAREN B GUZZO · 2015 to 2026
$9.6M
Multi-level factors affecting postpartum sterilizationR01HD098127 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ARORA, KAVITA SHAH · 2020 to 2023
$2.5M
Research Training Program in Reproductive and Sexual HealthR25HD115514 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI JESSICA N SANDERS, David Turok · 2024 to 2026
$474k
NICHD NIH HHS P2C HD050924NICHD NIH HHS R01 HD098127NICHD NIH HHS R25 HD115514NICHD NIH HHS T32 HD007168NIH HHS T32HD502468
6 · The paper itself

Abstract

backgroundCreated to protect patients from coercive sterilization, the federally mandated 30-day waiting period for patients with Medicaid desiring permanent contraception is a known barrier to permanent contraception fulfillment. Existing research does not explicitly explore how physicians interpret and operationalize the consent policy, how they counsel regarding the waiting period, or whether physicians believe the policy should be revised. The purpose of this paper is to better understand obstetrician-gynecologist (OB-GYN) feelings, thoughts, and counseling practices around the waiting period as key stakeholders in counseling and provision of permanent contraception care. BASIC PROCEDURES: We interviewed 81 postpartum people with a documented desire for permanent contraception and 61 OB-GYNs who delivered their infants at four hospitals across the United States. Interviews were audio-recorded, transcribed, and analyzed using rapid qualitative analysis and thematic content analysis. MAIN

findingsForty-seven physicians (70.2%) expressed negative feelings toward the Medicaid waiting period policy and 14 (20.9%) expressed neutral/mixed feelings. Physicians often viewed the Medicaid sterilization consent policy as inequitable and reported feeling that the waiting period hinders patient autonomy. Several physicians suggested that the waiting period needs revision. Physicians cited several barriers related to the implementation of the waiting period, including a lack of prenatal care or the conversation not being initiated. Physicians mentioned various approaches to counseling around the waiting period, either explicitly or inexplicitly explaining the policy. Last, physicians discussed differing interpretations around the waiting period policy. PRINCIPAL

conclusionsPhysicians in our sample largely do not favor the current Medicaid sterilization waiting period. However, physicians report varying approaches to clinical counseling as well as beliefs regarding policy revision. Revision to the policy should be informed by the lived experience and expertise of the various stakeholders, including patients, clinicians, and policymakers.

Indexed as

Attitude of Health PersonnelCounselingGynecologyMedicaidObstetricsPhysiciansSterilization, ReproductiveAdultContraceptionFemaleGynecologistsHumansInterviews as TopicMaleMiddle AgedObstetricians

Identifiers

PMID39965989
PMCPMC11911074

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.