Crack open the Champagne. With this issue, Perspectives on Sexual and Reproductive Health begins its 50th year of publication. Over the years, the journal that began as Family Planning Perspectives has changed quite a bit—in substance, reflecting the scope of a field that grew beyond the confines of family planning; and in process and presentation, reflecting trends in how journals are produced and used. The journal's early editors, for whom “cut and paste” meant “get out your scissors and tape,” could not have imagined today's digital environment and online‐only publication. And so it seems fitting that to celebrate the journal's history, the editors chose to look all the way back at what has been distinctive about Perspectives, and to present it mainly in a very 21st‐century way: The journal itself will carry a few special features throughout the year to mark the anniversary, but the bulk of the celebration is taking place on our blog, [email protected] (https://www.guttmacher.org/perspectives50). There, we present archival materials that help illustrate where we have been, along with new contributions from or about experts in the field and some material that is just plain fun. We invite readers to explore [email protected] while also moving ahead with us as we continue to present the latest peer‐reviewed research on sexual and reproductive health. Here is a brief look at what is in this issue.
- Women who undergo an abortion are known to have an elevated risk of subsequent unintended pregnancy, but the reasons for that are not clear. Using data from the Turnaway Study, Heidi Moseson and colleagues find that the explanation does not appear to be an absence of contraceptive use after abortion: In the roughly five years women were followed after having an abortion, the vast majority used some type of contraceptive (page 7). They were, in fact, more likely to use a method than were women who were denied abortions because of clinics’ gestational limits, and who therefore went on to give birth. However, they were less likely than those who gave birth to use sterilization and more likely to rely on relatively ineffective methods. While these differences may help explain the risk of unintended pregnancy after abortion, the researchers recommend that future work examine the role of modifiable sociodemographic characteristics.
- Parents, peers and the media serve as informal sources of sex education for young people, but relatively little is known about what kinds of information adolescents get from each. Amy Bleakley and colleagues help fill the gap with a study using data from nearly 2,000 U.S. youth aged 14–17 who took a 2015 online survey (page 15). They found that what teenagers learn about sex from informal sources differs by race and gender. For example, white youth reported learning more from parents, but less from media, than their black peers; females learned more about hormonal contraceptives from their parents, and more about relationships from peers and media, than males did. The study also showed associations between sources of information and selected behavioral outcomes. Longitudinal analyses exploring those kinds of associations, the authors conclude, are “a next step in finding ways to improve adolescents’ sexual health.”
- Intimate partner violence has been linked to STD susceptibility and acquisition, and Tiara C. Willie and her team sought to understand how those associations work during the often stressful period when young couples are new parents (page 25). Using data from a clinic‐based prospective cohort study, they found that violence victimization may be a risk factor for postpartum STD acquisition for young women, and that women's sexual autonomy may be protective for both themselves and their male partners. Victimization and one's own autonomy were not related, but young men's experiences of violence were associated with their partners’ levels of autonomy. The findings suggest numerous avenues for further research and appear to point to the importance of STD prevention programs’ including components designed to foster healthy, nonviolent relationships.
- In 2013, California enacted a law that has the potential to vastly expand women's access to first‐trimester aspiration abortion services by permitting nurse practitioners, certified nurse‐midwives and physician assistants to perform the procedure. In two rounds of qualitative interviews roughly 1–3 years later, Molly Frances Battistelli and colleagues spoke with administrators of organizations that had implemented the policy change about their experiences in doing so (page 33). The 25 participants generally agreed that the change improved access to care and facilities’ ability to manage postabortion complications. Yet they also described financial and logistical burdens, and not all felt that these were outweighed by the benefits. “To fully realize the benefits of an expanded abortion‐providing workforce,” the researchers conclude, “more needs to be done to address associated organizational constraints.”
- Some of the earliest research on abortion incidence and service availability was conducted by Stanley Henshaw during the more than 30 years he spent at the Guttmacher Institute. As part of our anniversary celebration, we asked him to share with us some reflections on his work. He graciously agreed, and the resulting interview, which was originally posted on [email protected], is presented in this issue (page 41). The interview provides insights into Henshaw himself, into how the field that he helped create took form and into what this leading expert feels are the important challenges still ahead.