What We Do

Abortion

Contraception

HIV/STI Prevention

Linking Reproductive Health & HIV

Fellowship

Other

Where We Work

Published groundbreaking study on abortion access among US military women
In the first study to investigate US servicewomen’s experiences seeking abortion during deployment, researchers at Ibis found that US military women and dependents face significant barriers when trying to access abortion care, including legal and logistical impediments to services in the countries where they are based, and difficulties accessing abortion elsewhere due to fear of negative impacts on their careers, confidentiality concerns, and the narrow timeframe for early abortion. With no perceived alternatives, some women reported considering unsafe methods to terminate the pregnancy themselves. The study results are reported in the July-August, 2011, issue of Women’s Health Issues.

“Abortion restrictions in the US military: Voices from women deployed overseas,” Kate Grindlay, Susan Yanow, Kinga Jelinska, Rebecca Gomperts, Daniel Grossman, Women’s Health Issues 2011 Jul-Aug;21(4):259-64.

Click here to read the full announcement
Click here to read the article abstract
Click here to request a copy of the article

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Launched Take Action guides to improve Medicaid coverage of abortion in the US
Building on Ibis’s previous work on the Hyde Amendment, we created two Take Action guides aimed at providing US abortion providers and advocates with a number of actions they can take to help expand access to Medicaid coverage of abortion. We generated the action steps based on interviews with abortion providers representing 70 facilities in 15 states and interviews with 71 low-income women who have had abortions. We also drew on the work of other advocates and researchers. Looking closely at the strategies put in place by women, advocates, and providers, we find that there are a number of effective policy, advocacy, and practice-based strategies that can help improve women’s access to timely abortion care. In 2012, we will release two additional Take Action guides for women and policymakers.

Click here to read the Take Action guide for providers. (Download the PDF)
Click here to read the Take Action guide for advocates. (Download the PDF)

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Released findings from the Border Contraceptive Access Study on women’s OTC birth control pill use
Ibis, in collaboration with the University of Texas and New York University as part of the Border Contraceptive Access Study, published research comparing women living on the Texas/Mexico border who obtain birth control pills over-the-counter (OTC) in Mexico with those who obtain birth control pills at clinics in El Paso. The researchers found that women who obtain pills OTC in Mexico are likely to stay on the birth control pill longer than those who obtain pills by prescription at US clinics. This suggests that removing unnecessary barriers to access—such as limits on the number of pill packs dispensed or the prescription requirement—could have an important impact on reducing unintended pregnancy. However, the study also found that women who obtained combined oral contraceptives, which contain both synthetic estrogen and progesterone, in Mexico were significantly more likely than US clinic users to have health conditions such as hypertension or smoking at age 35 and over that may put them at risk of complications while using this type of pill. These findings highlight the importance of providing women with tools to self-screen for contraindications when pills are made available over the counter.

Click here to read the full announcement
Click here to view the full article for the study by Potter et al.
Click here to view the abstract for the study by Grossman et al.
Contact us to request the full article by Grossman et al.

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Evaluation of educational materials on misoprostol to help inform women about safe abortion in Colombia and Peru
Ibis, in collaboration with the Latin American Consortium against Unsafe Abortion (CLACAI), completed an evaluation of CLACAI’s pamphlet on misoprostol use aimed to educate women about the correct dosages of the drug, side effects, the medication abortion process, and how to identify unsuccessful abortion. This information is crucial in order to help women in countries where abortion is illegal or severely restricted to have an effective and safe abortion.

Ibis found that the majority of women interviewed in Peru and Colombia found the educational material helpful, expressed positive opinions about it, and said that they would use misoprostol to interrupt a pregnancy if they needed to and/or they would recommend it to a friend. Nevertheless, some of the information included in the pamphlet was misunderstood or not fully understood by some of the participants, so Ibis also developed recommendations for how to improve the materials. Misoprostol used alone is a safe and effective way for women to end a pregnancy early in gestation, but it is crucial that women have correct information about the regimen. We hope our recommendations will help more women to receive accurate information about misoprostol when they are unable to access clinical services.

Ibis is also aiding CLACAI in developing a new educational material on misoprostol use for women across Latin America.

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Expanded to Namibia to begin research on the sexual health of HIV-positive individuals
Ibis’s first project in Namibia is a partnership with the Centers for Disease Control and Prevention’s (CDC) offices in Atlanta and Namibia, RTI International, and local Ministry of Health (MOH) staff in Namibia. With funding from the CDC, Ibis’s staff will play a role in training research team members and MOH staff in Namibia regarding implementation of the study. Beginning in 2012, Ibis’s staff will then lead on-the-ground monitoring and evaluation efforts throughout this study. The study aims to collect information regarding the prevalence and etiology of genital infections among HIV-infected adults as they are entering care in an HIV clinic and six months after entering care. We hope to use the findings to improve the diagnosis and management of infections among HIV-positive patients in out-patient care in this setting.

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Hosted national meeting to address teenage pregnancy in South Africa
Ibis’s staff in Johannesburg has worked for the past several years on a range of projects addressing teenage pregnancy and young women’s access to sexual and reproductive health (SRH) care in South Africa. (See our new briefs here and here on this work for more information.) In July, Ibis, in collaboration with the Ford Foundation Office for Southern Africa, hosted a two-day teenage pregnancy exchange in Johannesburg, South Africa. The attendees included government, civil society representatives, health professionals, and young women from South Africa. The aim of the exchange was to encourage sharing of policies and project information and to explore opportunities for collaboration. Ibis will continue to work with meeting participants by convening meetings with groups, including government departments, to address policies addressing teenage pregnancy.

Click here to read the full announcement

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Began study on emergency contraception availability and access in Tunisia
Ibis continues to build on our work in the Middle East and North Africa (MENA) region by launching a new study in Tunisia. The goals of the study are to assess the availability of emergency contraception pills (ECPs) in pharmacies by conducting interviews with pharmacists, evaluate how well women are able to access ECPs by conducting a survey at 50 pharmacies, and to explore what people think about ECPs through interviews with 50 women in Tunis. The findings will allow us to develop recommendations for improvement of family planning in Tunisia and will inform broader efforts in the MENA region to get more countries to register a dedicated emergency contraceptive product.

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Advanced innovative work on integration of reproductive health and HIV services in Kenya
Ibis, in collaboration with colleagues at the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco, and the Kenya Medical Research Institute, are studying whether integrating family planning services into HIV care and treatment increases contraceptive use and reduces rates of unintended pregnancy compared to the standard practice of referring women to a separate family planning clinic. Many programs that aim to reduce mother-to-child-transmission of HIV offer testing and treatment for the mother and infant, but there has been little focus on preventing unintended pregnancy or meeting comprehensive sexual and reproductive health needs among HIV-positive women. Even when contraceptive methods are available, busy providers are often not well-equipped with the information and materials needed to offer their patients a full range of contraceptive choices. In September we completed data collection for our cluster randomized trial comparing contraceptive use and unintended pregnancy among HIV-infected women at 12 public sector sites with integrated family planning services compared to six sites where clients were referred to a separate family planning clinic. We plan to have results from the study by mid-2012, and we plan to share them at the Integration for Impact Conference in Nairobi in September 2012, which we are co-hosting.

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Led new research on second-trimester abortion in South Africa
Building on our previous work in South Africa on access to and quality of second-trimester abortion care in South Africa, we have begun work on two new studies in South Africa that will help address gaps in clinical research on second-trimester abortion services. We will soon start recruitment for a study to compare laminaria to misoprostol for cervical priming before dilation and evacuation (D&E). Evidenced-based cervical priming regimens could reduce the proportion of women who expel the fetus prior to their surgical abortion (according to our prior research, almost 40% with the current misoprostol-alone protocol in South Africa), but there are currently no data comparing the two methods head-to-head.

Also, in June 2011, we received funding for a randomized controlled trial comparing a combined mifepristone-misoprostol regimen to misoprostol-alone for medical induction at 13-20 weeks gestation. This study will take place in both India and South Africa. Ibis’s previous research in South Africa found that the misoprostol-alone induction regimen can take many days and requires hospital admission; this research could improve second-trimester abortion services and make the process less burdensome and more comfortable for women and less costly to the health services.

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Ibis 2011 Publications

Blanchard K, Manski R. HIV-positive women need access to all health services, including abortion. RH Reality Check 1 December 2011.  Download

Dennis A, Blanchard K. A mystery caller evaluation of Medicaid staff responses about state coverage of abortion care. Women’s Health Issues. November 2011. (Online ahead of print). Click here to request

Dennis A, Blanchard K, Cordova D. Strategies for securing funding for abortion under the Hyde Amendment: A multistate study of abortion providers' experiences managing Medicaid. American Journal of Public Health. November 2011;101(11):2124-9. Click here to request

Harries J, Lince N, Constant C, Hargey A, Grossman D. The challenges of offering public second trimester abortion services in South Africa:  Health care providers’ perspectives. Journal of Biosocial Science. November 2011;17:1-12. (Online ahead of print). Click here to request

Harris L, Grossman D. Confronting the challenge of unsafe second-trimester abortion. International Journal of Gynecology and Obstetrics. October 2011; 115(1):77-9. Click here to request

Foster DG, Higgins JA, Karasek D, Ma S, Grossman D. Attitudes toward unprotected intercourse and risk of pregnancy among women seeking abortion. Women’s Health Issues. October 2011. (Online ahead of print). Click here to request

Blanchard K, Holt K, Bostrom A, van der Straten A, Ramjee G, de Bruyn G, Chipato T, Montgomery E, Padian N. Impact of learning HIV status on contraceptive use in the MIRA trial. Journal of Family Planning and Reproductive Health Care. October 2011; 37(4):204-208. Click here to request

Ibis Reproductive Health. Research brief: Young women's sexual and reproductive health in South Africa; Service availability and health care workers' opinions in Soweto. October 2011.  Download

Ibis Reproductive Health. Research brief: Young women's sexual and reproductive health in South Africa; A workshop for health care personnel on addressing the sexual and reproductive health service needs of young women. October 2011.  Download

Ibis Reproductive Health. State level research brief, Public Funding for Abortion: Florida. Reissued September 2011. Download

Grossman D, Constant D, Lince N, Alblas M, Blanchard K, Harries J. Surgical and medical second trimester abortion in South Africa: A cross-sectional study. BMC Health Services Research. September 2011;11(1):224. Click here to request

Holt K, Grindlay K, Taskier M, Grossman D. Unintended pregnancy and contraceptive use among women in the US military: A systematic literature review. Military Medicine. September 2011; 176(9);1056-1064. Click here to request

Grossman D. Over-the-counter access to oral contraceptives. Expert Review of Obstetrics & Gynecology. September 2011; 6(5);501-508. Click here to request

Dennis A, Manski R. How restrictions on health care funding affect low-income women's access to care. MomsRising. 25 August 2011.  Download

Foster DG, Karasek D, Grossman D, Darney P, Schwarz EB. Interest in using intrauterine contraception when the option of self-removal is provided. Contraception. August 2011. (Online ahead of print) Click here to request

Venkatesh K, de Bruyn G, Mayer K, Cheng H, Blanchard K, Ramjee G, Chipato T, Triche E, Padian N, van der Straten A. Changes in sexual risk behavior before and after HIV seroconversion in Southern African women enrolled in a HIV prevention trial. Journal of Acquired Immune Deficiency Syndromes. August 2011; 57(5):435-441. Click here to request

Dennis A, Clark J, Cordova D, McIntosh J, Edlund K, Wahlin B, Tsikitas L, Blanchard K. Access to contraception after health care reform in Massachusetts: A mixed-methods study investigating benefits and barriers. Contraception. (Online ahead of print). August 2011. Click here to request

Blanchard K. No co-pay for birth control? A great first step towards truly universal access. RH Reality Check. 19 July 2011.  Download

Grindlay K, Yanow S, Jelinska K, Gomperts R, Grossman D. Abortion restrictions in the US military: Voices from women deployed overseas. Women's Health Issues. July 2011; 21(4):259-264. Click here to request

Grossman D, Grindlay K, Buchacker T, Lane K, Blanchard K. Effectiveness and acceptability of medical abortion provided through telemedicine. Obstetrics and Gynecology. July 2011; 118(2):296-303 Click here to request

Grossman D, Grindlay K. Alternatives to ultrasound for follow-up after medication abortion: A systematic review. Contraception. June 2011; 83(6):504-510. Click here to request

Venkatesh KK, Van der Straten A, Mayer K, Blanchard K, Ramjee G, Lurie M, Chipato T, Padian N, De Bruyn G. African women recently infected with HIV-1 and HSV-2 have increased risk of acquiring N Gonorrhoeae and C Trachomatis in the MIRA trial. Sexually Transmitted Diseases. June 2011; 38(6):562-570. Click here to request

Liang S, Grossman D, Phillips K. Women's out of pocket expenditures and dispensing patterns for oral contraceptive pills between 1996 and 2006. Contraception. June 2011; 83(6):528-536. Click here to request

Blanchard K, Bostrom A, Montgomery E, van der Straten A, Lince N, Bruyn G, Grossman D, Chipato T, Ramjee G, Padian N. Contraception use and effectiveness among women in a trial of the diaphragm for HIV prevention. Contraception. June 2011; 83(6):556-563. Click here to request

Lara D, Garcia S, Wilson K, Paz F. How often and under which circumstances do Mexican pharmacy vendors recommend misoprostol to induce an abortion? International Perspectives of Sexual and Reproductive Health. June 2011; 37(2):75-83. Click here to request

Ibis Reproductive Health. State level research brief, Public funding for abortion: Illinois. May 2011. Download

Charlotte Ellertson Fellows. Abortion reproductive rights and health: Highlights for the Charlotte Ellertson Social Science Postdoctoral Fellowship 2003-2010. Women's Health Issues (Supplement). May 2011.  Click here to request

Foster A. Increasing access to health insurance for young adults: An unheralded benefit of the ACA. Momsrising. 23 March 2011.  Download

Wahlin B, Dennis A. Public funding of family planning is essential, even under health reform. RH Reality Check. 23 March 2011  Download

Dennis A, Blanchard K. In Massachusetts, health reform is a lifesaver for women. Momsrising. 23 March 2011.  Download

Bessett D. Young adults in Massachusetts speak about health reform. Momsrising. 23 March 2011.  Download

Potter J, McKinnon S, Hopkins K, Amastae J, Shedlin M, Powers D, Grossman D. Continuation of prescribed compared with over-the-counter oral contraceptives. Obstetrics and Gynecology. March 2011; 117(3): 551-557. Click here to request

Grossman D, White K, Hopkins K, Amastae J, Shedlin M, Potter J. Contraindications to combined oral contraceptives among over-the-counter compared with prescription users. Obstetrics and Gynecology. March 2011; 117(3): 558-565. Click here to request

Foster A, Dennis A, Smith F. Do religious restrictions influence ectopic pregnancy management? A national qualitative study. Women's Health Issues. March 2011; 21(2) 104-109 Click here to request

Ibis Reproductive Health. Research brief: Abortion access for women enrolled in Medicaid. March 2011.  Download

Grossman D. Making mifepristone available and accessible in Latin America. International Consortium for Medical Abortion. January 2011; 4:3. Download