The goal of clinical and social science research and clinical training at PPLM is to understand the critical factors that affect health equity and access to care and improve patient care.
ASPIRE: A Catalyst for Change
In June, PPLM announced the launch of a historic initiative: a new multidisciplinary center to advance health equity through research and education and train the next generation of reproductive health care providers. The ASPIRE (Advancing Science and Practice through Innovations in Research and Education) Center for Sexual and Reproductive Health will expand PPLM’s nationally recognized expertise in education, research, and clinical training through partnerships with academic institutions, teaching hospitals, health care professionals, and community organizations. It will focus on combatting systemic barriers that disproportionately prevent people of color, the LGBTQIA+ community, young people, and people with disabilities from accessing quality care. It will also provide critical national leadership in an era when reproductive freedoms and abortion access are increasingly threatened and restricted.
The Impact of Law
Two ongoing studies will assess the impact of the ROE Act on access to abortion in Massachusetts. Passed at the end of 2020, this legislation removed barriers to abortion for young people and those in need of later abortion care. One current investigation, co-lead by Dr. Alisa Goldberg, PPLM’s vice president of research and clinical training, and Smith Fellow Dr. Steffanie Wright, examines access to later abortion. The other, co-lead by Dr. Elizabeth Janiak, director of social science research, examines the impact on quality of care for abortion patients between 16 and 19 years old. Dr. Janiak and her research team also secured a multiyear grant from the Society of Family Planning Research Funds to explore abortion care access among patients traveling to Massachusetts for care. The study, known as Quality and Equity in Abortion Seeking Travel (QuEAST), will inform future research and programs to better serve the needs of the most vulnerable abortion travelers, particularly marginalized young people who are crossing state lines for care.
Removing Barriers to Abortion
PPLM patients have been presenting increasingly early in pregnancy for medication abortion, often making an appointment as soon as they have a positive pregnancy test. Yet many patients must wait for their abortion until ectopic pregnancies (pregnancies that occur outside the uterus) have been ruled out by a series of diagnostic tests. Dr. Goldberg led a team of researchers in a three-year study of over 5,000 PPLM patients to discover if mifepristone and misoprostol (abortion medications) could be safely administered very early in pregnancy—before a pregnancy can be visualized on ultrasound and before an ectopic pregnancy can be ruled out—rather than delaying until diagnostics were completed. Findings signaled good news for patients: it is safe to prescribe abortion pills for people with pregnancies of unknown location while simultaneously ruling out ectopic pregnancy with serial blood tests; however, patients should be informed that efficacy is slightly reduced. This study is a milestone in PPLM’s commitment to removing unnecessary delays and barriers to abortion access while maintaining safety and centering patient preferences. This study is a milestone in PPLM’s commitment to removing unnecessary delays and barriers to abortion access.
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