Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022;57(6):999-1006.
doi: 10.1080/10826084.2022.2046100. Epub 2022 Mar 11.

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

Joy D Scheidell  1 , Janna Ataiants  2 , Stephen E Lankenau  2
Affiliations

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

Joy D Scheidell et al. Subst Use Misuse. 2022.

Abstract

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.

Keywords: Reproductive health; abortion; drug use; miscarriage; women.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interest

The authors report no conflict of interest.

References

    1. Alves C, & Rapp A (2021). Spontaneous Abortion. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/32809356 - PubMed
    1. Ataiants J, Mazzella S, Roth AM, Robinson LF, Sell RL, & Lankenau SE (2020). Multiple Victimizations and Overdose Among Women With a History of Illicit Drug Use. J Interpers Violence, 886260520927501. 10.1177/0886260520927501 - DOI - PMC - PubMed
    1. Ataiants J, Mazzella S, Roth AM, Sell RL, Robinson LF, & Lankenau SE (2021). Overdose response among trained and untrained women with a history of illicit drug use: a mixed-methods examination. Drugs (Abingdon Engl), 28(4), 328–339. 10.1080/09687637.2020.1818691 - DOI - PMC - PubMed
    1. Ataiants J, Roth AM, Mazzella S, & Lankenau SE (2020). Circumstances of overdose among street-involved, opioid-injecting women: Drug, set, and setting. Int J Drug Policy, 78, 102691. 10.1016/j.drugpo.2020.102691 - DOI - PMC - PubMed
    1. Barros AJ, & Hirakata VN (2003). Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol, 3, 21. 10.1186/1471-2288-3-21 - DOI - PMC - PubMed

Publication types