Ushma D Upadhyay
Dados Biográficos
| ID | 288363 |
|---|---|
| NOME | Ushma D Upadhyay |
| PRENOMES | Ushma D |
| SOBRENOME | Upadhyay |
| ASSINATURA | UPADHYAY U D |
| AFILIAÇÕES | University of California, San Francisco |
| ORCID | 0000-0002-2731-2157 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 38 |
| TOTAL DE CITAÇÕES | 138 |
| TOTAL COMO AUTOR | 38 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2000 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 7 |
Young widowhood as a predictor of HIV risk behaviors in a high HIV prevalence setting in Siaya County, Kenya
BACKGROUND: Widowed women in sub-Saharan Africa bear a disproportionate burden of HIV/AIDS. OBJECTIVES: We examined the likely period of HIV exposure among widows living with HIV and the patterns and predictors of widowed women's HIV risk behaviors. METHODS: We performed a cross-sectional survey with an age-stratified random sample of widowed women in Siaya County, Kenya. We estimated the period of HIV exposure and the prevalence of HIV-risk beha…
“I don't want to be in the energy of that situation”
Medication abortion makes up the majority of abortions in the U.S. today. Use of medication abortion by telehealth, in which the entire abortion process occurs remotely, has also grown in recent years. In this study, we examine embodied experiences of telehealth abortion through 30 in-depth interviews. We explore how participants’ preferences for telehealth medication abortion and their assessment of a successful abortion were informed by embodie…
Widowhood stigma as a fundamental cause of poor mental, sexual, and reproductive health outcomes in sub-Saharan Africa
Widows in sub-Saharan Africa experience stigma linked to their social identity of widowhood. Despite the known significant impacts of stigma on health and wellbeing, widowhood stigma is less conceptualized and studied and its effects on widows' mental, sexual and reproductive health are not delineated. We thematically reviewed literature mentioning widowhood stigma and its effects in Africa. Applying the fundamental cause theory to this literatur…
Use of Preabortion Ultrasonography Among Telehealth Medication Abortion Patients
Hospitals, clinics, and imaging facilities can create policies to increase the accessibility of ultrasonography for those who desire or require pre-abortion ultrasonography
Development and Validation of the Agency in Contraceptive Decisions Scale in Uganda and Nigeria
To fill a gap in measures of empowered contraceptive decision‐making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews ( N = 80) and expert feedback and piloted a reduced item pool via surveys ( N = 3002). Exploratory factor analysis using a random half of the sample suggested a…
It Was So Easy in a Situation That's So Hard
For decades, sociological research has examined the role of stigma in contributing to health disparities, yet such research seldom grapples with the interplay between individuals and structures. There is a particular paucity of research on abortion that concurrently examines individual experiences with stigma and structural barriers. In this article, we use telehealth abortion as a case, which now accounts for one in five abortions in the United …
Amicus brief of over 300 reproductive health researchers supports mifepristone's safety and effectiveness
On January 30, 2024, over 300 researchers filed an amicus brief in FDA v. Alliance for Hippocratic Medicine, a United States (US) Supreme Court case concerning the regulatory status of mifepristone, one of two drugs used in medication abortion. In this Comment we summarize the legal challenge, responses from the FDA and drug manufacturer to these challenges, oral arguments presented before the Court, and the implications of the Court's decision o…
Pricing of medication abortion in the United States, 2021–2023
Medication abortion is offered at substantially lower prices by virtual clinics. However, not being able to use Medicaid or other insurance may make telehealth cost-prohibitive for some people, even if prices are lower. Additionally, many states do not allow telehealth for abortion, deepening inequities in healthcare
Brief of over 300 reproductive health researchers as Amici Curiae in FDA v. Alliance for Hippocratic Medicine
On January 30, 2024, over 300 researchers filed an amicus brief in FDA v. Alliance for Hippocratic Medicine, a United States (US) Supreme Court case that could have severely impacted access to mifepristone, one of the two drugs commonly used in medication abortion. The researchers summarize the legal challenges to the US Food and Drug Administration's (FDA's) original approval of mifepristone in 2000 and its 2016 and 2021 decisions modifying mife…
Patient Acceptability of Telehealth Medication Abortion Care in the United States, 2021‒2022
Objectives. Despite the recent expansion of direct-to-patient telehealth abortion care in the United States, patient experiences with the service are not well understood. Methods. We described care experiences of 1600 telehealth abortion patients in 2021 to 2022 and used logistic regression to explore differences by race or ethnicity and between synchronous (phone or video) and asynchronous (secure messaging) telehealth abortion care. Results. Mo…
Confirmatory Factor Analysis and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults in Kenya
Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted version of the Sexual and Reproductive Health Empowerment (SRE) Scale for Adolescents and Young Adults among 500 adolescent girls and young women aged 15–20 in Kisumu, Kenya. We used confirmatory factor analysis (CFA) to assess factor …
Waiting to start abortion
With the Dobbs leak introducing uncertainty about access and the Dobbs v. Jackson Women's Health Organization decision in June of 2022 overturning the US constitutional right to abortion, delays in accessing desired abortion care are likely growing longer and more common. Timely research on people's experiences waiting to access abortion care is needed. Using data from an abortion subreddit (r/abortion), we analyzed posts that described waiting a…
Adaptation of the sexual and reproductive empowerment scale for adolescents and young adults in Kenya
Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15–23 year-old female adolescents and young adults in Kis…
Separating Procedure-related Fears From Future Fertility Concerns Among a Cohort Seeking Abortion Information Online
Intimate relationships after receiving versus being denied an abortion
Carrying an unwanted pregnancy to term does not increase the chance of being in an intimate relationship with the man involved in the pregnancy but may have negative implications for the quality of future relationships up to 5 years post-abortion seeking
Barriers Push People into Seeking Abortion Care Later in Pregnancy
Denial of Abortion Because of Provider Gestational Age Limits in the United States
OBJECTIVES: We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. METHODS: We compared women who presented for abortion care who were under the facilities' gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We des…
State abortion policies and Medicaid coverage of abortion are associated with pregnancy outcomes among individuals seeking abortion recruited using Google Ads
Restrictive state-level abortion policies are associated with not having an abortion at all and lack of coverage for abortion is associated with prolonged abortion seeking. Medicaid coverage of abortion appears critical to ensuring that all people who want abortions can obtain them
Gender, justice and empowerment
Gender is one of the most important social determinants of health. Considerable research has shown that power imbalances due to gender and sexual orientation lead to numerous negative health outcom
Sociodemographic Characteristics of Women Able to Obtain Medication Abortion Before and After Ohio's Law Requiring Use of the Food and Drug Administration Protocol
Purpose: In 2011, a law went into effect in Ohio that regulates how abortion care providers can offer medication abortion to their patients. We sought to evaluate changes in sociodemographic characteristics of Ohio medication abortion patients before and after the implementation of this law. Methods: We used a retrospective cohort design, comparing characteristics of women obtaining a medication abortion at four abortion facilities before and aft…
The association between reproductive autonomy and abortion stigma among women who have had abortions in the United States
Contraceptive Use over Five Years After Receipt Or Denial of Abortion Services
Women's elevated risk of unintended pregnancy after abortion is likely due at least partly to reliance on methods with relatively low effectiveness. Factors affecting contraceptive access postabortion, as well as individual characteristics such as fecundability, require research attention
Hybrid Masculinity and Young Men's Circumscribed Engagement in Contraceptive Management
This research explores how gender shapes contraceptive management through in-depth interviews with 40 men and women of color ages 15 to 24, a life stage when the risk of unintended pregnancy is high in the United States. Although past research focuses on men's contraception-avoidant behaviors, little sociological work has explored ways men engage in contraception outside of condoms, such as contraceptive pills. Research often highlights how women…
Women’s Empowerment and Family Planning
This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South As…
Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion
In this study, compared with having an abortion, being denied an abortion may be associated with greater risk of initially experiencing adverse psychological outcomes. Psychological well-being improved over time so that both groups of women eventually converged. These findings do not support policies that restrict women's access to abortion on the basis that abortion harms women's mental health.
Do higher status and more autonomous women have longer birth intervals
Development and Validation of a Reproductive Autonomy Scale
No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as “reproductive autonomy.” We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selec…
The Stigma of Having an Abortion
This valid and reliable scale can be used in research examining abortion stigma and related outcomes (e.g., women's health, relationships and behavior). The scale can also be used to evaluate programs and interventions that aim to reduce the stigma experienced by women who have abortions
Hybrid Masculinity and Young Men's Circumscribed Engagement in Contraceptive Management
This research explores how gender shapes contraceptive management through in-depth interviews with 40 men and women of color ages 15 to 24, a life stage when the risk of unintended pregnancy is high in the United States. Although past research focuses on men's contraception-avoidant behaviors, little sociological work has explored ways men engage in contraception outside of condoms, such as contraceptive pills. Research often highlights how women…
Denial of Abortion Because of Provider Gestational Age Limits in the United States
OBJECTIVES: We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. METHODS: We compared women who presented for abortion care who were under the facilities' gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We des…
State abortion policies and Medicaid coverage of abortion are associated with pregnancy outcomes among individuals seeking abortion recruited using Google Ads
Restrictive state-level abortion policies are associated with not having an abortion at all and lack of coverage for abortion is associated with prolonged abortion seeking. Medicaid coverage of abortion appears critical to ensuring that all people who want abortions can obtain them
Safety of Aspiration Abortion Performed by Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants Under a California Legal Waiver
Objectives. We examined the impact on patient safety if nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) were permitted to provide aspiration abortions in California. Methods. In a prospective, observational study, we evaluated the outcomes of 11 487 early aspiration abortions completed by physicians (n = 5812) and newly trained NPs, CNMs, and PAs (n = 5675) from 4 Planned Parenthood affiliates and Kaiser…
India's New Economic Policy of 1991 and its Impact on Women's Poverty and Aids
This paper examines the effects of current policies intended to liberalize the Indian economy and facilitate globalization on women close to poverty. The New Economic Policy of 1991 included standard structural adjustment measures including the devaluation of the rupee, increase in interest rates, reduction in public investment and expenditure, reduction in public sector food and fertilizer subsidies, increase in imports and foreign investment in…
Waiting to start abortion
With the Dobbs leak introducing uncertainty about access and the Dobbs v. Jackson Women's Health Organization decision in June of 2022 overturning the US constitutional right to abortion, delays in accessing desired abortion care are likely growing longer and more common. Timely research on people's experiences waiting to access abortion care is needed. Using data from an abortion subreddit (r/abortion), we analyzed posts that described waiting a…
Utah's 72‐Hour Waiting Period for Abortion
As most women in this cohort were not conflicted about their decision when they sought care, the 72-hour waiting requirement seems to have been unnecessary. Individualized patient counseling for the small minority who were conflicted when they presented for care may have been more appropriate
Implications of Georgia’s 20-Week Abortion Ban
Objectives. We sought to understand more about women affected by a law enacted in January 2013 that led Georgia providers to stop providing abortion services at 24 weeks from a woman’s last menstrual period (LMP), and who would be affected if Georgia enforces the law banning abortions at 22 weeks from LMP. Methods. We obtained data on women obtaining abortions at or after 20 weeks from LMP in 2012 and 2013 from 4 Georgia facilities providing late…
Patient Acceptability of Telehealth Medication Abortion Care in the United States, 2021‒2022
Objectives. Despite the recent expansion of direct-to-patient telehealth abortion care in the United States, patient experiences with the service are not well understood. Methods. We described care experiences of 1600 telehealth abortion patients in 2021 to 2022 and used logistic regression to explore differences by race or ethnicity and between synchronous (phone or video) and asynchronous (secure messaging) telehealth abortion care. Results. Mo…
Confirmatory Factor Analysis and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults in Kenya
Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted version of the Sexual and Reproductive Health Empowerment (SRE) Scale for Adolescents and Young Adults among 500 adolescent girls and young women aged 15–20 in Kisumu, Kenya. We used confirmatory factor analysis (CFA) to assess factor …
The Influence of Parents' Marital Relationship and Women's Status on Children's Age at First Sex in Cebu, Philippines
This study examines the intergenerational effects of parents' marital relationship and the status of women on children's age at first sexual intercourse in Cebu, Philippines. Matched longitudinal data for 1,661 mothers and their children are analyzed. The mothers were interviewed in 1994, when their children were aged 9 to 11, about sociodemographic characteristics, their marital relationships, and women's status. Cox proportional hazards models …
Pricing of medication abortion in the United States, 2021–2023
Medication abortion is offered at substantially lower prices by virtual clinics. However, not being able to use Medicaid or other insurance may make telehealth cost-prohibitive for some people, even if prices are lower. Additionally, many states do not allow telehealth for abortion, deepening inequities in healthcare
Contraceptive Use over Five Years After Receipt Or Denial of Abortion Services
Women's elevated risk of unintended pregnancy after abortion is likely due at least partly to reliance on methods with relatively low effectiveness. Factors affecting contraceptive access postabortion, as well as individual characteristics such as fecundability, require research attention
Research Informs Abortion Care Policy Change In California
AffiliationsTracy Weitz, Diana Taylor, Ushma D. Upadhyay, Sheila Desai, and Molly Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF). Diana Taylor also maintains an appointment with the UCSF School of Nursing
India's New Economic Policy of 1991 and its Impact on Women's Poverty and Aids
This paper examines the effects of current policies intended to liberalize the Indian economy and facilitate globalization on women close to poverty. The New Economic Policy of 1991 included standard structural adjustment measures including the devaluation of the rupee, increase in interest rates, reduction in public investment and expenditure, reduction in public sector food and fertilizer subsidies, increase in imports and foreign investment in…
Do higher status and more autonomous women have longer birth intervals
The Influence of Parents' Marital Relationship and Women's Status on Children's Age at First Sex in Cebu, Philippines
This study examines the intergenerational effects of parents' marital relationship and the status of women on children's age at first sexual intercourse in Cebu, Philippines. Matched longitudinal data for 1,661 mothers and their children are analyzed. The mothers were interviewed in 1994, when their children were aged 9 to 11, about sociodemographic characteristics, their marital relationships, and women's status. Cox proportional hazards models …
Women’s Empowerment and Ideal Family Size
CONTEXT: The Demographic and Health Survey (DHS) program collects data on women's empowerment, but little is known about how these measures perform in Sub-Saharan African countries. It is important to understand whether women's empowerment is associated with their ideal number of children and ability to limit fertility to that ideal number in the Sub-Saharan African context. METHODS: The analysis used couples data from DHS surveys in four Sub-Sah…
At What Cost? Payment for Abortion Care by U.S. Women
The Stigma of Having an Abortion
This valid and reliable scale can be used in research examining abortion stigma and related outcomes (e.g., women's health, relationships and behavior). The scale can also be used to evaluate programs and interventions that aim to reduce the stigma experienced by women who have abortions
Safety of Aspiration Abortion Performed by Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants Under a California Legal Waiver
Objectives. We examined the impact on patient safety if nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) were permitted to provide aspiration abortions in California. Methods. In a prospective, observational study, we evaluated the outcomes of 11 487 early aspiration abortions completed by physicians (n = 5812) and newly trained NPs, CNMs, and PAs (n = 5675) from 4 Planned Parenthood affiliates and Kaiser…
Does abortion reduce self-esteem and life satisfaction
There is no evidence that abortion harms women's self-esteem or life satisfaction in the short term
Women's empowerment and fertility
Research Informs Abortion Care Policy Change In California
AffiliationsTracy Weitz, Diana Taylor, Ushma D. Upadhyay, Sheila Desai, and Molly Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF). Diana Taylor also maintains an appointment with the UCSF School of Nursing
Development and Validation of a Reproductive Autonomy Scale
No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as “reproductive autonomy.” We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selec…
Implications of Georgia’s 20-Week Abortion Ban
Objectives. We sought to understand more about women affected by a law enacted in January 2013 that led Georgia providers to stop providing abortion services at 24 weeks from a woman’s last menstrual period (LMP), and who would be affected if Georgia enforces the law banning abortions at 22 weeks from LMP. Methods. We obtained data on women obtaining abortions at or after 20 weeks from LMP in 2012 and 2013 from 4 Georgia facilities providing late…
Utah's 72‐Hour Waiting Period for Abortion
As most women in this cohort were not conflicted about their decision when they sought care, the 72-hour waiting requirement seems to have been unnecessary. Individualized patient counseling for the small minority who were conflicted when they presented for care may have been more appropriate
Women’s Empowerment and Family Planning
This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South As…
Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion
In this study, compared with having an abortion, being denied an abortion may be associated with greater risk of initially experiencing adverse psychological outcomes. Psychological well-being improved over time so that both groups of women eventually converged. These findings do not support policies that restrict women's access to abortion on the basis that abortion harms women's mental health.
Sociodemographic Characteristics of Women Able to Obtain Medication Abortion Before and After Ohio's Law Requiring Use of the Food and Drug Administration Protocol
Purpose: In 2011, a law went into effect in Ohio that regulates how abortion care providers can offer medication abortion to their patients. We sought to evaluate changes in sociodemographic characteristics of Ohio medication abortion patients before and after the implementation of this law. Methods: We used a retrospective cohort design, comparing characteristics of women obtaining a medication abortion at four abortion facilities before and aft…
The association between reproductive autonomy and abortion stigma among women who have had abortions in the United States
Contraceptive Use over Five Years After Receipt Or Denial of Abortion Services
Women's elevated risk of unintended pregnancy after abortion is likely due at least partly to reliance on methods with relatively low effectiveness. Factors affecting contraceptive access postabortion, as well as individual characteristics such as fecundability, require research attention
Hybrid Masculinity and Young Men's Circumscribed Engagement in Contraceptive Management
This research explores how gender shapes contraceptive management through in-depth interviews with 40 men and women of color ages 15 to 24, a life stage when the risk of unintended pregnancy is high in the United States. Although past research focuses on men's contraception-avoidant behaviors, little sociological work has explored ways men engage in contraception outside of condoms, such as contraceptive pills. Research often highlights how women…
Gender, justice and empowerment
Gender is one of the most important social determinants of health. Considerable research has shown that power imbalances due to gender and sexual orientation lead to numerous negative health outcom
State abortion policies and Medicaid coverage of abortion are associated with pregnancy outcomes among individuals seeking abortion recruited using Google Ads
Restrictive state-level abortion policies are associated with not having an abortion at all and lack of coverage for abortion is associated with prolonged abortion seeking. Medicaid coverage of abortion appears critical to ensuring that all people who want abortions can obtain them
Intimate relationships after receiving versus being denied an abortion
Carrying an unwanted pregnancy to term does not increase the chance of being in an intimate relationship with the man involved in the pregnancy but may have negative implications for the quality of future relationships up to 5 years post-abortion seeking
Barriers Push People into Seeking Abortion Care Later in Pregnancy
Denial of Abortion Because of Provider Gestational Age Limits in the United States
OBJECTIVES: We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. METHODS: We compared women who presented for abortion care who were under the facilities' gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We des…
Adaptation of the sexual and reproductive empowerment scale for adolescents and young adults in Kenya
Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15–23 year-old female adolescents and young adults in Kis…
Medicine (29 obras) · Reproductive Health and Contraception (26 obras) · Pregnancy (24 obras) · Abortion (23 obras) · Population (22 obras) · Political science (18 obras) · Reproductive Health and Technologies (17 obras) · Demography (16 obras) · Psychology (16 obras) · Environmental health (15 obras)