{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:46:41Z","timestamp":1757616401618,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2020,4,1]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Of the 70 000 people experiencing homelessness in Scotland, at least 40% are women. Little is known about their contraceptive usage. Most pregnancies in homelessness are unintended and children are usually looked after in the care system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A case note review of women\u2019s current contraceptive usage in a primary care service serving women experiencing homelessness in Edinburgh, Scotland. The service electronic database was searched for keywords relating to contraception to determine current usage, but also reproductive health, wider demographics and previous pregnancies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 174 women (16\u201355 years), 75 (43%) were recorded as using a contraceptive method. 49 (28%) were using long-acting reversible contraception (LARC), most of which was the contraceptive implant. However, 6\/41 (15%) of the most effective LARC (intrauterine contraception and implant) was being used beyond its\u2019 expiry date. 34 (20%) had no mention of contraceptive use in their medical record and 32 (19%) were not using contraception despite being sexually active. 6 (3%) had been hysterectomised\/female sterilisation. 26 (15%) were not sexually active. 179 of the 233 (77%) children mentioned in women\u2019s electronic records were recorded as being looked after out with their care. 138\/174 (79%) had current\/previous drug or alcohol misuse. 100\/174 (57%) had a history of domestic violence or abuse. 22\/174 (13%) were involved\/had been involved in sex work.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Primary care services need to give greater attention to the contraceptive needs of homeless women to empower them to become pregnant when the time is right for them and prevent the consequences of unintended pregnancy and homelessness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200541","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T17:37:42Z","timestamp":1589564262000},"page":"49-54","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Contraceptive usage in homeless women accessing a dedicated primary care service in Scotland, UK: a case note review"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9213-9007","authenticated-orcid":false,"given":"Katie Eirian","family":"Hawkins","sequence":"first","affiliation":[{"name":"Usher Institute, The University of Edinburgh, Edinburgh, UK"},{"name":"Edinburgh Access Practice primary care service, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"Montague-Johnstone","sequence":"additional","affiliation":[{"name":"Medical School, The University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"2025090511425476000_47.1.49.1","unstructured":"Baptista I . Women and Homelessness. In: O\u2019Sullivan E , BuschGeertsema V , Quilgars D , et al , eds. Homelessness research in Europe. Brussels: FEANTSA, 2010: 163\u201386."},{"key":"2025090511425476000_47.1.49.2","unstructured":"Fitzpatrick S , Pawson H , Bramley G , et al . The homelessness monitor Scotland 2019 London: crisis, 2019. Available: https:\/\/www.crisis.org.uk\/media\/240002\/the_homelessness_monitor_scotland_2019.pdf [Accessed Nov 2019]."},{"key":"2025090511425476000_47.1.49.3","unstructured":"Bramley G , Fitzpatrick S , Sosenko F . Hard edges Scotland. developing a profile of severe and multiple disadvantage in Scotland. Lankelly Chase 2019. technical report on integrated quantitative analysis and qualitative methodology, 2019. 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