{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:28:09Z","timestamp":1788805689614,"version":"build-2803163510"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>College-aged young adults in the US have low utilization and high need for reproductive healthcare. Multiple barriers to reproductive care exist. University Student Health Centers (SHCs) provide varying degrees of reproductive products and services. Recently, California legislated that public university SHCs add medication abortion to their care.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>To examine existing attitudes and barriers to reproductive healthcare for public university students, we conducted an anonymous online survey at a large, diverse, urban coastal California State University. Students were asked about numerous barriers accessing reproductive services in general and at the SHC, which we categorized into three groups: stigma, access and system. Respondents were also asked about knowledge and preferences for accessing and recommending various services. To understand the extent to which inequities exist, we compared differences across racialized\/ethnic identity, gender identity, anticipated degree, and living distance from campus using chi-squared tests.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The majority of survey (n\u2009=\u2009273) respondents experienced stigma and access barriers in general healthcare settings which made obtaining reproductive healthcare for themselves or their partners difficult (stigma barriers 55%; 95% CI 49%\u201361%; access barriers 68%; 95% CI 62\u201373%). Notably, students reported statistically significant lower rates of access barriers at the SHC, 50%, than in general reproductive healthcare settings, 68%. There were limited differences by student demographics. Students also reported a high willingness to use or recommend the SHC for pregnancy tests (73%; 95% CI 67\u201378%), emergency contraception pills (72%; 95% CI 66\u201378%) and medication abortion (60%; 95% CI 54\u201366%). Students were less likely to know where to access medication abortion compared to other services, suggesting unmet need.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our study provides evidence that students face barriers accessing reproductive healthcare and that SHCs are a trusted and accessible source of this care. SHCs have a key role in increasing health, academic and gender equity in the post-Roe era. Attention and financial support must be paid to SHCs to ensure success as state legislatures mandate them to expand reproductive and abortion care access.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-023-02230-5","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T09:03:18Z","timestamp":1677229398000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Decreasing reproductive and abortion care barriers: findings on the\u00a0student health center's role from a\u00a0student survey"],"prefix":"10.1186","volume":"23","author":[{"given":"Cynthia D.","family":"Rohrer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Modrek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"issue":"1","key":"2230_CR1","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s10900-016-0242-2","volume":"42","author":"M Bersamin","year":"2017","unstructured":"Bersamin M, Fisher DA, Marcell AV, Finan LJ. Reproductive health services: barriers to use among college students. J Community Health. 2017;42(1):155\u20139.","journal-title":"J Community Health"},{"issue":"1","key":"2230_CR2","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1177\/1090198120969372","volume":"48","author":"AM Lederer","year":"2021","unstructured":"Lederer AM, Hoban MT, Lipson SK, Zhou S, Eisenberg D. More than inconvenienced: the unique needs of U.S. college students during the COVID-19 pandemic. Health Educ Behav. 2021;48(1):14\u20139.","journal-title":"Health Educ Behav"},{"issue":"2","key":"2230_CR3","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.jadohealth.2018.04.009","volume":"63","author":"UD Upadhyay","year":"2018","unstructured":"Upadhyay UD, Cartwright AF, Johns NE. Access to medication abortion among California\u2019s Public University students. J Adolesc Health. 2018;63(2):249\u201352.","journal-title":"J Adolesc Health"},{"issue":"4","key":"2230_CR4","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1080\/07448481.2018.1431896","volume":"66","author":"MA Habel","year":"2018","unstructured":"Habel MA, Coor A, Beltran O, Becasen J, Pearson WS, Dittus P. The state of sexual health services at U.S. Colleges and Universities. J Am Coll Health. 2018;66(4):259\u201368.","journal-title":"J Am Coll Health"},{"key":"2230_CR5","unstructured":"Baker CN, Mathis J. Barriers to medication abortion among Massachusetts public university students. Contraception [Internet]. 2021 Dec 28 [cited 2022 Mar 15]; Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0010782421004790."},{"issue":"1","key":"2230_CR6","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/1472-6874-13-29","volume":"13","author":"MA Biggs","year":"2013","unstructured":"Biggs MA, Gould H, Foster DG. Understanding why women seek abortions in the US. BMC Womens Health. 2013;13(1):29.","journal-title":"BMC Womens Health"},{"issue":"4","key":"2230_CR7","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.contraception.2018.05.019","volume":"98","author":"MC Jaime","year":"2018","unstructured":"Jaime MC, Yakzan A, Lewis C, Schwarz EB. Abortion and student health services expanding the conversation with student perspectives. Contraception. 2018;98(4):301\u20135.","journal-title":"Contraception"},{"issue":"2","key":"2230_CR8","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/AOG.0000000000004224","volume":"137","author":"MY Sutton","year":"2021","unstructured":"Sutton MY, Anachebe NF, Lee R, Skanes H. Racial and ethnic disparities in reproductive health services and outcomes, 2020. Obstet Gynecol. 2021;137(2):225\u201333.","journal-title":"Obstet Gynecol"},{"issue":"4","key":"2230_CR9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1080\/19325037.2017.1316692","volume":"48","author":"AM Lederer","year":"2017","unstructured":"Lederer AM, Oswalt SB. The value of college health promotion: a critical population and setting for improving the public\u2019s health. Am J Health Educ. 2017;48(4):215\u20138.","journal-title":"Am J Health Educ"},{"key":"2230_CR10","unstructured":"American College Health Association. Healthy Campus 2020-Student Objectives [Internet]. 2012 [cited 2022 Jun 13]. Available from: https:\/\/www.acha.org\/HealthyCampus\/HealthyCampus\/Student_Objectives.aspx."},{"issue":"4","key":"2230_CR11","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1363\/psrh.12164","volume":"52","author":"BP Brown","year":"2020","unstructured":"Brown BP, Hebert LE, Gilliam M, Kaestner R. Distance to an abortion provider and its association with the abortion rate: a multistate longitudinal analysis. Perspect Sex Reprod Health. 2020;52(4):227\u201334.","journal-title":"Perspect Sex Reprod Health"},{"issue":"12","key":"2230_CR12","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1089\/jwh.2018.7496","volume":"28","author":"L Fuentes","year":"2019","unstructured":"Fuentes L, Jerman J. Distance traveled to obtain clinical abortion care in the united states and reasons for clinic choice. J Womens Health. 2019;28(12):1623\u201331.","journal-title":"J Womens Health"},{"issue":"5","key":"2230_CR13","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.contraception.2019.07.139","volume":"100","author":"C Myers","year":"2019","unstructured":"Myers C, Jones R, Upadhyay U. Predicted changes in abortion access and incidence in a post-Roe world. Contraception. 2019;100(5):367\u201373.","journal-title":"Contraception"},{"issue":"4","key":"2230_CR14","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.contraception.2018.05.014","volume":"98","author":"S Raifman","year":"2018","unstructured":"Raifman S, Anderson P, Kaller S, Tober D, Grossman D. Evaluating the capacity of California\u2019s publicly funded universities to provide medication abortion. Contraception. 2018;98(4):306\u201311.","journal-title":"Contraception"},{"key":"2230_CR15","unstructured":"Bill Text - SB-24 Public health: public university student health centers: abortion by medication techniques. [Internet]. [cited 2022 Apr 21]. Available from: https:\/\/leginfo.legislature.ca.gov\/faces\/billTextClient.xhtml?bill_id=201920200SB24."},{"key":"2230_CR16","unstructured":"U.S. Department of Education. National Center for Education Statistics (NCES) [Internet]. Undergraduate Student Financial Aid, 2020\u20132021. National Center for Education Statistics; [cited 2022 Jun 17]. Available from: https:\/\/nces.ed.gov\/."},{"key":"2230_CR17","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004757","author":"MA Biggs","year":"2022","unstructured":"Biggs MA, Ehrenreich K, Morris N, Blanchard K, Bustamante CK, Choimorrow SY, et al. Comprehension of an over-the-counter drug facts label prototype for a mifepristone and misoprostol medication abortion product. Obstet Gynecol. 2022. https:\/\/doi.org\/10.1097\/AOG.0000000000004757.","journal-title":"Obstet Gynecol"},{"key":"2230_CR18","unstructured":"StataCorp. Stata Statistical Software: Release 17. [Internet]. College Station, TX: StataCorp LLC; 2021. Available from: https:\/\/www.stata.com\/products\/"},{"key":"2230_CR19","unstructured":"Medication Abortion Now Accounts for More Than Half of All US Abortions [Internet]. Guttmacher Institute. 2022 [cited 2023 Jan 3]. Available from: https:\/\/www.guttmacher.org\/article\/2022\/02\/medication-abortion-now-accounts-more-half-all-us-abortions."},{"issue":"4","key":"2230_CR20","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1363\/psrh.12215","volume":"54","author":"RK Jones","year":"2022","unstructured":"Jones RK, Kirstein M, Philbin J. Abortion incidence and service availability in the United States, 2020. Perspect Sex Reprod Health. 2022;54(4):128\u201341.","journal-title":"Perspect Sex Reprod Health"},{"key":"2230_CR21","unstructured":"Grant JM, Mottet LA, Tanis J, Harrison J, Herman JL, Keisling M, et al. Injustice at every turn: a report of the national transgender discrimination survey [Internet]. Farmington Hills, MI; 2011 [cited 2021 Oct 1]. Available from: http:\/\/link.gale.com\/apps\/doc\/AKRXOT850135350\/AHSI?sid=primo&xid=1a38f696&pg=8"},{"key":"2230_CR22","doi-asserted-by":"crossref","unstructured":"Behonick D. Assessing the need for on-campus medication abortion at California Community Colleges. J Am Coll Health [Internet]. 2021; Available from:   https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/07448481.2021.1908308.","DOI":"10.1080\/07448481.2021.1908308"},{"key":"2230_CR23","unstructured":"Dragoman M, Fofie C, Bergen S, Chavkin W. Integrating self-managed medication abortion with medical care. Contraception [Internet]. 2021 Dec 27 [cited 2022 Jan 21];0(0). Available from: https:\/\/www.contraceptionjournal.org\/article\/S0010-7824(21)00474-1\/fulltext."},{"key":"2230_CR24","unstructured":"Belluck P. Abortion pills can now be offered at retail pharmacies, F.D.A. Says. The New York Times [Internet]. 2023 Jan 3 [cited 2023 Jan 5]; Available from: https:\/\/www.nytimes.com\/2023\/01\/03\/health\/abortion-pill-cvs-walgreens-pharmacies.html."},{"key":"2230_CR25","doi-asserted-by":"publisher","unstructured":"Modrek S, Wong M, Kulkarni A, Holschuh C, Kakar V. Medication abortion: state of information on student health center websites. J Am Coll Health. 2023. https:\/\/doi.org\/10.1080\/07448481.2022.2155472.","DOI":"10.1080\/07448481.2022.2155472"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02230-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-023-02230-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02230-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T09:03:32Z","timestamp":1677229412000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-023-02230-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,24]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2230"],"URL":"https:\/\/doi.org\/10.1186\/s12905-023-02230-5","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,24]]},"assertion":[{"value":"28 October 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The San Francisco State University Institutional Review Board provided ethics approval for this study (Protocol 2020-106). All subjects were informed about the aims of the online survey and consented to participate. All methods were conducted in accordance with the ethical standards of the Belmont Report and regulation under 45 CFR 46 of the U.S. Department of Health and Human Services.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}