Lab for Contraception and Abortion Research and Education in the Social Sciences

Mission Statement (CARE Lab)

  • The mission of the CARE Lab in the Social Sciences is to advance quality, equity, and justice in contraception and abortion care, with a primary focus on the United States.
  • We advance quality of care by investigating deficits in quality, exploring strategies to make care more patient-centered, and conceptualizing new quality-related metrics for use by researchers, clinical teams, and public health practitioners.
  • We advance equity in care by identifying health inequities related to abortion and contraception, centering the experiences of individuals most affected by societal dynamics of power and oppression, and designing and testing interventions to promote equity in care delivery.
  • We advance justice in care by grounding our analysis in a critical appraisal of the historical and contemporary power structures that influence reproductive health. We leverage our power as academics in a progressive policy environment to work in solidarity with collaborators and colleagues across geographies.

Our Team

Elizabeth Janiak, ScDElizabeth Janiak, ScD
Assistant Professor, Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School
Assistant Professor, Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
Director of Social Science Research, Planned Parenthood League of Massachusetts

Bio: Elizabeth Janiak is an interdisciplinary public health researcher and Assistant Professor at Harvard Medical School and the Harvard TH Chan School of Public Health. Her research explores how government and institutional policies create inequities in access to and quality of sexual and reproductive health (SRH) care, including contraceptive, abortion, and obstetric services. Current projects include several studies of mifepristone use for abortion and early pregnancy loss, social factors shaping postpartum contraceptive use, and the impacts of abortion-related travel following the Dobbs decision. Dr. Janiak completed her undergraduate and graduate training at Harvard. Her research is funded by the National Institutes of Health, the Society of Family Planning, and multiple institutional and foundation grants. Dr. Janiak's work has been cited by the National Academies of Sciences, Engineering and Medicine, and covered in dozens of media outlets including The Boston Globe, Salon, and National Public Radio. A full list of Dr. Janiak's publications can be found via Harvard Catalyst.

Sarah Johns, MPHSarah Lindsey Johns, MPH
Program Manager, Department of Obstetrics and Gynecology, Brigham and Women's Hospital

Bio: Sarah is a research program manager in the Division of Family Planning with the Department of Obstetrics and Gynecology. In addition to her role, Sarah is also a PhD student in Population Health Sciences at Harvard TH Chan School of Public Health. Trained in social work and public health, Sarah is passionate about access to quality health care shaped by policies and medical systems, with her work extending globally to support teams in various settings. Prior to joining the team in 2018, she lived in Rwanda, collaborating and conducting research with the Ministry of Health on malaria and malnutrition projects for children under 5. She leverages her personal and professional experiences to examine the relationship between the context where a person lives and their accessible healthcare. She is experienced with a variety of analytic methods to support her teams in understanding the way that social and built environments shape health of individuals.

Anusha Venkatesh, MBBS, MPHAnusha Venkatesh, MBBS, MPH
Program Manager, Department of Obstetrics and Gynecology, Brigham and Women's Hospital

Bio: Anusha Venkatesh is the program manager in the department of Obstetrics and Gynecology at Brigham and Women’s Hospital. She graduated with an MPH in Global Health with a concentration in Maternal and Child Health from Harvard T.H. Chan School of Public Health. As an intern with Ariadne Labs, she was actively involved in research and implementation of a residency education curriculum to promote birth equity and shared decision-making. She completed her medical school training from Kasturba Medical College, Manipal in 2020 and subsequently worked in the field of obstetrics and gynecology, particularly in primary health care institutions. She is passionate about improving access, health literacy and education in maternal health and reproductive justice to improve overall outcomes.

Alia CornellAlia Dorothy Cornell
Research Assistant, Department of Obstetrics and Gynecology, Brigham and Women's Hospital

Bio: Alia is a Research Assistant in the department of Obstetrics and Gynecology at Brigham and Women’s Hospital. She graduated with a BS in Biology and Sociology from UCLA, where she first became involved in sexual and reproductive health access research. She is passionate about abortion access and assists on projects related to medication abortion services in primary care and travel for abortion care in a post-Dobbs landscape. She also assists on projects related to postpartum contraception. She has a particular interest in qualitative methods as she appreciates the ability of this research to amplify the voices of historically underserved patient populations.

Projects

ExPAND Mifepristone (Excellence in Providing Access to New Directions in Mifepristone Use)

ExPAND Mifepristone is a didactic and technical assistance program for primary care and community-based healthcare providers. The program helps facilitate integration of medication abortion into primary care, a critical strategy for stabilizing and growing the abortion provider pool. With abortion care in the United States facing unprecedented challenges, primary care and community health centers play a critical role in abortion access. Serving as first point of care and rooted in longitudinal relationships, primary care providers can expand abortion access by providing accurate information and referrals to their patients seeking abortion, and by providing abortion care when the necessary supports are in place.

ExPAND focuses on capacity-building among the safety net providers that serve the most vulnerable patients, including federally qualified health centers (FQHCs) and look-alike clinics that follow a similar model of care delivery.

Project Website

Partners in Contraceptive Choice and Knowledge (PICCK)

This is an innovative clinical and public health program designed to promote contraceptive access and patient-centered contraceptive counseling across the Commonwealth of Massachusetts. PICCK data on outcomes will be shared throughout the Commonwealth and the country to inform continued efforts to improve health equity for all women and infants. Enacted in partnership with the state’s birth hospitals, the program provides education, training, and technical assistance to expand and sustain the capacity of hospitals statewide to provide contraceptive services.

PICCK is a five-year program funded by the Executive Office of Health and Human Services, Commonwealth of Massachusetts and housed at Boston Medical Center/Boston University School of Medicine.

Project Website

New patient-centered contraceptive counseling e-learning course now available!

PICCK is excited to announce the launch of our new e-learning course, What's Important: A Patient-Centered Approach to Contraceptive Counseling. We developed this course for healthcare professionals to redefine contraceptive counseling by focusing on the patient's needs and values, understanding the influence of bias and coercion in contraceptive care, and discovering what a shared decision-making approach to contraceptive counseling can do to improve the quality of care you provide. View more details.

Quality and Equity in Abortion-Seeking Travel (QuEAST)

The goal of QuEAST is to describe the burdens of interstate travel for abortion including health, psychosocial, and financial outcomes in the wake of the 2022 Supreme Court decision in Dobbs v Jackson Women’s Health Organization and subsequent state actions taken to curtail access to abortion. This mixed-methods study uses quantitative surveys and qualitative interviews to quantify these burdens and describe inequities in who is experiencing them and their relative impact across groups. We focus on understanding the experiences of those most marginalized in the health care system, specifically abortion travelers who are Black, Indigenous, or People of Color (BIPOC), low-income, younger individuals, trans* and gender-nonconforming individuals, and persons with disabilities.

This project is supported by grants from Harvard University’s Milton Fund, the Society of Family Planning Research Fund, and the Robert Wood Johnson Foundation’s Research in Transforming Health and Health Care Systems (RTHS) program, which supports policy-relevant, community-engaged research on current or potential policies to transform health and health care systems. The research team, housed within the ASPIRE Center for Sexual and Reproductive Health at the Planned Parenthood League of Massachusetts, Inc., conducts data collection and convenes a community advisory board to contribute to the project design, conduct, and dissemination of findings and recommendations. Preliminary data from QuEAST were presented at the FIGO Conference in Paris in October 2023, and data collection is ongoing.

ASPIRE Center Website

Birth Control to Improve Birth Spacing (BIBS)

Because most people return to sexual activity shortly after giving birth, consistent use of effective contraception is critical to supporting people in spacing births according to their personal preferences and goals. However, data are lacking regarding what knowledge and attitudinal factors drive pregnant people’s intention to use contraception after birth. Additionally, not all individuals who form an intention to use contraception postpartum end up being able to act on that intention after birth. It is unknown what specific environmental barriers prevent patients from receiving desired contraception postpartum. This study will fill the evidence gap around drivers of postpartum contraceptive use by clarifying the role of contraceptive knowledge, attitudes, norms, and self-efficacy in driving intention to initiate contraception postpartum and identifying barriers to enacting intended contraceptive use.

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