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Knowledge on lactational amenorrhoea and contraception in Kocaeli, Turkey.

OBJECTIVE: To determine the knowledge of women about lactational amenorrhoea and contraceptive properties of breastfeeding. DESIGN: A prospective, randomised descriptive study. SETTING: Kocaeli University School of Medicine, Department of Obstetrics and Gynecology. SUBJECTS OR PARTICIPANTS: Nine hundred and twenty-two women in their reproductive ages. INTERVENTION: A questionnaire was filled by doctors or nurses during face to face interview. MAIN OUTCOME MEASURES: There was significantly less knowledge for the importance of frequency and duration of suckling (p < 0.0001). The education increases the knowledge of lactational amenorrhoea as a interruptus contraceptive method. RESULTS: More than fifty-three per cent of women were using one of the modern contraceptive methods, 23.86% were using natural methods and 22.78% not using any family planning method. Intrauterine devices (30.15%), coitus interuptus (21.69%) and condom (16.48%) were the most common contraceptive methods. Nearly fifty-two per cent of women were not aware of the contraceptive property of breastfeeding, 25.68% of women knew lactation had a protective effect from pregnancy, 48.16%, did not know the importance of frequency and duration of suckling on fertility reducing effect of lactation. CONCLUSION: The level of knowledge on lactational amenorrhoea and frequency of suckling was significantly low in our study, especially in the illiterate group. Since efficacy of natural family planning depends on the compliance of women, education of women about lactation is very important. Family planning programmes should be focussed on breastfeeding and type of breastfeeding practices used, especially where there are no contraceptive alternatives.

Adolescent↗

What do women want? Counselling in contraception.

As Snowden (1) said nearly 20 years ago, 'The methods of fertility regulation from which most couples choose represent a choice among unpleasant alternatives. The choice is not so much a positive discrimination but a negative one, in that the methods not chosen are even more disliked than the method that is chosen. The contraceptive methods most people use are therefore the least unpleasant of the unpleasant set of alternatives. However, it is most important that this realistic summary is set against the other reality that consumers greatly prefer the available range of methods to no methods at all.' The choice of methods has now expanded but the decision process has not. Women want what everyone wants. They want their agenda to be addressed in a sensitive, considerate, complete and timely manner. They want to be given all relevant information in a way that they can understand by a person they like and who they can trust to advise them fully, correctly, confidentially and safely. They are quite happy to answer questions as long as they believe that they are necessary. They want the clinician to treat them with respect and to take into account their cultural and personal needs. The clinician must be able to advise them not only on contraceptive issues but also on all areas of sexual health. In short, just like all of us, women want to be treated as equals and trusted with information to enable them to make decisions about their life. Services can always improve and listening to our clients can help us aim for the sky. Let me share with you what they have to say.

Adolescent↗

Choosing and using contraception: toward a theory of women's contraceptive self-care.

Thirty women of varying ethnicity and socioeconomic status, who were actively seeking to avoid pregnancy, were interviewed concerning their lifetime experience with contraceptive use. The resulting description, Women's Contraceptive Self-Care, was divided into four processes: the central process, Choosing and Using Contraception, and three contextual processes. Forestalling Pregnancy was defined as using contraceptive methods or behaviors to prevent or delay childbearing. Assigning the Burden of Contraceptive Responsibility was defined as assuming responsibility for contraception or shifting that responsibility to a partner. Negotiating with Those who Control Contraception was defined as maneuvering among individuals and agencies that permit or hinder access to contraceptive methods and behaviors. Each process is comprised of thematic clusters and/or themes that are defined and illustrated.

Adult↗

Family planning in the Jewish population of Israel: correlates of withdrawal use.

This report describes trends and differentials in contraceptive practices among Israeli Jews. Data from two fertility surveys show a heavy reliance on the IUD, little use of sterilization, and declining, but still significant use of withdrawal. The factors associated with the practice of withdrawal are explored. Evidence is found in support of Santow's hypotheses that the degree of sex-role differentiation within marriage and the belief that men hold the authority in reproductive decisionmaking are both positively related to the practice of withdrawal. Fear of oral contraceptives, a dislike of sterilization, and a reliance on the IUD only at greater parities imply a continuing role for withdrawal, especially among Israeli Jewish couples in which wives are less educated and have more traditional sex roles than the wives in other couples.

Adult↗

The effect of sexual behavior and a pregnancy on contraceptive method switching among black female teens.

Little is known about determinants of contraceptive method switching and few reports use data that can link events that occur close in time. Using retrospective information from the sexual calendars of black female teens who attended a reproductive health clinic, determinants of method switching in four areas were investigated. Method switchers, those who switched from an unprepared to a prepared method (n = 62) and those who switched from a prepared to an unprepared method (n = 18), were matched with nonswitchers who used the same initial method. Associations between switching and changes in the frequency of intercourse, sexual abstinence, and pregnancy were found. It is suggested that abstinence may have a different role in switching from each type of method. Counselors need to emphasize the importance of method continuation, even when sex has not occurred for a short period of time.

Adolescent↗

Factors inhibiting the use of reversible contraceptive methods in rural south India.

In two rural districts in South India, the contraceptive prevalence rate for all modern family planning methods was 41 percent, and that for all reversible methods was only about 2 percent in 1990. Interviews with 35 health program professionals, 815 currently married women of reproductive age, 136 of their husbands, and 60 community leaders revealed that neither the demand for reversible methods nor the supply of services was strong in the study areas. Program managers and field-workers were not popularizing reversible methods, and therefore couples were unable to learn about their benefits. According to the authors, a strong commitment from program managers at all levels is needed to increase reversible-method use, and adequate services should be made available at clinics and in villages.

Adolescent↗

Vanguard family planning acceptors in Senegal.

This study examines contraceptive use among clients at the three clinics providing family planning services in Dakar, Senegal in early 1983. Most clients first became interested in family planning following the birth of a child, and most are interested in spacing future pregnancies, although one-third state that they want no more children. The clinic itself was found to be an important determinant of the type of contraceptive used, with only the government-operated clinic providing a balance between IUDs, oral contraceptives, and barrier methods. Nearly half of the clients interviewed said that a lack of knowledge about contraception is the reason for the low contraceptive prevalence rates among Senegalese women; another frequently cited reason was the opposition of the husband. Most clients reported the broadcast media to be the best means of providing family planning information to potential acceptors.

Contraceptive Devices, Male↗

Measuring university student satisfaction with a campus family planning clinic in Costa Rica.

Family planning clinics for university students play a valuable role in promoting health. This research project, a pilot study among women students who sought family planning services through a Costa Rican university clinic, introduced student evaluation of the family planning clinic, documented services provided in family planning visits, and identified issues for further study. Aged 18-33 years, the 53 respondents (a convenient sample) who completed a self-administered questionnaire were mostly (64%) single; all were sexually active; and 78% wished to have children (or more children) some day. Though all were sexually active at the time of their visit, only 62% were currently using contraception, and fewer than half of these were using effective methods. Nearly all students (96%) reported they learned new information during their appointment, and many received screening tests and examinations. Respondents rated their satisfaction with aspects of clinic service as high, citing the clinic's low visibility on campus as the most important area for improvement. All of the students said they would definitely return (85%) or would consider returning (15%). The results support the continuance of such a clinic on the campus, as well as of the practice of student evaluation. This collaborative study demonstrated areas for future research and stimulated interest in the university clinic as a research setting.

Adolescent↗

Contraceptive and sexual behavior of black female adolescents. A test of a social-psychological theoretical model.

To test a previous theoretical model, we studied the relationships between social, attitude, and psychological factors and adolescent contraceptive behavior over a 6-month period. A pretested questionnaire was administered to a random sample of 115 black females aged 12 to 18 years from a low socioeconomic population. Six months after the initial interview 113 of the subjects were administered a second questionnaire assessing their sexual and contraceptive behavior. Based on regression analysis, previous pregnancy and coital frequency explained 12.7% (p less than or equal to 0.0001) of the variation in engaging in unprotected coitus. When controlling for sexual activity, birth control knowledge and previous broken appointments explained an additional 5.5% of variation in the regression model (total R2 = 0.185). Coital frequency of the subjects was positively associated with Tanner stage, length of the relationship, effectiveness of previous contraceptive method(s), and degree of birth control knowledge. Coital frequency was inversely associated with a negative attitude toward pregnancy and negative parental attitudes toward adolescent pregnancy. The perceived risk of pregnancy was positively correlated with coital frequency and previous pregnancy. These findings support our model, but suggest that among low socioeconomic black female adolescents the interpretation of several model components depends on the subjects' attitude toward pregnancy and her perception of her parent's attitude toward adolescent pregnancy.

Adolescent↗

Determinants for contraceptive use in young, single, Danish women from the general population.

Determinants for contraceptive use were studied in 5031, non-pregnant women aged 20-29 years from the general population in Denmark. Most women (72%) had never been pregnant, 34% had a history of a sexually transmitted disease, and 22% had ever had a legal abortion. Current contraception was most frequently condoms (60%) or oral contraceptives (33%). Among the women who used OCs or IUD, 32% reported additional condom use (double contraception). Important predictors of using one contraceptive method were lifetime number of sexual partners, parity, and age at first sexual intercourse for condoms and age for oral contraceptives. Also, women with a previous legal abortion were more likely to use condoms currently and women with a history of STDs were less likely to use condoms, but more likely to use OCs. Lifetime number of sexual partners was the only predictor of double contraception. Our data suggest a potential for reducing the number of unintended pregnancies and STDs in single women by increasing the information about the double principle in contraception.

Abortion, Induced↗

Contraceptive status and sexual function of climacteric Chinese women.

The objective of the present survey was to assess the contraceptive status and sexual function of climacteric Chinese women. One cross-sectional study randomly recruited 742 premenopausal, perimenopausal, and naturally menopausal women aged 45-55 years from Beijing. Contraceptive methods were used by 75.6% of premenopausal and 54.2% of perimenopausal women. The primary methods were the IUD and barrier method. The women's choices of methods were related to parity and frequency of sexual activities. Sexual activity was related to the satisfaction of contraceptive methods. Perimenopausal and postmenopausal women were about half as likely to enjoy sexual activity and to experience orgasms than premenopausal women. Women of higher socioeconomic status had a lower risk for decreased sexual functioning. The IUD was the most popular and the most appropriate contraceptive method for perimenopausal women. Sexual function was associated with the women's satisfaction with the contraceptive method used, their menopausal status, and their socioeconomic class.

China↗