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Determinants of contraceptive use and method choice in Turkey.

In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple's living children, implying some preference for sons, although generally women prefer to have children of both sexes.

Adolescent↗

Predicting contraceptive behavior from attitudes: a comparison of within- versus across-subjects procedures.

Within- versus across-subjects procedures for predicting behavior from attitudes were contrasted. Each procedure requires a comparison among attitudes in order to generate a prediction; the comparison is either among the same attitudes held by different people (across subjects) or among different attitudes held by the same person (within subject). It was hypothesized that the within-subject model provides a more adequate explanation of behavior from attitudinal constructs and, hence, more accurate prediction of behavior from attitudes than does the across-subjects model. To test this view, a sample of 349 married couples was administered a questionnaire containing measures of three attitudinal components--affect, cognition, and conation--toward each of four contraceptive methods--oral contraceptives, IUD, diaphragm, and condoms. Contraceptive behavior was assessed 1 year later. In support of the hypothesis, the within-subject predictions bore a significantly stronger relation to the behavioral criteria than did the across-subjects predictions. This effect was consistent for each of the three components of attitude, for the prediction of behavior and behavioral intention, for male and female respondents, and for a variety of contraceptive behaviors. In addition, both the within- and the across-subjects analyses demonstrated a clear rank ordering in the predictive validity of the three attitudinal components: Conation was a better predictor of behavior than was affect, which, in turn, was better than cognition.

Affect↗

Patterns of contraceptive use among urban women in Taiwan.

Patterns of contraceptive use among married urban women in Taiwan were investigated. A convenience sample of 150 women attending health clinics for reasons other than contraceptive care were interviewed about their contraceptive use. The most prevalent contraceptive method used by these women was the intrauterine device, followed by the condom and birth-control pills. Participants had used only one or two contraceptive methods throughout their contraceptive careers, and many stated they were satisfied with their current method. Many participants were able to name the methods of birth control promoted by the Taiwan family-planning promotion program. Knowledge of alternative methods did not significantly relate to current method in use or to desire to change methods.

Adult↗

Women's patterns of contraceptive use.

Our purpose in conducting this research was to examine women's patterns of contraceptive use. Records for 800 women receiving care at a private, nonprofit agency providing well-woman and contraceptive care over a 15-year period constitute the data set. The records were examined for patterns of reported method choice and use, method destinations, first method choice, and demographic variables. Women reported making 1,889 method choices from among 16 different methods. Seventy-five percent of the women changed methods at least once and the women gave 1,036 reasons for changing methods. Oral contraceptives and condoms were the methods most commonly tried by the women. The women's patterns of contraceptive use were very individualized, were neither linear nor predictive as other investigators have reported, and method destinations could not be predicted from previous method use.

Adolescent↗

Contraceptive use in Australia: evidence from the 1995 National Health Survey.

This paper analyses the patterns of contraceptive use among Australian women, using data from the 1995 National Health Survey. More than 44% of all women aged 18-49 years reported using a method of contraception. Among users, the 2 most commonly reported methods were the pill (60%) and condom (27%); IUD and natural methods accounted for less than 5% each. Sterilizing operations of the women/partner were the most frequently reported reasons for nonuse of contraception in women aged over 35 years, while among the younger women the most reported reasons were pregnancy or trying to get pregnant and not being sexually active. Among pill-users about a quarter were smokers, 20% overweight and 13% reported heart or circulatory disease. These figures were generally lower than in the general population but indicate a need for regular monitoring. The survey demonstrates the continuing evolution in the use of contraception among Australian women.

Adolescent↗

The attitudes of clinic staff as factors in women's selection of Norplant implants for their contraception.

Medical and counseling staff at 13 family planning clinics in Texas, U.S.A., were surveyed regarding their opinions and level of information about the contraceptive Norplant. These responses were used to assess the relationships between clinicians' information and attitudes about the contraceptive and the use of that method by their patients. No differences were associated with respondents' clinical responsibilities or with their type of professional training. However, significant variations in the numbers of patients receiving Norplant from individual providers, and in the proportion receiving the method from certain clinics, were associated with responses to some attitudinal questions. These findings suggest that the opinions about Norplant held by personnel staffing family planning clinics influence the method selection of their patients.

Adolescent↗

The relevance of ethnic monitoring in the experience of Haringey Healthcare NHS trust community family planning clinics.

Ethnic monitoring of all new and first attenders in the year to community family planning clinics was carried out by means of an anonymous questionnaire during April to June 1997 inclusive to ascertain whether ethnic minority women attend family planning clinics. A 73 per cent response rate (2664 questionnaires) was obtained. The results showed that women came from a wide variety of ethnic groups and from almost every country in the world. Those of UK European origin were underrepresented. For 28 per cent of women, English was not their first language. A total of 66 languages were recorded. Sixty two per cent (1673) of all the women were between 20 and 34 years. Overall half of all the women attending did not have children. Though in some ethnic groups most women were parous, less than 20 per cent of Caribbean (born Caribbean) West African and Turkish Cypriot women and only six per cent of Turkish/Kurdish women born in Turkey had not had children. Thirty three per cent of women admitted to having had one or more terminations although there was only a 90 per cent response rate to this question. While between 20 and 25 per cent of United Kingdom, EEC and non EEC European and black British women had had one or more abortions, 49 per cent of West African, 43 per cent of Kurdish and 40 per cent of Turkish Cypriot women had had one or more abortions. The lowest percentage of women admitting to a termination were Irish (12 per cent). The majority of women did choose a method or methods of contraception. The oral contraceptive pill and the condom were the most popular methods, often being used together The method used was influenced by age and ethnicity. Younger women opted for 'the pill' while older women chose the intrauterine device. The combined pill and condom were relatively equally popular with UK, Irish, EEC European, Caribbean (born Caribbean, born UK) and 'other' groups of women; while the intrauterine device was the favoured method of Kurdish/Turkish women born in Turkey. Depo-Provera was used principally by UK, European, Caribbean (born Caribbean, born UK) and African (West and East) women. Twelve per cent of women were recorded as not using a method. These women might have attended for a pregnancy test, cervical smear, advice about general health, gynaecological problems, though this was not specifically recorded. These women featured in all age groups. While a third were UK European, two thirds were of other ethnic groups. This would appear to illustrate that those women do seem to be aware that family planning clinics can provide services in addition to supplying contraceptive methods. It was noted that the Kurdish/Turkish women favoured one particular clinic sited in the ante natal department of the local hospital (the North Middlesex) where linkworkers are available. They accounted for 34 per cent of those who attended (128 out of 371). However at all but one of the clinic sites, which are spread around the borough, the UK European group was in a minority ranging from 20 to 47 per cent in attendance, compared to other ethnic groups. It is proposed that ethnic monitoring will be routinely recorded from April 1998 for new and first time attenders. It is also planned to work more closely with various ethnic minority groups in the community.

Abortion, Induced↗

[Contraception after heart transplantation].

It was observed that fertility and menstrual function in heart-transplanted women, impaired before the operation, become normal with a new heart. The restoration of reproductive function is also confirmed by many cases of pregnancy in heart-transplant recipients, reported in the literature. Twenty-four cases were published worldwide up to 1997, out of which eighteen had a positive result. Also a case personally treated was successful. The outcome of a pregnancy after heart transplantation is, then, generally positive. Nevertheless, such a pregnancy involves important maternal and fetal risks. Thus, the gynecologist has to provide correct information about both such risks and the most suitable contraceptive methods, for these patients. Oral contraceptives are very effective and, in the new low-dose formulations, free from serious adverse effects. No adverse effects have been observed in our patient, who represents the only case, reported in the literature, in which an estroprogestinic contraception was utilized before a pregnancy. In conclusion, during an oral contraception or after a tubal sterilization, pregnancy is really unlikely to occur. Thus, when the couple either has completed the familial nucleus or does not desire offspring, a doubt is at least justified as to whether these safer methods of contraception are advisable in such women.

Contraceptives, Oral, Hormonal↗

Measuring contraceptive use patterns among teenage and adult women.

CONTEXT: Measures of contraceptive use at one point in time do not account for its changing nature. A measure that addresses the pattern of method use over time may better predict the cumulative risk of unintended pregnancy. METHODS: Women at risk of unintended pregnancy were selected from the 1995 National Survey of Family Growth, and their contraceptive use patterns were compared across age-groups. Survival analysis was used to validate women's long-term use pattern as an indicator of pregnancy risk, and multivariate regression analyses were used to explore potential covariates of current patterns of contraceptive use. RESULTS: More than two-thirds of women aged 15-19 report long-term uninterrupted contraceptive use, but they are more likely to report sporadic use and less likely to report uninterrupted use of a very effective method than are women aged 25-34. Compared with women aged 25-34, women aged 20-24 have higher rates of sporadic use and lower rates of effective uninterrupted use. Among teenagers, nonusers are 12 times as likely as uninterrupted effective users to experience an unintended pregnancy within 12 months at risk. Women in less stable relationships, those having more infrequent intercourse and women who have recently experienced nonvoluntary intercourse for the first time are more likely than others to have a high-risk contraceptive pattern. Women aged 17 and younger whose current partner is more than three years older are significantly less likely to practice contraception than are their peers whose partner is closer in age. CONCLUSIONS: Long-term contraceptive use pattern is a valid predictor of unintended pregnancy risk. Policies aimed at reducing unintended pregnancies should target women who do not practice contraception and those who are sporadic users. Women in unstable relationships, those having infrequent sex and women who experience sexual coercion need access to methods, such as emergency contraception, that can be used sporadically or after unprotected intercourse.

Adolescent↗