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PubMedDate not supplied

Contraceptive practice and trends in coital frequency.

Coital frequency among white, continuously married couples increased by 19 percent between 1965 and 1970, but by only five percent between 1970 and 1975. All of the increase in the latter five-year period is connected with a greater concentration of women in pregnancy-exposure and contraceptive-use categories associated with higher coital frequency. Over the five years, individual women who switched to more effective methods did not, on the average, experience as much of a decline in coital frequency as those who changed to less effective methods and those who did not change methods. (Some decline would be expected to be associated with the five-year increase in age.)

Adolescent↗
PubMed2003

Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda.

Unintended pregnancies account for about half of all pregnancies in the United States and, in 1995, numbered nearly 3 million pregnancies. They pose appreciable medical, emotional, social and financial costs on women, their families and society. The US is not attaining national goals to decrease unintended pregnancies, and little is known about effective means for reducing unintended pregnancy rates in adults or adolescents.To examine the evidence about the effectiveness, benefits and harms of counseling in a clinical setting to prevent unintended pregnancy in adults and adolescents and to use the evidence to propose a research agenda.We identified English-language articles from comprehensive searches of the MEDLINE, CINAHL, PsychLit and other databases from 1985 through May 2000; the main clinical search terms included pregnancy (mistimed, unintended, unplanned, unwanted), family planning, contraceptive behavior, counseling, sex counseling, and knowledge, attitudes and behavior. We also used published systematic reviews, hand searching of relevant articles, the second Guide to Clinical Preventive Services and extensive peer review to identify important articles not otherwise found and to assure completeness. Of 673 abstracts examined, we retained 354 for full article review; of these, we used 74 for the systematic evidence review and abstracted data from 13 articles for evidence tables. Four studies addressed the effectiveness of counseling in a clinical setting in changing knowledge, skills and attitudes about contraception and pregnancy; all had poor internal validity and generalizability and collectively did not provide definitive guidance about effective counseling strategies. Nine studies (three in teenage populations) addressed the relationship of knowledge on contraceptive use and adherence. Knowledge of correct contraceptive methods may be positively associated with appropriate use, but reservations about the method itself, partner support of the method, and women's beliefs about their own fertility are important determinants of method adherence that may attenuate the knowledge effect. Many factors influence contraceptive use and adherence; among them are age, marital status, ambivalence about becoming pregnant, attitudes of partner, side effects, satisfaction with provider and costs; however, the impact of such factors may not be consistent across populations defined by cultural, age or other factors. The studies themselves differed materially in outcome variables, populations and methodologies and did not yield a body of work that can reliably identify specific influences on contraceptive use and adherence. No literature reports on harms of counseling or on the costs or cost-effectiveness of different approaches to counseling about unintended conceptions in the primary care setting. Virtually no experimental or observational literature reliably answers questions about the effectiveness of counseling in the clinical setting to reduce rates of unintended (unwanted, mistimed) pregnancies in this country. Existing studies suffer from appreciable threats to internal validity and loss to follow-up and are extremely heterogeneous in terms of populations studied and outcomes measured. The quality of the existing research does not provide strong guidance for recommendations about clinical practice but does suggest directions for future investigations. Numerous issues warrant rigorous investigation.

Adolescent↗
PubMed1981

Social context of child development.

Theories of child development, no less than the ways in which children develop, are influenced by social context. This thesis is illustrated by examples drawn three areas relevant to pediatrics. First, given the data demonstrating that fewer biologic and social hazards result from first trimester abortion that from carrying an unwanted pregnancy to term, the current controversy about abortion can only be understood in relation to concerns about contemporary patterns of sexual behavior, contraceptive use, and preferred family size. Second, now that the majority of mothers are employed in the work force, stress on the importance of "bonding" in early infancy, on the basis of dubious evidence, leads to unwarranted implications for social policy. Third, in contrast to the traditional American belief in public schools as instruments for the democratization of our society, public education is now being assailed as useless (and thus undeserving of funding) despite data indicating that schools make a difference to both academic and behavioral outcomes. In these controversies, differing value commitments lead to the choice of different data sets to justify a priori conclusions. Social theories are, by their very nature, value-laden but they can nonetheless be effective guides to action if those values are made explicit.

Abortion, Induced↗
PubMed1982

Sex, sex guilt, and contraceptive use.

The Mosher True-False Sex-Guilt Inventory and questionnaires about sexual activity and contraceptive use were administered to a sample of 109 female college students in 1973 and a comparable sample of 111 female college students in 1978. Comparisons of these samples revealed an increase in sexual activity and a decrease in the use of effective contraception between 1973 and 1978. The data also confirmed the utility of the Mosher scale for predicting sexual activity and contraceptive use, while indicating that the level of sex guilt sufficient to inhibit sexual activity in 1973 was no longer sufficient in 1978. The discussion deals with clinical implications of these trends in contraceptive use among unmarried women and with methodological implications for use of the Mosher Sex-Guilt Inventory as a predictor of sexual activity.

Adult↗
PubMedDate not supplied

[Women and contraception: knowledge and use of contraceptive methods].

This article analyzes knowledge and use of contraceptive methods in women ages 10 to 49 years residing in the southern region of the city of São Paulo in 1992. A total of 1,157 childbearing-age women were studied, focusing on variables that might define them as to: knowledge in the use of contraceptive methods and reasons for choosing a given method. We observed that 86% of the women referred knowledge of some contraceptive method, while the most common was the pill (95.3%), followed by condoms (92.6%). Meanwhile, 14% of the interviewees denied knowledge of any contraceptive method. Of the sexually active women (66.4%), 34.9% reported never having used contraceptive methods. Of those who had, 35.3% used the pill, while 42.9% had resorted to sterilization. Only 5.2% used condoms. Despite the high level of knowledge concerning contraceptive methods, especially oral contraceptives and condoms, we observed limited use of same as compared to the high sterilization rate around the age of 27, thus leaving contraception limited to the pill and female sterilization.

Adolescent↗
PubMed1985

Contraceptive use before tubal sterilization.

A woman's decision to undergo tubal sterilization may be affected by her experience with temporary contraception. To examine this issue we analyzed data from the Collaborative Review of Sterilization, a multicenter, prospective study of the health effects of sterilization operations on women aged 15-44 years. Data on contraceptive use by a comparison group of nonsterilized women were drawn from a random, population-based sample of women aged 20-44 years who were controls in a large study of cancer and steroid hormone use. Sterilized women reported ever using a higher average number of contraceptive methods than did nonsterilized women. As compared with nonsterilized women, a higher percentage of sterilized women reported ever using contraceptives (99% versus 91%), especially two types, barrier and rhythm or withdrawal. Prior to selecting sterilization as a permanent contraceptive method, the sterilized women had more extensive experience with temporary contraceptives, particularly the less effective ones, than did the comparable nonsterilized women.

Adult↗
PubMed2005

School-based teenage pregnancy prevention programs: a systematic review of randomized controlled trials.

We compared school-based abstinence-only programs with those including contraceptive information (abstinence-plus) to determine which has the greatest impact on teen pregnancy. The United States has one of the highest rates of teen pregnancy in the industrialized world. Programs aimed at reducing the rate of teen pregnancy include a myriad of approaches including encouraging abstinence, providing education about birth control, promoting community service activities, and teaching skills to cope with peer pressure. We systematically reviewed all published randomized controlled trials of secondary-school-based teen pregnancy prevention programs in the United States that used sexual behavior, contraceptive knowledge, contraceptive use, and pregnancy rates as outcomes.

Adolescent↗
PubMed2005

Self-injection of monthly combined hormonal contraceptive.

OBJECTIVES: The monthly injectable contraceptive is usually administered in the office. We aimed to compare home self-injection with office administration with respect to satisfaction, compliance, and time and money spent on contraceptive behavior. METHODS: We enrolled 16 subjects and taught them self-injection for a prospective cohort trial with crossover. Subjects performed three self-injections at home and then had three office injections by the nurse. RESULTS: Ten subjects completed the protocol. They reported similarly low pain and anxiety with nurse injections and self-injections. Women reported spending less money and similar time for home injections. Most subjects strongly preferred giving themselves injections at home to office injections and would recommend self-injection to other women. CONCLUSIONS: Self-injection of the monthly contraceptive at home is a preferable alternative to office administration for these subjects. This study demonstrates the feasibility of teaching women self-injection. Future studies should look at how best to teach women self-injection and to select women who will be successful with self-injection of contraceptives.

Adolescent↗
PubMed1990

Pelvic inflammatory disease: the influence of contraceptive, sexual, and social life events.

In order to determine associations between pelvic inflammatory disease (PID) and contraceptive, sexual, and social life events, 620 Danish women aged 15-54 were invited to participate in an in-depth interview. Of 585 participating women, 459 were consecutive gynecological in- or outpatients, and 126 were randomly selected from visitors in general practice. Data were analyzed by multivariate test statistics. The mean number of PIDs thereby retrospectively assessed was 1.0. Two-thirds had never had PID, one third had had on average 3 PIDs. The sexual parameter which had the highest predictive value for later PID was the coital debut. Women with coital debut before the 16th year had double the number of PIDs, as women with sexual debut at age 18 or later. Likewise, the mean coital frequency was positively correlated to the number of PIDs. The number of sexual partners, on the other hand, was merely a risk-indicator without a direct influence on PID. Women who used barrier methods (condom and/or diaphragm) for 2 years or more had 23% fewer PIDs than women who had used barrier methods for less than two years. The small number of PIDs among women at high socioeconomic levels could be explained alone by a later coital debut and longer use of barrier methods than that among women at low socioeconomic levels.

Adolescent↗
PubMed1976

Contraception and the adolescent female.

Although most teenagers have some knowledge of birth control methods, most sexually active adolescents do not use one consistently. Some young women are too apathetic or irresponsible to use birth control, even if the method is available. However, most teenagers do not want to become pregnant. If factual information is given, the method is easily accessible and is acceptable to them, and if they have come to terms with their own sexuality, most young women will accept the responsibility of preventing an unwanted pregnancy.

Adolescent↗