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PubMed1996

The effectiveness of a mail reminder system for depot medroxyprogesterone injections.

To determine if a mail reminder system leads to an increase in the percentage of depot medroxyprogesterone acetate (Depo-Provera) injections administered on time, the charts of 184 women were reviewed. The reminder postcard included the due dates of both the next medroxyprogesterone injection and the next Papanicolaou test. Timeliness of injections improved with the reminder system from 64% administered on time to 76% (P < .02). Injections given late despite the reminders were late a mean of 8 days. Injections given late before the reminder system began were late a mean of 20 days (P < .05). If injections given during the injection's 14-day "grace" period are included, the on-time rate improved from 87% to 96% with the reminder system (P < .005). The reminder system was not effective in ensuring annual Papanicolaou testing. Vigilance is needed to ensure that women receiving medroxyprogesterone injections also receive timely Papanicolaou testing.

Adult↗
PubMed1998

Missed opportunities: teenagers and emergency contraception.

OBJECTIVE: To determine American teenagers' awareness of and knowledge about emergency contraceptive pills and their likelihood to use them. METHODS: We conducted a nationally representative telephone survey between March 28, 1996, and May 5, 1996, of 1510 teenagers (757 girls and 753 boys), aged 12 to 18 years, living in the continental United States in households with telephones. The sample overrepresented African American, Latino, and low-income teenagers. The error attributable to sampling and other random effects for the total sample is +/-3 percentage points at the 95% confidence level. RESULTS: Of the 1510 teenagers, only about one quarter (23%) were aware that "anything" could be done after unprotected sex to prevent pregnancy. Slightly more (28%) had heard of "morning-after pills" or emergency contraceptive pills. Of the 423 teenagers who had heard of emergency contraceptive pills, one third (32%) did not know that a prescription is necessary to obtain them, and three quarters (78%) underestimated how long after unprotected intercourse the emergency contraceptive pill regimen could be initiated. Only 9% knew that emergency contraceptive pills are effective as long as 72 hours after unprotected sex. After being told about the option of emergency contraceptive pills, two thirds (67%) of teenaged girls said that they would be likely to use emergency contraceptive pills. Among the 66% of teenaged girls who had not previously heard of emergency contraceptive pills, 64% said that they would be likely to use them. CONCLUSIONS: Emergency contraceptive pills have great potential as a tool for reducing unplanned pregnancies among teenaged girls in the United States. Few teenaged girls were aware that this option exists. Once informed, teenaged girls reported being very interested in taking emergency contraceptive pills if needed.

Adolescent↗
PubMed1995

Teenage childbearing. An adaptive strategy for the socioeconomically disadvantaged or a strategy for adapting to socioeconomic disadvantage?

OBJECTIVE: To examine the relation between childbearing and educational and vocational achievements of American females high school students. DATA SOURCE: Articles published in English during the past decade about the educational, vocational, and socioeconomic sequelae of childbearing among female high school students. DATA SELECTION: Articles that did not contain data about the relation between adolescent childbearing and educational and vocational achievement were excluded. DATA SYNTHESIS: Most females who begin childbearing during adolescence obtain less schooling and poorer-paying jobs than do females who postpone childbearing. The reasons for this are elusive. Differences in the family and cultural backgrounds of early (high school-age) and later (18 years and older) childbearers explain some but not all of the association between early childbearing and educational and vocational underachievement. The effect of childbearing preferences on the educational and vocational achievements of teenagers has not been studied adequately. Lack of concrete information could result in underestimation of the effect of early childbearing on the socioeconomic well-being of young Americans, and create the impression that adolescent pregnancy is an adaptive response to urban poverty. CONCLUSIONS: As much as the long-term socioeconomic sequelae of adolescent childbearing reflect factors that influence the judgments young people make about the costs and benefits of contraception and parenthood, adolescent childbearing is a means of adapting to urban poverty. Thus postponing adolescent conceptions and parenthood may have a less important effect on the socioeconomic well-being of young Americans than expected.

Adolescent↗
PubMed1996

Sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention. Combined contraceptive practices among urban African-American early adolescents.

OBJECTIVE: To evaluate the success of efforts to educate youth not only to use prescription contraceptives to avoid pregnancy, but also to use condoms to avoid sexually transmitted diseases, including infection with the human immunodeficiency virus. METHODS: Longitudinal study of 383 African-American youth aged 9 to 15 years enrolled in a randomized, controlled trial of an acquired immunodeficiency syndrome (AIDS) risk reduction intervention. Data about contraceptive practices were obtained at baseline and 6, 12, and 18 months later using a culturally and developmentally appropriate risk assessment tool administered with "talking" computers (Macintosh, Apple Computer Inc, Cupertino, Calif). RESULTS: Approximately three fourths of sexually active youth used some form of contraception in each 6-month round, with almost half of the youth using combinations of contraceptives. Among all youth at baseline and among control youth throughout the study, more than half used condoms and more than two thirds who used oral contraceptives also used condoms. Receipt of an AIDS education intervention was associated with use of more effective contraceptive practices (eg, condoms and another prescription or nonprescription method of birth control). After receiving the intervention, more than 80% of the youth who used oral contraceptives also used condoms. Contraceptive practices showed considerable stability. Knowledge about AIDS was positively associated with use of more effective contraceptive methods. CONCLUSIONS: Many youth are using condoms and prescription birth control simultaneously, and these use rates can be increased through AIDS education interventions.

Adolescent↗
PubMedDate not supplied

Dizziness associated with discontinuation of oral contraceptives in Bangladesh.

Data from four studies in Bangladesh indicate that dizziness is a frequent complaint of women taking oral contraceptives and the most commonly cited reason for discontinuation. Results of a fifth study showed that multiple vitamin or glucose capsules were effective in treating dizziness in about half of the women studied. Although the cause of dizziness is not clear, it may be partly due to the small stature and poor nutritional status of many Bangladeshi women.

Bangladesh↗
PubMed1975

Attitudes of men toward contraception.

This report describes a pilot study conducted to determine the attitudes of men toward contraception. A questionnaire elicited responses from 436 males regarding: Personal data; contraceptive responsibility; contraceptive knowledge; use of contraception and preference for future methods. Results include attitudes toward contraceptive responsibility, assistance to pregnant partners and knowledge regarding eight common contraceptives. Usage of contraceptives in general and condoms and withdrawal specifically is reported. Preference for eight common contraceptive methods is also presented, along with data on delay of intercourse due to lack of contraceptives, partners' requests for male use of condoms/withdrawal and attitudes toward dissemination of contraceptive material to the public. Also reported are attitudes toward development of new contraceptives, use of male sterility shots or pills and the prices that men would pay for newly developed male contraceptives. The most preferred male contraceptive for future development is reported. It was concluded that the survey form and methodology were valid; that men desired to participate in family regulation; that the majority of men placed a low economic value on male contraceptives and finally that the overwhelming majority of men wanted contraceptive information to be widely disseminated in the public.

Abortion, Induced↗
PubMed1991

Measuring contraceptive values: an alternative approach.

Previous assessments of individuals' values for various contraceptive consequences have employed one of four methodologies: free elicitation, direct ratings, multiple regression, or factor analysis. All four methodologies are flawed because they produce group rather than individual values, relying on rating scales, and fail to incorporate information regarding consequence trade-offs. Axiomatic conjoint measurement is proposed as an alternative methodology and used to determine individuals' values for a selected set of contraceptive consequences at two stages of the family-planning career.

Attitude↗
PubMed1994

The dynamics of oral contraceptive use in The Netherlands 1990-1993.

Data from an ongoing series of surveys on contraceptive use in the Netherlands were analyzed with respect to the percentages of oral contraceptive (OC) users who annually started use, discontinued use or switched to another OC type. The surveys had been conducted between 1990 and 1993 among samples of women aged 15-49 who belonged to a survey panel. Response rates of the surveys were 89-90% and the sample sizes ranged from 4560 to 4621 women. The assessed OC use rates reflected those of the Dutch population reasonably well. Of all respondents who had used OCs during the 12 months prior to the surveys, 12-15% discontinued use within this period, mainly in order to get pregnant, 12-16% were starters and 9-14% switchers. Of all starters 37% switched to another OC type within the first 12 months after starting. Switching was mainly related to the experience of perceived side-effects and wishes for better cycle control. The results highlighted the relevance of closely monitoring the individual woman's satisfaction with her OC. Since OC use appeared in many cases to be characterized by an active seeking for the most acceptable OC type, a wide range of OC types available and the development and introduction of new types is highly relevant for tailoring contraceptive use to individual needs.

Adolescent↗
PubMed1993

Oral contraception in the former Czech and Slovak Federal Republic: attitudes and use.

This paper presents and discusses data on oral contraception from a national representative survey (n = 1072) on knowledge, attitudes and practice with regard to contraceptive use in the Czech and Slovak Federal Republic (CSFR). Only 7% of the women at risk of unplanned pregnancy used the pill. The low rate of use seems to be due to the general negative image of oral contraception, reinforced by the experiences of past users and opinions expressed by relative, friends, doctors, and the media. In particular, perceived psychological disadvantages have an important bearing on the decision not to use the method, whereas perceived advantages have hardly any impact. It is likely that this negative image is closely linked with the types of oral contraceptives that have been available in the country and also with the limited choice. Second- and third-generation oral contraceptives have only very recently become available. It is recommended that balanced information on the advantages and disadvantages of oral contraception be made available to doctors and to the general public on a large scale and through a variety of channels.

Adolescent↗
PubMed1992

An evaluation of IUD insertion by a non-clinical delivery system.

To evaluate the safety, effectiveness, side-effects, and continuation rate associated with non-clinical IUD insertion compared to IUD insertion in routine clinical facilities, a cohort comparative study was done on two groups of IUD users self-selected for either the non-clinical or clinical delivery system in Yogyakarta Special Area Province. During the months of January to March 1985, 454 non-clinical and 625 clinical acceptors were recruited into this study. However, only 414 non-clinical and 605 clinical acceptors fulfilled the inclusion criteria and were included in the analysis. Bleeding and pain were the most common side-effects reported by acceptors. The frequency of bleeding was higher in the non-clinical group than in the clinical group. However, the difference was a not statistically significant relative risk (RR) of 1.09 (0.8-1.4) to 1.2 (0.9-1.5). Severe menstrual blood loss mostly occurred in the first three months after insertion and then declined in the rest of the year in both groups. The frequency of pain was not clearly different between the two groups during the whole year, with RR 0.8 (0.5-1.3) to 1.3 (0.8-2.0). The actual number of pregnancies was very small and the difference was not statistically significant (p = 0.375). The 12-month expulsion rates were 7.22 per 100 IUD users for the non-clinical group and 7.00 for the clinical group. The difference was not statistically significant (p = 0.660). The cumulative probability of women who were still using IUDs at 12 months was 89.7% and 89.1% for the non-clinical and clinical groups, respectively. The non-clinical delivery system seemed to be responsive to an unmet demand for family planning among women with lower educational background compared with those in the clinical setting service. While the characteristics of a population obviously influence the contraceptive behavior, this study shows that the non-clinical delivery system family planning method provides a similarly efficacious and safe service to the usual clinical system.

Cohort Studies↗
PubMed1993

Contraceptive practice and attitudes in former Soviet women.

For decades, abortion has been the principal birth control method for Soviet women. As indicated by some earlier local surveys, most couples use unreliable methods. Little is known about the latest trends in contraceptive use affected by the recent general liberalization of Soviet society, including more open attitudes about sex. A survey was conducted in 1991 via a questionnaire in the popular 'Health' magazine with national circulation. A total of 8059 women returned the questionnaire. The sample is selective with an overrepresentation of young and better educated urban residents, mostly from Russia and the Ukraine. Some 81% reported use of a contraceptive method during the last 5 years. Traditional methods still prevail (41% used withdrawal, rhythm and douche). Among women younger than 25 years there is a clear trend toward use of modern methods (IUD 35% and the pill 10%), although their notion of the 'pros" and 'cons' is biased. Of the respondents, 20% used a barrier method, mainly condom. The preferred method is the IUD (51%) and the pill (18%). Abortions resulting from contraceptive failure were reported by 60% of women. Eighty-nine percent considered pregnancy termination more dangerous than its prevention. For only 12% of respondents, a physician was the main source of contraceptive information, although 49% addressed him for advice. The results indicate a gap between conservative birth control practice and preferences of Russian women, with a positive general trend in the near future.

Abortion, Induced↗
PubMedDate not supplied

Adolescent pregnancy: the clinician's role in intervention.

Adolescent childbearing has adverse sequelae that are intensified when the onset of sexual activity takes place at a particularly early age. A relationship between the onset of sexual activity and the age of maturation has been demonstrated; as the mean age of menarche has become younger, a greater discontinuity has been created between physical development on the one hand and cognitive and emotional development on the other. Initiatives to prevent early sexual initiation and unintended pregnancy must be designed in that context and with an appreciation of normative social pressures. This report reviews research on adolescent development and sexual behavior, including the relationship between maturation and the onset of sexual activity, the timing of pregnancy risk, clinic utilization and reasons for delay in clinic attendance, and clusters of high-risk behaviors. It discusses the role of clinical interventions, suggesting ways in which those who treat adolescents can assist them in acquiring and maintaining protective behaviors.

Adolescent↗
PubMed1991

Contraceptive use in young women: uptake, availability and education.

Despite increased availability of contraception and a relaxation of prescribing laws unplanned pregnancies will still occur. However when the right to life of the unborn child is enshrined in the constitution it is vital to provide adequate sex education and ensure the availability of all methods of contraception to reduce unplanned pregnancies to a minimum. This paper surveys the use of contraception prior to pregnancy in a group of unmarried mothers who delivered at a Dublin maternity hospital. It also surveys the availability of contraception from the pharmacies within the hospital's catchment area and the provision of sex education in the surrounding schools.

Adult↗
PubMed2006

Effect of postpartum counseling on postpartum contraceptive use.

OBJECTIVE: The aim of this study was to evaluate the effect of postpartum counseling on postpartum contraceptive use. METHODS: One hundred and forty-three women who delivered between 1 January 2004 and 31 September 2004 and counseled about postpartum contraception were included in the study. The participants were interviewed by telephone. Age, gravidity, parity, and mode of delivery of the participants were recorded. Their method of contraception before pregnancy, their decision on the contraceptive method after counseling and the method actually used were asked. RESULTS: Just after postpartum counseling, 47 women (32.9%) decided to use the intrauterine device (IUD), 23 (16.1%) condoms, 16 (11.2%) progestin injections, 7 (4.9%) oral contraceptives, and 7 (4.9%) coitus interruptus for contraception. Thirty-six women (25.2%) did not decide on any method of use. At the time of the telephone interview the actual method used was learned. Fifty-one women (35.7%) were using coitus interruptus, 45 women (31.5%) condoms, and 14 (9.8%) the IUD. Sixteen women (11.2%) were reported as not using any methods. CONCLUSION: In spite of postpartum counseling, a high majority of the women appeared to use traditional and less effective contraceptive methods.

Adolescent↗
PubMed1976

Psychometric testing as a basis for counseling patients choosing a method of contraception. A retrospective survey.

To investigate the merits of using psychometric testing as a predictive adjunct to counseling patients in the choice of a contraceptive method, 134 family-planning patients using an oral contraceptive for one year or longer completed the Neuroticism Scale Questionnaire. Clinic records of these patients were examined to determine consistency of contraceptive usage. Patients who were inconsistent in contraceptive usage scored significantly higher on the anxiety and emotional immaturity for inconsistent users. Results of this study provided support for the findings of two similar studies but failed to provide support for others. However, the over-all predictive ability of the questionnaire scores proved to be low. Further study is recommended.

Adolescent↗