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PubMed1987

Follow-up of adolescents previously studied for contraceptive compliance.

Identification of adolescents at risk for contraception noncompliance and consequent pregnancy presents an important challenge to physicians caring for this age group. The present study examines the relationship between psychosocial information found in earlier studies to predict short-term contraceptive compliance to compliance one to three years later. Of the 31 patients located, 45% had become pregnant, of whom more than half had undergone therapeutic abortions. Three subscales of the Piers-Harris Self-Concept Scale had been significantly lower at baseline in the group that subsequently became pregnant. Those who chose to abort their pregnancies had higher baseline self-image. Low baseline scores on self-image and reproductive knowledge differentiated the group that became pregnant and kept their babies from those who had not become pregnant. There was excellent concordance between contraceptive compliance four months after prescription and compliance one to three years later. Accordingly, adolescent females who are using prescribed contraception at six months are likely to continue to do so subsequently. This suggests that follow-up should be frequent during this six-month period to maximize the likelihood of compliance.

Adolescent↗
PubMed2006

Specialist contraceptive counselling and provision after termination of pregnancy improves uptake of long-acting methods but does not prevent repeat abortion: a randomized trial.

BACKGROUND: One in four abortions in the UK is undertaken for women who have had one before. Women undergoing abortion in Edinburgh were targeted for improved contraceptive advice and provision in this randomized trial. METHODS: Between November 2001 and May 2002, women recruited at assessment for abortion were randomized at admission to receive specialist contraceptive advice and enhanced provision (316 women) or standard care (297 women). Randomization was based on the week of admission. Contraceptive use 16 weeks after abortion was assessed by questionnaire and subsequent abortions by review of the hospital records 2 years later. RESULTS: Women receiving specialist advice and enhanced provision were more likely to leave the hospital with contraception (271 versus 115, P < 0.001), which was more likely to be a long-acting method (141 versus 78, P < 0.001) than women receiving standard care. Four months later, there was no significant difference in contraceptive prevalence or continuation, but women in the intervention group were more likely to be using contraceptive implants (32 versus 6, P < 0.001). Two years later, 14.6% of women in the intervention group (44/302) and 10% of controls (27/268) had undergone another abortion in the same hospital (P = 0.267). CONCLUSIONS: Specialist contraceptive advice and enhanced provision had a short-lived effect on contraceptive uptake and increased the use of long-acting methods but did not appear to reduce repeat abortions.

Abortion, Induced↗
PubMed1988

Contraception.

The technology of fertility control has made dramatic strides in the past 25 years, offering a wider variety of safe, effective contraceptive choices than ever before. Lower dose oral contraceptives, new barrier techniques, and improved IUDs have been important recent advances, and new methods of hormonal delivery offer promise for the future. However, the search for safer, more effective, and more convenient contraceptive options must continue as a high research priority.

Contraception↗
PubMed2006

Acceptability and satisfaction using Quick Start with the contraceptive vaginal ring versus an oral contraceptive.

BACKGROUND: Many women discontinue their use of hormonal contraception, and even those who continue so may have difficulty using oral contraceptive pills consistently. New delivery systems, including the vaginal ring, may be easier to use, but user acceptability and satisfaction with these new methods may be affected by women's experience with their bodies. MATERIALS AND METHODS: Data for this study were collected as part of a randomized clinical trial on 201 women comparing immediate start of vaginal ring use with immediate start of low-dose oral contraceptive use. We assessed user satisfaction and method continuation 3 months after ring or pill initiation. RESULTS: At 3 months, 174 of 201 subjects (87%) had follow-up interviews. Among the 174 study participants with follow-up data, 61% of ring subjects and 34% of pill subjects were very satisfied with their methods (p=.003). For posttrial contraception, 79% of ring subjects chose to continue with the ring whereas 59% of pill subjects chose to continue with the pill (p<.001). Women who reported greater comfort in touching their genitals, greater frequency of masturbation, more comfort with intercourse and past use of vaginal contraceptives and products were not more likely than others to be satisfied with the ring or to continue using it for birth control. CONCLUSION: Women who were allocated to vaginal ring use, regardless of their baseline characteristics or behavior, were likely to be highly satisfied with the method and to continue its use.

Adult↗
PubMed1994

Reproductive health in central and eastern Europe: priorities and needs.

The countries in Central and Eastern Europe combine induced abortion as the method of choice for family planning with low contraceptive use (Hungary and Slovenia excepted). This widespread use of induced abortion has a negative influence on reproductive and general public health, and an effort should be made to introduce modern, effective family planning. Both information, education and communication (IEC) programmes (for the users) and training in contraceptive technology and counselling (for the providers) is badly needed, as well as a continuing supply of contraceptives. In order to design optimal programmes, more research into knowledge, attitude and practice with regard to sexuality, sexual behaviour and contraception is urgently needed. So far, little research into contraceptive behaviour and its determinants has been done in Central and Eastern Europe, but the few data that are available point towards a lack of contraceptive knowledge in both the population and amongst contraception providers. The cultural differences between Western and Eastern industrialized countries are often underestimated or ignored, but because of the special situation in the countries in Central and Eastern Europe, education programmes which were successful elsewhere in the world may not work in these countries and may require extensive adaption to local needs and customs. Alternatively, special education programmes need to be developed. Programmes, especially those addressing contraception, should be combined with a long-term commitment for support and the provision of contraceptives.

Abortion, Induced↗
PubMed1976

[Etiology of shock lung: case report (author's transl)].

In a woman, 29, two times resection and anastomosis of the small intestine because of extended infarction was performed. Following peritonitis and septic shock a progressive respiratory insufficiency developed and patient died 48 hours later despite intensive ventilatory treatment. Autopsy findings were manifold vascular damage (aorta) and thromboembolisms in mesenteric vessels and iliac veins too. Patient received oral contraceptives over several years, changed the preparation previously and contraceptive therapy was continued with another one. Thromboembolic complications may understood as undesirable side effects of the contraceptives. By microscopy of lung thrombosis in capillaries was seen and in small arteries too, as embolism carried by the blood stream. In pathogenesis of shock lung macrothrombosis as an aetiologic factor is to be discussed.

Adult↗
PubMed1980

Blood pressure changes and oral contraceptive use: a study of 2676 black women in the southeastern United States.

Blood pressure (BP) and weight were measured on 2676 black women attending a large southeastern family planning clinic. Repeat measurements were made after a minimum of six and upt to 24 months on 673 women who continuously used nonhormonal contraceptive (OC) therapy, and 1390 women who continuously used OCs. The mean change in systolic blood pressure (SBP) adjusted for initial BP and change in per cent ideal body weight is +1.44 mmHg in the new users of OC. This slight increase in SBP is statistically significant (p = 0.04) relative to the +0.41 mmHg increase observed in the control group. However, the adjusted diastolic blood pressure (DBP) change (+0.46 mmHg in new OC users and +1.54 mmHg in the control group) fails to support the hypothesis of a greater increase in DBP in new OC users. The adjusted mean rise in mean arterial BP does not differ significantly between new OC users and the control group. The proportion of women developing a DBP greater than or equal to 90 mmHg during the average follow-up interval of one year is 2.4% in the control group, 1.0% in the new OC users and 0.2% in the continued OC users. These results provide evidence that OC use has no significant effect on the level of mean arterial BP in black women followed for 6-24 months; and fail to support the hypothesis of a causal relationship between OC use and elevated BP in black women.

Adolescent↗
PubMed2002

Oral contraception: patterns of non-compliance. The Coraliance study.

OBJECTIVES: To determine the number of times women failed to take their oral contraceptive medication and their behavior in response to a missed pill. Another objective was to determine the potential benefit provided by a continuously administered oral contraceptive compared with an oral contraceptive involving a pill-free interval during a 6-month period. METHODS: Healthy women were enrolled in a cohort study; their contraceptive practices were followed by their gynecologists. Data were collected at inclusion using cross-sectional method with retrospective data collection for the previous 6 months and, more specifically, on their previous or their current menstrual cycle. Women on the pill were asked to specify the number of times and precise time at which they missed one or more pills and what they did in response to missing a pill. RESULTS: A total of 617 gynecologists enrolled and followed 3316 patients from six geographic areas throughout France. The mean age of patients was 30 years. Duration of oral contraceptive use was 8 years. During their previous cycle, 23% of women (n = 737) missed a pill at least once. Among women on the pill involving a treatment-free interval, 42% of instances of missing a pill occurred during the first week following the treatment-free interval. In response to missing a pill, patients read the product information leaflet (39%) or asked someone's advice (28%), mainly their gynecologist (63%) or their family physician (18%). Almost one-third of women did not take any specific measures. CONCLUSIONS: Patients on a discontinuous oral contraceptive regimen tended to miss a pill during the first week of treatment. Prescription of a continuous regimen without a treatment-free interval may improve compliance.

Adolescent↗
PubMedDate not supplied

Patterns of contraceptive use in the United States: the importance of religious factors.

Previous research has shown that the major religious communities in the US have all shifted their expected family size downward but significant differences in contraceptive use styles continue to characterize Catholics, Protestants, Jews, and those of no religious affiliation. This paper examines data from Cycle IV of the National Survey of Family Growth (1988) to extend the time period covered by previous research by comparing the emerging contraceptive use patterns and fertility expectations among women in the late 1980s with earlier cohorts from previous national studies, beginning in the 1960s. The categories of religious affiliation are extended to include specific religious denominations (fundamentalist Protestants, Baptists, and other denominations, as well as Mormons) and include measures of religiosity--church attendance, the extent of receiving communion among Catholics, and attendance at church-related schools. These data are examined for blacks, Hispanics, and non-Hispanic whites. The analysis suggests how religious affiliation and religiosity continue to be important factors in the contraceptive paths to low fertility under general conditions of controlled fertility and in the context of secularization.

Adolescent↗