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PubMed1999

Marriage structure and contraception in Niger.

Analysis of the 1992 Niger Demographic and Health Survey showed that although roughly two-thirds of both polygamous and monogamous women approve of birth control, polygamous wives are less likely than monogamous wives to discuss family size or birth control with their husband or to plan on using birth control. The study suggests that characteristics of polygamous couples have caused polygamous women to be more resistant to birth control use than monogamous women. The polygamous women tended to be married to older men who had not gone to primary school and who desired more children than monogamous husbands. The influence of marital structure is not significantly associated with intention to use birth control when the husband's age and the wife's ideal number of children were controlled for in the multivariate logistic regression model suggesting that background social factors may be more influential. In fact, educational level and age at first marriage were significantly associated with attitudes towards birth control and also with marital structure.

Adolescent↗
PubMed1998

Adolescent males' combined use of condoms with partners' use of female contraceptive methods.

OBJECTIVE: Protection from both sexually transmitted diseases and pregnancy is best obtained by the combined use of male condoms and effective female contraceptive methods. This research examines dual contraceptive method use among teenage men. METHOD: Analyzed data from the 1995 National Survey of Adolescent Males, a nationally representative survey of 15 to 19-year-old males. Used bivariate analyses and logistic regression to examine the correlates of combined use of condoms and female methods. RESULTS: At last intercourse, 17% of sexually active males reported use of a condom and a female method of contraception. Condom use, alone and in combination with a female method, was positively associated with talking with the partner about contraception and condoms, believing that males have a responsibility for contraception, and being in an earlier stage of a relationship. Only high levels of worry about sexually transmitted diseases differentially influenced dual method use, increasing the likelihood of using a condom with a female method, but not using condoms alone. CONCLUSIONS: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method. Providing information to young males about the high prevalence and serious consequences of sexually transmitted diseases may increase dual method use among adolescents.

Adolescent↗
PubMed2002

Contraception--past and future.

Modern contraceptive methods have a surprisingly short history and are dominated by the oral contraceptive pill, which came on to the market in 1960. New developments since the advent of the pill have been largely limited to tinkering with the contents and routes of administration of hormonal contraception. The knowledge that would allow a more exciting approach to new contraceptives does exist but the will to proceed is hampered by financial, political and moral factors, and perhaps ironically by the AIDS epidemic.

Contraception↗
PubMed2001

Contraceptive use at the family planning clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria.

During the five year review period (January 1993-December 1997), 19,470 clients visited the family planning clinic of the University of Nigeria Teaching Hospital, Enugu. Of these, 2402 clients (12%) were new patients and 17,068 (88%) were old patients. Among the new clients, 2262 (94%) eventually accepted a contraceptive method. The majority of the women (60%) chose the intrauterine contraceptive device (IUCD), 20% chose the injectables, while bilateral tubal ligation and norplant were chosen by 8% and 7%, respectively, of the clients. The oral contraceptive pill was the least popular (1%). Variations in the pattern of contraceptive use among clients at the family planning clinic were discussed. Measures to increase the contraceptive prevalence, and particularly strategies to meet the specific contraceptive needs of clients at the clinic, were also examined.

Contraception Behavior↗
PubMed2002

Reasons for pregnancy termination, contraceptive habits and contraceptive failure among Swedish women requesting an early pregnancy termination.

BACKGROUND: More than 30 000 legal abortions are performed every year in Sweden despite sexual education in schools, widespread youth-clinics and family planning services that are free of charge. The aim of this study was to investigate reasons for induced abortion, contraceptive habits and reasons for contraceptive failure among women presenting for induced abortion. METHODS: A questionnaire was administered to 591 Swedish-speaking women consecutively attending three different health care providers concerning an induced abortion during spring 2000. RESULTS: The response rate was 88% (n = 518). As many as 43%, among daily smokers 53%, had experienced one or more previous legal abortions. The majority of the women (97%) had discussed the decision about abortion with someone. The most cited reasons contributing to their decision were financial concerns, worries about the relationship and bad timing of the pregnancy. Though 85% had used contraception during the previous year, 36% of the women had not used any contraceptive method at the time of conception. The main reason given for not using contraception was the belief that they could not at that time become pregnant (35%). Ninety percent of the women planned to use contraception after the abortion. CONCLUSION: Women's decisions regarding induced abortion are multifactorial. One important reason was "poor economy". One out of three did not use any contraception, as they believed they could not become pregnant. Women presenting for induced abortion are a risk-group for further terminations. Counseling must include information about the fertile window, effective contraceptives and the emergency contraceptive pill.

Abortion Applicants↗
PubMed1999

Gender difference in management of epilepsy-what women are hearing.

This study reports the results of a questionnaire survey of female members of the British Epilepsy Association (BEA). The women were asked about their concerns about their epilepsy with respect to being female, and, in particular, asked about the information they had been given on important topics such as contraception and pregnancy. A questionnaire was sent to 6000 BEA female members of whom 1855 (31%) replied. Forty-six percent of the women (mainly aged between 26 and 45) stated that they currently used some form of contraception. The most frequently used method was the condom (34%). Twenty-two percent of the women using contraception were taking the oral contraceptive pill whilst a further 4% were using a hormonal contraceptive injection. Fifty-one percent of the women aged between 16 and 55 claimed not to have received any advice about possible interactions between contraception and antiepileptic drug therapy. With regards to pregnancy, 34% claimed they had not received any advice and 25% had not discussed pregnancy with anyone. The women planning to have children over the subsequent 2 years received the greatest amount of advice about epilepsy and pregnancy, although 20% still claimed not to have received any information. Thirty-four percent of the women in the study stated that they were either menopausal or post-menopausal. Twenty-nine percent of women who had taken hormone replacement therapy in the past reported an increase in seizure frequency compared with 18% amongst current users. This survey has shown that women with epilepsy want, and need, more information and counselling about issues relating to contraception, pregnancy and the menopause.

Adolescent↗
PubMed2001

Successful use of oral contraceptives.

Typical failure rates for oral contraceptives remain much higher than ideal failure rates. Patients can cite the pill's perceived risks more readily than its benefits, and many women use oral contraceptives inconsistently or discontinue them entirely without a medical reason. Successful use of oral contraceptives mandates that we rethink our roles as providers. Medical barriers, such as mandatory pelvic examinations, impede clients' access to services and require reevaluation. Efforts must also focus on thorough, individualized counseling. Because compliance poses difficulties for many women and noncompliance results in reduced efficacy, counseling must address content points relevant to proper, consistent use. Additionally, as unexpected side effects often cause frustration and method discontinuation, counseling should anticipate their occurrence. Adolescents present additional challenges. However, with careful attention to concerns relevant to teenage women and consideration of obstacles to compliance, oral contraceptives can indeed be used successfully in this group. Regardless of age, all clients should receive information regarding emergency contraception, and instructions for pill use should be individualized to meet the needs of each patient.

Adolescent↗
PubMed2001

[Frequency and reasons for switching/stopping use of oral contraceptives. Results of the German Cohort Study on Women Health].

Frequency and reasons for switching/stopping use of oral contraceptives. Results of the German Cohort Study on Women Health. Use of oral contraceptives is the safest and most commonly used method of contraception. The frequency of use underscores the importance of research on benefits, risks, and acceptability of long-term use. - An interim analysis of the German Cohort Study on Women's Health (aged 15-65 years) was performed to analyse frequency and reason of switching or stop of OC-use. We got for this analysis over 10 000 women with almost 100 000 years of observation from first to last (or current) OC use. - The prevalence of ever use of OCs was 85.5 % in our cohort. Switching or stop of OC use was observed in 93 % of the women. The frequency of switching increased with age and duration of use. Social parameter such as education, employment status, and living in the old or the new Federal States were not materially associated with the frequency of switching or stopping OC use. Satisfaction with general health, psychic stability, and sexual life was slightly associated with the frequency of switching: The better satisfaction the lower frequency of switching, but the sequence of cause and consequence is unclear. The most frequent categories of reasons for switching were observed side effects and personal reasons. Desire to get pregnant was the number one single reason, followed by headache/migraine, and bleeding problems. The frequency of more than 50 single reasons is listed. - The frequency and the knowledge of reason for switching or stopping OC use underlines the need for a good collaboration between physician and treated woman. However, also research on long-term compliance is required and the development of OCs with even less side effects.

Adolescent↗
PubMed1995

[Diabetes mellitus--an epidemiologic study of fertility, contraception and sterility].

MATERIAL AND METHODS: Data from 672 female patients with diabetes mellitus between 17 and 42 years of age were collected by questionnaire. Mean manifestation age was 19.9 years (min. 1, max. 38). RESULTS: 72.39% of the patients were treated with insulin; one third had successful pregnancies. Only one of ten diabetics delivered more than once after diabetes had become manifest. At the time of the study, 126 (19.1%) of the patients attempted pregnancy; about one-fifth of these for more than 2 years. Diabetes manifestation occurred significantly earlier in patients who did not achieve conception. Correlation between daily insulin dose and infertility was proved, whereas duration of diabetes had no significant influence on fertility. Habitual abortion was found in 0.62%, among nulliparous patients 1.64%, respectively. Contraception was performed in 64.2% (32.8% hormonal contraceptives, 18.6% IUD, 1.8% natural family planning, 11.0% tubal sterilisation or hysterectomy, 35.8% no contraception). 47% of the used oral contraceptives contained a reduced oestrogen dose (30 micrograms estradiol). In one third of the users, IUD were longer than 5 years in place. Tubal sterilisation was found in 69 (10.44%) of diabetic patients; in 51 cases before the age of 30 years. CONCLUSIONS: Contraceptive methods should be selected carefully. Diabetic patients unsuccessfully attempting pregnancy should be referred early to a centre for reproductive medicine.

Abortion, Habitual↗
PubMed1994

[Contraception in patients with type I diabetes: a survey of 808 women of reproductive age].

UNLABELLED: In-depth advice about contraception is important for type I diabetic women since special medical aspects have to be considered and because pregnancy should be planned. The actual contraceptive practice in diabetic women living in Germany had not been investigated before. METHODS: In December 1992 type I diabetic women of 16 to 46 yrs of age who had consecutively participated in a diabetic treatment and teaching programme (n = 1028) were mailed a multiple-choice questionnaire about reproductive and contraceptive issues. 409 non-diabetic women were also questioned and served as a control group. RESULTS: 808 diabetic women (age 32[7] yrs, duration of diabetes 14[8] yrs) returned the questionnaire. The percentage of women using a method of contraception was comparable between diabetic and control women (76 vs. 72%). Of these, fewer diabetic women used oral contraceptives (OC) (33 vs. 57%). The OC-using diabetic women were younger than those using other methods (27[5] vs. 33[7] yrs), however 63% had at least one of the contraindications for OC-use (smoking, hypertension, proteinuria, retinopathy, poor metabolic control) and 18% were using high-dose preparations. More diabetic than control women used IUDs (19 vs. 12%) and more diabetic women were sterilised (19 vs. 9%). Compared to controls diabetic women had had sterilisation at a younger age (31[5] vs. 36[4] yrs) and more sterilised women were childless (29 vs. 14%). Methods of lower efficacy (condom, diaphragma, spermatocides) were used by 26% of diabetic women (controls 20%), p < 0.05. Nearly half of the diabetic women had received contraceptive advice exclusively by gynaecologists. 22% of all pregnancies were unplanned (controls 17%); 0 > 0.05). CONCLUSION: More diabetic women should use methods of contraception with high efficacy. However, when prescribing OCs more attention must be payed to special contraindications. Sterilisation should be recommended more cautiously to diabetic women without advanced diabetic complications. Contraceptive advice to diabetic women must be given by gynaecologists and diabetologists.

Adolescent↗
PubMed1986

[Reliability of the vaginal diaphragm as a contraceptive method].

With a failure rate of between 2 and 4 in recent statistics, the vaginal diaphragm can be considered a relatively reliable method of contraception. The physician can therefore recommend this method as an alternative if, e.g., ovulation inhibitors are contraindicated and the patient rejects an intrauterine pessary. In such cases diaphragms are as acceptable as condoms, the more so because the two methods are completely harmless. (Table 9 summarizes the advantages and disadvantages of diaphragms.) Whether, in the final analysis, the condom or the diaphragm is accepted, will largely depend on whether the man or the woman assumes the responsibility for family planning. The physician can use his influence when explaining the contraceptive principle of the diaphragm and showing the patient how to use it to keep the failure rate to a minimum. The present authors consider that even today, good, objective counseling on reliable family planning is one of the physician's most important tasks in the sphere of preventive medicine.

Adolescent↗
PubMed2005

Understandings of the 'natural' body: a comparison of the views of users and providers of emergency contraception.

BACKGROUND: 'Natural' is a pervasive discourse with mixed meanings in contemporary society. I was interested in how users and providers of emergency contraception conceptualised the 'natural' body in contraceptive decision making. METHOD: Thirty-two users and 19 providers of emergency contraception from three sites in metropolitan Melbourne were interviewed, or participated in focus groups, about emergency contraceptive use, contraceptive decision making and perceptions of risk. The qualitative data were transcribed and coded to identify the key ways that both users and providers perceived the 'natural' body. RESULTS: Providers and users adopted different frameworks for interpreting the discourse of the 'natural' body. Thirteen of the 32 users identified the 'natural' body as a factor in their decision making. They identified a 'natural' body as a body experiencing no interruption with ovulation, and/or free from unwanted side effects. Six of the 13 women who discussed the 'natural' body used a contraceptive that allowed them to preserve their natural body (e.g. condoms). The remaining seven women identified it as an ideal that they could not achieve. Providers in general discredited the idea of a 'natural' body and instead conceptualised contraceptive decision making as a 'simple' risk-benefit analysis. CONCLUSIONS: The differences between the two groups can be understood in a number of different ways. The important conclusion however, is that the different perspectives present a potential barrier to effective communication in the contraceptive consultation, and may be able to be resolved through the development of an embodied risk-benefit analysis that may be meaningful to both groups.

Adult↗
PubMedDate not supplied

Investigating the knowledge, attitude and its relationship with the mean of using emergency contraception.

The aim of this study was to investigate women s knowledge about and attitude toward emergency contraception (EC) in women who referred to health centers of Tehran University of Medical Science. The subjects in this study consisted of 250 married women of fertility age who had been selected randomly and interviewed by the researcher. The majority of the subjects had not used EC. Just 5.2% (13 women) had used this method and 8.31% had knowledge and information about EC. There was a significant correlation between knowledge about and use of this method (p = 0.0001). Although the users of this method were more knowledgeable about EC than nonusers, a majority of subjects (76.57%) had a positive attitude toward EC; however, there was not a significant correlation between positive attitude and use of EC (p = 0.184).

Adult↗
PubMed2006

CRACK/project prevention: providing a social service or promoting social control?

This paper tests the arguments put forth by Morgan (2004) and several others that the CRACK/Project Prevention programme, which offers substance-abusing women a monetary incentive to choose long-term or permanent birth control, is racist and unethical. Findings from a sample of 521 participants in the programme show that the majority of women chose a birth control method that was not permanent, and race did not play a statistically significant role in explaining the birth control choices among the women. Rather, the participant's age and the number of pregnancies she had experienced were more influential. The findings suggest that the prior criticisms of the programme for targeting minority and inherently vulnerable, addicted women for sterilisation are unsupported. Women in this study appeared to follow the larger trends among women of all races and socioeconomic backgrounds in choosing permanent birth control: they were older and had more children.

Adolescent↗