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PubMed1992

Contraception for the postpartum woman.

The postpartum woman has the full array of contraception options available to her to prevent a subsequent pregnancy. Two factors may influence the choice of the method and the timing of the onset of use (when pregnancy risk increases): the infant feeding mode chosen and the reproductive involution process. The major controversial area regarding contraception postpartum is the use of oral contraceptives if the mother is breastfeeding (ie, if and how do steroids affect the lactation process or infant health). This article reviews the physiologic and hormonal changes that occur after birth, examines the data available in relation to the influence of steroidal contraceptives on lactation, and presents postpartum implications of the use of the spectrum of contraceptive choices. The nurse can provide an important role in counseling postpartum women regarding contraceptive alternatives and supporting families in attaining their childbearing goals.

Breast Feeding↗
PubMedDate not supplied

Oral contraceptive pill use after an initial visit to a family planning clinic.

A retrospective study of 1,311 women making initial family planning visits to metropolitan-area health department clinics found that many women switch methods or discontinue use in the first year following the clinic visits. Among a subgroup of women, most of whom selected the pill as their primary method and who used the pill for at least one of the months in the study period, almost half either changed methods or used no method at some point during a follow-up period averaging eight months. This includes 13 percent of women who made two or more changes. In addition, only 42 percent said they took a pill every day, and only half of these said they always took their pill at about the same time every day. Despite such irregularities, pill users were approximately one-third as likely to get pregnant during the study period as women making an initial family planning visit to a health department clinic who did not use the pill at all.

Contraception Behavior↗
PubMed1991

[Use of contraception among women applying for abortion].

During a period of one year (1988-89), a questionnaire was distributed to women applying for legal abortion at Frederikssund Hospital in Denmark. Two hundred and eight-eight answered the questions about why they had become pregnant. 84% of the women had used contraceptive methods. The remainder included women who regretted a planned pregnancy and women who believed they were infertile. 50% of the women had at least one intercourse without using contraceptives. Women using barrier-methods who forgot the contraceptive once or women who had stopped using the pill were mainly concerned. 23% of the women said they had used contraceptives correctly and consistently. After the abortions 75% intended to use IUD, oral contraceptives or sterilization. Suggestions to reduce the number of unwanted pregnancies are discussed. Eg. spread of the knowledge of postcoital contraception as an extraordinary measure after an unprotected coitus is suggested. This will not replace other contraceptives, but should be used in a emergency.

Abortion Applicants↗
PubMedDate not supplied

What do women use when they stop using the pill?

Current use of oral contraceptives among currently married women aged 15-44 declined from 25 percent to 13 percent between 1973 and 1982, while ever-use increased from 60 percent to 80 percent. By 1982, the pill appeared to be used mainly to delay first pregnancies, secondarily to space subsequent conceptions, and only rarely as a means of ending childbearing. Most women who had stopped using the pill by 1982 had done so on their own initiative: Only about one-third had been advised by a doctor to discontinue use. Virtually all former users gave some physical problem connected with pill use as a reason for quitting the method. At the time they quit, former users had been taking the pill for an average of 3.2 years. The decline in current use of the pill during the 1970s coincided with a marked increase in contraceptive sterilization, but was not the result of a direct switching from the pill to sterilization by individual women. Only 21 percent of women who quit the pill chose sterilization as their next method. The majority--60 percent--switched to nonpermanent methods, the condom being the most popular in all age-groups; the proportions selecting the condom as their next method ranged from 20 percent of 15-19-year-olds to 12 percent of 30-44-year-olds. Nineteen percent of former pill users did not adopt any method after discontinuing the pill.

Abortion, Induced↗
PubMed1983

Contraceptive knowledge, contraceptive use, and pregnancy risk experience among young Manawatu women.

The contraceptive knowledge, use, and desire for information of never-married Manawatu women aged 16-19 years were examined, distinguishing between respondents with and without pregnancy risk (coital) experience. Overall, 45.7% of the women had ever been at risk, the percentage varying positively with age. Awareness of contraceptive methods (especially the pill and condom) was widespread, particularly among the sexually experienced, a higher percentage of whom had also ever wanted and sought contraceptive information. Women who had never been at risk were less knowledgeable, fewer had ever wanted information (19.3%) and about one-third knew of no source of contraceptive information. Few (7.9%) of the sexually experienced had never used any contraceptive methods but others (19.9%) had not yet employed an effective female method. These results, akin to previous studies, indicate a need for school-based sex education.

Adolescent↗
PubMedDate not supplied

Contraceptive efficacy of the diaphragm, the sponge and the cervical cap.

A reanalysis of data from two clinical studies--in which 1,439 women were randomly assigned to use either the contraceptive sponge or the diaphragm and 1,394 women were randomly assigned to use either the cervical cap or the diaphragm--found first-year probabilities of failure during typical use of 17% for the sponge, 18% for the cervical cap and 13-17% for the diaphragm. The first-year probabilities of failure during perfect use are 11-12% for the sponge, 10-13% for the cervical cap and 4-8% for the diaphragm. The probability of failure during perfect use is significantly higher among women who have given birth than among those who have not for users of the sponge (19-21% vs. 9-10%) and users of the cervical cap (26-27% vs. 8-10%), but not for users of the diaphragm.

Contraceptive Devices, Female↗
PubMed1998

[Which contraceptive methods are recommended for young women with type 1 diabetes mellitus? A survey among practitioners in Germany].

AIM: The aim of this study was to find out which recommendations German gynecologists gave to young patients with type 1 diabetes mellitus in respect to contraception. In addition, it was asked to what extent German gynecologists/obstetricians had experience regarding counselling of young women with type 1 diabetes. SUBJECTS AND METHODS: A structured questionnaire containing questions about attitudes, health care beliefs and contraception in young women with type 1 diabetes was developed. 804 attendees of the Giessen Gynecological Seminar which was held in January 1997 were asked to participate in the study. RESULTS: Only 142 (17.7%) of the questionnaires were returned. There was no consensus in respect to contraception in young women with diabetes. 61% of the respondents referred to the micropill (< 0.3 mg estrogen) as the preferred contraceptive method for young women with diabetes. Condoms were regarded as second line contraceptive devices in this age and patient group. There was only very limited experience in regard to counselling and treating adolescents/young women with type 1 diabetes. CONCLUSION: Among the German gynecologists questioned there was no consensus in respect to contraception in young women with diabetes. Most importantly, there was only very limited individual experience in regard to counselling and treating adolescents/young women with type 1 diabetes among the doctors who participated in the study.

Adolescent↗
PubMed1987

Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status.

Thirteen pregnant women who conceived within six months after terminating oral contraceptive agent therapy of at least three years' duration participated in this study. Nine pregnant women with no history of oral contraceptive agent use served as controls. At delivery, erythrocyte counts were reduced, and during the first trimester and at delivery mean corpuscular hemoglobin and volume values were increased and erythrocyte zinc values were reduced in the oral contraceptive agent group as compared with controls. These changes appeared to be subclinical in magnitude and oral contraceptive agents may have induced a macrocytic erythrocyte population. Because no changes in maternal plasma zinc and copper levels were observed and no hematologic, biochemical, or anthropometric differences were observed in neonates, long-term oral contraceptive agent usage appeared to have little or no effect on zinc and copper metabolism in a subsequent pregnancy.

Adolescent↗
PubMed1986

The ability of women to recall their oral contraceptive histories.

Self-reported contraceptive histories were obtained at interview from 99 women and compared with prospectively collected data from the Oxford-Family Planning Association cohort study. The effect of different memory aids was evaluated and an assessment was made of the completeness and accuracy of contraceptive histories recorded in general practice notes. Accuracy of recall of total duration of use was sufficiently good to establish the presence or otherwise of a duration-response relationship and could be improved by the use of a contraceptive calendar. Recall of specific brands used was less accurate. In studies where accurate information on use of particular preparations is required, the use of a photo album is recommended, supplemented by data obtained from general practice records to improve the accuracy of dates. General practice records on their own are not sufficiently complete to be used as a sole source of exposure data in studies in which it is important to obtain a complete oral contraceptive history.

Adult↗
PubMed1990

Use of oral contraceptives in relation to dietary habits and alcohol consumption.

The relationship between oral contraceptive (OC) use, dietary habits and alcohol consumption in young women was studied in Tromsø, Norway. A total of 5,800 women aged 20-39 years answered a questionnaire in 1986/1987. Women with long-term duration of OC use reported more frequent intake of meat for dinner, preferred low-fat milk and drank less coffee. For other food items such as intake of fats, fish, fruit and vegetables, no differences were found. Strong associations were found for alcohol consumption, with increasing frequency of use among long-term users of OCs. These results are discussed in relation to the possible association between OC use and breast cancer in young women.

Adult↗
PubMed1991

Failed contraception in Nigerian women: outcome of pregnancy and subsequent contraceptive choice.

The outcome of pregnancy in 56 patients who had contraceptive failure out of the 5,431 new acceptors at the Family Planning Clinic of the Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, between 1 January 1981 and 31 December 1989, were analysed. There were 40 IUD, 6 OC, and 4 injectable failures. Three patients had had voluntary surgical contraception (VSC) and 3 used barrier methods. The mean +/- SD age and parity were 32.2 +/- 4.4 years and 4.4 +/- 1.9, respectively. There were 17 (30.1%) live births, 34 (56.6%) terminations of pregnancy and 3 (5.2%) spontaneous abortions. Two (3.0%) patients were lost to follow-up. There was neither any statistically significant difference in the outcome of pregnancy between patients with 5 or more children and less than 5 children (p greater than 0.05), nor between patients less than 31 years of age and those older. Fifty per cent of the patients who had used the IUD continued with the method. Seven patients subsequently requested VSC. None of the patients using the injectable contraceptive or barrier methods continued with the method (p greater than 0.05).

Adult↗