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PubMed2003

[Contraceptive practices among students].

Research has shown that university students tend to have specific sexual behaviour. It is worth mentioning that not much attention has been paid to pregnancy prevention practices among medical students nor has any survey been conducted in this matter. The purpose of this survey was to ascertain the frequency of contraceptive usage among students at Medical University of Warsaw. Specially designed questionnaires were anonymously self-administered by 634 female and 354 male medical students. 52.2% of the female students and 67.2% of the male students were sexually active at the time. 43.4% of the survey participants used condoms, while 26.3% used oral contraception pill (OCP) as contraceptive methods. Only 0.5% of those participants used intrauterine device. The survey result indicates an apparent dichotomy between the male and female students in terms of (appropriate) choice of the following contraceptive methods: condom, OCP, withdrawal, basal body temperature and Billings' methods.

Adult↗
PubMed1987

Pregnancy after removal of Norplant implants contraceptive.

Many concerns have been expressed regarding the introduction of a new contraceptive method into family planning programmes. One of the concerns is the return of fertility after discontinuing the method. To evaluate the subsequent fertility status of the Indonesian women after removal of Norplant, a prospective longitudinal study was undertaken in Klinik Radeb Saleh, Jakarta. Fifty-one women whose Norplant were removed because of their wish to become pregnant were followed-up for a period of two years or until pregnancy occurred, whichever was earlier. Two groups of women who had Lippes C IUD removed or discontinued the use of DMPA for planning pregnancy served as control and were followed-up for equal length of time. The cumulative conception rate for ex-Norplant users, ex-IUD users and ex-DMPA users at one year was 76.5, 74.7 and 70.2 per 100 women, respectively. There was no significant difference between the groups (p greater than 0.05). The present study, along with other studies, indicate that the prolonged use of Norplant do not impair the return of fertility.

Adult↗
PubMed2001

Contraceptive use and family planning after labor in the European part of the Russian Federation: 2-year monitoring.

OBJECTIVES: To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning. METHODS: Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor. RESULTS: The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively. CONCLUSIONS: Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.

Abortion, Induced↗
PubMed2005

Sources of contraceptive commodities for users in Nigeria.

BACKGROUND: Understanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives. METHODS AND FINDINGS: A multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15-49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15-24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives. CONCLUSION: Strategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.

Adolescent↗
PubMed1996

Does the use of contraception reduce the risk of pregnancy-induced hypertension?

To estimate the impact of the exposure to spermatozoa on the risk of developing pregnancy-induced hypertension, the duration of sexual cohabitation with the father and the use of contraceptive methods were evaluated among 113 primigravid women with pregnancy-induced hypertension and 109 age- and parity-matched controls. The duration of unprotected sexual cohabitation was approximately 50% shorter in women with pregnancy-induced hypertension (2.3 versus 4.7, P < 0.0001), regardless of the contraceptive method previously used. However, the duration of oral contraception use was similar in cases and controls (22.1 versus 23.4 months). Also, of the total group of women who developed pregnancy-induced hypertension, 85.5% (97) became pregnant during the first 3 months of unprotected sexual intercourse in comparison with 54.1% (59) in the control group (P < 0.0001). Results suggest that the risk of pregnancy-induced hypertension in primigravidae is reduced with duration of sexual cohabitation, and therefore with exposure to paternal spermatozoa. However, the protective effect of exposure is not achieved while using oral contraceptives. Considering the present options for nulliparous women, contraception does not appear to be a viable public health policy to reduce the risk of pregnancy induced hypertension.

Adult↗
PubMed1977

Oral contraception.

Explore the source record for details and available documents.

Contraceptives, Oral↗
PubMed2003

Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women.

The objective of the study was to assess the association between systolic and diastolic blood pressure (SBP and DBP) and the use of oral contraceptives (OC) in hypertensive women. In a prospective cross-sectional study, we evaluated 171 women who were referred to the Hypertension Outpatient Clinic of Hospital de Clínicas de Porto Alegre; 66 current users of OC, 26 users of other contraceptive methods and 79 women who were not using contraception. The average of six blood pressure readings was used to establish the usual blood pressure of the participants. Current OC users were compared with users of other methods and with patients not using contraception. Main outcome measures were SBP and DBP among the different groups, and prevalence of uncontrolled hypertension (SBP >or= 140 mmHg and DBP >or= 90 mmHg). DBP was higher in OC users (100.2 +/- 15.9 mmHg) than in patients using other contraceptive methods (93.4 +/- 14.7 mmHg) and not using contraceptives (93.3 +/- 14.4 mmHg, p = 0.016). Women using OC for more than 8 years presented higher age-adjusted blood pressure levels than women using OC for shorter periods. Patients using OC had poor blood pressure control (p for trend = 0.046) and a higher proportion of them presented moderate-severe hypertension. These results were independent of antihypertensive drug use. In a logistic regression model, we found that current OC use was independently and significantly associated with prevalence of uncontrolled hypertension. It is concluded that hypertensive women using OC present a significant increase in DBP and poor blood pressure control, independent of age, weight and antihypertensive drug treatment.

Adolescent↗
PubMed2006

Contraceptive care for the adolescent.

Despite recent improvements in rates of teen pregnancy, abortion, birth,and contraceptive use, effective contraceptive counseling for adolescents should be a high priority for the primary care provider in the office setting. Adolescent psychosocial risk screening and appropriate counseling about sexual decision-making is necessary. Contraceptive services visits include, relevant history, limited physical examination, provision of information, anticipatory guidance about sexual behaviors, and the provision of contraceptive methods. Teens should always be encouraged to use a male condom during sex to reduce STI risk. A variety of barrier and hormonal contraceptive methods are available for the adolescent population. Education about and provision of EC is effective in reducing the rate of unintended pregnancy and abortion in the United States. Contraceptive care for adolescents is a rewarding experience for primary care providers.

Adolescent↗
PubMed1999

[Contraception: gypsy versus non-gypsy women].

OBJECTIVE: To find the contraceptive methods used or known by women of fertile age, and find differences between gypsy and non-gypsy women. DESIGN: Descriptive study. SETTING: Primary care centre in El Prat de Llobregat (Barcelona). PARTICIPANTS: Women of fertile age, who were sexually active and did not wish to become pregnant, and who attended the centre for any reason. MEASUREMENTS: From March to August 1997, a survey was conducted in which personal data, number of sexual contacts, parity, use and knowledge of contraceptive methods, if and where their method is monitored, and satisfaction with their method were asked. RESULTS: 186 non-gypsy and 126 gypsy women answered the survey. The gypsy women knew less about barrier contraception (diaphragm p < 0.0001); IUD p = 0.0003; spermicides p = 0.001), periodic abstention (p = 0.002) and definitive methods (vasectomy p < 0.0001; tubal occlusion p = 0.0004). The commonest method used by the gypsy women was coitus interruptus (p = 0.0002). Gypsy women asked for less contraceptive advice and had less monitoring of their method (p = 0.001). They had more pregnancies which led to a greater number of live children (p < 0.0001) and induced abortions (p = 0.01). They lived more often with their sexual partner (p = 0.0005). CONCLUSIONS: Gypsy women know about safe methods but do not use them. They ask less for contraceptive advice and have more induced abortions. There should be family planning programmes aimed at this group, whose cultural and family features are distinct.

Abortion, Induced↗
PubMed2001

Contraception for adolescents: social, clinical and service-delivery considerations.

A large proportion of the millions of adolescents worldwide who are sexually active have sex without using modern contraceptives or protection against sexually transmitted infections (STI). In many cases, this results in too-early (and often unwanted) pregnancies and STI, with negative consequences at different levels. Adolescents in general--and unmarried adolescents in particular--often find it difficult to obtain the contraceptives they need. Health workers are often unaware of the special needs of adolescents, and contraceptive services are only rarely provided in a manner that is accessible to adolescents. The World Health Organization stresses that age alone does not constitute a medical reason for denying any available contraceptive method to adolescents. However, it recommends that it is important for health workers to be well aware of the biomedical, psychological and social issues that affect how they can assist adolescents in making well-informed choices of contraceptive methods that suit their special needs, and in using the contraceptives, they choose in an effective manner.

Adolescent↗
PubMedDate not supplied

Acceptability for the use of postpartum intrauterine contraceptive devices: Assiut experience.

OBJECTIVES: To evaluate the acceptance of postpartum intrauterine contraceptive devices (PPIUCD) among the inhabitants of Assiut governorate, Egypt and to study the factors that influence this acceptance. SUBJECTS AND METHODS: Contraceptive counseling was given to 3,541 clients: 1,880 and 1,661 during the antenatal visits and postpartum hospitalization, respectively. Acceptors during antenatal counseling were to receive IUCDs via postplacental insertion in the case of vaginal delivery or transcesarean insertion in case of abdominal delivery. The clients who refused PPIUCD and chose interval IUCD insertion were referred to the Family Planning Clinic after the end of puerperium. Among postpartum counselees, PPIUCD acceptors received predischarge insertion within 48 h of delivery and the interval IUCD were referred to have IUCD inserted after the end of puerperium. The acceptance rate of both PPIUCD and interval IUCD and the percentage of actual insertions were recorded. The causes of both acceptance and refusal were also recorded. RESULTS: Of the 3,541 clients, 1,024 (28.9%) accepted the use of IUCD after delivery. Acceptance was approximately the same during antenal and postpartum counseling: 26.4 and 31.8%, respectively. Verbal acceptance was higher among women with formal education than among illiterate women. Planning another pregnancy in the near future, preference for another contraceptive method, namely lactational infertility, and complications from previous use of IUCD were the most common reasons for refusing the use of IUCD. Of the 1,024 verbal acceptors, only 243 (23.7%) had the actual insertion of IUCD. CONCLUSION: Both the acceptance and actual insertion of IUCD were low probably because the use of IUCD is a new concept in the community. For these women, the only opportunity to receive information about contraceptives is during childbirth when they are in contact with medical personnel. Hence, it is suggested that family planning should be integrated with maternal and child-care services in order to effectively promote the use of contraceptive devices in these women who otherwise would not seek the use of such a device.

Adult↗
PubMed1999

[Contraception].

Prescribing a contraceptive method is a routine act in medical and gynecological practice. A large variety of available methods allows to adapt the prescription to most patients, taking care of contra-indications. In this review article, we will describe the various contraceptive methods available, their mechanisms of action and properties, highlighting their advantages and disadvantages.

Adult↗
PubMed2005

Depot medroxyprogesterone acetate: implications for weight status and bone mineral density in the adolescent female.

Depot medroxyprogesterone acetate (DMPA) is an effective and easy-to-use contraceptive method for adolescents. However, recent literature suggests that overweight teens may be at increased risk for weight gain while on this contraceptive method, and decreases in bone mineral density have been documented in adolescents on DMPA, particularly with longer duration of use. Consideration of this new literature on DMPA and its implications for clinical practice must be done in the context of the United States having the highest adolescent pregnancy rate in the industrialized world. Hence, potential DMPA risks need to be weighed against the risk of unintended pregnancy in an adolescent.

Adolescent↗
PubMed2003

Understanding risk: a randomized controlled trial of communicating contraceptive effectiveness.

OBJECTIVE: To determine which of three different approaches increased women's understanding of risk of pregnancy associated with different contraceptive methods. METHODS: We randomly assigned 461 reproductive-age women to one of three tables presenting pregnancy risk (Food and Drug Administration table with numbers, World Health Organization table with numbers and categories, or table with categories). We evaluated participant knowledge before and after being shown the assigned table. RESULTS: The most important reason for choosing a contraceptive was how well it works (53%), followed by ease of use (13%), and protection against sexually transmitted disease or human immunodeficiency virus (11%). Before looking at the tables, about half the participants knew that hormone shots are more effective than pills (48%) and that pills are more effective than condoms (57%). For these two key comparisons, the category table compared to the Food and Drug Administration table with numbers improved knowledge significantly more (37% versus 20% and 27% versus 14%; both P <.05). Compared with those assigned to the Food and Drug Administration table with numbers, significantly fewer participants assigned to the category table said the table was difficult to read (6% versus 19%; P <.01). Most participants in all three groups said their assigned table provided enough information to choose a contraceptive method. CONCLUSION: The table with categories communicated relative contraceptive effectiveness better than the tables with numbers. However, without being presented with numbers, participants grossly overestimated the absolute risk of pregnancy using contraceptives. A combination of categories and a general range of risk for each category may provide the most accurate understanding of both relative and absolute pregnancy risk.

Adolescent↗
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↗