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PubMedDate not supplied

Use of traditional medical practitioners to delivery family planning services in Uttar Pradesh.

This pilot study conducted in Muzaffarnagar district in the state of Uttar Pradesh, India, demonstrates the potential for using traditional medical practitioners in the delivery of family planning services after a brief training period. Practitioners participated continuously in the program for an intervention period of two years during which their services were accepted by the community. The impact of their involvement was reflected in increased knowledge of permanent as well as reversible contraceptive methods and in higher contraceptive use rates, especially of reversible methods adopted by women younger than 25 years (from 8 percent to 37 percent), in the intervention villages, as compared with increased knowledge and use (from 13 percent to 25 percent) of permanent methods alone in the control villages.

Adolescent↗
PubMed1997

Family planning counselling--a priority for post abortion care.

OBJECTIVE: To assess the impact of providing contraceptive care to post abortal women. DESIGN: This was a descriptive study in which data were collected through subject interviews. SETTING: Women presenting with complications of abortion at Harare and Parirenyatwa Hospitals, Harare. SUBJECTS: 2,050 women with complications of abortion. MAIN OUTCOME MEASURES: Use of a contraceptive method before and after the intervention. RESULTS: Basic characteristics are similar to those reported previously. Seventy six per cent were not using any form of contraception prior to pregnancy. After the intervention 97% were discharged with a contraceptive method of their choice. CONCLUSIONS: The results emphasize the importance of family planning in the prevention of unplanned pregnancies and the need to make these services easily available and accessible. Emphasis should initially be on eliminating need for abortion by provision of adequate family planning services.

Abortion, Illegal↗
PubMed1995

Adolescent sexuality and its problems.

Adolescent sexual activity is increasing globally. Abstinence and a delay in the start of sexual intercourse may be the most effective methods in preventing the consequences of teenage sexual activity. However, these goals are seldom met. With the change in social norms, peer pressure and media influences; teenagers are engaging in premarital sex earlier. Family life education in countries like Sweden and Finland reduces teenage pregnancy and abortion. It is unrealistic to expect sexually active adolescents to stop their sexual activity. An effective contraceptive method will provide an alternative to prevent teenage pregnancy. Issues on compliance of contraceptive use, especially at the very outset of sexual activity should be addressed. Most of the problems associated with teenage pregnancy are now thought to be related to the social circumstances of the mother, the poor nutritional status before pregnancy and poor attendance at antenatal clinics. Risk-taking behaviour in this age group will also make them more prone to contracting sexually transmitted diseases. High risk groups should be screened and treated early. Contraceptive methods with protection against sexually transmitted diseases should be advised.

Adolescent↗
PubMed1996

Contraception with anti-progesterone.

Anti-progesterones have potential as contraceptives, acting either by the inhibition of ovulation or the inhibition of endometrial development. Clinical studies have shown that once-a-month treatment with Mifepristone in the early luteal phase is an effective contraceptive method, and that emergency post-coital contraception with Mifepristone is at least as effective as other methods currently used. Recent studies indicate that the endometrium is more susceptible to Mifepristone than are the hypothalamic and pituitary regions, and it may therefore be possible to develop a new contraceptive method based on low daily or once-weekly doses of Mifepristone that does not influence ovarian function.

Contraceptive Agents, Female↗
PubMed1981

[The position of the IUD and intrauterine pregnancies].

In 59 women who became pregnant with an IUD the position of the device was controlled by ultrasound. Before the 9th week of pregnancy the device was located in 40 women (78.4%) in the cervix or in the isthmic region of the uterus. In 11 cases the IUD was in correct position. 8 women had a pregnancy of more than 9 weeks and were not included in the study as the gestational sac could have influenced the IUD position. The possibility of regular control of the IUD position by ultrasound is discussed in order to reduce the failure rate of this contraceptive method.

Cervix Uteri↗
PubMedDate not supplied

[Barrier contraceptives and the IUD: educational technology for the visually impaired].

Family planning is fundamental for the appropriate structuring of the family. This offers knowledge to decide on the number of children, and the most adequate moment to have them. The current health information being advertised is based on visual communication. This fact hinders the access of visually impaired people to such important knowledge. The present study has as objectives the creation of self-instructional educational material concerning mechanical contraceptive methods and IUD, as well as its evaluation. The research was divided in two methodological parts. In the first part, methods that explored the senses of hearing and touch were elaborated. In the second part, these methods were tested by a sight impaired couple. The data for the evaluation was obtained through interviews. Results show that the use of appropriate content and language facilitate the understanding of the contraceptive methods by these people. Verbal and tactile communication was favored and contributed on the reconstruction of citizenship for the visually impaired.

Contraception↗
PubMed2004

Missed opportunities: emergency contraception utilisation by young south African women.

Although contraceptives, including emergency contraceptives, are widely available free at public health facilities in South Africa, rates of teenage and unintended pregnancy are high. This paper analyses awareness and utilisation of emergency contraception amongst 193 young women (aged 15-24 years) attending public sector health facilities. Structured interviews were held at 17 and 14 primary health clinics in an urban and a rural area respectively. Respondents were asked about their knowledge of contraceptive methods and use, and specifically about emergency contraceptive utilisation. More sexually active young urban women (76%) were currently using a method of contraception, compared to the young rural women (53%). Only 17% had ever heard of emergency contraception, although significantly more in the urban area (p = 0.005) had heard of it. Only one woman from each site had ever used emergency contraception, although 39% had had unprotected intercourse in the previous year when they did not wish to conceive. Young South African women should be the focus of interventions aimed at improving awareness of the availability of emergency contraception and knowledge about its correct utilisation.

Adolescent↗
PubMed2000

Is low income a constraint to contraceptive use among the Pakistani poor?

This paper examines whether low income is a barrier to contraceptive use in Pakistan, a country in which economic conditions are deteriorating at a time when the private sector is becoming a more important supplier of contraception. Multivariate regression analysis performed using the Pakistan Contraceptive Demand Survey suggests that low income is a deterrent to modern contraceptive use in Pakistan. This is particularly the case for contraceptive methods supplied through the private sector. It is concluded that, if the aim of family planning programmes is to reach low-income people, the prices of contraceptives supplied through the private sector should be kept as low as possible.

Adolescent↗
PubMed1987

Five-year experience with Norplant.

At Klinik Raden Saleh, Department of Obstetrics and Gynaecology, University of Indonesia, from 1 May until 31 August, 1981, Norplant contraceptive implants were inserted into 437 Indonesian women. The continuation rates of Norplant at first, second, third, fourth and fifth year were, respectively, 96%, 92%, 88%, 82% and 78%. Bleeding problems were the most common cause for removal. The cumulative five-year net pregnancy rate for Norplant was 1.8 per 100 women. The Norplant contraceptive system is thus seen to combine the highest acceptability as measured by its continuation rate with the highest long-term effectiveness among the available temporary contraceptive methods.

Adult↗
PubMedDate not supplied

[Abortion or contraception (author's transl)].

The period immediately following an abortion, spontaneous or induced, has been considered favourable to the initiation of high efficicy contraception: sterilization, oral contraceptives, or intrauterine devices. The rate of post-abortal complications associated with these contraceptive methods was evaluated using data drawn from published and unpublished studies. The following conclusions were reached: sterilization is advisable only for women who do not desire additional children, and is obviously not recommended for young nulliparous women. The effective use of oral contraceptives requires a high motivational level and is therefore advisable only in cases where such motivation exists. The insertion of an intrauterine device seems to be the most adequate contraceptive method for women with low motivational level.

Abortion, Spontaneous↗
PubMed1997

Sexual behaviour of adolescents before and after the advent of AIDS.

OBJECTIVES: To asses changes in sexual behaviour and use of contraceptive methods in Danish adolescents from the period before the advent of AIDS up to the present. DESIGN: Comparative study comparing data obtained from two identical cross sectional surveys SETTING: Grenaa Gymnasium, Denmark. SUBJECTS: 626 high school students in 1982 and 499 high school students in 1996. METHODS: An anonymous standardised self administered questionnaire handed out to high school students at Grenaa Gymnasium in spring 1982. In spring 1996 an identical questionnaire was handed out to every high school student at the same gymnasium. MAIN OUTCOME MEASURES: Age at first sexual intercourse, contraceptive use, and reasons for choice of contraceptive strategy. RESULTS: Today more males had experienced the first sexual intercourse before their 16th birthday (p = 0.047) compared with 1982, the reverse held for females (p = 0.003). From 1982 to 1996 condom use increased in males with no regular partner (p = 0.009). In females with no regular partner, there was during the same period an increase in considering the condom a personal contraceptive method (p = 0.017). In 1982 and 1996 protection from sexually transmitted diseases was given as reason for the choice of contraceptive strategy by 21% and 72% of males with no regular partner (p < 0.001), and by 7% and 32% of males with a regular partner (p < 0.001). The corresponding figures for females in 1982 and 1996 were 10% and 71% (p < 0.001) for those with no regular partner and 4% and 21% (p < 0.001) for those with a regular partner. CONCLUSION: Condom use has increased among adolescents with no regular partner brought up under the widespread awareness of AIDS, and the reason for this is to be protected from sexually transmitted diseases. A future decline in the incidence of various sexually transmitted diseases may be expected, and information on safe sexual practices should be continued.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Contraception: an overview.

In this century, paramount progress has been made in many areas of medicine, not least in the field of contraception, with landmarks such as the introduction of intrauterine contraceptive devices (IUDs), hormonal contraceptives (OCs), and laparoscopic sterilization. The general optimism of the 1960s about overcoming the problems of global overpopulation with these new tools has subsequently been replaced by growing concern about the risks of contraception in general and of OCs especially. It was not before the 1980s that the benefit-risk balance of hormonal contraception turned out to be much more favorable than was formerly suspected. The wide variation from country to country in the prevalence of contraceptive methods has economic, political, religious, sociological, educational, and legal rather than medical reasons. Former misjudgments have led to a ban on valuable tools such as the sequential regimen or the use of 17-acetoxyprogestogen analogues as components in OCs, or to a ban on the licensing of depot progestogens in some countries but not in others. The recent decision of U.S. firms to cease production and sale of IUDs for legal reasons is unique and hopefully will not be imitated elsewhere. Just after the introduction of oral contraception, tremendous inventive dynamics led to the discovery of several new contraceptive principles. Most of these have reached the stage of clinical application and are being used satisfactorily, at least in some parts of the world. Later contraceptive concepts are still in the stage of experimentation and no breakthrough appears to be directly ahead. If contraception means more than just meeting individual wants--if it is also to be an instrument for handling the increasing problems of overpopulation--then much more must be done to deepen our knowledge of reproductive physiology, to popularize efficient means of contraception, and to make them available to everyone. Otherwise, all efforts to improve health standards throughout the world according to the "WHO Global Strategy for Health for All by the Year 2000" will be in vain.

Contraception↗
PubMed1982

Reproductive mortality in the United States.

Maternal mortality in the United States has declined by 50% during the last decade. This decline took place at the same time as changes in the availability and use of contraceptive measures, including temporary contraceptives and sterilization. To examine the impact of these changes on mortality we estimated the reproductive mortality rate, which includes pregnancy-related deaths as well as deaths from the side effects of contraceptive methods. The estimated reproductive mortality rate fell by 73% from 1955 to 1975. The decrease was greater for women younger than 35 years. The slower decline for women aged 35 years and older was due to oral-contraception-related deaths. By 1975, pregnancy prevention was responsible for nearly as many deaths as pregnancy itself. The reproductive mortality rate is more appropriate than the maternal mortality rate for evaluating the health risks of reproduction and contraception. We urge that national surveillance of maternal mortality should be expanded to include deaths associated with contraceptive methods.

Abortion, Induced↗
PubMed1994

High school students' knowledge, attitude and practice of contraception in Harer town, eastern Ethiopia.

A survey of knowledge, attitude and practice of contraception was carried out among 1,674 students (mean age 17.4 years) in Harer town, eastern Ethiopia. Fifty-four per cent of the students spontaneously mentioned a modern contraceptive method when asked, but large numbers of students did not know the answers to specific questions about prevention of pregnancy. The students were receptive to more information in schools on sexuality and contraception. Overall, 20% of females and 65% of males admitted to having had sexual intercourse at least once. Among sexually active females, 60% said they were using a contraceptive method. However, 76% of these were using only the calendar method. Twenty per cent of the sexually experienced female students had been pregnant, and of these 56% had elected for induced abortions. If only unmarried students are considered, 75% of those who had been pregnant had had an induced abortion. Since induced abortions are not legal in Ethiopia, these students are at high risk for complications of abortions.

Abortion, Illegal↗
PubMed1998

Contraceptive efficacy of low doses of mifepristone.

OBJECTIVE: To determine whether a 5-mg dose of mifepristone is sufficient to prevent pregnancy. DESIGN: Clinical study. SETTING: Academic research center. SUBJECT(S): Healthy, fertile, sexually active female volunteers. INTERVENTION: Volunteers received a 5-mg dose of mifepristone once weekly, starting on cycle day 2, for up to 6 months. This was their only contraceptive method. MAIN OUTCOME MEASURE(S): Number of pregnancies. RESULT(S): The treatment resulted in a significant decrease in pregnancy rate without affecting the menstrual cycle or causing disturbing side effects. CONCLUSION(S): A low dose of mifepristone, which does not inhibit ovulation, reduces fertility significantly by affecting the endometrium. However, the contraceptive effect needs to be improved for the drug to compete with other contraceptive methods.

Adult↗
PubMed2002

Availability of emergency contraceptive pills at university and college student health centers.

The author used the stages of change model to determine how ready student health centers at surveyed universities and colleges were to make emergency contraceptive pills (ECPs) available to students. Of the 358 centers that responded, 52.2% offered ECPs and 47.8% did not. The benefits of offering ECPs were listed as pregnancy prevention, the opportunity to introduce students to traditional contraception methods, and students' appreciation. Barriers to offering ECPs included institutions' religious affiliations, clinic and administrative staff objections, inability to prescribe or dispense medications, fear of liability, concern that ECPs would undermine students' use of traditional contraception methods, and no expressed need. Whether ECPs were available was associated with demographic characteristics of the institutions that responded, including geographic region, type of institution, size of student population, and students' status as commuter or on-campus residents.

Adolescent↗