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PubMed2006

Matching estimates of the impact of over-the-counter emergency birth control on teenage pregnancy.

In this paper, we demonstrate how matching estimators can be used to evaluate policy interventions which are implemented in relatively few regions at different times. Our technique is based on translating calendar time into 'experimental time' to provide a common starting point for entry by different areas into the scheme. Such an approach is likely to have many applications, in particular to cases of state- or country-level interventions for which only aggregate data are available. We illustrate the technique using the case of free over-the-counter access to emergency birth control for teenagers at pharmacies in England. We construct matching estimates of the impact of this scheme on the under-18 conception rate in local authorities. Irrespective of either the matching or the adjustment procedure, we find no evidence that over-the-counter emergency birth control schemes lead to lower teenage pregnancy rates.

Adolescent↗
PubMed2001

Factors influencing women's satisfaction with birth control methods.

OBJECTIVES: To study the extent to which variation in satisfaction with a birth control method is explained by variation in perceived physical and psychological effects. METHODS: A population survey among 1466 German women was carried out. Within the overall sample, 1303 women had ever used oral contraceptives, 996 had relied on condoms, 342 had ever used intrauterine devices (IUD), 428 had used natural family planning and 139 women were sterilized. For each method a woman had ever used, she answered questions about satisfaction with the method, concerns about getting pregnant or suffering health risks during use, ease of use, changes in sexual relationship, relationship with the partner and mood. Past and current users of oral contraceptives and IUDs and sterilized women additionally reported changes in menstrual bleeding. RESULTS: Variation in satisfaction was, for a large part, explained by variation in health concerns among oral contraceptive users, by variation in perceived changes in the quality of the sexual relationship among condom users, by perceived ease of use among IUD users and sterilized women, and by variation in pregnancy concern among natural family planning users. CONCLUSION: Counselling about these perceived experiences is most likely to result in greater satisfaction and therefore improved compliance.

Adult↗
PubMed1998

Eugenics and birth control: contraceptive provision in North Wales, 1918-1939.

The close relationship between the provision of birth control advice and the ideology of eugenics deserves closer attention. This paper focuses on the enthusiasm for eugenic ideas amongst an influential section of the medical profession and their ability to initiate contraceptive provision. A study of North Wales suggests that clinic provision in the interwar period reflected the enthusiasm or hostility of the medical profession more closely than the needs or demands of the female population, and illustrates how, for some doctors, the issue of contraception was seen in the wider context of the nation's health.

Contraception↗
PubMed2003

Ultrasound detection of the Essure permanent birth control device: a case series.

BACKGROUND: The current recommendation to check the position of the Essure permanent birth control (PBC) micro-insert device after its insertion is by abdominal X-ray 3 months after insertion. We propose that ultrasound imaging is more suited for this purpose and gives reassurance much earlier. The sonographic appearance of the micro-inserts and the reliability of this modality in localising the devices is described in the present study. OBJECTIVE: To ascertain the appearance of the Essure PBC device at transvaginal and transabdominal ultrasound scanning and to determine the reliability of this approach in localising the contraceptive device. STUDY POPULATION AND METHODS: All patients who had the Essure PBC procedure between June 2002 and January 2003 at our centre were offered an ultrasound scan to check device position. RESULTS: The micro-inserts were easily distinguished by their echogenic coil-like appearance within each uterine cornua extending into the proximal fallopian tube. Of the 15 patients examined, 14 pairs of devices were seen: one device was malpositioned in the lower part of the uterus. In one patient, only one device was seen in the correct position but the other device was not identified and presumably expelled after a notably difficult insertion. DISCUSSION: Ultrasound appears to be well suited for micro-insert localisation. An early post insertion ultrasound scan is recommended to reassure about correct positioning of device and may potentially alleviate patient anxiety, or diagnose malposition early.

Adult↗
PubMed1995

European Society of Contraception oral contraceptives survey update: birth control methods in "Europe of the 12".

The European Society of Contraception developed a survey to examine birth control methods in the 12 countries++ of the European Community. Responses to those questions relating to prescribing++ practices of oral contraceptives (OCs) are presented herein. The survey was sent to 400 physicians. One hundred two responded, most from France, Belgium, and the United Kingdom. The responses revealed that the most popular OCs are modern combined formulations containing low doses of ethinyl estradiol and progestogens such as norgestimate, desogestrel, gestodene, and levonorgestrel. More than half of physicians prescribe a particular formulation because of its tolerability and 20% because of its hormonal content. More than 90% prescribe OCs to healthy, nonsmoking women over 40. However, three fourths will not prescribe OCs to smokers over 35. Half of physicians recommend mammography for their older OC patients. Half also recommend cholesterol screening, but 8% only for women over 30. Most physicians are no longer reluctant to prescribe OCs to their diabetic patients: 61% prescribe OCs for women with non-insulin-dependent diabetes, 56% for those with insulin-dependent diabetes, and 85% for those with a history of gestational diabetes. Despite recent studies showing no relation between past OC use and cardiovascular disease, 42% of physicians said that their greatest OC-related health concern is cardiovascular disease. One third cited noncompliance as their greatest concern. These results reveal inhomogeneous prescribing practices for OCs among European physicians. ¿Over-screening¿--not prescribing the pill because of perceived (but not necessarily real) health risks--may be depriving many women of the contraceptive and noncontraceptive benefits of OCs. Complete and accurate information--as promoted by the European Society of Contraception--is one way to combat such overscreening.

Adult↗
PubMed2006

Hysterosalpingography for assessing efficacy of Essure microinsert permanent birth control device.

OBJECTIVE: The Essure microinsert is a new U.S. Food and Drug Administration-approved method of birth control. The objective of this study is to report our initial experience using hysterosalpingography (HSG) to assess its efficacy for permanent tubal occlusion. CONCLUSION: The Essure microinsert produced tubal blockage in all patients. As this device may become more widely used, radiologists should be aware of the device's appearance and be able to assess device position and presence of tubal occlusion on HSG.

Adult↗
PubMed1980

Sexual experience, birth control usage, and sex education of unmarried Canadian university students: changes between 1968 and 1978.

Changes in coital experience, birth control usage, and sex education between 1968, 1971, 1974, and 1978 were studied in unmarried Canadian university students. The percentage of coitally experienced females increased from 32% in 1968 to 58% in 1978 and of males from 40% to 62%. There was no significant change between 1974 and 1978 for either sex, nor were there sex differences in coital experience in either year. Coitally experienced females were more likely to have had intercourse in the 3 months preceding both 1974 and 1978 surveys, but otherwise there were no sex differences in coital frequency, lifetime number of coital partners, or age at first intercourse. Religion was a more reliable indicator of coital experience in 1968 than in 1978. Males were more likely than females to report postpubertal sexual contacts which they classified as homosexual (16.5% vs. 7%) whereas 12-13% of both sexes reported no sexual contacts of any kind with another person. Contraceptive risk-taking was high at first intercourse and among those having infrequent coitus. However, both this group and more coitally active students were less likely to take such risks in 1978 than in 1968, almost entirely because of increased pill use. Coitally experienced vs. inexperienced students differed in their ranking of the major influences on their knowledge and attitudes about sex.

Abortion, Induced↗
PubMed1992

The birth control pill revisited.

The evolution of oral contraceptives is summarized in this chapter. The social context into which the birth control pill was introduced, early and recent formulations of the pill, side effects, and the identification of serious complications of taking the pill are presented. The role of the nurse as a health educator of women and the responsibility of nurses to assist patients to make informed decisions about their reproductive function are emphasized. The outlook for future research and development of alternative forms of contraception is discussed.

Adolescent↗
PubMed1992

Sexuality, birth control and childbirth in orthodox Jewish tradition.

This paper examines some of the traditional texts that deal with sexuality, birth control and childbirth in the orthodox Jewish tradition and presents the rules governing these areas. For instance, a married woman should avoid being alone with a male physician unless other people are in earshot and have access to the room. A husband and wife must separate during the woman's menses and for the first 7 days afterward. Contraception is permitted if childbearing would endanger a woman's life or health. Termination of pregnancy is also permitted to preserve a woman's health, including her mental health. During childbirth the health of the mother is primary and supercedes all other rules or laws, including those of Sabbath observance. In general, orthodox Jewish women try to live as much as possible within the framework of Halacha. These customs are examined as examples of the need for sensitivity to cultural norms that affect the behaviour of different ethnic groups.

Abortion, Therapeutic↗
PubMed1976

[Aspects to birth control (author's transl)].

From 1964, the year with the highest new born rate since 1945, until 1972, the number of births in the BRD was reduced for 34%. Simultaneously, the birth rate of women between 20 and 30 years was decreased for a third. Presently, the average age of half of the women who deliver their first or second child is over 30 years. While on the one hand there are investigations on the practical experiences which are hidden behind the obvious "one child effect", it would be, on the other hand, dangerous, to lay out a demographic "production policy" which shows no interest in economy. In birth-control, biotic-private individual foundations are variable elements; social values, however, are non individual objectives [corrected] with temporal relatively great constancy. The splitting of these elements is, in the 20th century, tracing back with violent actuality to the original big line of Malthus and Darwin, which is to maintain sufficient scope for nourishment and reproduction to the human world with its vegetable and animal life. This concerns industrial and development countries as well. The challenge is to line out acceptable ideas for the solution of the Circulus vitiosus, based on statistical data, on socio-philosophic understandings which have to be worked out yet and on common sense.

Age Factors↗
PubMedDate not supplied

References concerning birth control methods in Ancient Indian Classics: an exposition.

Reproduction is the basic phenomenon of Biological activity. Like other living beings man has a desire to reproduce. Unlike others he can control reproduction at his will. From early vedic periods belonging to several centuries prior to Christian era, we find references concerning methods of controlling the population over growth. Views of vedic sages, sexologists of ancient and medieval India regarding the birth control methods are expressed in this presentation.

Books↗
PubMed1995

Biodegradable delivery system for a birth control vaccine: immunogenicity studies in rats and monkeys.

PURPOSE: The purpose of this study was to develop a single administration delivery system for a model birth control vaccine, in order to reduce the need for multiple injections and enhance immunogenicity. METHODS: The immunogen-loaded microspheres were prepared by solvent evaporation method and characterized for loading levels, size distribution and in vitro release kinetics. The microspheres were immunized intramuscularly in wistar rats and bonnet monkeys, and the antibody response was compared to that obtained with the same total dose of the immunogen on alum given at a monthly interval. RESULTS: Results indicated that a single injection of the immunogen entrapped in the microspheres generated a response comparable to that obtained by the same immunogen on alum injected at a monthly interval. The antibodies generated by the microspheres in the monkeys also had a good bioneutralization capacity indicating immunogen integrity during the microencapsulation process. CONCLUSIONS: Biodegradable microspheres served as an effective delivery system for a model immunogen used in this study to reduce the need for frequent immunizations and enhance immunogenicity.

Animals↗
PubMed1985

The identification of candidate antigens for the development of birth control vaccines. An international multi-centre study on antibodies to reproductive tract antigens, using clinically defined sera.

In an attempt to identify appropriate antigens for birth control vaccines, the Task Force on Immunological Methods for Fertility Regulation under WHO's Special Programme of Research, Development and Research Training in Human Reproduction carried out an investigation of naturally occurring immune responses to reproductive tract antigens which were consistently associated with infertility. Large volumes of sera from subjects satisfying the criteria for one of 16 different clinical categories (listed in Table 1) were collected and samples were subsequently assessed, under code, by investigators with experience in the detection of antibodies to antigens involved in the reproductive process. Sera from 329 persons were included in the study and 20 laboratories examined the sera for antibodies to sperm, zona pellucida, and trophoblast or trophoblast products. In addition, antibodies to certain microbial antigens and to various leucocyte and organ antigens were investigated. The results of these studies are presented in the following papers.

Antibodies↗