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PubMed2002

[Who are the users of emergency contraception?].

INTRODUCTION: A user profile is necessary in order to direct future campaigns for emergency contraception (EC). MATERIAL AND METHODS: Over a three-month period, 423 women with prescriptions for EC were consecutively entered in the study, which was carried out in four inner-city pharmacies in Copenhagen, Denmark. RESULTS: The median age was 24 years (range 13-50 years). Most women (73%) were first-time users of EC. The reason for the current need for EC was most often condom failure (54%) or non-use of any contraceptive method (41%). Only six women (1.4%) reported non-use of contraception because of their knowledge of EC and only four women (0.9%) reported EC as the usual method of contraception. Knowledge about EC more often came from family or friends (51%) and advertising (47%), than from general practitioners (26%) or through sex education in schools (3%). Altogether 282 women (69%) received EC from a doctor in the medical emergency service or a casualty ward. DISCUSSION: Overall, EC is used as recommended. Its availability does not seem to reduce the use of safer contraceptive methods. The mandatory sex education in school should include information on EC.

Adolescent↗
PubMed2002

Attitudes towards contraceptive pill use in two different populations in Thrace, Greece.

OBJECTIVE: To investigate the differentiation in attitudes towards contraceptive pill use in two different populations in Thrace, Greece. A retrospective study on representatives of the two major religious subgroups in Thrace: 127 Orthodox Christians and 120 Muslims. The questionnaire was designed to investigate women's opinions concerning the possible beneficial and adverse effects of the contraceptive pill. RESULTS: In comparison with Christians, a higher percentage of Muslims responded 'don't know' in questions about the pill's efficacy in regulating menses (p = 0.019), 'yes' concerning the inconvenience of daily uptake (p = 0.032) and the pill's contribution to nausea (p = 0.003), and 'maybe' in the question concerning the pill's contribution to depression and headaches (p < 0.001). A higher percentage of Christians responded 'yes' concerning the pill's contribution to depression and headaches, and 'don't know' concerning the pill's contribution to nausea. There were no significant differences in the responses to the remaining questions, and it was clear that most women believed that use of the pill is correlated with increased risk of cardiovascular disease and cancer. CONCLUSIONS: Muslims appeared more reluctant than Christians to use the pill as a contraceptive method. Christians seemed to be better informed about the pill's phamacological actions and beneficial effects, but both populations were unaware of current information regarding the pill's safety. There is a need to promote information about these topics in Thrace.

Adolescent↗
PubMed2002

Current perspectives on emergency contraception.

Emergency contraception is safe and effective for preventing an unplanned pregnancy, although it is not widely used. Widespread and appropriate use of emergency contraception should be encouraged as it is a promising means to arrest the increasing abortion rate. It is therefore important for all doctors to be able to prescribe emergency contraceptive pills and to educate women of reproductive age about emergency contraception. This article provides an update on the prescription of emergency contraceptives so that doctors may become more confident at prescribing emergency contraceptives and educating women about this back-up contraceptive. The current changes in the delivery of emergency contraceptive pills from prescription-only through self administration to over-the-counter sales will be discussed.

Contraception Behavior↗
PubMed1976

The record of family planning programs.

In the developing countries in recent years there has been a great expansion of public programs to provide modern means of fertility control. This paper is an effort to appraise the demographic impact of such programs through a comprehensive evaluation of the record. The paper briefly reviews the criticisms of such programs and the historical and comparative background before turning directly to issues of performance. After establishing the broad range of acceptance, the paper reviews the nature of acceptors and of fertility control methods as they affect overall impact. Then follow a series of tabulations and analyses of country performance by both social setting and program effort in an attempt to discern the effect of "modernization" and "family planning" in line with the current controversy over their relative importance. That detailed analysis is followed by an extensive review of 14 country cases, similarly organized, plus brief summaries of 15 major experiments/demonstrations in this field and one example of a developed country program. After a brief section on the alternatives to family planning programs, the paper concludes with a summary of major findings-underlined in the text-and the authors' personal commentary on their implications for both study and action.

Abortion, Legal↗
PubMed2002

[No reduced number of abortions despite easily available emergency contraceptive pills. Studies of women's knowledge, attitudes and experience of the method].

Despite the fact that emergency contraceptive pills (ECP) have become easily available across the country during recent years, abortion numbers continue to rise in Sweden, especially in the young age groups (< 25). In a series of studies, we have investigated knowledge, attitudes and experience of ECP among young women. Our results show that, whereas most women are aware of the method, many lack knowledge about the mechanism of action and time frames for best use, which could explain why ECPs are not used by more than a fraction of women who might have had benefit from their use. Since half of the women requesting a termination of pregnancy stated that they would have used ECP if they had had them available at home at the time of the unprotected intercourse which led to an unintended pregnancy, it seems reasonable to encourage women to keep ECPs at home, in case the need should arise. It is important that ECPs are available without prescription, but beyond that, much more information about ECP is necessary in order for the method to be widely accepted and used as a back-up after failure with other contraceptives.

Abortion, Legal↗
PubMed2003

[Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods].

OBJECTIVE: To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. MATERIAL AND METHODS: A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. RESULTS: Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR = 3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR = 2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. CONCLUSIONS: These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical insurance and those living in semi-urban settings. It is also recommended to conduct studies on family planning education programs that can be introduced earlier in the school system in Mexico.

Adolescent↗
PubMedDate not supplied

Evaluation of the efficacy of a nonlatex condom: results from a randomized, controlled clinical trial.

CONTEXT: To reduce unintended pregnancy and HIV infection, it is critical to develop reliable male condoms that will attract consumers who reject conventional latex condoms. METHODS: In a prospective clinical trial conducted in 1998-2000, 830 monogamous couples were randomized in equal numbers to use either a nonlatex condom or a commercial natural latex condom for six months as their only method of birth control. Couples completed detailed reports for the first five condom uses and recorded intercourse and condom use in coital diaries. Pregnancy rates associated with typical and consistent condom use were calculated using life-table analysis. Rates of clinical failure (condom breakage or slippage) were determined for the first five condom uses. RESULTS: During the first five uses, the nonlatex condom had a higher frequency of breakage or slippage during intercourse or withdrawal (4.0%) than latex condoms (1.3%); the breakage rate for the nonlatex condom was about eight times that of latex condoms. The six-cycle typical-use pregnancy rate did not differ significantly between users of nonlatex (10.8%) and latex condoms (6.4%). The six-cycle consistent-use pregnancy rate was higher for nonlatex condom users than for latex condom users (4.9% vs. 1.0%). CONCLUSIONS: The data present strong indirect support for public health messages that promote the use of latex condoms and, for individuals who cannot or are unwilling to use latex condoms, the use of nonlatex condoms for prevention of pregnancy and disease.

Adult↗
PubMedDate not supplied

Evidence from peninsular Malaysia of breastfeeding as a contraceptive method.

This report examines Malaysian women's perceptions of the contraceptive effect of breastfeeding, the determinants of their perceptions, and any effect these perceptions might have on nursing duration and contraceptive use. The report also considers whether women are consciously replacing breastfeeding with modern contraceptive methods. Data from the 1976 Malaysian Family Life Survey are analyzed, and the author concludes that Malaysian women do perceive that breastfeeding has a contraceptive effect, but that this perception is not universal. Ethnicity and desire for a particular family size are the most significant determinants of this perception. Finally, Malaysian women's recognition of the contraceptive effect of nursing does not influence either the duration of their breastfeeding or their adoption of contraception. Malaysian women may not be abandoning breastfeeding to adopt contraception. More probably, breastfeeding declines and contraceptive prevalence increases with modernization.

Adolescent↗
PubMed2003

Discontinuation of contraceptive use in Ghana.

Using data from the Ghana Demographic and Health Survey 1998, this paper analyzed the duration of use of a contraceptive method and the reasons for its non-use given by former users of contraception. The results showed that the duration of use tended to be short, particularly so for the use of condom and withdrawal. Injectable contraceptives and periodic abstinence tended to be used for relatively long periods. After type of method, a woman's age and residence (urban or rural) were the most significant predictors of duration of use. The reasons for not currently using contraception given by significant numbers of former users of pill and injectable contraceptives should concern service providers and educators.

Adolescent↗
PubMedDate not supplied

Contraceptive use and sterilization among Puerto Rican women.

A comparison of contraceptive use in the early to mid-1980s among married Puerto Rican women aged 15-49 in the New York City area reveals that island-born Puerto Rican women living in New York rely on female sterilization to nearly the same extent as do women living in Puerto Rico (45% and 41%, respectively) and that mainland-born Puerto Rican women use sterilization as much as do all women in the United States (19% for both groups). Puerto Rican women in New York use reversible methods to a greater extent than do women in Puerto Rico (22% v. 16%), but to a lesser extent than do all women in the United States (37%). Although mainland-born Puerto Rican women in New York use reversible methods more than do island-born women in New York (42% v. 23%), they tend not to adopt these methods to the same extent as do all U.S. women during the early reproductive years, when education and employment are critical to socioeconomic attainment.

Adolescent↗
PubMed2003

A comparative analysis of the modification of sexual desire of users of oral hormonal contraceptives and intrauterine contraceptive devices.

OBJECTIVE: To compare the influence of oral hormonal contraceptives (OCs) and the use of intrauterine contraceptive devices (IUDs) on the modification of sexual desire. MATERIALS AND METHODS: A prospective observational study of 1073 women using OCs or an IUD at the Family Planning Center 'Marina Alta' in Alicante, Spain. In order to evaluate the relative risk regarding the decrease in libido attributed to each contraceptive method, a logistic regression analysis was undertaken which considered the factors of age adjustment, level of studies, family planning information, relationship with partner, age when sexual relationships were initiated, parity, contraceptive method previously used and the duration of use of the contraceptive method. RESULTS: No differences in the decrease of sexual desire were observed between the use of the OC and IUD (odds ratio (OR) 1.32; 95% confidence interval (CI) 0.70-2.49), yet differences were noted, however, in relation to age (OR 1.05; 95% CI 1.01-1.10). Although these differences were not statistically significant, a high level of awareness regarding family planning was shown to increase sexual desire when compared to a lower level of information on this subject (OR 0.64; 95% CI 0.41-1.01). Sexual desire was seen to decrease if the quality of the relationship with the partner was average (OR 2.24; 95% CI 1.36-3.69) or poor (OR 4.69; 95% CI 1.93-11.4). Nulliparous women showed a greater decrease in sexual desire in relation to women who had already given birth (OR 1.57; 95% CI 1.00-2.47). Sexual desire was greater if the contraceptive method had already been in use for 6-12 months (OR 0.41; 95% CI 0.17-0.98). CONCLUSIONS: Sexual desire does not vary in relation to the use of OCs or IUDs, yet it does decrease with age, in nulliparous women and in those with an average or poor relationship with their partner. Furthermore, sexual desire shows an increase between the first 6 and 12 months of contraceptive treatment.

Adolescent↗
PubMed2003

Why do university students use hormonal emergency contraception?

OBJECTIVES: To establish why university students in Finland, who have easy access to well-affordable health services, still use hormonal emergency contraception. METHOD: All students who sought emergency contraception in the Tampere Student Health Station during the period from 1 September 2000 to 31 December 2001 received a questionnaire on their use of it. Of the total, 114 (67%) were returned. RESULTS: Two-thirds of respondents experienced condom failure, and the remainder used no contraception. In open answers, respondents gave many explanations as to why they had used no contraception, e.g. having been over-passionate or drunk. CONCLUSION: Finnish students use emergency contraception, but to no great extent. Our results indicate that service providers should pay attention to sexual health in the full sense but not omit to give detailed advice on condom use during counselling.

Adult↗
PubMed2003

[Influence of a new monophasic oral contraceptive on body metabolism].

OBJECTIVES: Androgenic activity as adverse effects of oral contraception can influence on discontinuation of the therapy. New gestagens used in oral contraception do not reveal androgenic activity. The aim of the study is to assess the safety of the therapy with a new monophasic oral contraception on metabolism. MATERIAL AND METHODS: 99 healthy women aged mean 23.5 +/- 2.1 years were enrolled in the study. They received a monophasic contraceptive pill containing 30 micrograms ethinylestradiol and 2.0 mg dienogest during 13 cycles. Biochemical parameters in blood were measured before and after 6 and 12 cycles of therapy. RESULTS: The concentrations of liver enzymes, glucose and lipids did not differ significantly. CONCLUSIONS: The study suggests that a new monophasic oral contraceptive pill containing 30 micrograms ethinylestradiol and 2.0 mg dienogest is safe and good tolerated preparation.

Adolescent↗
PubMed2003

'Failed' contraception in a rural South African population.

OBJECTIVE: To investigate whether the free availability of contraception affects the need for termination of pregnancy (TOP). DESIGN: Case-control study. SETTING: South African rural hospital. POPULATION: Three thousand and ninety-five TOP seekers and 439 non-pregnant controls. METHODS: Structured questionnaire followed by ultrasonography. MAIN OUTCOME MEASURES: Current use or recent discontinuation of contraception and the reason for discontinuation. RESULTS: Less than one-third (28.6%) of TOP seekers claimed to be using contraception versus 85.0% of controls. Injectable contraception (IC) was preferred by the controls and oral contraception (OC) by TOP seekers (chi 2 = 48.5, p < 0.0001, OR 0.34 (95% confidence interval 0.25, 0.46)). The percentage of discontinuation of hormonal contraception was higher in controls (chi 2 = 6.3, p = 0.012, OR 0.51 (0.31, 0.85)). The reason for discontinuation of hormonal contraception was obtained from 31.2% of TOP seekers and 63.3% of controls; no reason for discontinuation was acknowledged by 30.1% of the former and 6.3% of the latter (chi 2 = 33.4, p < 0.0001, OR 6.40 (3.25, 12.56)). Side-effects of hormonal contraception prompted more discontinuation in the failed-contraception group (chi 2 = 120.5, p < 0.0001, OR 49.4 (21.6, 112.5)). Poor compliance and absence of an acknowledged reason for discontinuing hormonal contraception resulted in 173 unwanted pregnancies. CONCLUSION: In South Africa two main components of women's reproductive health and rights are freely available, namely contraception and TOP. Not using contraception is one of the main causes of unwanted pregnancy. Better education of both service providers and users is needed to improve use, compliance and perseverance with contraception.

Abortion, Induced↗