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At least 1,351 records · Page 75Linked to original sources
PubMed1999

Issues in balancing teenage clients' confidentiality and reporting statutory rape among Kansas Title X clinic staff.

Through Federal welfare reform, Congress directed states to aggressively enforce statutory rape laws. Family planning professionals deal with many adolescent clients, and their support for such enforcement or willingness to report is unclear. The authors of this study examined current attitudes and practices of family planning program managers (FPPMs) about statutory rape law enforcement, including current reporting practices. In 1997, all 77 local Kansas Title X FPPMs were surveyed. Structured telephone interviews were conducted with 10 FPPMs to add detail to quantitative responses. Sixty-eight FPPMs responded to the written survey (88%). Of these, 79% supported aggressive enforcement, and 43% thought enforcement would reduce adolescent pregnancy rates. With increased enforcement, 38% believed teenagers would be discouraged from seeking reproductive health care, compared to 41% who believed they would not. Among key informants, all of whom were FPPMs, willingness to report cases was mixed, with those who would report wanting the flexibility to judge on a case-by-case basis. For those not reporting cases, confidentiality concerns overrode beliefs in any positive outcome of enforcement. Kansas Title X FPPMs strongly supported aggressive enforcement, but had mixed beliefs about negative consequences. Among those interviewed, there were also mixed beliefs and practices about reporting. Reporting from FPPMs will be sporadic and arbitrary unless protocols are developed and laws are clarified.

Adolescent↗
PubMed1992

Alternate scenarios for population control in Pakistan: the issue of contraceptive method mix.

The authors review Pakistan's population program, with a focus on the ideal mix of contraceptive methods needed to slow population growth. "Our objective in this exercise is to estimate the extent of services required to achieve a certain level of the Contraceptive Prevalence Rate (CPR) necessary to bring fertility down to a level desired by women." Comparison is made between single- and multiple-method approaches.

Asia↗
PubMed1977

A study of abortion in countries where abortions are legally restricted.

In countries where induced abortion is permitted, national family planning programs are able to combine pre- and postconceptive fertility control methods to maximize success in achieving personally desired fertility levels and nationally desired growth levels. The proscription against induced abortion tends to produce criminal abortions and consequent morbidity and mortality which, in some countries, are often recognized as a national health problem. The International Fertility Research Program has undertaken this study of incomplete, inevitable, threatened and septic abortion cases, using a standard data collection instrument, to facilitate comparisons across institutions and countries. The data gather since 1971 in nine Asian, African and Middle Eastern hospitals includes 7,331 cases. Policies of the participating institutions with respect to what constitutes a therapeutic abortion affected the proportions of spontaneous abortions and of abortions induced outside the hospital and inside the hospital. Women treated for induced abortion tended to be of higher parity and more likely to have attained their desired family size than patients treated for spontaneous abortions. Morbidity rates were quite low for patients treated in centers where vacuum aspiration was mainly used, particularly in contrast to the morbidity rates for patients treated in centers where dilatation and curettage was used exclusively. High mortality rates in patients admitted with sepsis confirm the need not only for improvement of clinical procedures but also for reconsideration of the legal issues since many patients admitted with sepsis can be assumed to have had abortions induced.

Abortion, Illegal↗
PubMed1981

Contraception and lactation.

Lactation worldwide is estimated to prevent more births than all organized family planning programs, and thus has a definite contraceptive action. In addition, it contributes to better infant nutrition and well-being. In some societies women do not cohabit while lactating and therefore need no contraception. This situation is being eroded, and in any case does not apply generally. The risk of pregnancy increases with the length of lactation, and thus some form of added contraception needs to be adopted during lactation. Because of the nutritional value of lactation, the CMC deprecates the exploitative commercial advertising and promotion of bottlefeeding that exists in many parts of the world. It recommends that the IPPF and its member associations should actively promote breastfeeding. Since pregnancy can occur during lactation, additional contraception is desired. It should be remembered that IUDs, spermicides, mechanical methods, depot medroxyprogesterone acetate, progestagen-only oral contraceptives (OCs), and sterilization have no adverse effects on lactation. Evidence is accumulating that combined OCs have an adverse effect on the quantity and possibly the quality of breastmilk. Therefore, much greater caution should be exercised in distributing combined OCs than previously. Combined OCs should not be started until lactation is well established, and ideally not before 6 months or until the infant is weaned, whichever occurs 1st. If, however, no alternative contraception is available then OCs may be used earlier.

Breast Feeding↗
PubMed1988

Minimizing adverse effects of low birthweight: four-year results of an early intervention program.

The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.

Child, Preschool↗
PubMedDate not supplied

Postpartum and postabortion use of the TCu-220C and Lippes Loop: A comparative study.

The postinsertion experience of 274 women with the TCu-220C and 522 women with the Lippes Loop in a university hospital family planning program in Bogotá, Colombia, has been studied by a life-table method. Pregnancy and continuation rates are similar for both devices. Although the expulsion rate of the TCu-220C is significantly lower than that of the Loop up to 12 months, higher removal rates for the TCu-220C account for the similarity in overall continuation.

Abortion, Spontaneous↗
PubMed1996

Is tubal sterilization associated with an increased risk of subsequent hysterectomy but a decreased risk of ovarian cancer? A review of recent literature.

Recent epidemiologic studies have suggested that tubal sterilization (TS) may lead to an increased incidence of subsequent hysterectomy but a decreased risk of ovarian cancer. This review evaluates the nature and magnitude of these two relationships, which should be of great concern and interest to women, clinicians and the administrators of family planning programs. The positive relationship between TS and subsequent hysterectomy is more likely to be of a motivational rather than biological nature, and a considerable number of unnecessary hysterectomies after TS could be avoided by changing the attitudes of physicians and women. The inverse relationship between TS and ovarian cancer appears causal, although the exact biological mechanisms remain to be clarified. Theoretically, this non-contraceptive beneficial effect of TS could be used as a primary preventive measure to curb the incidence of the highly fatal ovarian cancer. However, a number of medical, ethical, and economic questions attending use of a generally irreversible contraceptive procedure as a preventive measure must first be answered. The issue of whether TS is associated with any long-term sequelae, and, if so, whether the association is of a cause-and-effect nature or a by-product of time passage and aging of the woman, should be addressed by well-designed studies.

Case-Control Studies↗
PubMed1996

Dihydroxyprogesterone acetophenide 150 mg + estradiol enantate 10 mg as monthly injectable contraceptives.

A survey among users and health personnel participating in the Salvadorian Social Security Institute (ISSS) Family Planning Program revealed interest in including a monthly preparation for injection as a contraceptive method offered by this Institution. The formulation containing dihydroxyprogesterone acetophenide (DHPA) 150 mg + estradiol enantate (E2EN) 10 mg was chosen for conducting an open and prospective study of efficacy and tolerability. Between January 1992 and March 1994, 7054 women were treated with this product for a total of 60010 months. A sample composed of 4505 women treated at this Institution confirmed that average users are young, have one or two children, do not show a particular geographical distribution and choose the monthly injection instead of oral contraceptives as the first contraceptive method or for the puerperium. The study formulation showed a high efficacy (Pearl Index: 0.018) and tolerability (general withdrawal rate throughout the study: 27.09%). The most frequent adverse events included bleeding disorders, headache and mastalgia; their incidence decreased spontaneously from the sixth month (3.9%), reaching 0% after two years. Treatment was discontinued due to adverse events in 3.47% of women. No significant bodyweight or systolic and diastolic blood pressure alterations were observed. Based on these results, the monthly injectable contraceptive was included in the basic product list at ISSS.

Adolescent↗
PubMed1985

Acceptability of the IUD in a Jordanian community.

Jordan has a population of about three million without a government family planning program. In this study, carried out in two medical centers in Amman, Jordan, over a period of two years, 600 copper intrauterine devices were inserted, with a failure rate of 2.8%.

Adult↗
PubMed1985

Recent changes in the sociodemographic profile of sterilization acceptors in Nepal.

The records of 8056 Nepalese males and 9291 females sterilized from 1979-1983 were analyzed. Compared with data from previous studies (1970-1976), significant decreases occurred in the average age of female acceptors (30.6 vs. 33.1, P less than 0.01) and wives of male acceptors (28.4 vs. 31.7, P less than 0.01). Also, the average number of living children per couple decreased by one child (4.9-3.9, P less than 0.01) for male acceptors and 0.6 (4.8-4.2, P less than 0.01) for female acceptors. Finally in 83.2% of the cases, the operation was performed within 3 years of the last delivery.

Adult↗
PubMed1988

Maternal mortality in Indonesia and Egypt.

Twenty-three percent of deaths to women of reproductive age (15-49 years) in Bali, Indonesia and Menoufia, Egypt were due to maternal causes. Among the younger women, the percentage was even higher. In both areas complications of pregnancy and childbirth were a leading cause of death (the first cause in Bali, the second in Menoufia). In both sites, postpartum hemorrhage was the most common cause of maternal death. Relative to the United States, the number of maternal deaths per 100,000 live births was 20 times higher in Menoufia and 78 times higher in Bali. Families of women of reproductive age who died were interviewed about the conditions leading to death and other characteristics of the deceased. Completed histories were reviewed by a Medical Panel who were able to assign a cause of death in more than 90% of cases. Two-thirds of the maternal deaths occurred to women who were over 30 and/or who had 3 children--the usual targets of family planning programs. Other possible intervention strategies include antenatal outreach programs, training of traditional birth attendants, and better hospital management of obstetric emergencies.

Adolescent↗