WorldWideScience

Sample records for pregnancy symptoms contraceptive

  1. Adolescent pregnancy and contraception.

    Science.gov (United States)

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena

    2014-09-01

    7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods.

  2. Contraception and unwanted pregnancy.

    Science.gov (United States)

    Adler, N E

    1984-01-01

    An overview of research findings in the US on the psychological and social variables associated with unwanted pregnancy and on the consequences of unwanted pregnancy was provided. Studies which examined personality differences between women and adolescent females who practicaed effective contraception and thesse who experienced unwanted pregnancy consistently found that the latter group, compared to the former group, had lower self-esteem, were more passive, tended to engage in more risk taking behavior, and were less achievement and future oriented. Several studies found that those who experienced unwanted pregnancies were often poorly informed about sex and contraception. Sex education, however, did not always lead to an increase in the knowledge and use of contraception. Sex education was unable to overcome the effects of male and female sexual socialization processes in which adolescents were inculcated with a double sex standard and females with a sense of guilt concerning the use of contraception. Numerous studies showed that unperceived or denied motives played a role in the occurence of unwanted pregnancies. Unwanted pregnancies were associated with loss, and these pregnancies probably represented an attempt to replace the loss of a loved person. Women who were in conflict about their work and mothering roles, and women who did not want to work but felt pressured to do so, frequently had inappropriate pregnancies. Teenagers who were not interested in school or in future careers often had unwanted pregnancies. These pregnancies probably represented an attempt to establish a social identity. W.B. Miller identified 8 stages in the reproductive life span when unwanted pregnancies were most likely to occur. These stages were 1) the initial stage of adolescence when the individual may not be fully aware of her fertility, 2) the 1st 6 months following the initiation of sexual activity, 3) at the beginning of a new relationship, 4) during the initial stage of

  3. Preventing Unintended Pregnancy Among Young Sexually Active Women: Recognizing the Role of Violence, Self-Esteem, and Depressive Symptoms on Use of Contraception.

    Science.gov (United States)

    Nelson, Deborah B; Zhao, Huaqing; Corrado, Rachel; Mastrogiannnis, Dimitrios M; Lepore, Stephen J

    2017-04-01

    Ineffective contraceptive use among young sexually active women is extremely prevalent and poses a significant risk for unintended pregnancy (UP). Ineffective contraception involves the use of the withdrawal method or the inconsistent use of other types of contraception (i.e., condoms and birth control pills). This investigation examined violence exposure and psychological factors related to ineffective contraceptive use among young sexually active women. Young, nonpregnant sexually active women (n = 315) were recruited from an urban family planning clinic in 2013 to participate in a longitudinal study. Tablet-based surveys measured childhood violence, community-level violence, intimate partner violence, depressive symptoms, and self-esteem. Follow-up surveys measured type and consistency of contraception used 9 months later. Multivariate logistic regression models assessed violence and psychological risk factors as main effects and moderators related to ineffective compared with effective use of contraception. The multivariate logistic regression model showed that childhood sexual violence and low self-esteem were significantly related to ineffective use of contraception (adjusted odds ratio [aOR] = 2.69, confidence interval [95% CI]: 1.18-6.17, and aOR = 0.51, 95% CI: 0.28-0.93; respectively), although self-esteem did not moderate the relationship between childhood sexual violence and ineffective use of contraception (aOR = 0.38, 95% CI: 0.08-1.84). Depressive symptoms were not related to ineffective use of contraception in the multivariate model. Interventions to reduce UP should recognize the long-term effects of childhood sexual violence and address the role of low self-esteem on the ability of young sexually active women to effectively and consistently use contraception to prevent UP.

  4. Primary ovarian pregnancy with intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Sabita Saichandran

    2015-08-01

    Full Text Available Primary ovarian pregnancy is a rare variant of extra-uterine pregnancies. However the cause for primary ovarian pregnancy is still obscure. Some studies have reported a strong correlation of this condition with intrauterine contraceptive device (IUCD. The diagnosis of ovarian ectopic pregnancy is seldom made before surgery though ultrasound proves to be an invaluable tool for its diagnosis. We describe here about a case of primary ovarian pregnancy which was diagnosed only at the time of operation and was managed with wedge resection of the ovary. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1191-1193

  5. sexuality, contraception and unintended pregnancy among female ...

    African Journals Online (AJOL)

    Dr. E. P. Gharoro

    AMONG FEMALE STUDENT NURSES IN CALABAR, NIGERIA ... influence sexual behaviour and contraceptive use among young women. Methods – A ... sexuality, knowledge and use of modern ... unwanted pregnancy is by abortion 9. ... being young adults, majority aged 15- ..... cultural attitudes and the judgmental.

  6. Ectopic pregnancy after levonorgestrel emergency contraception

    Directory of Open Access Journals (Sweden)

    Ahmet Karatas

    2013-08-01

    Full Text Available Levonorgestrel Emergency Contraception (LNG-EC is the safest and the most commonly used oral regimen that can be used after an unprotected intercourse. Although it is highly effective, failures can occur especially if it is used in the peri /or postovulatory period. It can not inhibit ovulation if used in these periods and the altered tubal motility together with the ciliary dysfunction can prevent the transfer of the fertilized ovum from the fallopian tube to the endometrial cavity, causing an ectopic pregnancy, which is one of the important concerns after failed LNG-EC. This risk was reported not to be higher than the risk of ectopic pregnancy observed in the general population, but the users of this medication should still warned about this risk. Here we report a case of ectopic pregnancy from Turkey after midcyclic use and failure of LNG-EC. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 749-750

  7. Ectopic pregnancy following levonorgestrel emergency contraception: a case report

    Science.gov (United States)

    Kaymak, Oktay; Şimşek, Yavuz; Doğanay, Melike; Yıldız, Yasemin; Mollamahmutoğlu, Leyla

    2010-01-01

    Hormonal contraceptive pills containing 750 microgram levonorgestrel are the most commonly used postcoital contraceptive method because of their high efficacy and fewer side effects. Emergency contraceptive pills containing levonorgestrel present their effects by several mechanisms, including delayed tubal transport of the ovum. A delay of tubal transportation of an ovum is also one of the possible etiologic factors of tubal ectopic pregnancies. There are limited data on the risk of ectopic pregnancy following levonorgestrel treatment as an emergency contraception. Here, a case of tubal pregnancy associated with the use of levonorgestrel containing emergency contraceptive pills has been presented along with discussion of the relevant literature. PMID:24591928

  8. [Badly resolved triad: sexuality, contraception and pregnancy].

    Science.gov (United States)

    Oliane, A H

    1993-09-01

    Sexuality, contraception, and pregnancy are inseparable, yet they are a taboo subject both for the whole country and for adolescents. The ever-earlier awakening of sexuality requires educational mechanisms that assign fundamental importance to the implementation of social, psychological, and cultural protection strategies. The resolution of pregnancy is dependent on income just as maternity is secondary to financial independence. The majority of rich adolescents get an abortion, while poor adolescents carry to term their undesired pregnancies. Adolescence is a phase of confusion with peculiar psychosocial and cultural aspects. In the low-income population the start of formal education is precarious and delayed, an important factor in the discrepancies between well-to-do and poor social classes. Pregnancy and abortion rates vary according to economic conditions, however, their resolution clearly shows ethical, religious, and moral subjectivity. The media, rural exodus, increasing urbanization, and the economic crisis make maternity a less dominant aspect of women's lives. Young people do not obtain the necessary information for safeguarding their fertility because of the lack of specialized services, thus they are uncertain about what the health care system can provide. Much opportunity is lost because professionals are too busy or too disinterested to listen to these alienated youngsters. Preconceived notions, disinformation, and uncertainty coupled with emotional obstacles and noncooperation of the partner result in the use of contraceptives becoming a complex and difficult problem to resolve. It is necessary to alter our perceptions of adolescent sexual development. In Brazil, where more than half of the population is young, it is indispensable to devise collective programs not restricted to conventional medical practices to reach all adolescents.

  9. Contraceptive discontinuation and unintended pregnancy: an imperfect relationship.

    Science.gov (United States)

    Curtis, Siân; Evens, Emily; Sambisa, William

    2011-06-01

    Contraceptive discontinuation is a common event that may be associated with low motivation to avoid pregnancy. If this is the case, a substantial proportion of pregnancies that follow discontinuation will be reported as intended. Demographic and Health Survey data from six countries (Bangladesh, the Dominican Republic, Kazakhstan, Kenya, the Philippines and Zimbabwe) over the period 1999-2003 were used to explore the proportions of pregnancies women reported as intended or unintended following various contraceptive behaviors. Multivariate logistic regression analysis was used to examine the characteristics of women who reported births as intended when they followed contraceptive failure or discontinuation for reasons other than a desire for pregnancy. The proportion of births reported as intended following contraceptive failure ranged from 16% in Bangladesh to 54% in Kazakhstan, and the proportion reported as intended following discontinuation for reasons other than a desire for pregnancy ranged from 37% in Kenya to 51% in Kazakhstan. In at least half the countries, associations were found between selected women's characteristics and their reports that births following either contraceptive failure or discontinuation were intended: Factors that were positively associated were women's age and the time elapsed between contraceptive discontinuation and the index conception; factors that were negatively associated were increasing number of living children and reporting method failure as opposed to method discontinuation. These findings suggest that underlying variation in the motivation to avoid pregnancy is an important factor in contraceptive discontinuation.

  10. Contraceptive practice, unwanted pregnancies and induced abortion in Southwest Nigeria.

    Science.gov (United States)

    Omideyi, Adekunbi Kehinde; Akinyemi, Akanni Ibukun; Aina, Olabisi Idowu; Adeyemi, Adebanjo Babalola; Fadeyibi, Opeyemi Abiola; Bamiwuye, Samson Olusina; Akinbami, Catherine Abiola; Anazodo, Amechi

    2011-01-01

    Despite widespread awareness of and access to modern contraception, high rates of unwanted pregnancies and abortions still persist in many parts of the world, even where abortion is legally restricted. This article explores perspectives on contraception and abortion, contraceptive decision-making within relationships, and the management of unplanned pregnancies. It presents findings from an exploratory qualitative study based on 17 in-depth interviews and 6 focus group discussions conducted in 2 locations in Nigeria in 2006. The results suggest that couples do not practice contraception consistently because of perceived side effects and partner objections. Abortion is usually resorted to because pregnancy was unwanted due to incomplete educational attainment, economic hardship, immaturity, close pregnancy interval, and social stigma. Males usually have greater influence in contraceptive-decision making than females. Though induced abortion is negatively viewed in the community, it is still common, and women usually patronise quacks to obtain such services. An abortion experience can change future views and decisions towards contraception. Family planning interventions should include access to and availability of adequate family planning information. Educational campaigns should target males since they play an important role in contraceptive decision-making.

  11. [Contraception and breast feeding. Spacing of pregnancies. Present concepts].

    Science.gov (United States)

    Buitrón-García-Figueroa, Rafael; Malanco-Hernández, Luz María; Lara-Ricalde, Roger; García-Hernández, Alejandra

    2014-06-01

    The risk of pregnancy in breastfeeding should be a concern of women. Family planning programs in the postnatal period contraceptive choices offer high efficiency. Breastfeeding is a natural contraception method (LAM) as a contraceptive shield has 98 % efficiency. Women should consider using an alternate contraceptive method when feeding requirements for this method to be effective are not met. Some of contraceptive alternatives in lactation include hormonal methods. According to the Medical Eligibility Criteria for Contraceptive Use WHO combined hormonal methods are contraindicated during breast feeding, hormonal progestogen only method are considered only in Group 3 and Group 1 immediate postpartum after 6 weeks postpartum. There are modifications to these criteria by the CDC and the UK for the use of these hormones in early in lactation.

  12. Ectopic Pregnancy After Plan B Emergency Contraceptive Use.

    Science.gov (United States)

    Steele, Brianne Jo; Layman, Kerri

    2016-04-01

    Pregnancy outcomes after emergency contraceptive use has been debated over time, but review of the literature includes mechanisms by which these medications may increase the chance of an ectopic pregnancy. Such cases are infrequently reported, and many emergency providers may not readily consider this possibility when treating patients. This is a case presentation of ectopic pregnancy in a patient who had recently used Plan B (levonorgestrel) emergency contraceptive. She presented with abdominal pain and vaginal spotting, and was evaluated by serum testing and pelvic ultrasound. She was discovered to have a right adnexal pregnancy. She was treated initially with methotrexate, though she ultimately required surgery for definitive treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report aims to bring a unique clinical case to the attention of emergency providers. The goal is to review research on the topic of levonorgestrel use and the incidence of ectopic pregnancies. The mechanism of action of this emergency contraceptive is addressed, and though no definite causal relationship is known between levonorgestrel and ectopic pregnancies, there is a pharmacologic explanation for how this event may occur after use of this medication. Ultimately, the emergency provider will be reminded of the importance of educating the patient on the possible outcomes after its use, including failure of an emergency contraceptive and the potential of ectopic pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Contraceptive practices and pregnancy intendedness among pregnant adolescents

    Directory of Open Access Journals (Sweden)

    Lanjakornsiripan W

    2015-03-01

    Full Text Available Wakul Lanjakornsiripan, Siriruthai Amnatbuddee, Kanok Seejorn, Yuthapong Werawatakul, Pilaiwan Kleebkaow, Ratana Komwilaisak, Sanguanchoke Luanratanakorn Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Background: Adolescent pregnancy is a major health problem in many developing countries.Objective: To assess contraceptive practices and pregnancy intendedness in pregnant adolescents.Materials and methods: This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR and 95% confidence interval (CI of independent predictors.Results: Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0% were currently in school. Seventy-five (37.5% participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%. Only two participants (1.0% had ever used an intrauterine device or implant. Participants’ age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94–14.04. Of the 200 participants, 132 (66.0% declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27–13.75 and participants’ age (aOR, 5.76; 95% CI, 2.42–13.70.Conclusion: Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants’ age was an independent factor

  14. Contraceptive medicalisation, fear of infertility and teenage pregnancy in Brazil.

    Science.gov (United States)

    Gonçalves, Helen; Souza, Ana D; Tavares, Patrícia A; Cruz, Suélen H; Béhague, Dominique P

    2011-02-01

    In Brazil, as in many other countries, teenage pregnancy is widely recognised as a public health problem. Buttressed by a public health science of the economics of teenage pregnancy that emphasises the postponement of parenthood as key to poverty reduction, young people's lack of appreciation for medical knowledge of contraceptives is most often credited for failed attempts to reduce teenage pregnancy. Based on a longitudinal ethnographic study conducted in Pelotas, Brazil, with young people over the course of 10 years, our study found that young women who became teenage parents did not lack medical knowledge but were, rather, highly medicalised. Not only were they intensely concerned with the ill-effects of oral contraceptives on possible future fertility, they also engaged in intricate routines of contraceptive-use as a way of testing and safeguarding their fecundity. Our analysis attends to the way these practices are shaped by the problematisation of the economics of teenage pregnancy, as well as by the gendering of cultural norms relating to the transition to adulthood. We theorise the results by considering how contraceptive medicalisation enabled some women to engage with the authority of normative society, while developing a potent off-stage critique of this authority and of what they considered to be discriminatory messages imbedded in scientific discourses on teenage pregnancy.

  15. Inflammatory Bowel Disease, the Oral Contraceptive Pill and Pregnancy

    Directory of Open Access Journals (Sweden)

    Robert N Allan

    1994-01-01

    Full Text Available This paper summarizes our current knowledge of the role of the oral contraceptive pill in the pathogenesis of inflammatory bowel disease (IBO, followed by a review of fertility in women and men. IBD and pregnancy, including the impact on the fetus and the mother with ulcerative colitis or Crohn’s disease, is considered. The safety of drug treatment during pregnancy, the outcome of surgical treatment during pregnancy and the problems that may be encountered during pregnancy in patients with an ileostomy or ileo-anal pouch are discussed, followed by a review of the short and long term prognosis of ulcerative colitis and Crohn’s disease partition.

  16. Pregnancy and contraceptive issues in renal transplant recipients.

    Science.gov (United States)

    Karkar, Ayman

    2008-03-01

    Fertility is improved within months and conception is achieved within one to six years after kidney transplantation. Pregnancy is safe and has little effect on long-term graft survival, but has increased maternal and fetal risks. Pregnancy is contraindicated in the first two years post-kidney transplantation due to increased risk of acute rejections and higher doses of immunosuppressive drugs. Poor renal function, uncontrolled diabetes mellitus and hypertension are other contraindications. Family planning and counseling, and consideration of a suitable contraceptive method are essential before transplantation. Tubal ligation and vasectomy are permanent contraceptives with the least failure results. Combined pills are highly effective and are among the lowest failure rate contraceptives, but they interact with cyclosporine, and are contraindicated in patients with thromboembolism and deep vein thrombosis. Progesterone-only minipill has the advantage of avoiding the risks associated with estrogen, but has a higher failure rate than the combined pills. The barrier methods (condom and diaphragm) are effective and safe contraceptives and can prevent sexually transmitted diseases, but require motivated couples. Intra uterine devices are convenient contraceptives, but have higher failure rate and are associated with increased incidence of pelvic infection. Pregnancy in renal transplant recipients should be managed by a multidisciplinary approach in a tertiary centre.

  17. Pregnancy and Contraceptive Issues in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Karkar Ayman

    2008-01-01

    Full Text Available Fertility is improved within months and conception is achieved within one to six years after kidney transplantation. Pregnancy is safe and has little effect on long-term graft survival, but has increased maternal and fetal risks. Pregnancy is contraindicated in the first two years post-kidney transplantation due to increased risk of acute rejections and higher doses of immunosuppressive drugs. Poor renal function, uncontrolled diabetes mellitus and hypertension are other contraindications. Family planning and counseling, and consideration of a suitable contraceptive method are essential before transplantation. Tubal ligation and vasectomy are permanent contraceptives with the least failure results. Combined pills are highly effective and are among the lowest failure rate contraceptives, but they interact with cyclosporine, and are contraindicated in patients with thromboembolism and deep vein thrombosis. Progesterone-only minipill has the advantage of avoiding the risks associated with estrogen, but has a higher failure rate than the combined pills. The barrier methods (condom and diaphragm are effective and safe contraceptives and can prevent sexually transmitted diseases, but require motivated couples. Intra uterine devices are convenient contraceptives, but have higher failure rate and are associated with increased incidence of pelvic infection. Pregnancy in renal transplant recipients should be managed by a multidisciplinary approach in a tertiary centre.

  18. Swazi youths’ attitudes and perceptions concerning adolescent pregnancies and contraception

    Directory of Open Access Journals (Sweden)

    I S Ziyane

    2006-01-01

    Full Text Available This study investigated Swazi adolescents’ attitudes and perceptions concerning adolescent pregnancies and contraceptive practices in order to help address the continued challenge posed by large numbers of adolescent pregnancies in Swaziland. Opsomming Hierdie studie het Swazi adolessente se houdings en persepsies in verband met adolessente swangerskappe en voorbehoedpraktyke ondersoek om die volgehoue uitdaging van groot getalle adolessente swangerskappe in Swaziland aan te spreek. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  19. Determinants of emergency contraception non-use among women in unplanned or ambivalent pregnancies

    Directory of Open Access Journals (Sweden)

    Osmara Alves dos Santos

    2014-08-01

    Full Text Available Objective To analyze the determinants of emergency contraception non-use among women in unplanned and ambivalent pregnancies. Method Cross-sectional study with a probabilistic sample of 366 pregnant women from 12 primary health care units in the city of São Paulo, Brazil. A multinomial logistic regression was performed, comparing three groups: women who used emergency contraception to prevent ongoing pregnancies (reference; women who made no use of emergency contraception, but used other contraceptive methods; and women who made no use of any contraceptive methods at all. Results Cohabitation with a partner was the common determinant of emergency contraception non-use. No pregnancy risk awareness, ambivalent pregnancies and no previous use of emergency contraception also contributed to emergency contraception non-use. Conclusion Apart from what is pointed out in the literature, knowledge of emergency contraception and the fertile period were not associated to its use.

  20. Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai

    Science.gov (United States)

    Joshi, Beena; Velhal, Gajanan; Chauhan, Sanjay; Kulkarni, Ragini; Begum, Shahina; Nandanwar, Y. S.; Fonseca, Michelle; Baweja, Sujata; Turbadkar, Dilip; Ramchandran, Anita; Dalal, Asha; Shastri, Jayanti; Agrawal, Sachee; Panhale, Manisha; More, Vasundhara; Sanap, Pravin; Panchal, Renuka; Kanougiya, Suman

    2015-01-01

    Background: Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program's potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people. Objectives: To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV. Materials and Methods: A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire. Results: In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV). Conclusion: Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India. PMID:26170540

  1. Pregnancy and contraception in systemic and cutaneous lupus erythematosus.

    Science.gov (United States)

    Guettrot-Imbert, G; Morel, N; Le Guern, V; Plu-Bureau, G; Frances, C; Costedoat-Chalumeau, N

    2016-10-01

    A causal link has long been described between estrogen and systemic lupus erythematosus activity. Contraceptive and pregnancy management is now common for lupus patients, but pregnancy continues to be associated with higher maternal and fetal mortality/morbidity in systemic lupus erythematosus patients than among the general population. Potential complications include lupus flares, obstetric complications (fetal loss, in utero growth retardation, premature birth) and neonatal lupus syndrome. Association with antiphospholipid antibodies or antiphospholipid syndrome increases the risk of obstetric complications. Anti-SSA and/or anti-SSB antibodies put fetuses at risk for neonatal lupus. Improving the outcome of such pregnancies depends upon optimal systematic planning of pregnancy at a preconception counseling visit coupled with a multidisciplinary approach. Absence of lupus activity, use of appropriate medication during pregnancy based on the patient's medical history and risk factors, and regular monitoring constitute the best tools for achieving a favorable outcome in such high-risk pregnancies. The aim of this review is to provide an update on the management of contraception and pregnancy in systemic lupus erythematosus, cutaneous lupus and/or antiphospholipid syndrome in order to reduce the risk of complications and to ensure the best maternal and fetal prognosis.

  2. Contraceptive use and risk of unintended pregnancy in California.

    Science.gov (United States)

    Foster, Diana G; Bley, Julia; Mikanda, John; Induni, Marta; Arons, Abigail; Baumrind, Nikki; Darney, Philip D; Stewart, Felicia

    2004-07-01

    California is home to more than one out of eight American women of reproductive age. Because California has a large, diverse and growing population, national statistics do not necessarily describe the reproductive health of California women. This article presents risk for pregnancy and sexually transmitted infections among women in California based on the California Women's Health Survey. Over 8900 women of reproductive age who participated in this survey between 1998 and 2001 provide estimates of access to care and use of family-planning methods in the state. We find that 49% of the female population aged 18-44 in California is at risk of unintended pregnancy. Nine percent (9%) of women at risk of an unintended pregnancy are not using any method of contraception, primarily for method-related reasons, such as a concern about side effects or a dislike of available contraceptive methods. Among women at risk for unintended pregnancy, we find disparities by race/ethnicity and education in use of contraceptive methods.

  3. Ectopic pregnancy as contraceptive failure in patient with epilepsy.

    Science.gov (United States)

    Radaković, Branko; Goldstajn, Marina Sprem

    2012-12-01

    Epilepsy is a common neurologic condition which includes many women's health issues. Menstrual disorders, reproductive endocrinological disturbances, ovulatory dysfunction and infertility appear to be relatively frequent in women with epilepsy. Clinical decision making which contraceptive regimen is optimal for an individual woman with epilepsy is one of the most challenging tasks when taking care of women with epilepsy. A higher incidence of breakthrough bleeding and contraceptive failure was determined among women using antiepileptic drugs. There is the increased risk for contraceptive failure with the use of P450 3A4 enzyme-inducing antiepileptic drugs (AEDs) such as phenobarbital, carbamazepine, phenytoin, felbamate, topiramate and oxcarbazepine. Therefore, it is recommended to use noninducing AEDs, or for those who use inducing AEDs, the use of oral hormonal contraceptive pills which contained equal or more than 50 microg of estrogen, or intrauterine devices. The aim of the article is to present woman with epilepsy who was used combined low dose oral contraceptive pills containing 20 microg of ethinyl estradiol which in interaction with carbamazepine resulted with ectopic tubar pregnancy.

  4. [Adolescents and young subjects facing contraception, pregnancy and abortion].

    Science.gov (United States)

    Lesa, A M; Zurlo de Mirotti, S M; Barrón de Carbonetti, M; Villiarolo, P

    1995-01-01

    The objective aimed was to obtain information about the sexual behavior of adolescents and youths attending university as regards contraception, pregnancy and abortion and the knowledge of the Papanicolau test as a preventive, method for malignant diseases. An anonymous survey which was especially designed for this investigation was implemented with 438 students - 123 women and 315 men - divided into three groups according to age; between 17 - 20, 21 - 24 and more than 25 years-old. Taking into account the sexually active population. 70% of the men between 17-20 use contraceptive methods (condoms 98,6%) and so do 100% of the women of the same age (menstrual cycle control method 71,4%, contraceptive pills 14,2%, or her partner uses condom 21,4%). In the group of youths between 21-24 years old, 76,8% of the men and 82,7% of the women use contraceptive methods: 70% of the men use condoms and 30% contraceptive methods used by their patner, whereas 58,3% of the women use the menstrual cycle control method, 25% take pills and 8,3% use DIU. In the group of older youths 71,4% of the men use contraception methods (66,6% condoms) and 51,14% of the women (100% the menstrual cycle control method) and 25% add other methods to this one. Only 20,68% of the women stated having had pregnancies (all of the between 21 - 24). As there is the same porcentage of abortion in this age groups, it can be presumed that all the pregnancies ended in abortion. This contradicts the position stated regarding abortion due to the fact that 66% of the population questioned in the survey was against abortion and defended the right to live, whereas 23% was for abortion mainly in the case of rapes and/or maternal diseases. A small porcentage was for abortion in the case of pregnancies which may disturb their life projects. As regards the Papanicolau test, all the groups have a good knowledge about it, but only women over 25 years old practice it responsably.

  5. Ambivalence and Pregnancy: Adolescents' Attitudes, Contraceptive Use and Pregnancy

    National Research Council Canada - National Science Library

    Hannah Brückner; Anne Martin; Peter S. Bearman

    2004-01-01

    CONTEXT: It is often argued that adolescents who become pregnant do not sufficiently appreciate the negative consequences, and that prevention programs should target participants' attitudes toward pregnancy. METHODS...

  6. Use of long-acting reversible contraceptives to reduce the rate of teen pregnancy.

    Science.gov (United States)

    Rome, Ellen

    2015-11-01

    Long-acting reversible contraceptives (LARCs) are safe for use in adolescents and do not rely on compliance or adherence for effectiveness. Continuation rates are higher and pregnancy rates are lower for adolescent users of LARCs compared with short-acting methods such as oral contraceptives. Similarly, repeat pregnancy rates are lower when LARCs are used compared with other forms of contraception. Myths and misconceptions about LARCs and other contraceptives remain a barrier to their use. Health care providers are in a unique position to provide confidential care to adolescents, and should provide education to them about the various contraceptive options, especially LARCs.

  7. Increasing Use of Long-Acting Reversible Contraception to Decrease Unplanned Pregnancy.

    Science.gov (United States)

    Lotke, Pamela S

    2015-12-01

    Unintended pregnancy remains high in the United States, accounting for one-half of pregnancies. Both contraceptive nonuse and imperfect use contribute to unplanned pregnancies. Long-acting reversible contraception (LARC) have greater efficacy than shorter acting methods. Data from large studies show that unplanned pregnancy rates are lower among women using LARC. However, overall use of LARC is low; of the reproductive age women using contraception, less than 10% are LARC users. Barriers include lack of knowledge and high up-front cost, and prevent more widespread use. Overcoming these barriers and increasing the number of women using LARC will decrease unplanned pregnancies and abortions.

  8. Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

    Science.gov (United States)

    Kiykac Altinbas, Sadiman; Bayoglu Tekin, Yesim; Dilbaz, Berna; Kilic, Selim; Khalil, Susan S; Kandemir, Omer

    2014-12-01

    To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies. Does a high-risk pregnancy condition affect future postpartum contraceptive method choice? Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period. A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (pcontraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge. A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods. Copyright © 2014 Australian College of Midwives. All rights reserved.

  9. Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China.

    Directory of Open Access Journals (Sweden)

    Hongjing Wang

    Full Text Available This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9% of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge.

  10. Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes.In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  11. Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  12. Stroke in women - oral contraception, pregnancy, and hormone replacement therapy.

    Science.gov (United States)

    Rantanen, Kirsi; Tatlisumak, Turgut

    2013-01-01

    Stroke is a devastating disease affecting millions of people worldwide every year. Female stroke victims have higher mortality rates and they do not re-cover as well as men. Women's longevity and different vascular risk factor burden like a larger prevalence of atrial fibrillation play a role. Women also have unique risk factors such as oral contraception, pregnancy, estrogen decrease after the menopause and hormone replacement therapy, which should all be evaluated and taken into consideration in treatment decisions both in the acute phase of stroke and in secondary prevention. In this review, the evidence regarding these hormonal aspects and the risk of stroke in women are evaluated. The relevant guidelines are studied and research gaps identified. Future topics for research are recommended and current treatment possibilities and their risks discussed.

  13. Prevention of unintended pregnancy and use of contraception-important factors for preconception care.

    Science.gov (United States)

    Kallner, Helena Kopp; Danielsson, Kristina Gemzell

    2016-09-20

    Preservation of fertility and optimizing health before pregnancy is becoming increasingly important in societies where childbirth often is postponed. Research shows that as women postpone childbirth they achieve higher levels of education and higher incomes. This leads to advantages for their children and for society. However, as women postpone childbearing they are at risk for contracting conditions which may affect fertility and/or pregnancies, pregnancy outcome, and the newborn child. Preconception counseling is therefore becoming increasingly important. Women are often unaware of the added health benefits of contraception and have the right to be well informed so they can make decisions to fulfill their reproductive desires. Contraception can reduce the risk of unintended pregnancies, ectopic and molar pregnancies, and sexually transmitted infections. In addition, hormonal contraceptives reduce the risk of some types of cancer, dysmenorrhea, heavy menstrual bleeding, and anemia and are a treatment for endometriosis. Contraception should increasingly be looked upon as a means of preserving fertility and optimizing health status before a planned pregnancy. Thus, effective contraception can provide women with a possibility of achieving their long-term reproductive goals, although childbearing is actually postponed. The most effective contraceptive methods are the long-acting reversible contraceptives, which have been shown to be highly effective especially in young women who have difficulties with adherence to user-dependent methods. Therefore, these methods should increasingly be promoted in all age groups.

  14. Contraception usage and timing of pregnancy among pregnant teenagers in Cape Town, South Africa.

    Science.gov (United States)

    Vollmer, Linda R; van der Spuy, Zephne M

    2016-06-01

    To evaluate knowledge and use of contraception among pregnant teenagers in the Cape Town metropolitan area. A cross-sectional study enrolled women aged 16 to 19 years who were pregnant and attending prenatal clinics, and prenatal and labor wards at regional hospitals and midwife-run obstetric clinics in the Cape Town area between March 1, 2011 and September 30, 2011. Data were collected using an administered questionnaire. The study enrolled 314 participants. Of the participants, 240 (76.4%) felt their pregnancies had occurred at the "wrong time" but only 38 (12.1%) were using contraception at the time of conception. The form of contraception that participants most commonly had knowledge of was injectable hormonal contraception (274 [87.3%]). Contraception use was low, with 126 (40.1%) participants having never used contraception. The forms of contraception used most commonly were the male condom (106 [33.8%]) and injectable contraception (98 [31.2%]). The majority of participants found it easy to get contraception (192 [61.1%]) and felt that information regarding contraception was readily available (233 [74.2%]). Contraception use is suboptimal but this may not simply be a reflection of ineffective family-planning services. Further research is needed to fully explain the lack of contraceptive use in this population. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Sex Differences in Contraception Non-Use among Urban Adolescents: Risk Factors for Unintended Pregnancy

    Science.gov (United States)

    Casola, Allison R.; Nelson, Deborah B.; Patterson, Freda

    2017-01-01

    Background: Contraception non-use among sexually active adolescents is a major cause of unintended pregnancy (UP). Methods: In this cross-sectional study we sought to identify overall and sex-specific correlates of contraception non-use using the 2015 Philadelphia Youth Risk Behavior Survey (YRBS) (N = 9540). Multivariate regression models were…

  16. Contraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trial.

    Science.gov (United States)

    Akello, Carolyne A; Bunge, Katherine E; Nakabiito, Clemensia; Mirembe, Brenda G; Fowler, Mary Glenn; Mishra, Anupam; Marrazzo, Jeanne; Chirenje, Zvavahera M; Celum, Connie; Balkus, Jennifer E

    2017-06-01

    Recent HIV prevention trials required use of effective contraceptive methods to fulfill eligibility for enrollment. We compared pregnancy rates in a subset of participants enrolled in the Microbicide Trials Network protocol (MTN-003), a randomized trial of chemoprophylaxis to prevent HIV acquisition among women aged 18-45 years who initiated depot medroxyprogesterone acetate (DMPA) or combined oral contraceptives (COCs) at enrollment, relative to those already using DMPA or COCs. Data were analyzed from MTN-003 participants from Uganda. Before enrollment, information on contraceptive type and initiation date was obtained. Urine pregnancy tests were performed at monthly follow-up visits. Cox proportional hazards models were used to compare pregnancy incidence among new users (initiated ≤60 days before enrollment) and established users (initiated >60 days before enrollment). Of 322 women enrolled, 296 were COC or DMPA users, 82 (28%) were new users, and 214 (72%) were established users. Pregnancy incidence was higher among new contraceptive users compared to established users (20.70% vs. 10.55%; adjusted hazard ratio [HR] = 1.66; 95% confidence interval [95% CI] 0.93-2.96). Among DMPA users, pregnancy incidence was 10.20% in new users versus 3.48% in established users (HR = 2.56; 95% CI 0.86-7.65). Among new COC users, pregnancy incidence was 42.67% in new users versus 23.67% in established COC users (adjusted HR = 1.74; 95% CI 0.87-3.48). New contraceptive users, regardless of method, at the Uganda MTN-003 site had an increased pregnancy risk compared to established users, which may be due to contraceptive initiation primarily for trial eligibility. New users may benefit from intensive contraceptive counseling and additional contraceptive options, including longer acting reversible contraceptives.

  17. The risk of unintended pregnancy among young women with mental health symptoms

    Science.gov (United States)

    Kusunoki, Yasamin; Gatny, Heather; Barber, Jennifer

    2013-01-01

    Depression and stress have been linked with poor contraceptive behavior, but whether existing mental health symptoms influence women's subsequent risk of unintended pregnancy is unclear. We prospectively examined the effect of depression and stress symptoms on young women's pregnancy risk over one year. We used panel data from a longitudinal study of 992 U.S. women ages 18-20 years who reported a strong desire to avoid pregnancy. Weekly journal surveys measured relationship, contraceptive use and pregnancy outcomes. We examined 27,572 journal surveys from 940 women over the first study year. Our outcome was self-reported pregnancy. At baseline, we assessed moderate/severe depression (CESD-5) and stress (PSS-4) symptoms. We estimated the effect of baseline mental health symptoms on pregnancy risk with discrete-time, mixed-effects, proportional hazard models using logistic regression. At baseline, 24% and 23% of women reported moderate/severe depression and stress symptoms, respectively. Ten percent of young women not intending pregnancy became pregnant during the study. Rates of pregnancy were higher among women with baseline depression (14% vs. 9%, p=0.04) and stress (15% vs. 9%, p=0.03) compared to women without symptoms. In multivariable models, the risk of pregnancy was 1.6 times higher among women with stress symptoms compared to those without stress (aRR 1.6, CI 1.1,2.7). Women with co-occurring stress and depression symptoms had over twice the risk of pregnancy (aRR 2.1, CI 1.1,3.8) compared to those without symptoms. Among women without a prior pregnancy, having co-occurring stress and depression symptoms was the strongest predictor of subsequent pregnancy (aRR 2.3, CI 1.2,4.3), while stress alone was the strongest predictor among women with a prior pregnancy (aRR 3.0, CI 1.1,8.8). Depression symptoms were not independently associated with young women's pregnancy risk. In conclusion, stress, and especially co-occurring stress and depression symptoms

  18. Twelve-month contraceptive continuation and repeat pregnancy among young mothers choosing postdelivery contraceptive implants or postplacental intrauterine devices.

    Science.gov (United States)

    Cohen, Rebecca; Sheeder, Jeanelle; Arango, Natalia; Teal, Stephanie B; Tocce, Kristina

    2016-02-01

    To compare discontinuation rates and incidence of repeat pregnancy within 1 year among young mothers choosing postplacental intrauterine devices (IUDs) versus postpartum contraceptive implants. We enrolled a prospective cohort of postpartum adolescents and young women who chose either postplacental IUDs or postpartum contraceptive implants prior to hospital discharge. We used chart review and phone interviews to assess device discontinuation (by request or expulsion) and pregnancy within 12 months. Of the 244 13-22 year-old participants, 82 chose IUDs (74 levonorgestrel IUDs and 8 copper IUDs), and 162 chose implants. Both groups had participant-requested discontinuation rates of 14% (9/67 IUD; 19/135 implant) within 1 year. Participants choosing IUDs had a 25% (17/67) expulsion rate. Median time to expulsion was 4.1 weeks (range: 0.4-29.3 weeks, 16/17 within 12 weeks), and participants recognized 15/17 expulsions. IUD initiators had significantly higher pregnancy rates by 12 months (7.6% vs. 1.5%, p=0.04). Most pregnancies occurred when women discontinued their initial device and did not start alternative contraception. Participant-requested discontinuation was similar in both groups. Differences in overall device discontinuation rates were due to IUD expulsions. Pregnancy rates by 12 months postpartum were lower than previously reported in this age group in both implant initiators and IUD initiators. Young mothers who choose postplacental IUDs or postpartum contraceptive implants are unlikely to request removal within the first year. Clinicians should counsel postplacental IUD users that early expulsion is common (25%) and may be unrecognized (11% of expulsions). Patients should have a plan for contraceptive management should expulsion occur. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. TEEN PREGNANCY AND THE USE OF CONTRACEPTIVE METHODS

    Directory of Open Access Journals (Sweden)

    Thelma Spindola

    2012-01-01

    Full Text Available Resumo Objetivos: Conhecer a percepção das gestantes adolescentes sobre emprego dos métodos contraceptivos; discutir a vivência das jovens relacionada à contracepção e práticas sexuais. Método: Pesquisa descritiva em abordagem qualitativa, com emprego da entrevista semi-estruturada e técnica de análise de conteúdo. Resultados: Participaram do estudo 17 gestantes adolescentes. Na análise temática das entrevistas emergiram quatro categorias: As adolescentes e adoção dos métodos contraceptivos; A contracepção na visão das gestantes adolescentes; As atividades educativas e a participação das jovens; Métodos Contraceptivos: dúvidas e incertezas das adolescentes. Conclusão: O estudo revela a vulnerabilidade das jovens para a ocorrência de uma gestação não planejada e o risco de uma reincidência. Acreditamos que as práticas educativas podem contribuir para o esclarecimento dos jovens acerca de sua sexualidade e práticas sexuais, prevenindo agravos na saúde sexual e reprodutiva.Abstract Goals: Perceptions of pregnant adolescents about employment of contraceptive methods; discuss the experience of young people regarding contraception and sexual practices. Method: Descriptive Research, qualitative approach, employment of content analysis technique and semi-structured interview. Results: Participated in the study 17 pregnant adolescents. The thematic analysis of interviews emerged four categories: The adolescent and adoption of contraception; contraception in vision of pregnant adolescents; educational activities and participation of young people; methods contraceptives: doubts and uncertainties of teenagers. Conclusion: The study highlights the vulnerability of youth to the occurrence of an unplanned pregnancy and the risk of a recurrence. We believe that educational practices can contribute to the understanding of young people about their sexuality and sexual practices, preventing injuries from sexual and reproductive

  20. Linking Changes in Contraceptive Use to Declines in Teen Pregnancy Rates

    OpenAIRE

    Jennifer Manlove; Quentin Karpilow; Kate Welti; Adam Thomas

    2015-01-01

    Using a unique microsimulation tool, Teen FamilyScape, the present study explores how changes in the mix of contraceptive methods used by teens contributed to the decline in the U.S. teen pregnancy rate between 2002 and 2010. Results indicate that changes in contraceptive use contributed to approximately half of the decline in the teen pregnancy rate during this time period (48%) and that a little more than half of this “contraceptive effect” was due to an increase in teen condom use (58%). T...

  1. Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy.

    Science.gov (United States)

    2015-10-01

    Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires multiple approaches, individual obstetrician-gynecologists may contribute by increasing access to contraceptive implants and intrauterine devices. Obstetrician-gynecologists should encourage consideration of implants and intrauterine devices for all appropriate candidates, including nulliparous women and adolescents. Obstetrician-gynecologists should adopt best practices for long-acting reversible contraception insertion. Obstetrician-gynecologists are encouraged to advocate for coverage and appropriate payment and reimbursement for every contraceptive method by all payers in all clinically appropriate circumstances.

  2. Linking Changes in Contraceptive Use to Declines in Teen Pregnancy Rates

    Directory of Open Access Journals (Sweden)

    Jennifer Manlove

    2015-12-01

    Full Text Available Using a unique microsimulation tool, Teen FamilyScape, the present study explores how changes in the mix of contraceptive methods used by teens contributed to the decline in the U.S. teen pregnancy rate between 2002 and 2010. Results indicate that changes in contraceptive use contributed to approximately half of the decline in the teen pregnancy rate during this time period (48% and that a little more than half of this “contraceptive effect” was due to an increase in teen condom use (58%. The remaining share of the contraceptive effect can be attributed to an increase in the use of more effective hormonal (pill, patch, ring and long-acting reversible contraceptive (LARC/injectable methods (Intrauterine Devices (IUD, implant and injectable. Results from an additional counterfactual analysis suggest that the contraceptive effect was driven by the fact that the percentage of teens using no birth control fell during the study time period, rather than by the fact that some teens switched from less effective methods (condoms to more effective hormonal and LARC/injectable methods. However, very high typical use failure rates for teen condom users suggest the need for a two-pronged approach for continuing reductions in teen pregnancy for sexually active teens: first, targeting the youth most at risk of not using contraception and helping them choose contraception, and second, increasing the effectiveness of method use among existing contraceptors.

  3. Contraceptive Use and Unintended Pregnancy in Women With Congenital Heart Disease.

    Science.gov (United States)

    Lindley, Kathryn J; Madden, Tessa; Cahill, Alison G; Ludbrook, Philip A; Billadello, Joseph J

    2015-08-01

    To identify patterns of contraceptive use and pregnancy in an academic adult congenital cardiology practice. In this cross-sectional study, from October 2013 through March 2014, 100 women with congenital heart disease aged 18-45 years were recruited from an academic congenital heart disease clinic and administered a survey regarding pregnancy history, contraception use, and understanding of pregnancy-related and contraceptive-related risk. The primary outcome was current use of long-acting reversible contraception, including intrauterine devices or subdermal implants. Of 83 sexually active women, 63 (75.9%, 95% confidence interval [CI] 65.3-85.1) reported currently using any contraceptive method, including 30 of 83 (36.1%, 95% CI 25.9-47.4) using tier I methods (typical-use failure rates of less than 1% per year) and 20 of 83 (24.1%, 95% CI 15.4-34.7) using tier II methods (typical-use failure rates of 6-12% per year). Nine of 83 (10.8%, 95% CI 5.1-19.6) reported currently using long-acting reversible contraception. Sixty-four of 141 total pregnancies (45.4%, 95% CI 31.9-58.9) were self-reported by participants as "unexpected" rather than "planned." Only one (1.6%, 95% CI 0-4.6) of the 64 unintended pregnancies occurred when the woman was using a tier I method of contraception at the time of conception. Most women with congenital heart disease of childbearing age are sexually active. The high incidence of unintended pregnancy in this group may be related to underuse of highly effective methods of contraception. Specific counseling on tier I methods may reduce unintended pregnancies in women with congenital heart disease. III.

  4. Ectopic pregnancy with use of progestin-only injectables and contraceptive implants: a systematic review.

    Science.gov (United States)

    Callahan, Rebecca; Yacobson, Irina; Halpern, Vera; Nanda, Kavita

    2015-12-01

    Use of contraception lowers a woman's risk of experiencing an ectopic pregnancy. In the case of method failure, however, progestin-only contraceptives may be more likely to result in ectopic pregnancies than some other methods such as combined hormonal and barrier contraceptives. To describe ectopic pregnancy risk associated with use of implants and progestin-only injectable contraceptives through a systematic review of published studies. We searched electronic databases for articles in any language published through May 2015 describing studies of progestin-only injectables and implants. We also searched bibliographies and review articles for additional studies. Studies that reported any pregnancies were included in the review. Independent data extraction was performed by two authors based on predefined data fields, and where possible, we calculated the proportion of pregnancies that were ectopic and the ectopic pregnancy incidence rate per 1000 woman-years. Fifty-three studies of implants and 28 studies of injectables were identified; 79% reported pregnancy location. The proportion of ectopic pregnancy ranged from 0 to 100% with an incidence of 0-2.9 per 1000 woman-years in studies of marketed levonorgestrel implants. Studies of etonogestrel implants and the injectables, depot-medroxyprogesterone acetate and norethisterone enanthate, reported few ectopic pregnancies. Progestin-only contraceptive implants and injectables protect against ectopic pregnancy by being highly effective in preventing pregnancy overall; however, the absolute risk of ectopic pregnancy varies by type of progestin. Risk of ectopic pregnancy should not be a deterrent for use or provision of these methods. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  5. A qualitative study of pregnancy intention and the use of contraception among homeless women with children.

    Science.gov (United States)

    Kennedy, Sara; Grewal, Mandeep; Roberts, Elizabeth M; Steinauer, Jody; Dehlendorf, Christine

    2014-05-01

    We undertook a qualitative analysis informed by grounded theory to explore pregnancy intention and the barriers to contraceptive use as perceived by homeless women with children. Semi-structured interviews (n = 22) were performed in English and in Spanish. The dominant theme emerging from the interviews was a strong desire to avoid pregnancy while homeless. However, few women in our sample used contraception or accessed reproductive health care consistently. There were multiple barriers to using contraception and to accessing reproductive health care services that homeless women reported: (1) inability to prioritize health due to competing demands, (2) shelter-related obstacles and restrictive provider practices that impede access to reproductive health care services and the use of contraception, and (3) change in the power dynamics of sexual relationships while homeless, making women more vulnerable to sexual exploitation. Findings suggest a multifactorial approach is needed to help homeless women use contraception and access reproductive health services.

  6. 'Without a plan' but 'keeping on track': views on contraception, pregnancy and abortion in Mexico City.

    Science.gov (United States)

    Juarez, Fatima; Bayer, Angela M

    2011-01-01

    Despite increased use of modern contraception among Mexican women, there has been a significant increase in abortions. Little is known about the experiences behind these trends. This study examines decision-making around contraception, pregnancy, childbearing and abortion. We carried out 26 in-depth interviews with 23- to 35-year-old females and males in Mexico City. Interviewees described reproductive planning 'without a plan' and sporadic contraceptive use. Linking of reproductive preferences and contraceptive use occurred only after raising a child for a few years or after experiencing an abortion. Interviewees described side effects of hormonal contraceptives and the intrauterine device (IUD) and problems with condoms. Only 8% of participants disagreed with abortion completely. Those with mixed views opposed abortion for pregnancies resulting from lack of responsibility or due to personal problems or concerns about one's future. However, these more controversial reasons were the primary motivations for terminating pregnancies. Females and males expressed that females made most decisions related to contraception, pregnancy and abortion. Further research could explore the reasons behind reproductive planning 'without a plan', 'on and off' contraceptive use and abortion beliefs and experiences that are somewhat contradictory.

  7. The relationship between repeated unintended pregnancies and current contraceptive use: National Survey of Family Growth (NSFG) 2006-2008 data.

    Science.gov (United States)

    Matsuda, Yui; Masho, Saba; McGrath, Jacqueline M

    2012-01-01

    The purpose of this study is to examine the relationship between the number of unintended pregnancies and current contraceptive use. This is a secondary analysis of a cross-sectional survey, the 2006-2008 National Survey of Family Growth, which included 4,052 women between the ages of 15 and 44 years. A statistically significant association was found between the nonuse of contraceptives and repeated unintended pregnancies, as well as among those who used an effective contraceptive method and repeated unintended pregnancies. Nurses are encouraged to ask questions about intendedness of pregnancies during women's visits and help women choose appropriate contraceptive methods.

  8. How Australian Female Adolescents Prioritize Pregnancy Protection: A Grounded Theory Study of Contraceptive Histories

    Science.gov (United States)

    Smith, Jennifer L.; Skinner, S. Rachel; Fenwick, Jennifer

    2011-01-01

    Grounded theory principles were systematically employed to reveal key differences in pregnancy risk and underlying disparities in contraceptive use in (a) never-pregnant (b) pregnant-terminated and (c) pregnant-continued teenagers. Analysis of 69 semistructured interviews revealed a bicausal model of pregnancy protection that accounted for…

  9. Sexual orientation differences in teen pregnancy and hormonal contraceptive use: An examination across two generations

    Science.gov (United States)

    Charlton, Brittany M.; Corliss, Heather L.; Missmer, Stacey A.; Rosario, Margaret; Spiegelman, Donna; Austin, S. Bryn

    2013-01-01

    Objectives To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in two intergenerational cohorts. Study Design Data were collected from 91,003 women in the Nurses’ Health Study II (NHSII),born between 1947–1964, and 6,463 of their children, born between 1982–1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios (RR) for teen pregnancy and hormonal contraception use in sexual minorities compared to heterosexuals and meta-analysis techniques were used to compare the two cohorts. Results Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared to their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with RRs ranging from 1.61 (95%CI 0.40, 6.55) to 5.82 (95%CI 2.89, 11.73). Having a NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the two cohorts. Conclusions Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population. PMID:23796650

  10. Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations.

    Science.gov (United States)

    Charlton, Brittany M; Corliss, Heather L; Missmer, Stacey A; Rosario, Margaret; Spiegelman, Donna; Austin, S Bryn

    2013-09-01

    To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in 2 intergenerational cohorts. Data were collected from 91,003 women in the Nurses' Health Study II (NHSII), born between 1947-1964, and 6463 of their children, born between 1982-1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios for teen pregnancy and hormonal contraception use in sexual minorities compared with heterosexuals and metaanalysis techniques were used to compare the 2 cohorts. Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared with their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with risk ratios ranging from 1.61 (95% confidence interval, 0.40-6.55) to 5.82 (95% confidence interval, 2.89-11.73). Having an NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the 2 cohorts. Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population. Copyright © 2013 Mosby, Inc. All rights reserved.

  11. A checklist approach to caring for women seeking pregnancy testing: effects on contraceptive knowledge and use.

    Science.gov (United States)

    Lee, Jessica; Papic, Melissa; Baldauf, Erin; Updike, Glenn; Schwarz, E Bimla

    2015-02-01

    To assess how a checklist reminding clinicians to deliver a bundled intervention affects contraceptive knowledge and use 3 months after women seek walk-in pregnancy testing. Pre-intervention, an inner-city family planning clinic provided unstructured care; during the intervention period, clinic staff used a checklist to ensure women received needed services. Women seeking walk-in pregnancy testing who wished to avoid pregnancy for at least 6 months were asked to complete surveys about their contraceptive knowledge and use immediately after and 3-months after visiting the study clinic. To assess the significance of changes over time, we used logistic regression models. Between January 2011 and May 2013, over 1500 women sought pregnancy testing from the study clinic; 323 completed surveys (95 pre-intervention and 228 during the intervention period). With this checklist intervention, participants were more likely to receive emergency contraception (EC) (22% vs. 5%, [aOR 4.66 (1.76-12.35)], [corrected] have an intrauterine device or implant placed at the time of their clinic visit (5% vs. 0%, p=0.02), or receive a contraceptive prescription (23% vs. 10%, pknowledgeable about intrauterine and subdermal contraception and were more likely to report at 3-month follow-up a method of contraception more effective than the method they used prior to seeking pregnancy testing from the study clinic (aOR=2.02, 95% CI=1.03-3.96). The authors would like to apologize for any inconvenience caused. [corrected]. Women seeking walk-in pregnancy testing appear more likely to receive EC and to have switched to a more effective form of birth control in the 3 months following their visit when clinic staff used a 3-item checklist and provided scripted counseling. A checklist reminding clinic staff to assess pregnancy intentions, provide scripted counseling about both emergency and highly-effective reversible contraception, and offer same-day contraceptive initiation to women seeking walk

  12. Contraceptive use and pregnancy outcomes among opioid drug-using women: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Charles S Cornford

    Full Text Available The contraceptive needs of illicit opioid users differ from non-drug users but are poorly understood. The aim of this study was to describe contraceptive use and pregnancy outcomes in opioid-using women, and to examine their association with a range of risk factors.This retrospective cohort study used UK general practice records, Treatment Outcomes Profile and National Drug Treatment Monitoring System data, and a nested data validation exercise. A cohort of 376 women aged 20-61 years were in active treatment for opioid addiction in October 2010 at two specialised primary care practices in North-East England. Outcomes were age-adjusted prevalence estimates for contraceptive use and pregnancy outcomes in users of illicit opioids. The association between lifestyle-related risk factors and contraception was explored.Drug-using women made lower use of planned (non-condom contraception (24% vs 50%, p<0.001, had more frequent pregnancy terminations (0.46 vs. 0.025, p = 0.004 and higher annual incidence of chlamydia (1.1% vs. 0.33%, p<0.001, when compared with age-matched population data. Specifically, there was low use of oral contraceptives (4% vs. 25%, p<0.001, IUCD (1% vs. 6%, p<0.001, and sterilisation (7% vs. 6%, p = 0.053, but higher rates of injectable contraceptives (6% vs. 3%, p = 0.003. A total of 64% of children aged <16 years born to this group did not live with their mother. No individual risk factor (such as sex-working significantly explained the lower use or type of non-condom contraception.This is the first study to describe planned contraceptive use among drug-users, as well as the association with a range of risk factors and pregnancy outcomes. The low uptake of planned contraception, set against high rates of terminations and sexually transmitted disease demonstrates the urgent clinical need to improve contraceptive services, informed by qualitative work to explore the values and beliefs influencing low contraceptive uptake.

  13. Managing Unplanned Pregnancies in Five Countries: Perspectives on Contraception and Abortion Decisions

    Science.gov (United States)

    2014-01-01

    Why is induced abortion common in environments when modern contraception is readily available? This study analyzes qualitative data collected from focus group discussions and in-depth interviews with women and men from low income areas in five countries -- the U.S., Nigeria, Pakistan, Peru and Mexico -- to better understand how couples manage their pregnancy risk. Across all settings, women and men rarely weigh the advantages and disadvantages of contraception and abortion before beginning a sexual relationship or engaging in sexual intercourse. Contraception is viewed independently of abortion, and the two are linked only when the former is invoked as a preferred means to avoiding repeat abortion. Contraceptive methods are viewed as suspect because of perceived side effects, while abortion experience, often at significant personal risk, raised the specter of social stigma and motivation for better contraceptive practice. In all settings, male partners figure importantly in pregnancy decisions and management. Although there are inherent limitations from small sample sizes, the study narratives reveal psychosocial barriers to effective contraceptive use and identify nodal points in pregnancy decision-making that can inform and structure future investigation. PMID:21756080

  14. A prospective study of the onset of symptoms of pregnancy.

    Science.gov (United States)

    Sayle, Amy E; Wilcox, Allen J; Weinberg, Clarice R; Baird, Donna D

    2002-07-01

    The objective of this study was to provide prospectively collected data on the onset of pregnancy symptoms. Two hundred twenty-one women attempting pregnancy kept daily records of the occurrence of symptoms of pregnancy. Among 136 women delivering live infants, half began experiencing symptoms by day 36 after their last menstrual period (LMP), and 89% by the end of the eighth week. Onset of symptoms occurred later in pregnancies that went on to miscarry. Among 48 women with biochemically detected pregnancy loss before 6 weeks LMP, symptoms were substantially reduced but not entirely absent. Women who smoked tobacco or marijuana tended to have delayed onset of symptoms. Nearly 90% of women with successful pregnancies experience symptoms within 8 weeks LMP. Even pregnancies lost very early (before 6 weeks) are sometimes symptomatic. The earliest symptoms do not begin until after key stages of embryogenesis, reinforcing the need for women to initiate sound health behaviors before pregnancy is apparent. Published by Elsevier Science Inc.

  15. Provision of no-cost, long-acting contraception and teenage pregnancy.

    Science.gov (United States)

    Secura, Gina M; Madden, Tessa; McNicholas, Colleen; Mullersman, Jennifer; Buckel, Christina M; Zhao, Qiuhong; Peipert, Jeffrey F

    2014-10-02

    The rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential. The Contraceptive CHOICE Project was a large prospective cohort study designed to promote the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St. Louis region. Participants were educated about reversible contraception, with an emphasis on the benefits of LARC methods, were provided with their choice of reversible contraception at no cost, and were followed for 2 to 3 years. We analyzed pregnancy, birth, and induced-abortion rates among teenage girls and women 15 to 19 years of age in this cohort and compared them with those observed nationally among U.S. teens in the same age group. Of the 1404 teenage girls and women enrolled in CHOICE, 72% chose an intrauterine device or implant (LARC methods); the remaining 28% chose another method. During the 2008-2013 period, the mean annual rates of pregnancy, birth, and abortion among CHOICE participants were 34.0, 19.4, and 9.7 per 1000 teens, respectively. In comparison, rates of pregnancy, birth, and abortion among sexually experienced U.S. teens in 2008 were 158.5, 94.0, and 41.5 per 1000, respectively. Teenage girls and women who were provided contraception at no cost and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were much lower than the national rates for sexually experienced teens. (Funded by the Susan Thompson Buffett Foundation and others.).

  16. Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

    2005-01-01

    Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban...... and rural Tanzania underlines the need of scaling up postabortion contraceptive service....

  17. Contraceptive discontinuation and pregnancy postabortion in Nepal: a longitudinal cohort study.

    Science.gov (United States)

    Puri, Mahesh; Henderson, Jillian T; Harper, Cynthia C; Blum, Maya; Joshi, Deepak; Rocca, Corinne H

    2015-04-01

    To examine postabortion contraceptive discontinuation and pregnancy in Nepal, where abortion was decriminalized in 2002. We conducted an observational cohort study of 654 women obtaining abortions from four public and nongovernmental facilities in 2011. Patients completed questionnaires at their abortion visit and 6 and 12 months later. We used Cox proportional hazards models to assess contraceptive discontinuation and pregnancy by method initiated postabortion and other sociodemographic and reproductive factors. Among the 78% (508/654) of women who initiated a modern contraceptive method within 3 months postabortion, the 1-year contraceptive discontinuation rate was 62 per 100 person-years. Discontinuation was far lower among the 5% of women using long-acting reversible methods (21/100 person-years) than among those using condoms (74/100 person-years), pills (61/100 person-years) and the injectable [64/100 person-years; adjusted hazard ratio (aHR)=0.32 (0.15-0.68)]. Unmarried women and those not living with their husband experienced higher contraceptive discontinuation [aHR=2.16 (1.47-3.17)]. The 1-year pregnancy rate for all women was 9/100 person-years. Pregnancy was highest among those who initiated no modern method postabortion (13/100 person-years) and condoms (12/100 person-years), and pregnancy was lowest among users of long-acting reversible methods (3/100 person-years). The poorest women were at increased pregnancy risk [aHR=2.31 (1.32-4.10)]. Women using intrauterine devices and implants experienced greatly reduced contraceptive discontinuation and pregnancy within a year postabortion, although initiation of these long-acting methods was low. Increased availability of long-acting methods in Nepal and similar settings may help to prevent unwanted pregnancy and attendant maternal mortality and morbidities. Initiation of modern contraception was high postabortion; however, 1-year discontinuation was high for the condom, pill and injectable, the methods most

  18. Estradiol valerate and dienogest: a novel four-phasic oral contraceptive pill effective for pregnancy prevention and treatment of heavy menstrual bleeding.

    Science.gov (United States)

    Micks, Elizabeth; Jensen, Jeffrey T

    2011-09-01

    Estradiol valerate and dienogest have been combined to create a novel four-phasic oral contraceptive pill effective for both pregnancy prevention and treatment of heavy menstrual bleeding. This formulation represents the only oral contraceptive pill available in the USA containing an estrogen component that is biologically active as the endogenous estrogen 17β-estradiol. This medication was developed out of efforts to replace the most common estrogen in contraceptive pills, ethinyl estradiol, which is known to be a potent inducer of hepatic protein synthesis. Estradiol valerate has been available since the 1970s in oral and injectable forms indicated for the treatment of menopausal climacteric symptoms. Dienogest has been used in other oral contraceptive pills for over 10 years. Previous attempts to develop an oral contraceptive pill with natural estradiol or estradiol valerate were unsuccessful due to poor cycle control. A novel dynamic-dosing regimen was devised to improve the bleeding pattern. This medication has been shown in several clinical trials to have good contraceptive efficacy and cycle control. Recent studies have also demonstrated that this medication is effective for the treatment of heavy menstrual bleeding. However, compared with other oral contraceptive pills, this medication is associated with a higher frequency of absent withdrawal bleeding. Furthermore, the dynamic dosing regimen requires relatively complex instructions for users who miss pills.

  19. Happiness about unintended pregnancy and its relationship to contraceptive desires among a predominantly Latina cohort.

    Science.gov (United States)

    Aiken, Abigail R A

    2015-06-01

    Women frequently profess happiness about unintended pregnancies; such incongruence is associated with use of less effective contraceptive methods and inconsistent or incorrect method use. Yet, the methods women use may differ from those they desire. Data on 578 women were drawn from a prospective survey of postpartum women aged 18-44 recruited from three hospitals in Texas between 2012 and 2014. Jonckheere-Terpstra tests were used to compare women's feelings about a future pregnancy with their childbearing intentions. Fisher-Freeman-Halton tests compared distributions of contraceptive methods currently used and desired by women who professed happiness about a future unintended pregnancy, as well as distributions of desired methods by women's reported feelings. The proportion of women who reported happiness about a future pregnancy was 59% among those intending to wait two or three years for another child, 46% among those intending to wait four or more years, and 36% among those intending to have no more children. Among women who professed happiness, a greater proportion desired to use a highly effective contraceptive method than were currently using one (72% vs. 15% among those intending no more children; 55% vs. 23% among those intending to wait at least four years; and 36% vs. 10% among those intending to wait two or three years). Across intention categories, the types of methods desired did not differ by whether women professed happiness or unhappiness. Women who profess happiness about a future unintended pregnancy may nonetheless desire highly effective contraceptive methods. Copyright © 2015 by the Guttmacher Institute.

  20. Reducing unintended pregnancies: a microsimulation of contraceptive switching, discontinuation, and failure patterns in france.

    Science.gov (United States)

    Diamond-Smith, Nadia G; Moreau, Caroline; Bishai, David M

    2014-12-01

    Although the rate of contraceptive use in France is high, more than one-third of pregnancies are unintended. We built a dynamic microsimulation model that applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for five years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France by adjusting for underreporting of contraceptive nonuse and abortion. We then test three behavior-change scenarios that could reduce unintended pregnancies: decreasing method failure, increasing time using effective methods, and increasing switching from less effective to more effective methods. Our model suggests that decreasing method failure is the most effective means of reducing unintended pregnancies, but we found that all of the scenarios reduced unintended pregnancies by at least 25 percent. Dynamic microsimulations may have great potential in reproductive health research and prove useful for policymakers.

  1. Hormonal Contraceptive Use During Relationship Formation and Sexual Desire During Pregnancy

    OpenAIRE

    2015-01-01

    Women who are regularly cycling exhibit different partner preferences than those who use hormonal contraception. Preliminary evidence appears to suggest that during pregnancy women’s partner preferences also diverge from those prevalent while regularly cycling. This is consistent with the general assertion that women’s mate preferences are impacted by hormonal variation. During pregnancy, women’s preferences are thought to closely resemble those displayed by women who are using hormonal contr...

  2. Menarche, oral contraceptives, pregnancy and progression of disability in relapsing onset and progressive onset multiple sclerosis

    NARCIS (Netherlands)

    D'hooghe, M. B.; Haentjens, P.; Nagels, G.; D'Hooghe, T.; De Keyser, J.

    2012-01-01

    Female gender and hormones have been associated with disease activity in multiple sclerosis (MS). We investigated age at menarche, use of oral contraceptives and pregnancy in relation to progression of disability in relapsing onset and progressive onset MS. We conducted a cross-sectional survey amon

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

    Science.gov (United States)

    Núñez-Urquiza, Rosa María; Hernández-Prado, Bernardo; García-Barrios, Cecilia; González, Dolores; Walker, Dylis

    2003-01-01

    To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive 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. 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. 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

  4. Helping Clinicians Prevent Pregnancy among Sexually Active Adolescents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use.

    Science.gov (United States)

    Godfrey, Emily M

    2015-08-01

    The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents.

  5. Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

    Science.gov (United States)

    Bahamondes, Luis; Lira-Plascencia, Josefina; Martin, Ricardo; Marin, Victor; Makuch, Maria Y

    2015-01-01

    Background Unintended pregnancy is a public health problem and unmet medical need worldwide. It is estimated that in the year 2012, almost 213 million pregnancies occurred, and the global pregnancy rate decreased only slightly from 2008 to 2012. It was also estimated that 85 million pregnancies (40% of all pregnancies) were unintended and that 38% ended in an unintended birth. Objectives To assess knowledge and attitudes of Latin American (LA) obstetricians and gynecologists (OBGYNs) regarding unintended pregnancies and aspects of combined oral contraceptive (COC) use. Methods A survey was conducted during a scientific meeting about contraception in 2014, in which OBGYNs from 12 LA countries who provide attention in contraception were invited to respond to a multiple-choice questionnaire to assess their knowledge and attitudes regarding unplanned pregnancy and some aspects regarding COC use. Results A total of 210 OBGYNs participated in the study. Their knowledge regarding COC failure was low. The participants reported they believed that their patients habitually forgot to take a pill and that their patients did not know what to do in these situations. They were aware of the benefits of COC use; however, they were less prone to prescribe COCs for the purpose of protecting against ovarian and endometrial cancer, and one-quarter of them had doubts about the association between COC use and cancer risk. Conclusion The interviewed LA OBGYNs showed some flaws in terms of knowledge of COC failure rates and the non-contraceptive benefits and risks of COCs. To adequately counsel their patients regarding COC intake, OBGYNs must be updated regarding all aspects of COC use. PMID:25999766

  6. Reproductive counseling, contraception, and unplanned pregnancy in fertile women treated by gynecologic oncologists.

    Science.gov (United States)

    Crafton, Sarah M; Lynch, Courtney D; Cohn, David E; Eisenhauer, Eric L

    2017-02-01

    We sought to identify how gynecologic oncologists approach reproductive counseling for their fertile, reproductive age patients, and their experience with unplanned pregnancies. Members of the Society of Gynecologic Oncology (SGO) were surveyed electronically regarding consistency of counseling patterns of contraception and fertility concerns, most and least common contraceptive methods utilized, referral patterns, and incidence of unplanned pregnancy. Of the 1424 SGO members identified, 261 participated in the questionnaire, yielding a response rate of 18%. Eighty-two percent of respondents agreed unplanned pregnancy is a potential problem, but only 57% believed their patients understood unplanned pregnancy is possible during treatment. Half of respondents report "always" in terms of frequency that contraception is addressed among their high-risk patients. After adjustment for gender, we found that the odds of reporting providing fertility counseling were nearly three times higher among attendings as compared to fellows [AOR = 2.72; 95% CI = (1.44, 5.12), three times higher in women as compared to men [AOR = 2.80; 95% CI = (1.46, 5.38)], as well as in individuals 50 + years as compared to those unplanned pregnancies, to their knowledge, in the previous five years of clinical practice. Most providers acknowledge that unplanned pregnancy is a potential risk in fertile gynecologic oncology patients, but only half believe their patients understand an unplanned pregnancy is possible. An opportunity exists to provide more directed counseling regarding fertility during and after cancer therapy, and to educate patients and providers regarding more reliable, long acting contraceptive methods.

  7. Reasons for pregnancy termination: negligence or failure of contraception?

    Science.gov (United States)

    Savonius, H; Pakarinen, P; Sjöberg, L; Kajanoja, P

    1995-11-01

    Interviews with 200 abortion seekers at a Finnish hospital revealed a high incidence of contraceptive failure. Although 93% claimed to have adequate knowledge about contraception, only 23 women (11.5%) were using a reliable method (pill or IUD) at the time of conception. 126 (63%) were relying on a less safe method (e.g., condoms, spermicides, rhythm) and 51 (25.5%) were not using any form of fertility control. 9 of the 16 pill users admitted irregular use; another 3 experienced vomiting or diarrhea at the time of conception, which may have compromised the method's effectiveness. Of the 116 condom users, 89 reported that the condom had broken or slipped off during intercourse or that use had been irregular. Concern about side effects was the most frequently cited reason for not using the pill or IUD; in many other cases, women had been advised by their physician to take a break from use of these methods. Overall, contraceptive failure was considered to have occurred in 43 cases (21.5%); the methods involved were IUD (7 cases), pill (4 cases), condoms (27 cases), and spermicides (5 cases). Recommended to reduce the high rate of contraceptive failure are counseling on proper method use and the alleviation of concern about side effects associated with the most effective methods.

  8. Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

    Directory of Open Access Journals (Sweden)

    Bahamondes L

    2015-05-01

    Full Text Available Luis Bahamondes,1 Josefina Lira-Plasencia,2 Ricardo Martin,3 Victor Marin,4 Maria Y Makuch1 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP, Campinas, Brazil; 2Instituto Nacional de Perinatología, México, DF, México; 3Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia; 4Hospital Central, Petróleos Mexicanos, México, DF, México Background: Unintended pregnancy is a public health problem and unmet medical need worldwide. It is estimated that in the year 2012, almost 213 million pregnancies occurred, and the global pregnancy rate decreased only slightly from 2008 to 2012. It was also estimated that 85 million pregnancies (40% of all pregnancies were unintended and that 38% ended in an unintended birth. Objectives: To assess knowledge and attitudes of Latin American (LA obstetricians and gynecologists (OBGYNs regarding unintended pregnancies and aspects of combined oral contraceptive (COC use. Methods: A survey was conducted during a scientific meeting about contraception in 2014, in which OBGYNs from 12 LA countries who provide attention in contraception were invited to respond to a multiple-choice questionnaire to assess their knowledge and attitudes regarding unplanned pregnancy and some aspects regarding COC use. Results: A total of 210 OBGYNs participated in the study. Their knowledge regarding COC failure was low. The participants reported they believed that their patients habitually forgot to take a pill and that their patients did not know what to do in these situations. They were aware of the benefits of COC use; however, they were less prone to prescribe COCs for the purpose of protecting against ovarian and endometrial cancer, and one-quarter of them had doubts about the association between COC use and cancer risk. Conclusion: The interviewed LA OBGYNs showed some flaws in terms of knowledge of COC failure rates and the non-contraceptive benefits and risks

  9. Individual features and contraceptive attitudes of women who had unintended pregnancy

    Directory of Open Access Journals (Sweden)

    Ebru Ersoy

    2015-09-01

    Full Text Available Objective: To explore preconceptional family planning attitudes in patients who delivered at term and causes of unplanned pregnancies. To explore contraception preferences in these patients. Methods: This study was conducted in Zekai Tahir Burak Teaching and Research Hospital between September 2013 and February 2014. A questionnaire was administered face to face (n=475. Demographic findings, level of education, family type, level of income, preconceptional planning, preconceptional and postpartum contraception preferences were questioned. These data were recorded with neonatal outcomes. Results: Three hundred sixty five (76.8% patients stated that they preconceptionally planned their pregnancies. There were 110 (23.2% women who defined their gestation as unplanned. The frequency of preconceptionally planned pregnancies were higher in nulliparous women (88.4% than multiparous women (67.9% (p<0.001. There was no significant difference between planned and unplanned pregnancies with respect to financial income, infant’s birth weight, and hemoglobin levels at delivery. However, educational level of the patients were significantly lower in patients with unplanned pregnancy (p<0.001. The time interval since last pregnancy was longer in patients with unplanned pregnancy and they were more motivated to use any kind of postpartum contraception (p<0.001. In planned pregnancies, the frequency of preconceptional gynecologic examination and using folic acid supplements were 32.9% and 16%, respectively. Conclusion: In our study, it was noticed that educational level of the women was a prominent factor on whether the pregnancy was planned or not. Family planning trainings must be structured according to the educational level of the couples and awareness about family planning must be increased. J Clin Exp Invest 2015; 6 (3: 250-255

  10. Is education the best contraception: the case of teenage pregnancy in England?

    Science.gov (United States)

    Girma, Sourafel; Paton, David

    2015-04-01

    This paper examines potential explanations for recent declines in teenage pregnancy in England. We estimate panel data models of teenage conception, birth and abortion rates from regions in England. Although point estimates are consistent with the promotion of long acting reversible contraception (LARC) having a negative impact on teenage pregnancy rates, the effects are generally small and statistically insignificant. In contrast, improvements in educational achievement and, to a lesser extent, increases in the non-white proportion of the population are associated with large and statistically significant reductions in teenage pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Emergency contraception: knowledge and use among Danish women requesting termination of pregnancy

    DEFF Research Database (Denmark)

    Perslev, A; Rørbye, C; Boesen, H C

    2002-01-01

    The aim of this study was to describe knowledge about and use of emergency contraception (EC) among Danish women requesting termination of pregnancy. The study included 1514 women (response rate 83.7%) referred during the period August 2000 to May 2001. Sufficient knowledge of EC was defined...... terminations of pregnancies. EC was used in the actual pregnancy by 6.6% and 24.1% had used it previously. Actual or formers users were characterized in the same way. The general knowledge about EC has not improved significantly during the last few years and there is still need for information about...

  12. Contraceptive method preferences and provision after termination of pregnancy: a population-based analysis of women obtaining care with the British Pregnancy Advisory Service.

    Science.gov (United States)

    Aiken, Ara; Lohr, P A; Aiken, C E; Forsyth, T; Trussell, J

    2017-04-01

    To examine contraceptive choices among women seeking termination of pregnancy (TOP) and the provision of the chosen methods. Population-based study. British Pregnancy Advisory Service (BPAS) clinics in England and Wales. Between 1 January 2011 and 31 December 2014, 211 215 women had a TOP at BPAS, were offered contraceptive counselling, and were eligible to obtain contraception at no cost. We examined electronic records from BPAS and assessed the proportions of women who accepted contraceptive counselling and chose a contraceptive method, as well as the distributions of methods chosen, analysed by provider and by TOP type. We calculated the proportions receiving their chosen method and the methods chosen by women using no method at conception. We used logistic regression to examine the factors associated with choice of an intrauterine contraceptive (IUC) or implant. Post-TOP contraceptive method choice. Receipt of chosen method post-TOP. Eighty-five per cent of women accepted contraceptive counselling and 51% chose to obtain a method from BPAS rather than from a GP or contraception and sexual health clinic post-TOP. [correction added on 25 November 2016 after first online publication: 51% has been inserted in the preceding sentence.] Among those who wanted to receive contraception from BPAS, 51% chose an IUC or implant and 19% chose oral contraceptives. Ninety-one per cent of women who obtained contraception from BPAS received their chosen method. Women were more likely to choose an IUC or implant if they obtained contraception from BPAS, had a surgical TOP, were parous, young, white, or had one or more previous TOPs. The standards set for patient-centred TOP care should emphasise the need for a full range of contraceptive options to be offered and provided post-TOP. Uptake targets for long-acting reversible methods do not reflect women's post-TOP contraceptive preferences. © 2016 Royal College of Obstetricians and Gynaecologists.

  13. Reproductive counseling, contraception, and unplanned pregnancy in fertile women treated by gynecologic oncologists

    Directory of Open Access Journals (Sweden)

    Sarah M Crafton

    2017-02-01

    Members of the Society of Gynecologic Oncology (SGO were surveyed electronically regarding consistency of counseling patterns of contraception and fertility concerns, most and least common contraceptive methods utilized, referral patterns, and incidence of unplanned pregnancy. Of the 1424 SGO members identified, 261 participated in the questionnaire, yielding a response rate of 18%. Eighty-two percent of respondents agreed unplanned pregnancy is a potential problem, but only 57% believed their patients understood unplanned pregnancy is possible during treatment. Half of respondents report “always” in terms of frequency that contraception is addressed among their high-risk patients. After adjustment for gender, we found that the odds of reporting providing fertility counseling were nearly three times higher among attendings as compared to fellows [AOR = 2.72; 95% CI = (1.44, 5.12, three times higher in women as compared to men [AOR = 2.80; 95% CI = (1.46, 5.38], as well as in individuals 50+ years as compared to those <40 years old [AOR = 4.91; 95% CI = (2.05, 11.74]. Ninety-six percent reported <5 unplanned pregnancies, to their knowledge, in the previous five years of clinical practice. Most providers acknowledge that unplanned pregnancy is a potential risk in fertile gynecologic oncology patients, but only half believe their patients understand an unplanned pregnancy is possible. An opportunity exists to provide more directed counseling regarding fertility during and after cancer therapy, and to educate patients and providers regarding more reliable, long acting contraceptive methods.

  14. Pregnancy in HIV clinical trials in Sub Saharan Africa: failure of consent or contraception?

    Directory of Open Access Journals (Sweden)

    Agnes Ssali

    Full Text Available OBJECTIVE: Higher than expected pregnancy rates have been observed in HIV related clinical trials in Sub-Saharan Africa. We designed a qualitative study to explore the factors contributing to high pregnancy rates among participants in two HIV clinical trials in Sub-Saharan Africa. METHODS: Female and male participants enrolled in one of two clinical HIV trials in south-west Uganda were approached. The trials were a phase III microbicide efficacy trial among HIV negative women using vaginal gel (MDP; and a trial of primary prevention prophylaxis for invasive cryptococcal disease using fluconazole among HIV infected men and women in Uganda (CRYPTOPRO. 14 focus group discussions and 8 in-depth interviews were conducted with HIV positive and negative women and their male partners over a six month period. Areas explored were their experiences about why and when one should get pregnant, factors affecting use of contraceptives, HIV status disclosure and trial product use. RESULTS: All respondents acknowledged being advised of the importance of avoiding pregnancy during the trial. Factors reported to contribute to pregnancy included; trust that the investigational product (oral capsules/vaginal gel would not harm the baby, need for children, side effects that led to inconsistent contraceptive use, low acceptance of condom use among male partners. Attitudes towards getting pregnant are fluid within couples over time and the trials often last for more than a year. Researchers need to account for high pregnancy rates in their sample size calculations, and consider lesser used female initiated contraceptive options e.g. diaphragm or female condoms. In long clinical trials where there is a high fetal or maternal risk due to investigational product, researchers and ethics committees should consider a review of participants contraceptive needs/pregnancy desire review after a fixed period, as need for children, partners and health status of participants may

  15. Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, Midwestern state: health promotion implications.

    Science.gov (United States)

    Campo, Shelly; Askelson, Natoshia M; Spies, Erica L; Losch, Mary

    2010-05-01

    Despite high rates of unintended pregnancy among women aged 18 to 30 years, little research has been conducted to understand the factors associated with their contraceptive use. Eighteen focus groups were conducted with young adult women (N = 106) who were mostly white, non-Hispanic. Results suggested that contraceptive use was negatively affected by low contraceptive knowledge; use of alcohol; a lack of planning for sex; a misperception of the likelihood of pregnancy; forgetting to use contraceptives; and concerns about side effects, cost, and confidentiality. Women liked the peace of mind that using contraceptives gave them and the benefits of regular periods from some hormonal methods. Implications for reducing unintended pregnancies through interventions are offered.

  16. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... prevents pregnancy in the same way as regular birth control pills: By preventing or delaying the release of an ...

  17. High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need

    Directory of Open Access Journals (Sweden)

    Alexson Debbie

    2011-08-01

    Full Text Available Abstract Background The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs in Vancouver. Methods The study sample was obtained from a community-based prospective cohort study (2006-2008 of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody, and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4 were examined. Results Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5. The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR: 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3, apprehension (median = 2; IQR:1-4 and adoption (median = 1; IQR:1-2 among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45], and permanent contraceptives (e.g., tubal ligation and hysterectomy (OR = 2.76; [95%CI = 1.36-5.59] were both significantly associated with having five or more pregnancies. Conclusion These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver.

  18. Sleep quality during pregnancy: associations with depressive and anxiety symptoms.

    Science.gov (United States)

    Polo-Kantola, Päivi; Aukia, Linda; Karlsson, Hasse; Karlsson, Linnea; Paavonen, E Juulia

    2017-02-01

    Sleep disturbances are common during pregnancy, yet underdiagnosed and under-investigated. We evaluated sleep quality during pregnancy and assessed associated factors, especially depressive and anxiety symptoms. A total of 78 healthy pregnant women from the FinnBrain Birth Cohort Study were studied twice prospectively during pregnancy (in mid-pregnancy and late pregnancy). Sleep quality was evaluated by the Basic Nordic Sleep Questionnaire, depressive symptoms by the Edinburgh Postnatal Depression Scale, and anxiety symptoms by the State-Trait Anxiety Inventory. Poor general sleep quality, difficulty falling asleep, the number of nocturnal awakenings per night, and too-early morning awakenings increased in late pregnancy compared with mid-pregnancy (all p-values anxiety symptoms were cross-sectionally related to sleep disturbances, but depressive or anxiety symptoms in mid-pregnancy were not associated with sleep disturbances in late pregnancy. We found deterioration in sleep quality across pregnancy. However, no increase in negative daytime consequences was found, presumably indicating a compensatory capacity against sleep impairment. Additionally, depressive and anxiety symptoms and sleep disturbances were only cross-sectionally associated. Our study calls for further research on the factors that influence sleep disturbances during pregnancy. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Contraceptive Use, Unmet Need for Contraception, and Unintended Pregnancy in a Context of Mexico-U.S. Migration

    Directory of Open Access Journals (Sweden)

    Kathryn Kessler

    2010-10-01

    Full Text Available This study examines the impact of migration on contraceptive use, unmet need for contraception, and unintended pregnancy among migrants from Tlacuitapa, Jalisco, a migrant-sending community in Mexico with a long history of out-migration to the United States. Our analysis found that after controlling for demographic factors, being born in the United States and having lived in the United States for at least one year during youth have a statistically significant positive effect on using medical contraception. We also found that having lived in the United States during youth has a negative influence on unmet need, suggesting that exposure to the United States during these formative years may facilitate access to contraception. In terms of migration and unintended pregnancy, our analysis yielded that being born in the United States and having lived in the United States during youth have a positive effect on unintended pregnancies, suggesting that U.S. experience may in fact be a risk factor for, rather than protective against, unintended pregnancy.Cette étude examine l’impact de l’immigration sur l’utilisation de contraceptifs, le besoin non satisfait de contraception, et les grossesses non désirées chez les migrants de Tlacuitapa, dans l’état de Jalisco, communauté du Mexique ayant une longue tradition d’immigration vers les Etats-Unis. Notre étude a montré, après contrôle des facteurs démographiques, que le fait d’être né aux Etats-Unis et d’avoir vécu dans ce pays pendant au moins un an pendant sa jeunesse avait un effet positif statistiquement significatif sur l’utilisation d’une contraception médicale. Nous avons également démontré que le fait d’avoir vécu aux Etats-Unis pendant sa jeunesse avait une influence négative sur le besoin non satisfait de contraception, laissant entendre que la présence aux Etats-Unis pendant ces années décisives de la vie peut faciliter l’accès à la contraception. En

  20. Severity of signs and symptoms in lumbopelvic pain during pregnancy

    NARCIS (Netherlands)

    Mens, Jan M. A.; 't Veld, Yvonne H. Huis In; Pool-Goudzwaard, Annelies

    2012-01-01

    Data on the severity of signs and symptoms of lumbopelvic pain (LPP) during pregnancy are scarce. Therefore, this cross-sectional study examines the severity of LPP and pain-related signs and symptoms. Women with an uncomplicated pregnancy of 20-30 weeks were invited to participate. They rated their

  1. Severity of signs and symptoms in lumbopelvic pain during pregnancy

    NARCIS (Netherlands)

    Mens, Jan M. A.; 't Veld, Yvonne H. Huis In; Pool-Goudzwaard, Annelies

    2012-01-01

    Data on the severity of signs and symptoms of lumbopelvic pain (LPP) during pregnancy are scarce. Therefore, this cross-sectional study examines the severity of LPP and pain-related signs and symptoms. Women with an uncomplicated pregnancy of 20-30 weeks were invited to participate. They rated their

  2. Hormonal Contraception, Pregnancy, Breastfeeding, and Risk of HIV Disease Progression Among Zambian Women.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Haddad, Lisa; Vwalika, Bellington; Lakhi, Shabir; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Mulenga, Joseph; Tichacek, Amanda; Allen, Susan

    2016-03-01

    Some studies suggest that hormonal contraception, pregnancy, and/or breastfeeding may influence rates of HIV disease progression. From 1994 to 2012, HIV discordant couples recruited at couples' voluntary HIV counseling and testing centers in Lusaka were followed 3-monthly. Multivariate survival analyses explored associations between time-varying contraception, pregnancy, and breastfeeding and 2 outcomes among HIV-positive women: (1) time to death and (2) time to antiretroviral treatment (ART) initiation. Among 1656 female seropositive, male seronegative couples followed for 3359 person-years (PY), 224 women died [6.7/100 PY; 95% confidence interval (CI): 5.8 to 7.6]. After 2003, 290 women initiated ART (14.5/100 PY; 95% CI: 12.9 to 16.2). In a multivariate model of time to death, hormonal implant [adjusted hazard ratio (aHR) = 0.30; 95% CI: 0.10 to 0.98] and injectable (aHR = 0.59; 95% CI: 0.36 to 0.97) were significantly protective relative to nonhormonal method use, whereas oral contraceptive pill (OCP) use was not (aHR = 1.08; 95% CI: 0.74 to 1.57) controlling for baseline HIV disease stage, time-varying pregnancy, time-varying breastfeeding, and year of enrollment. In a multivariate model of time-to-ART initiation, implant was significantly protective (aHR = 0.54; 95% CI: 0.31 to 0.95), whereas OCP (aHR = 0.70; 95% CI: 0.44 to 1.10) and injectable (aHR = 0.85; 95% CI: 0.55 to 1.32) were not relative to nonhormonal method use controlling for variables above, woman's age, and literacy. Pregnancy was not significantly associated with death (aHR = 1.07; 95% CI: 0.68 to 1.66) or ART initiation (aHR = 1.24; 95% CI: 0.83 to 1.86), whereas breastfeeding was protective for death (aHR = 0.34; 95% CI: 0.19 to 0.62) and ART initiation (aHR = 0.49; 95% CI: 0.29 to 0.85). Hormonal implants and injectables significantly predicted lower mortality; implants were protective for ART initiation. OCPs and pregnancy were not associated with death or ART initiation, whereas

  3. Knowledge, attitudes and behaviours of adolescents in relation to STIs, pregnancy, contraceptive utilization and substance abuse in the Mhlakulo region, Eastern Cape : original research

    National Research Council Canada - National Science Library

    Mona, K; Mbulawa, N; Mohlajoa, N.A; Bhat, V.G; Libazi, S; Ramnaran, B; Maholwana, Y; Marafungana, N; Bana, A; Godlwana, X; Nondula, N.N; Mofuka, J; Qubekile, Y; Mbonisweni, A.M

    2010-01-01

    ...) and in economically poor, rural populations. This study aimed to assess the youthsâ?? knowledge, attitudes and behaviours regarding STIs, teenage pregnancy, contraception and substance abuse. Methodology...

  4. Knowledge, attitudes and behaviours of adolescents in relation to STIs, pregnancy, contraceptive utilization and substance abuse in the Mhlakulo region, Eastern Cape

    National Research Council Canada - National Science Library

    Bana, A; Bhat, VG; Godlwana, X; Libazi, S; Maholwana, Y; Marafungana, N; Mona, K; Mbonisweni, AM; Mbulawa, N; Mofuka, J; Mohlajoa, NA; Nondula, NN; Qubekile, Y; Ramnaran, B

    2010-01-01

    ...) and in economically poor, rural populations. This study aimed to assess the youths' knowledge, attitudes and behaviours regarding STIs, teenage pregnancy, contraception and substance abuse. Methodology...

  5. Contraceptive use and risk of unintended pregnancy in California

    OpenAIRE

    Foster, Diana; Bley, Julia; Mikanda, John; Induni, Marta; Arons, Abigail; Baumrind, Nikki; Darney, Philip D; Stewart, Felicia

    2004-01-01

    Abstract California is home to more than one out of eight American women of reproductive age. Because California has a large, diverse and growing population, national statistics do not necessarily describe the reproductive health of California women. This article presents risk for pregnancy and sexually transmitted infections among women in California based on the California Women’s Health Survey. Over 8900 women of reproductive age who participated in this survey between 1998 and 2001 pr...

  6. Improving Access to Long-Acting Contraceptive Methods and Reducing Unplanned Pregnancy Among Women with Substance Use Disorders.

    Science.gov (United States)

    Black, Kirsten I; Day, Carolyn A

    2016-01-01

    Much has been written about the consequences of substance use in pregnancy, but there has been far less focus on the prevention of unintended pregnancies in women with substance use disorders (SUDs). We examine the literature on pregnancy incidence for women with SUDs, the clinical and economic benefits of increasing access to long-acting reversible contraceptive (LARC) methods in this population, and the current hurdles to increased access and uptake. High rates of unintended pregnancies and poor physical and psychosocial outcomes among women with SUDs underscore the need for increased access to, and uptake of, LARC methods among these women. A small number of studies that focused on improving access to contraception, especially LARC, via integrated contraception services predominantly provided in drug treatment programs were identified. However, a number of barriers remain, highlighting that much more research is needed in this area.

  7. Emergency Contraception

    Science.gov (United States)

    ... the pill that contains ulipristal acetate reduces the risk of pregnancy more effectively than pills that contain levonorgestrel.It is important to remember that emergency contraceptive pills will not prevent pregnancy if you have ...

  8. ACOG Committee Opinion no. 450: Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy.

    Science.gov (United States)

    2009-12-01

    High unintended pregnancy rates in the United States may in part be the result of relatively low use of long-acting reversible contraceptive (LARC) methods, specifically the contraceptive implant and intrauterine devices. Top-tier reversible methods share the characteristic of requiring a single act of motivation for long-term use, eliminating adherence and user-dependence from the effectiveness equation. According to the World Health Organization's evidence-based Medical Eligibility Criteria for contraceptive use, LARC methods have few contraindications, and almost all women are eligible for implants and intrauterine devices. Because of these advantages and the potential to reduce unintended pregnancy rates, LARC methods should be offered as first-line contraceptive methods and encouraged as options for most women. To increase use of LARC methods, barriers such as lack of health care provider knowledge or skills, low patient awareness, and high upfront costs must be addressed.

  9. The underrated benefits of oral contraception: consequences of pregnancy and induced abortion in teenagers.

    Science.gov (United States)

    Dreyfus, R

    1992-01-01

    If complications occur within a pregnancy planned and brought to term, they often can be dealt with and accepted. They are even more traumatic when they occur in an unwanted pregnancy that could have been prevented through contraception. Teenagers, because of their physical and psychological immaturity and also because of their social environment, seem to suffer with undue frequency from the complications of induced abortion. Its result, for the teenager, is a handicapped future in comparison to other women. Hence, access to contraception is important for all women, and especially for teenagers, in order to avoid such prejudicial situations. It is important, then, to prescribe oral contraception for its efficacy and its short- and long-term innocuousness. Because of her immaturity, the pregnant teenager is at risk: of spontaneous abortion, pre-eclampsia, anemia, hemorrhage, and prematurity. She is also at risk because of the social difficulties she will be facing. This is particularly true in families from developing countries. From birth, the child is also at risk: of low birth weight for the term, mortality in the first year of life, and all risks linked to abandonment, or education by a third party. In a proportion of 13 to 30% in western countries and in a proportion of 3% in East Asia or in Northwest Africa (Maghreb), induced abortions are a reflection of the following: early sexual activity without contraception even if fertility is still low in very young teenagers, absence of social protection or social independence, refusal of forced marriage, and presence or absence of liberal legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Contraception, reproductive health and pregnancy outcomes among women exposed to intimate partner violence in Nigeria.

    Science.gov (United States)

    Okenwa, Leah; Lawoko, Stephen; Jansson, Bjarne

    2011-02-01

    To examine the association between reproductive health practices/outcomes and exposure to intimate partner violence (IPV) among women in Nigeria. More specifically, the association between IPV and use of contraception; miscarriages,induced abortions, stillbirths, and infant mortality; and having many children, was assessed. Data on studied variables were retrieved from the Demographic and Health Surveys of Nigeria 2008, a nationally representative sample of 33,385 women of reproductive age. IPV was defined as exposure to physical, sexual or emotional abuse. The association between contraception use, pregnancy outcomes and infant mortality, and exposure to IPV was assessed using the chi-square test for unadjusted analyses. To control for potential confounding, socio-demographic variables were adjusted for using multiple logistic regression. Compared with women not exposed to IPV, those who were, exhibited a higher likelihood of using modern forms of contraception; having a history of miscarriages, induced abortions, stillbirths, or infant mortality; and having many children. The aforementioned observations still stood after adjustment for potential confounders (e.g., demographic and socioeconomic factors). Though causal inference cannot be drawn due to the cross-sectional design, the study has important implications for incorporation of IPV detection and management in initiatives aimed at improving women's reproductive health.

  11. Contraceptive Methods.

    Science.gov (United States)

    Colquitt, Charlie W; Martin, Tonya S

    2017-02-01

    The prevention of pregnancy remains an important part of the practice of medicine. Contraception can occur at a number of points in the basic reproductive biological process and through a number of contraceptive product options. Pharmacists are health care providers appropriately positioned to assist patients in suitable contraceptive product selection based on their personal situations and lifestyles. This article provides an overview of available products for prevention of pregnancy and associated risks and benefits. Contraceptive products are categorized by their hormonal content and method of action. Hormonal options include oral contraceptive pills, contraceptive patch, implants, injection, intravaginal, and intrauterine devices. Barrier products prevent pregnancy by creating a physical obstacle to the successful fertilization of an egg by sperm. All products and methods are associated with benefits and potential complications that must be considered as patients, and health care providers select the most satisfactory option.

  12. Emergency contraception (post-coital Contraception).

    Science.gov (United States)

    Pham, Angie

    2002-06-01

    Emergency Contraception is a post-coital contraceptive for women who have had unprotected intercourse or have reason to believe that their contraceptive method has failed. The article focuses mainly on Emergency Contraceptive Pills (ECPs) because they are the most frequently used form of post-coital contraception. In 1997 the FDA approved the "off-label" use of high dose of oral contraceptives for use as post-coital contraception. Since then, they have been approved for repackaging and marketed solely for use as post-coital emergency contraception. The first dose of ECPs must be administered within 72 hours of the act of unprotected intercourse. The second dose is taken 12 hours later. ECPs are believed to work in one of three ways depending on where the woman is in her menstrual cycle when she seeks treatment. It can delay or prevent ovulation, impair formation of the corpus luteum, or cause histological or biochemical changes within the endometrium, thus preventing implantation. Their effectiveness is approximately 75%, being most effective when administered as quickly as possible after the act of unprotected intercourse. The pills can cause nausea and vomiting, so the pre-administration of an anti-emetic may help alleviate these symptoms. A major issue concerning the ECPs is the lack of knowledge and availability. Very few health-care providers discuss ECPs with their patients. Most people cited the media as the primary source of information. The 72-hour window in which the ECPs must be administered makes it important for women to have easy access to these post-coital contraceptives. However, women who seek treatment will often find that their health-care provider will require a physical exam and/or a pregnancy test before writing a prescription. Yet, studies show that ECPs do not affect an implanted fetus, and there are no emergency contraceptive protocols that require pregnancy tests or physical exams prior to treatment. The AMA is encouraging physicians to

  13. The Oportunidades conditional cash transfer program: effects on pregnancy and contraceptive use among young rural women in Mexico.

    Science.gov (United States)

    Darney, Blair G; Weaver, Marcia R; Sosa-Rubi, Sandra G; Walker, Dilys; Servan-Mori, Edson; Prager, Sarah; Gakidou, Emmanuela

    2013-12-01

    Oportunidades is a large conditional cash transfer program in Mexico. It is important to examine whether the program has any direct effect on pregnancy experience and contraceptive use among young rural women, apart from those through education. Data from the 1992, 2006 and 2009 waves of a nationally representative, population-based survey were used to describe trends in pregnancy experience, contraceptive use and education among rural adolescent (15-19) and young adult (20-24) women in Mexico. To examine differences in pregnancy experience and current modern contraceptive use among young women, multivariable logistic regression analyses were conducted between matched 2006 samples of women with and without exposure to Oportunidades, predicted probabilities were calculated and indirect effects were estimated. Over the three survey waves, the proportion of adolescent and young adult women reporting ever being pregnant stayed flat (33-36%) and contraceptive use increased steadily (from 13% in 1992 to 19% in 2009). Educational attainment rose dramatically: The proportion of women with a secondary education increased from 28% in 1992 to 46% in 2009. In multivariable analyses, exposure to Oportunidades was not associated with pregnancy experience among adolescents. Educational attainment, marital status, pregnancy experience and access to health insurance--but not exposure to Oportunidades--were positively associated with current modern contraceptive use among adolescent and young adult women. Through its effect on education, Oportunidades indirectly influences fertility among adolescents. It is important for Mexico to focus on strategies to increase contraceptive use among young rural nulliparous women, regardless of whether they are enrolled in Oportunidades.

  14. Factors influencing decision-making regarding contraception and pregnancy among nursing students.

    Science.gov (United States)

    Arhin, Afua Ottie; Cormier, Eileen

    2008-02-01

    The current nursing shortage, now referred to as a 'global crisis', is having a widespread impact on health systems around the world. In view of the international nursing shortage, the retention and matriculation of nursing students who gain entry to nursing programs is a vital facet of nursing education that has broad ramifications. Although enrollment in higher institutions in the United States has increased in the last two decades; graduation rates have not increased at the same rate. Yet the impact of pregnancy on the progression and matriculation of what remains a female dominated nursing student population in her child bearing years has not been adequately addressed. This exploratory study used grounded theory methodology to identify and describe the decision-making processes and coping of African American nursing students who become pregnant. Five interrelated themes emerged from the data. Participants reported inconsistent use of contraceptives but experienced discovery of the pregnancy as highly traumatic. Participants also described the decision to keep the pregnancy as conflict-ridden and difficult as a result of family values and religious beliefs and ultimately driven by maternal support. Maternal and faculty support was central to successful coping and matriculation while in nursing school. With the changing profile of the nursing student, it is important for educational institutions to become more pregnancy friendly in their endeavors to retain and matriculate nursing students.

  15. Association between long-acting reversible contraceptive use, teenage pregnancy, and abortion rates in England

    Directory of Open Access Journals (Sweden)

    Connolly A

    2014-11-01

    Full Text Available Anne Connolly,1 Guilhem Pietri,2 Jingbo Yu,3 Samantha Humphreys4 1The Ridge Medical Practice, Cousen Road, Bradford, UK; 2HERON – A PAREXEL® Company, London, UK; 3Merck & Co, Inc., Whitehouse Station, NJ, USA; 4Merck Sharp & Dohme Limited, Hertfordshire, UK Background: Since the late 1990s, the British government has launched major strategies to address high teenage pregnancy and abortion rates in England. These have focused in part on improving access to contraception through national campaigns. This study assessed teenage pregnancy and abortion rate trends since 1998 and possible associations with usage of long-acting reversible contraceptives (LARCs. Methods: Teenage conception rates and age-specific abortion rates were obtained from the Office for National Statistics and the Department of Health. LARC usage data was obtained for Depo-Provera, Implanon/Nexplanon, intrauterine devices, Mirena, and Noristerat from the IMS British Pharmaceutical Index, IMS Hospital Pharmacy Audit, IMS Disease Analyzer, and KT-31 reports. Through linear regression methods, changes in conception and abortion-related outcomes during 1998–2011 and the associations with LARC usage were assessed. Results: Conception rates for girls younger than 18 years of age decreased significantly between 1998–2011, from 46.6 to 30.7 per 1,000 girls. A statistically significant association was observed between this decrease and increased LARC usage (P=0.0024 in this population. Abortion rates among females aged <18 years or aged 18–19 years decreased between 1998–2011, and their associations with increased LARC usage were statistically significant (P=0.0029 and P=0.0479, respectively. The pattern in older women was complex; abortion rates in women aged 20–24 years or 25–34 years increased slightly from 1998 to 2011, with stabilization during 2007–2011. Conclusion: Increased LARC usage in England was significantly associated with decreased teenage pregnancy rates

  16. Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial.

    Science.gov (United States)

    Hubacher, David; Spector, Hannah; Monteith, Charles; Chen, Pai-Lien; Hart, Catherine

    2017-02-01

    Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible contraception compared with short-acting reversible contraception. Women who choose long-acting reversible contraception may differ in key ways from women who choose short-acting reversible contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible contraception. Wider use of long-acting reversible contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible contraception has in preventing unintended pregnancy relative to short-acting reversible contraception. We conducted a partially randomized patient preference trial and recruited women aged 18-29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible contraception or short-acting reversible contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Of the 916

  17. [Contraception in perimenopause].

    Science.gov (United States)

    Merki-Feld, G S

    2000-10-01

    Perimenopausal women are still potentially fertile and pregnancy is attended with increased maternal and perinatal mortality. Several contraceptive methods can be used therapeutic for the treatment of climacteric symptoms like menstrual irregularities, flushes and vaginal dryness. Low-dose oral contraceptives (OC) prevent climacteric symptoms and additionally protect from perimenopausal bone loss. However, the individual cardiovascular risk increases with age and is even higher in perimenopausal women using OCs. Therefore for women with cardiovascular risk factors sterilization, barrier methods, progestin-only methods and intrauterine devices (IUD) are the better choice. Prolonged and heavy menses can be treated with the levonorgestrel-releasing IUD or injectable progestogens. If estrogen replacement is necessary, a low-dose treatment with natural estrogens can be combined with barrier methods, the levonorgestrel-releasing IUD and injectable progestogens. The variety of contraceptive options available to perimenopausal women allows individual counseling and thus may enhance compliance.

  18. Anxiety symptoms during pregnancy and postpartum.

    Science.gov (United States)

    Breitkopf, Carmen Radecki; Primeau, Loree A; Levine, Ruth E; Olson, Gayle L; Wu, Z Helen; Berenson, Abbey B

    2006-09-01

    This cross-sectional study compared the distribution of anxiety symptoms among pregnant, non-pregnant, and postpartum women of lower socioeconomic status. Participants were 807 women who were pregnant (24-36 weeks), postpartum (2-8 weeks), or not pregnant. Anxiety and depressive symptoms were assessed by the state-trait anxiety index and the Beck depression inventory, respectively. English and Spanish versions of the instrument were available. Group differences in anxiety were evaluated using analysis of variance. Multivariate regression was performed to evaluate differences in anxiety while controlling for marital status, education, race/ethnicity, employment, cohabitation, income, parity, history of depression/anxiety, and depressive symptoms. Anxiety scores were lower among postpartum women relative to pregnant and non-pregnant women (both P < 0.001), who did not differ (P = 0.99). After controlling for depressive symptoms and patient characteristics, anxiety remained lowest among postpartum women. Additionally, history of depression/anxiety and depressive symptoms were significant predictors of anxiety in the multivariate analysis. Comparatively low anxiety and depressive symptoms were observed among women who were 2-8 weeks postpartum. Anxiety symptoms that occur postpartum may not appear until later in the postpartum period.

  19. The Relationship between Contraceptive Use and Unintended Pregnancies among Married Women in Thatta District, Pakistan

    Directory of Open Access Journals (Sweden)

    Sumera Ali

    2017-07-01

    Full Text Available Background & aim: The rate of unintended pregnancy has decreased from 24% to 16% in the last four to five years in Pakistan. However, this rate stills varies among the women living in the rural and urban areas of Pakistan. The females residing in the rural areas are less likely to have many contraceptive choices and receive no/low-quality family planning services; as a result, they end up with birth control failure and unintended pregnancy. Regarding this, more studies are needed to investigate the association between the unintended pregnancy and contraceptive use, particularly in the rural areas of Pakistan.Therefore, the aim of the present study was to determine the relationship between contraceptive use and unintended pregnancy among the women at reproductive age living in Thatta district, Sindh, Pakistan. Methods:This nested case-control study was conducted on the women living in Thatta district during June 2011-July 2012. The pregnant women who did not want more children were considered as cases, and those who intended to have more children were considered as controls. The categorical and continuous variables were analyzed using the Chi-square test and independent t-tests, respectively. Results: According o the results of the present study, the use of contraceptive methods was significantly associated with increased risk of unintended pregnancy among the women living in Thatta district [OR: 2.77 (1.46-5.25]. Moreover, there was 14% increased risk of unintended pregnancy with one year increase in the age of the women [OR: 1.14 (1.10-1.19]. The age at marriage showed negative association with unintended pregnancy [OR: 0.92 (0.87-0.97]. The women having at least one son (alive were almost three times more likely to report their recent pregnancies as unintended, compared to those with no living son [OR: 2.97 (1.82-4.84]. In addition, the husband’s education and their opposition with the use of family planning methods [OR 2.16 (1.06-4.39] were

  20. Contraception use and pregnancy among 15–24 year old South African women: a nationally representative cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Pascoe Sophie

    2007-10-01

    Full Text Available Abstract Background Adolescent reproductive health has not continued to receive the attention it deserves since the start of the HIV epidemic. In South Africa, high numbers of adolescent women report pregnancies that are unwanted and yet few have accessed available termination of pregnancy services. Enabling contraception use is vital for meeting the goals of HIV prevention. Methods A nationally representative survey of South African 15–24 year olds was undertaken. Participants completed a questionnaire on sexual behaviour and provided an oral fluid sample for HIV testing. Analysis of the data was restricted to women (n = 6217, particularly those who reported being sexual active in the last 12 months (n = 3618 and was conducted using svy methods in the program STATA 8.0 to take account of sampling methods. Univariate and multivariate analyses were conducted to explore factors associated with contraceptive use. Results Two thirds of all women reported having ever been sexually active and among these 87% were sexually active in the past 12 months. Among women who reported currently being sexually active, 52.2% reported using contraceptives. There was evidence of association between contraceptive use and being employed or a student (vs unemployed; fewer sex partners; type of last sex partner; having talked to last partner about condom use and having ever been pregnant. Conclusion Specific emphasis must be placed on encouraging young women to use contraceptive methods that offer protection against pregnancy and STIs/HIV. Our consistent finding of a relationship between discussing condom use with partners and condom use indicates the importance of involvement of male partners in women's contraceptive decisions.

  1. Heterotopic pregnancy following intrauterine insemination ...

    African Journals Online (AJOL)

    2011-04-27

    Apr 27, 2011 ... [1] Heterotopic pregnancy often poses diagnostic and therapeutic ... use of hormonal contraceptives. Laparoscopy ... The symptoms persisted after .... stimulation for treatment of infertility: An audit of a new IUI programme in a.

  2. Understanding contraceptive failure

    OpenAIRE

    Trussell, James

    2009-01-01

    Contraceptive failure is a major source of unintended pregnancy. This chapter will review sources of data and measurement of contraceptive failure, summarize results from the literature on the risks of contraceptive failure during typical and perfect use for available methods of contraception, provide a tool for communicating risks of contraceptive failure to clients, examine determinants of contraceptive failure, and identify methodological pitfalls in the published literature.

  3. [Shock in pregnancy: foetal distress may be the first symptom

    NARCIS (Netherlands)

    Vergeldt, T.F.; Kortenhorst, M.S.Q.; Hasaart, T.H.M.; Wijnberger, L.D.

    2014-01-01

    Shock may be difficult to recognize in pregnant women due to the physiological changes that take place in the cardiovascular system. The first symptom of shock may be foetal distress. We present two patients to illustrate this condition. The first patient had an uncomplicated pregnancy until she awo

  4. The influence of psychosocial factors on pregnancy related pelvic symptoms

    NARCIS (Netherlands)

    Pol, G. van de

    2006-01-01

    This thesis encloses studies which are separate analyses of the PRIMIS Study. In the PRIMIS Study a cohort of healthy women who expected their first child was followed up from early pregnancy to one year after delivery. Self-report questionnaires regarding psychosocial factors, urogenital symptoms a

  5. Contraception and Birth Control

    Science.gov (United States)

    ... to the NICHD Staff Directory Skip sharing on social media links Rollup Image Home > Health & Research > A-Z Topics > Contraception and Birth Control > About Page Content ​About Contraception and Birth Control Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to ...

  6. Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births - Pregnancy Risk Assessment Monitoring System (PRAMS), 2004-2008.

    Science.gov (United States)

    2012-01-20

    Approximately 400,000 teens aged 15-19 years give birth every year in the United States (1), and the teen birth rate remains the highest in the developed world. Teen childbearing is a public health concern because teen mothers are more likely to experience negative social outcomes, including school dropout. In addition, infants of teen mothers are more likely to be low birth weight and have lower academic achievement, and daughters of teen mothers are more likely to become teen mothers themselves. To learn why teens wishing to avoid pregnancy become pregnant, CDC analyzed data from the 2004-2008 Pregnancy Risk Assessment Monitoring System (PRAMS). This report describes estimated rates of self-reported prepregnancy contraceptive use among white, black, and Hispanic teen females aged 15-19 years with unintended pregnancies resulting in live births. Approximately one half (50.1%) of these teens were not using any method of birth control when they got pregnant, and of these, nearly one third (31.4%) believed they could not get pregnant at the time; 21.0% used a highly effective contraceptive method (although less than 1% used one of the most effective methods, such as an intrauterine device [IUD]); 24.2% used the moderately effective method of condoms; and 5.1% used the least effective methods, such as rhythm and withdrawal. To decrease teen birth rates, efforts are needed to reduce or delay the onset of sexual activity, provide factual information about the conditions under which pregnancy can occur, increase teens' motivation and negotiation skills for pregnancy prevention, improve access to contraceptives, and encourage use of more effective contraceptive methods.

  7. Adolescent contraception.

    Science.gov (United States)

    Nelson, A L

    1996-12-01

    By age 19, the average North American man has had sex with 5.11 people. Almost two thirds of high-school senior-aged women have had sex. While the rates of sexual activity among teens in the US are not substantially different from rates in other developed western countries, adolescent pregnancy rates in the US are several times higher than in most other countries. These high rates of adolescent pregnancy are partly due to the collective reluctance among adults in the US to discuss sexuality issues with adolescents and provide them with contraception. Effective communication is the key to providing contraception to teens. Studies have clearly shown that teens are interested in sexuality and would like to discuss the issue with their physicians. The author notes that any successful program to reduce unwanted pregnancies among teens will understand that teens are often concrete thinkers focused upon their physical appearance and dedicated to taking risks. Oral contraception, long-acting progestin methods, condoms, and other options are discussed. However, emergency contraception with birth control pills is the one most important contraceptive option which can be provided to teens. The approach has recently been approved by the FDA Advisory Board for both safety and efficacy. Recent studies, however, show that less than 10% of US clinicians informed their patients of the availability of emergency contraception. Information on providers of emergency contraception can be obtained by dialing Princeton University's Office of Population Research's toll-free emergency contraception hotline at (800) 584-9911.

  8. Emergency contraception.

    Science.gov (United States)

    Van Look, P F; von Hertzen, H

    1993-01-01

    The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services.

  9. Gravidez e contracepção na doença falciforme Pregnancy and contraception in sickle cell disease

    Directory of Open Access Journals (Sweden)

    Angela Maria D. Zanette

    2007-09-01

    Full Text Available A contracepção hormonal na doença falciforme é considerada atualmente uma forma segura de diminuir o risco de uma gestação indesejada e/ou de planejar a prole das pacientes acometidas pela doença. Na doença falciforme, a gestação é uma situação de risco materno-fetal elevado, necessitando abordagem multidisciplinar, com o objetivo de reduzir as conseqüências danosas da anemia hemolítica crônica e da vaso-oclusão, típicas da doença. Nesse artigo são abordados os principais aspectos relacionados à contracepção e à gestação em pacientes com doença falciforme, com um panorama atualizado em relação a ambos os temas.For women with sickle cell disease , hormonal contraception is an acceptable and reliable method of decreasing the risk of unwanted pregnancies. The use of combined oral contraceptives is considered safe in this group of patients according to the World Health Organization criteria. Medroxyprogesterone acetate is considered the safest hormonal contraceptive in sickle cell disease. Pregnancy carries increased risks of complications for woman as well as to the fetus, such as higher frequency of painful crises, spontaneous abortions, intrauterine growth retardation and higher neonatal mortality. Multidisciplinary teams are needed to manage pregnancy in sickle cell disease. The purpose of this article is to review some important aspects related to hormonal contraception and pregnancy in sickle cell disease.

  10. Early pregnancy loss in women stimulated with gonadotropin-releasing hormone antagonist protocols according to oral contraceptive pill pretreatment.

    Science.gov (United States)

    Bellver, José; Albert, Carmen; Labarta, Elena; Pellicer, Antonio

    2007-05-01

    To evaluate and compare the risk of early pregnancy loss in patients stimulated with GnRH antagonist protocols according to oral contraceptive pill (OCP) pretreatment. Retrospective case-control study. Instituto Valenciano de Infertilidad. University of Valencia. Spain. One thousand five hundred thirty-nine patients, aged <36, stimulated with GnRH antagonists for IVF between January 1, 2000 and November 1, 2005. Reproductive outcome was compared based on the application (or not) of OCP pretreatment: 944 women were included in the OCP group and 595 in the non-OCP group. The Student's t test was used for statistics. Pregnancy, biochemical pregnancy, ectopic pregnancy, early clinical pregnancy loss, early pregnancy loss, and ongoing pregnancy rates. No significant differences were observed in any of the outcome parameters. Early pregnancy loss rates were similar: 23% in the OCP pretreatment group versus 19.2% in the non-OCP pretreatment group. However, longer periods of ovarian stimulation and higher doses of gonadotropins needed to be employed in the OCP group. There is not sufficient evidence to confirm OCP pretreatment as a risk factor for miscarriage in patients stimulated with GnRH antagonist protocols.

  11. Prevalence rate of signs and symptoms in pregnancy

    Directory of Open Access Journals (Sweden)

    Jaspinder Kaur

    2014-05-01

    Full Text Available "Every pregnancy faces risks" with occurrence of various signs and symptoms including danger signs during antepartum, intrapartum and postpartum phases which require regular antenatal services. The current retrospective study was aimed to assess the prevalence of signs/symptoms of pregnancy. It was being conducted in Obstetrics Department, Punjab Institute of Medical Sciences, Jalandhar (India during April to June, 2012. Socioeconomic variables, parity, antenatal care and event outcomes were explored. Majority of mothers belonged to 21-30 years age group (75.00% and middle socioeconomic status (67.00%. 42% mothers conceived within year of marriage and were referred from periphery (57.00%. 44% suffered from Nausea and Vomiting of Pregnancy whereas, anorexia reported among 12% women. 76% mothers took regular iron and calcium while 5% reported intolerance to iron tablets. 61% and 22% mothers experienced ankle edema in second and third trimester, respectively. Backache, leg cramps, abdominal pain and increased urinary frequency was complained in 47%, 14%, 33% and 50% mothers, respectively. Similarly, 32% experienced constipation and discharge per vaginum was seen among 12% mothers. While, 03%, 05%, 13% and 16% of mothers had leakage per vaginum, bleeding per vaginum, urinary tract infection and headaches, respectively. Various unusual signs/symptoms appear during pregnancy due to physiological hormonal changes. If ignored, they may lead to complications which may prove dangerous for mother and baby. Pregnant women should be able to recognize these symptoms and approach for emergency care for the same. Education programs should be promoted to enhance knowledge of danger signs among pregnant females including family members.

  12. Contraceptive procedures.

    Science.gov (United States)

    Beasley, Anitra; Schutt-Ainé, Ann

    2013-12-01

    Although most women desire to control the size and spacing of their family, the rate of unintended pregnancy in the United States remains high, with approximately half of all pregnancies being unintended. Reducing unintended pregnancy is a national public health goal, and the increased use of long-acting reversible contraceptives (LARCs) (intrauterine devices and implants) can help meet this goal. LARCs are among the most effective forms of contraception available. There are few contraindications to their use, and insertion and removal are straightforward procedures that are well tolerated in the outpatient office setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. [Thyroid function in women: problems created by oral contraceptives, pregnancy and menopause (author's transl)].

    Science.gov (United States)

    Letonturier, P

    1983-01-01

    Thyroid anomalies are more frequent in women than men. Variations in estrogen levels as observed during pregnancy and oral contraception using combined pills may vitiate the results of certain types of thyroid hormone analysis. Consequently, as a result of an increase in thyroxine carrier proteine levels, the total thyroxine levels will be falsely higher whereas the results of the Hamolsky test will be falsely lower. However, the free thyroxine index obtained by combining the results of the 2 tests is not altered by the fluctuations of carrier proteins induced by estrogen overcharge. Although estrogen fluctuations modify thyroxine carrier proteine levels, they hardly influence thyroid function, particularly if hyperthyroidea occurs in menopause. It is simply coincidental. In the same way, thyroidal pathology actually interferes very little with ovarian function. As for the treatment of thyroid problems in pregnant women, difficulties may occur in the case of hyperthyroidea, since theoretically the usual treatments (lugol, beta-blockers, synthetic antithyroidals, radioactive iodine, or surgery on evolutive hyperthyroidea) cannot be applied. In practice, the best solution is to prescribe mild doses of synthetic antithroidals in order to decrease the basic problem without inducing hypothryoidea. (author's)

  14. Hormonal effects on women's facial masculinity preferences: the influence of pregnancy, post-partum, and hormonal contraceptive use.

    Science.gov (United States)

    Cobey, Kelly D; Little, Anthony C; Roberts, S Craig

    2015-01-01

    Here, we investigate changes in women's facial masculinity preferences across pregnancy and the post-partum period. The majority of previous research demonstrating changes in women's masculinity preferences has examined the impact of hormonal variation across the female menstrual cycle. Hormonal changes experienced during pregnancy and the post-partum period, critical periods in women's reproductive life histories, are considerably more extreme than the variation that occurs across the menstrual cycle, suggesting that differences in preferences may also be displayed during these times. We find that women's preference for masculinity in men's faces, but not women's faces, decreases in the post-partum period relative to pregnancy. Furthermore, when compared to a sample of nulliparous control participants, post-partum participants showed different masculinity preferences compared with women who were using hormonal contraception, with the direction of this difference dependent upon the sex of the face assessed.

  15. Non-contraceptive benefits of oral contraceptives

    Directory of Open Access Journals (Sweden)

    Dhont M

    2011-10-01

    Full Text Available Marc Dhont Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium Abstract: The health benefits of the oral contraceptive (OC pill are numerous and outweigh the risks of OC use. There are unintended but useful preventive side effects and potential therapeutic uses of OCs apart from contraception itself. Unequivocal evidence for the protective influence of combined OCs against ovarian and endometrial cancers, and colon cancer to a lesser extent, has been found. The pill also reduces the incidence of benign breast disease, functional ovarian cysts, pelvic inflammatory disease requiring hospitalization, ectopic pregnancy, and iron-deficiency anemia. The pill can be used for the treatment of several gynecologic disorders such as dysmenorrhea, irregular or excessive bleeding, acne, hirsutism, and endometriosis-associated pain, whether prescribed solely to treat these symptoms or prescribed to treat them in addition to providing contraception. These health benefits are often underestimated, as they get too little attention from the mass media. Keywords: the pill, estrogens, progestogens, safety, contraception

  16. Associations of life events during pregnancy with longitudinal change in symptoms of antenatal anxiety and depression

    NARCIS (Netherlands)

    Meijer, Judith L; Bockting, Claudi L H; Stolk, Ronald P; Kotov, Roman; Ormel, Johan; Burger, Huibert

    2014-01-01

    OBJECTIVE: to investigate the association of life events during pregnancy with change in antenatal anxiety and depression symptoms. We distinguished pregnancy related and non-pregnancy related events and assessed specificity of these associations for depressive or anxious symptoms. In addition, we i

  17. A retrospective cohort analysis comparing pregnancy rates among HIV-positive women using contraceptives and efavirenz- or nevirapine-based antiretroviral therapy in Kenya

    Science.gov (United States)

    PATEL, Rena C.; ONONO, Maricianah; GANDHI, Monica; BLAT, Cinthia; HAGEY, Jill; SHADE, Starley B.; VITTINGHOFF, Eric; BUKUSI, Elizabeth A.; NEWMANN, Sara J.; COHEN, Craig R.

    2015-01-01

    SUMMARY Background Given recent concerns of efavirenz reducing the efficacy of contraceptive implants, we sought to determine if pregnancy rates differ among HIV-positive women using various contraceptive methods and efavirenz- or nevirapine-based antiretroviral therapy (ART) regimens. Methods We conducted a retrospective cohort analysis of HIV-positive women aged 15–45 years enrolled in HIV care facilities in western Kenya from January 2011 to December 2013. Pregnancy was diagnosed clinically and the primary exposure was a combination of contraceptive method and ART regimen. We used Poisson models, adjusting for repeated measures, as well as demographic, behavioral and clinical factors, to compare pregnancy rates among women on different contraceptive/ART combinations. Findings 24,560 women contributed 37,635 years of follow-up with 3,337 incident pregnancies. Among women using implants, adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 1·1 (95% CI 0·72–1·5) and 3·3 (95% CI 1·8–4·8) per 100 women-years (w-y), respectively (adjusted incidence rate ratio (aIRR) 3·0, 95% CI 1·3–4·6). Among women using depomedroxyprogesterone acetate (DMPA), adjusted pregnancy incidence for nevirapine- and efavirenz-based ART users were 4·5 (95% CI 3·7–5·2) and 5·4 (95% CI 4·0–6·8) per 100 w-y, respectively (aIRR 1·2, 95% CI 0·91–1·5). Women using other contraceptive methods, except for intrauterine devices and permanent methods, experienced 3·1–4·1 higher rates of pregnancy than women using implants, with 1·6–2·8 higher rates specifically among women using efavirenz-based ART. Interpretation While HIV-positive women using implants on efavirenz-based ART faced three times higher risk of contraceptive failure than those on nevirapine-based ART, these women still experienced lower contraceptive failure rates than women on all other contraceptive methods, except for intrauterine devices and permanent methods

  18. Contraceptive implants.

    Science.gov (United States)

    McDonald-Mosley, Raegan; Burke, Anne E

    2010-03-01

    Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe for use by women with many chronic medical problems. The newest implant, Implanon (Organon International, Oss, The Netherlands), is the only device currently available in the United States and was approved in 2006. It is registered for 3 years of pregnancy prevention. Contraceptive implants have failure rates similar to tubal ligation, and yet they are readily reversible with a return to fertility within days of removal. Moreover, these contraceptive devices can be safely placed in the immediate postpartum period, ensuring good contraceptive coverage for women who may be at risk for an unintended pregnancy. Irregular bleeding is a common side effect for all progestin-only contraceptive implants. Preinsertion counseling should address possible side effects, and treatment may be offered to women who experience prolonged or frequent bleeding. Thieme Medical Publishers.

  19. Non-contraceptive oestrogen-containing preparations for controlling symptoms of premenstrual syndrome.

    Science.gov (United States)

    Naheed, Bushra; Kuiper, Jan Herman; Uthman, Olalekan A; O'Mahony, Fidelma; O'Brien, Patrick Michael Shaughn

    2017-03-03

    Premenstrual syndrome (PMS) is a psychological and somatic disorder of unknown aetiology, with symptoms typically including irritability, depression, mood swings, bloating, breast tenderness and sleep disturbances. About 3% to 10% of women who experience these symptoms may also meet criteria for premenstrual dysphoric disorder (PMDD). PMS symptoms recur during the luteal phase of the menstrual cycle and reduce by the end of menstruation. PMS results from ovulation and may be due to ovarian steroid interactions relating to neurotransmitter dysfunction. Premenstrual disorders have a devastating effect on women, their families and their work.Several treatment options have been suggested for PMS, including pharmacological and surgical interventions. The treatments thought to be most effective tend to fall into one of two categories: suppressing ovulation or correcting a speculated neuroendocrine anomaly.Transdermal oestradiol by patch, gel or implant effectively stops ovulation and the cyclical hormonal changes which produce the cyclical symptoms. These preparations are normally used for hormone therapy and contain lower doses of oestrogen than found in oral contraceptive pills. A shortened seven-day course of a progestogen is required each month for endometrial protection but can reproduce premenstrual syndrome-type symptoms in these women. To determine the effectiveness and safety of non-contraceptive oestrogen-containing preparations in the management of PMS. On 14 March 2016, we searched the following databases: the Cochrane Gynaecology and Fertility Group (CGF) Specialised Register; Cochrane Central Register of Studies (CRSO); MEDLINE; Embase; PsycINFO; CINAHL; ClinicalTrials.gov; metaRegister of Controlled trials (mRCT); and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) Search Portal. In addition, we checked the reference lists of articles retrieved. We included published and unpublished randomized placebo or active

  20. Failure of the emergency contraceptive levonorgestrel and the risk of adverse effects in pregnancy and on fetal development: an observational cohort study.

    Science.gov (United States)

    De Santis, Marco; Cavaliere, Anna Franca; Straface, Gianluca; Carducci, Brigida; Caruso, Alessandro

    2005-08-01

    To determine pregnancy and neonatal outcome after the failure of levonorgestrel as an emergency contraceptive. A retrospective observational cohort study. Telephone consultations concerning reproductive risk factors conducted by Telefono Rosso-Teratology Information Service, Catholic University of Sacred Heart, Rome, Italy. Women exposed to levonorgestrel (36 cases) compared with a control group (80 cases). Teratological counseling. The rate of congenital anomalies, the prepartum or peripartum complications, and the pregnancy outcomes. Twenty-five exposed newborns with length and weight identical to that of the control group were shown to be without increased risk of congenital malformation. No statistical differences were observed in terms of spontaneous or legal abortion and pregnancy and neonatal complications, and there was no ectopic pregnancy in either group. Although the sample size was small, in our experience, the failure of levonorgestrel as an emergency contraceptive was not associated with an increased risk of major congenital malformations, prepartum or peripartum complications, or an adverse pregnancy outcome.

  1. Searching for Ideal Contraceptives.

    Science.gov (United States)

    Djerassi, Carl

    1985-01-01

    Discusses the problem of adolescent pregnancy and focuses on improving contraception as a practical solution. Describes the advantages and disadvantages of existing methods (the condom, the pill, and the contraceptive sponge). Predicts that the development of a fundamentally new contraceptive, such as a monthly menses-inducer pill, will not occur…

  2. Impact of emergency contraception status on unintended pregnancy: observational data from a women’s health practice

    Directory of Open Access Journals (Sweden)

    Payakachat N

    2010-09-01

    Full Text Available Objective: This study aimed to determine if non-prescription emergency contraception (EC availability impacted self-reported unintended pregnancy rates and to assess women’s knowledge and awareness of EC prior to and after non-prescription availability.Methods: A survey regarding contraception use and knowledge was verbally administered to a cross-sectional, convenience sample of 272 pregnant women receiving prenatal care at a large urban community women’s clinic between August 2003 and October 2008. Statistical analyses determined the differences between two groups (before [BA] and after, [AA] non-prescription EC availability in the U.S. drug market in terms of self-reported unintended pregnancy rates, knowledge and awareness of EC.Results: The AA group reported higher incidence of unintended pregnancy when compared to the BA group (90.7% vs. 72.7%, P = 0.0172. The majority of both groups reported that they were not using any contraception at the time of conception (BA-84.4%; AA-83.3%. There was no significant difference in the participants’ awareness of EC between the two groups (BA-46.8% vs. AA-43.0% nor was there a significant difference between the two groups in the self-reported willingness to use EC in the future (BA-53.1% vs. AA-63.4%. However, among participants who were unaware of EC, 61% reported they would consider using it in the future after receiving brief EC counseling from a pharmacist or student pharmacist. Neither age nor pregnancy intention was associated with self-reported EC awareness but there was an association with income (P = 0.0410 and education (P = 0.0021.Conclusion: The change from prescription-only to non-prescription status of EC in the U.S. drug market did not impact the unintended pregnancy rate in this patient population. Lack of knowledge and awareness is still a major barrier to widespread EC use.

  3. What impact has England's Teenage Pregnancy Strategy had on young people's knowledge of and access to contraceptive services?

    Science.gov (United States)

    French, Rebecca S; Mercer, Catherine H; Kane, Roslyn; Kingori, Patricia; Stephenson, Judith M; Wilkinson, Paul; Grundy, Chris; Lachowycz, Kate; Jacklin, Paul; Stevens, Maryjane; Brooker, Sue; Wellings, Kaye

    2007-12-01

    To describe young people's knowledge and use of contraceptive services over initial stages of England's Teenage Pregnancy Strategy, and to investigate factors associated with use of different services. A random location sample of young people aged 13-21 years (n = 8879) was interviewed in 12 waves over 2000-2004. Individual data were analysed to investigate factors associated with knowledge and use of contraceptive services and to observe trends over time. Area-level data were analyzed to explore differences in key variables. In all, 77% of young women and 65% of young men surveyed knew a service they could use to obtain information about sex. Amongst those who had had vaginal sexual intercourse, the most common source of contraceptive supplies was general practice for young women (54%) and commercial venues for young men (54%). Young women's use of school-based services to obtain supplies increased significantly from 15.4% in Year 1 to 24.4% in Year 4, p < .001. Young men's use of the commercial sector declined significantly over the same time period (60.3% to 50.6%, p = .002), while their use of general practice and family planning clinics increased (from 8.9% to 12.4%, p = .008, and 21.2% to 29.1%, p = .054, respectively). Use of family planning clinics and designated young people's clinics was associated with first vaginal intercourse before the 16th birthday and living in a deprived area. Young people's patterns of contraceptive service use have changed since implementation of the Strategy; although no increase in overall service use was observed. The contribution of school-based services needs further exploration.

  4. [The difficulties of contraception: conflicts and paradoxes].

    Science.gov (United States)

    Cribier, F

    1988-06-01

    This work uses clinical examples to explore sources of conflict and denial of patients and physicians during contraception consultations. The discovery of oral contraceptives (OCs) and improvements in mechanical contraception raised hopes that couples could achieve total control of their fertility. But continued high abortion rates and the persistence of sexual problems and maladjustments have demonstrated that contraception alone is not a panacea. Conflicts about contraception may be conscious and quickly expressed during a consultation, even if a medical pretext is given. The resentment when 1 partner desires a child and the other does not for example can translate into a conflict about contraception. Some women are fully aware of their own ambivalence about pregnancy and contraception and able to express it openly, but very often the woman's concerns are expressed by questions, fears, and verbal slips. The fear that pills are unnatural or will cause congenital defects can be interpreted as an expression of guilt over the pleasure that pills permit. Sterility is the ultimate fear caused by this unlimited possibility for pleasure. In the majority of cases, physical complaints are the means by which contraception clients address their physicians. In some cases, intolerance to OCs may actually be a hysterical manifestation that is not understood. Such symptoms as nausea, breast swelling, dizziness, vomiting, nervousness, and insomnia may be signs of early pregnancy as well as of intolerance for pills. Intolerance to pills may be caused by intolerance of a sexuality in which all things seem possible but in which the individual feels unrecognized by the partner. The resulting aggression may be turned inward in the form of a morbid symptom or of forgetting or stopping pill use, recourse to abortion, and demand for recognition. Acting out, especially by adolescents, is common in the area of contraception. In some cases the psychological or emotional needs of the patient

  5. Impact of Hypnosis Intervention in Alleviating Psychological and Physical Symptoms During Pregnancy.

    Science.gov (United States)

    Beevi, Zuhrah; Low, Wah Yun; Hassan, Jamiyah

    2016-04-01

    Physical symptoms (e.g., vomiting) and psychological symptoms (stress, anxiety, and depression) during pregnancy are common. Various strategies such as hypnosis are available to reduce these symptoms. The objective of the authors in this study is to investigate the impact of a hypnosis intervention in reducing physical and psychological symptoms during pregnancy. A pre-test/post-test quasi-experimental design was employed in this study. The hypnosis intervention was given to the experimental group participants at weeks 16 (baseline), 20 (time point 1), 28 (time point 2), and 36 (time point 3) of their pregnancy. Participants in the control group received only the traditional antenatal care. Participants from both groups completed the Depression Anxiety Stress Scale-21 (DASS-21) and a Pregnancy Symptoms Checklist at weeks 16, 20, 28 and 36 of pregnancy. Results indicated that stress and anxiety symptoms were significantly reduced for the experimental group, but not for the control group. Although mean differences for the depressive symptoms were not significant, the experimental group had lower symptoms at time point 3. The physical symptoms' results showed significant group differences at time point 3, indicating a reduction in the experience of physical symptoms for the experimental group participants. Our study showed that hypnosis intervention during pregnancy aided in reducing physical and psychological symptoms during pregnancy.

  6. Emergency Contraception

    Science.gov (United States)

    ... It works because the copper prevents sperm from swimming or functioning well. While more expensive than ECPs, an IUD is the most effective type of emergency contraception. It also can prevent future pregnancies for up to 12 years after insertion. How ...

  7. Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Sandra I McCoy

    Full Text Available BACKGROUND: Prevention of unintended pregnancies among women living with HIV infection is a strategy recommended by the World Health Organization for prevention of mother-to-child transmission of HIV (PMTCT. We assessed pregnancy intentions and contraceptive use among HIV-positive and HIV-negative women with a recent pregnancy in Zimbabwe. METHODS: We analyzed baseline data from the evaluation of Zimbabwe's Accelerated National PMTCT Program. Eligible women were randomly sampled from the catchment areas of 157 health facilities offering PMTCT services in five provinces. Eligible women were ≥16 years old and mothers of infants (alive or deceased born 9 to 18 months prior to the interview. Participants were interviewed about their HIV status, intendedness of the birth, and contraceptive use. RESULTS: Of 8,797 women, the mean age was 26.7 years, 92.8% were married or had a regular sexual partner, and they had an average of 2.7 lifetime births. Overall, 3,090 (35.1% reported that their births were unintended; of these women, 1,477 (47.8% and 1,613 (52.2% were and were not using a contraceptive method prior to learning that they were pregnant, respectively. Twelve percent of women reported that they were HIV-positive at the time of the survey; women who reported that they were HIV-infected were significantly more likely to report that their pregnancy was unintended compared to women who reported that they were HIV-uninfected (44.9% vs. 33.8%, p<0.01. After adjustment for covariates, among women with unintended births, there was no association between self-reported HIV status and lack of contraception use prior to pregnancy. CONCLUSIONS: Unmet need for family planning and contraceptive failure contribute to unintended pregnancies among women in Zimbabwe. Both HIV-infected and HIV-uninfected women reported unintended pregnancies despite intending to avoid or delay pregnancy, highlighting the need for effective contraceptive methods that align with

  8. The state of hormonal contraception today: established and emerging noncontraceptive health benefits.

    Science.gov (United States)

    Maguire, Karla; Westhoff, Carolyn

    2011-10-01

    In the 50 years since the advent of combined oral contraceptives the amount of estrogen in oral contraceptives dropped from over 100 mcg to less than 30 mcg. Many noncontraceptive health benefits have emerged that decrease mortality and improve quality of life. Some of the immediate benefits include improvement of menorrhagia and dysmenorrhea, reduction in premenstrual dysphoric disorder symptoms, and decreased acne. As an effective birth control method oral contraceptives also decrease pregnancy-related deaths by preventing pregnancy. After the reproductive years, previous use of oral contraceptives continues to be beneficial, reducing the risk of death from ovarian and endometrial cancer. All these benefits have held up over time whereas cardiovascular risks have lessened because of the decrease in oral contraceptive pill dosage. Decreased ovarian cyst formation is an example of benefit with higher-dose oral contraceptive formulations that no longer holds true with low-dose pills. Copyright © 2011 Mosby, Inc. All rights reserved.

  9. Intravenous Iron Given prior to Pregnancy for Restless Legs Syndrome is Associated with Remission of Symptoms

    OpenAIRE

    2012-01-01

    Restless legs syndrome (RLS) is more common during pregnancy than in the general population, occurring at a 2-3 times higher prevalence. While iron, genetics, and central nervous system dopamine have been shown to play major roles in RLS unrelated to pregnancy, the etiology and treatment of RLS during pregnancy have not been adequately delineated. We describe a novel approach where a 23-year-old female was given intravenous iron prior to pregnancy, with complete remission of RLS symptoms unti...

  10. Long-term contraceptives.

    Science.gov (United States)

    Brown, Audrey

    2010-10-01

    To avoid unintended pregnancy, women in the UK need to consistently use reliable contraception for over 30 years. The long-acting reversible contraceptive methods compromise the progestogen-only implant, the progestogen-only injectable contraceptive, the copper-bearing intra-uterine device and the levonorgestrel-releasing intra-uterine system. These methods of contraception are highly reliable in pregnancy prevention, and are amongst the medically safest methods for users. Despite this, these long-acting methods are used by less than 10% of the UK population. National guidance has advised that increasing uptake of these long-acting methods will reduce the unplanned pregnancy rate. In addition, these methods are more cost effective than the oral contraceptive even at 1 year of use. Obstetricians and gynaecologists frequently come into contact with women requiring contraceptive advice, and should have a sound knowledge of the long-acting methods. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Impact of Counseling on Repeated Unplanned Pregnancy and Contraceptive Behavior in Low SES Abortion Population.

    Science.gov (United States)

    Burnhill, Michael S.; And Others

    High numbers of repeat abortions at a medical school clinic prompted clinic personnel to develop an experimental fertility control counseling program. Counseling objectives included the following: (1) to engender rapport and trust; (2) to assess the patient's past contraceptive use and psychosocial history; (3) to improve patient's knowledge of…

  12. Combined hormonal contraception and risk of venous thromboembolism within the first year following pregnancy

    DEFF Research Database (Denmark)

    Petersen, Jesper Friis; Bergholt, T; Nielsen, A. K.

    2014-01-01

    throughout the follow-up year. After childbirth, individuals that used combined hormonal contraceptives were more likely than non-users to experience VTE depicted by crude incidence ratios; however, the difference was only significant after 14 weeks. This implied that the numbers needed to harm were lower...

  13. Factors influencing pregnancy intentions and contraceptive use: an exploration of the 'unmet need for family planning' in Tanzania.

    Science.gov (United States)

    Rusibamayila, Asinath; Phillips, James; Kalollela, Admirabilis; Jackson, Elizabeth; Baynes, Colin

    2017-01-01

    Estimation of unmet need for contraception is pursued as a means of defining the climate of demand for services and the rationale for family planning programmes. The stagnation of levels of unmet need, as assessed by Demographic and Health Surveys, particularly in sub-Saharan Africa, has called into question the practical utility of this measure and its relevance to policies and programmes in settings where evidence-based guidance is needed the most. This paper presents evidence from qualitative research conducted in rural Tanzania that assesses the diverse context in which pregnancy intentions and contraceptive behaviours are formed. The multi-level sets of influences on intentions and behaviours - that is, the dichotomous components used to calculate unmet need for family planning - are reviewed and discussed. While results lend support to the concept that unmet need exists and that services should address it, they also attest to the synergistic influences of individual, spousal, organisational and societal factors that influence the implementation of childbearing preferences. Altogether, the analysis suggests that ways for assessing and addressing unmet need in Tanzania, and similar settings, be revised to reflect contextual influences that not only shape individual preferences, but constrain how individuals implement them.

  14. Swedish teenager perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits--a focus group study among 17-year-old female high-school students.

    Science.gov (United States)

    Ekstrand, Maria; Larsson, Margareta; Von Essen, Louise; Tydén, Tanja

    2005-10-01

    Sweden has the highest abortion numbers among the Nordic countries. Since 1995, the abortion rate among teenagers has increased by nearly 50%. We therefore undertook a study where the overall aim was to gain a deeper understanding on which factors female teenagers believe may explain the increasing numbers of teenage abortions. Teenagers' perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits were investigated. Six focus group interviews with 17-year-old Swedish girls were conducted. The interviews were tape-recorded, transcribed verbatim, and analyzed by manifest content analysis. Negative attitudes toward teenage pregnancy and supportive attitudes toward abortion were expressed. Risk-taking behaviors such as negligence in contraceptive use and intercourse under the influence of alcohol were suggested as main reasons behind the increasing numbers of abortions among Swedish teenagers. The contemporary, sexualized, media picture was believed to influence adolescents' sexual behavior, and liberal attitudes toward casual sex were expressed. Girls were perceived as more obliged than boys in taking responsibility for contraceptive compliance and avoidance of pregnancy. The apprehension that hormonal contraceptives cause negative side-effects was widely spread, and the participants were found to have a somewhat limited knowledge of abortion. The majority were unsatisfied with the quality of sexual education provided by the schools. Possible reasons for increased abortion numbers among teenagers in Sweden could be liberal attitudes toward casual sex in combination with negligence in contraceptive use, use of alcohol followed by sexual risk-taking, fear of hormonal contraceptives, and a deterioration of sexual education in the schools.

  15. Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts

    DEFF Research Database (Denmark)

    Rodriguez, A; Miettunen, J.; Henriksen, Tine Brink

    2007-01-01

    pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure...... and cohort country of origin. Children of women who were both overweight and gained a large amount of weight during gestation had a 2-fold risk of ADHD symptoms (OR: 2.10, 95% CI: 1.19, 3.72) compared to normal-weight women.Conclusions:We show for the first time that pre-pregnancy BMI is associated with ADHD......Objectives:We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring.Design:Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within...

  16. Abortion, contraceptive use, and adolescent pregnancy among first-year medical students at a major public university in Mexico City.

    Science.gov (United States)

    Ortiz-Ortega, Adriana; De La Torre, Guadalupe García; Galván, Fernando; Cravioto, Patricia; Paz, Francisco; Díaz-Olavarrieta, Claudia; Ellertson, Charlotte; Cravioto, Alejandro

    2003-08-01

    If properly trained, medical students could become future opinion leaders in health policy and could help the public to understand the consequences of unwanted pregnancies and of abortions. The objective of this study was to analyze the frequency of unwanted pregnancies and induced abortions that had occurred among women who were first-year medical students at a major public university in Mexico City and to compare the experiences of those women with the experiences of the general population of Mexican females aged 15 to 24. In 1998 we administered a cross-sectional survey to all the first-year medical students at the National Autonomous University of Mexico, which is the largest university in Latin America. For this study we analyzed 549 surveys completed by female students. Out of the 549 women, 120 of them (22%) had been sexually active at some point. Among those 120 sexually active students, 100 of them (83%) had used a contraceptive method at some time, and 19 of the 120 (16%) had been pregnant. Of those 19 women who had been pregnant, 10 of them had had an illegal induced abortion (in Mexico, abortions are illegal except under a small number of extenuating circumstances). The reported abortion rate among the female medical students, 2%, was very low in comparison with the 11% rate for women of similar ages in the Mexican general population. The lower incidence of abortion among the female medical students indicates that when young Mexican women have access to medical information and are highly motivated to avoid unintended pregnancy and abortion, they can do so.

  17. Contraception and cardiovascular disease

    NARCIS (Netherlands)

    Roos-Hesselink, JolienW.; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G.; Veldtman, Gruschen R.; Johnson, Mark R.

    2015-01-01

    Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an

  18. Contraception and cardiovascular disease

    NARCIS (Netherlands)

    Roos-Hesselink, JolienW.; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G.; Veldtman, Gruschen R.; Johnson, Mark R.

    2015-01-01

    Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an u

  19. Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

    Directory of Open Access Journals (Sweden)

    Kutovoy A.B.

    2015-09-01

    Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

  20. Obesity and hormonal contraceptive efficacy.

    Science.gov (United States)

    Robinson, Jennifer A; Burke, Anne E

    2013-09-01

    Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

  1. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  2. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  3. Sex, Pregnancy and Contraception: A Report of Focus Group Discussions with Adolescents.

    Science.gov (United States)

    Sugland, Barbara W.; Wilder, Kathleen J.; Chandra, Anita

    Findings in this report summarize the first phase of a larger, multi-year study that is combining qualitative and quantitative methods to outline a conceptual framework to guide future demographic/fertility research, pregnancy prevention programs and policies. Twelve focus groups--involving a multiculturally representative group of male and female…

  4. More vasomotor symptoms in menopause among women with a history of hypertensive pregnancy diseases compared with women with normotensive pregnancies

    NARCIS (Netherlands)

    Drost, J.T.D.; Schouw, Y.T. van der; Herber-Gast, G.C.; Maas, A.H.E.M.

    2013-01-01

    OBJECTIVE: Cardiovascular disease is the major cause of mortality in women worldwide. In recent years, several female-specific cardiovascular risk factors, such as hypertensive pregnancy diseases (HPDs) and vasomotor menopausal symptoms (VMS), have been identified. In this study, we evaluated the as

  5. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

    Directory of Open Access Journals (Sweden)

    Fill Malfertheiner Sara

    2012-09-01

    Full Text Available Abstract Background Symptoms of gastro-esophageal reflux disease (GERD in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed. Methods We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3. Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ. Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7 was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy. Results The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%. Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI. Conclusion GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief.

  6. Are Maternal Smoking and Stress during Pregnancy Related to ADHD Symptoms in Children?

    Science.gov (United States)

    Rodriguez, Alina; Bohlin, Gunilla

    2005-01-01

    Background: There are some indications that maternal lifestyle during pregnancy (smoking and stress) contributes to symptoms of ADHD in children. We prospectively studied whether prenatal exposure to maternal smoking and/or stress is associated with ADHD symptoms and diagnostic criteria (according to DSM-IV) in 7-year-olds. Methods: Nulliparous…

  7. [Choosing contraception].

    Science.gov (United States)

    Gonzalez Velez, A C

    1998-06-01

    The development of contraception has allowed women to think about and experience motherhood not as their destiny but as an option. Humans have always been interested in controlling their fertility. Writings unearthed in the 18th century demonstrated the interest of the ancient Egyptians and Greeks in fertility control. The oral contraceptive (OC) pill, developed in the 1950s by Pincus and Rock, has allowed millions of women to avoid unwanted pregnancy. Since 1960, when the oral contraceptive Enovid was first marketed in the US, over 200 million women throughout the world have used OCs. Modern formulations have low hormone doses, which has minimized side effects. OCs now have an effectiveness of 98%. The method is controlled by the woman, permitting autonomous decisions about pregnancy. Currently, in Colombia, 12.9% of women in union use OCs, 25.7% are sterilized, 11.1% each use IUDs and traditional methods, 4.3% use condoms, 2.5% use injectables, 1.4% use vaginal tablets, 0.7% each use Norplant and vasectomy, and 1.8% use other methods. 27.8% use no method. OCs can be used as an emergency method in case of rape, an unexpected sexual encounter, or failure of another method. When used as a postcoital method, OCs must be taken within 72 hours of unprotected sexual intercourse.

  8. Contraceptive prevalence in Paraguay.

    Science.gov (United States)

    Morris, L; Anderson, J E; Monteith, R S; Kriskovich, R; Schoemaker, J; Frutos, O

    1978-01-01

    Contraceptive use, source of contraception, history of abortion, current pregnancy intention, and fertility rates are evaluated for a national sample of women using data from the Paraguay Contraceptive Prevalence Survey, conducted in 1977. The survey found that 15.5 percent of all women aged 15--44 and 23.6 percent of ever-married women were using effective contraceptive methods. The urban/rural difference in contraceptive use paralleled fertility differentials: over 40 percent of ever-married women were using contraception in Greater Asuncion and other urban areas compared with 15 percent in rural areas. Overall, the data indicate that high-parity rural women have the greatest need for family planning services in Paraguay.

  9. The Pregnancy Obsession-Compulsion-Personality Disorder Symptom Checklist

    NARCIS (Netherlands)

    van Broekhoven, K.; Hartman, E.; Spek, V.; Bergink, V.; van Son, M.J.M.; Karreman, A.; Pop, V.

    2016-01-01

    Background: Up until now, very little research has been undertaken on the possible role of personality traits, such as perfectionism and obsessive compulsive personality disorder (OCPD), on pregnancy distress. This is possibly due to the fact that no appropriate instruments are available for use dur

  10. Can the delivery method influence lower urinary tract symptoms triggered by the first pregnancy?

    Directory of Open Access Journals (Sweden)

    Simone Botelho

    2012-04-01

    Full Text Available INTRODUCTION AND OBJECTIVES: The increase of the intensity of urinary symptoms in late pregnancy and postpartum has been well documented by several authors, but their causes remain uncertain, partly because of its probable multifactor origin. There are also controversies whether the etiology of lower urinary tract symptoms during pregnancy is the same as postpartum and whether the method of delivery could influence the risk of onset of urinary symptoms. This study aimed to evaluate the urinary symptoms triggered during pregnancy and its evolution in the late puerperium, correlating them with the delivery method. MATERIALS AND METHODS: A longitudinal study was conducted, which included 75 primigravidae women, classified according to method of delivery as: (VD vaginal delivery with right mediolateral episiotomy (n = 28; (CS elective caesarean section (n = 26; and (EC emergency caesarean section (n = 21. Urinary symptoms were assessed in the last trimester of pregnancy and at 45 days (± 10 of puerperium with validated versions for Portuguese language of the following questionnaires: International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB. RESULTS: It was observed that frequency, urgency, nocturia and urge incontinence, triggered during pregnancy, decreased significantly in the postpartum period, regardless of the delivery method (p = 0.0001. However, symptoms related to urinary loss due to stress persisted after vaginal delivery (p = 0.0001. CONCLUSIONS: Urgency, frequency and nocturia triggered during pregnancy tend to disappear in the late postpartum period, regardless of the delivery method, but the symptoms related to urinary loss due to stress tend to persist in late postpartum period after vaginal delivery.

  11. A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis.

    Science.gov (United States)

    Ackerman, Ilana N; Ngian, Gene-Siew; Van Doornum, Sharon; Briggs, Andrew M

    2016-01-01

    This systematic review aimed to determine the effectiveness of interventions for improving knowledge and/or self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis (RA). We searched four databases (MEDLINE, CINAHL, Cochrane Trials, PsycINFO) using a comprehensive search strategy. Studies were eligible if they were prospective, published in English from 2004 to 2015, included participants with RA and tested an intervention designed to improve knowledge and/or self-management skills relating to family planning, pregnancy or breastfeeding. As no studies met the latter criterion, the search strategy was expanded to include all prospective studies evaluating RA educational and/or self-management interventions. Data on study characteristics, participant characteristics and programme content were extracted to summarise the evidence base for interventions to support people with RA during their reproductive years. Expanded literature searches identified 2290 papers, of which 68 were eligible. Of these, nine papers (13%) specifically excluded pregnant women/breastfeeding mothers or recruited only older people. Only one study (1%) explicitly evaluated pregnancy-focused education via a motherhood decision aid, while eight studies (12%) incorporated relevant (albeit minor) components within broader RA educational or self-management interventions. Of these, three studies provided methotrexate education in relation to conception/pregnancy/breastfeeding; three incorporated discussions on RA and relationships, impact of RA on the family or sexual advice; one provided information regarding contraception and fertility; and one issued a warning regarding use of biologic therapy in pregnancy/breastfeeding. In conclusion, information regarding family planning, pregnancy or breastfeeding represents a negligible part of published RA educational interventions, with scope to develop targeted resources.

  12. knowledge, attitude and practice of emergency contraceptives ...

    African Journals Online (AJOL)

    GB

    BACKGROUND: Unwanted pregnancy followed by unsafe abortion is one of the major ... contraceptives among Adama University female students. Hence behavioral change strategies should be considered ... KEYWORDS: emergency contraceptives, knowledge, attitude, practice, Ethiopia .... Younger than 10 years. 7. 3.6.

  13. Symptoms of Allergic Rhinitis in Women during Early Pregnancy Are Associated with Higher Prevalence of Allergic Rhinitis in Their Offspring

    Directory of Open Access Journals (Sweden)

    Miwa Shinohara

    2007-01-01

    Results: Offspring whose mothers had any AR symptoms during early pregnancy showed a significantly higher adjusted odds ratio for the onset of AR in offspring than those whose mothers had no symptoms during pregnancy (adjusted Odds Ratio: 6.26, p=0.036. However, the symptoms of AR during late pregnancy showed no effects on the odds ratio. In contrast, the presence or absence of AR symptoms during early or late pregnancy showed no association with the prevalence of food allergy, atopic dermatitis or asthma in offspring. Conclusions: Our results suggest the presence of possible epigenetic mechanisms regulating the onset of AR in humans presumably through increased organ-specific hypersensitivity.

  14. Effects of Contraceptive Education on Adolescent Male Contraceptive Behavior and Attitudes.

    Science.gov (United States)

    Taylor, Mary E.; And Others

    1989-01-01

    The relationship between contraceptive education and teenage male contraceptive behavior was investigated. Findings indicated that brief or moderately in-depth contraceptive education had little effect on contraceptive behavior. The teenage pregnancy and other sex-related problems may make parents and schools more amenable to comprehensive…

  15. [Contraception and obesity].

    Science.gov (United States)

    Lobert, M; Pigeyre, M; Gronier, H; Catteau-Jonard, S; Robin, G

    2015-11-01

    The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in obese women. The combined estrogen-progestin contraceptives (pill, patch and vaginal ring) may be proposed in very strict conditions (no other associated vascular risk factor). Obesity does not increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. It requires to program a possible pregnancy and contraception is needed for several months. Some bariatric surgical techniques such as by-pass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure.

  16. Elevated Corticotropin-Releasing Hormone in Human Pregnancy Increases the Risk of Postpartum Depressive Symptoms

    Science.gov (United States)

    Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2009-01-01

    Context Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence. Objective To determine whether accelerated pCRH increases throughout pregnancy are associated with PPD symptoms. Design Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks gestational age (GA) for assessment of pCRH, cortisol and ACTH. Depressive symptoms were assessed with a standardized questionnaire at the last four pregnancy visits and postpartum. Setting Subjects were recruited from two Southern California Medical Centers, and visits were conducted in university research laboratories. Participants 100 adult women with a singleton pregnancy. Main Outcome Measure PPD symptoms were assessed 8.7 weeks (SD = 2.94 wks) after delivery with the Edinburgh Postnatal Depression Scale. Results Sixteen women developed PPD symptoms. At 25 weeks GA, pCRH was a strong predictor of PPD symptoms (R2 = .21, β = .46, p < .001), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver Operating Characteristic curve analyses revealed that pCRH at 25 weeks GA is a useful diagnostic test (area under the curve = .78, p = .001). Sensitivity (.75) and specificity (.74) at the ideal cut-off point (56.86 pg/ml pCRH) were high. Growth curve analyses indicated that pCRH trajectories in women with PPD symptoms are significantly accelerated between 23 and 26 weeks GA. Conclusion There is a critical period in mid-pregnancy during which pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for identification and treatment of pregnant women at risk of PPD. PMID:19188538

  17. Associations between acetaminophen use during pregnancy and ADHD symptoms measured at ages 7 and 11 years.

    Directory of Open Access Journals (Sweden)

    John M D Thompson

    Full Text Available OBJECTIVE: Our aim was to replicate and extend the recently found association between acetaminophen use during pregnancy and ADHD symptoms in school-age children. METHODS: Participants were members of the Auckland Birthweight Collaborative Study, a longitudinal study of 871 infants of European descent sampled disproportionately for small for gestational age. Drug use during pregnancy (acetaminophen, aspirin, antacids, and antibiotics were analysed in relation to behavioural difficulties and ADHD symptoms measured by parent report at age 7 and both parent- and child-report at 11 years of age. The analyses included multiple covariates including birthweight, socioeconomic status and antenatal maternal perceived stress. RESULTS: Acetaminophen was used by 49.8% of the study mothers during pregnancy. We found significantly higher total difficulty scores (Strengths and Difficulty Questionnaire parent report at age 7 and child report at age 11 if acetaminophen was used during pregnancy, but there were no significant differences associated with any of the other drugs. Children of mothers who used acetaminophen during pregnancy were also at increased risk of ADHD at 7 and 11 years of age (Conners' Parent Rating Scale-Revised. CONCLUSIONS: These findings strengthen the contention that acetaminophen exposure in pregnancy increases the risk of ADHD-like behaviours. Our study also supports earlier claims that findings are specific to acetaminophen.

  18. Parental Depressive and Anxiety Symptoms during Pregnancy and Attention Problems in Children: A Cross-Cohort Consistency Study

    Science.gov (United States)

    Van Batenburg-Eddes, T.; Brion, M. J.; Henrichs, J.; Jaddoe, V. W. V.; Hofman, A.; Verhulst, F. C.; Lawlor, D. A.; Smith, G. Davey; Tiemeier, H.

    2013-01-01

    Background: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating whether parental symptoms in early childhood may…

  19. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So

  20. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  1. Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

    Science.gov (United States)

    Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

    2012-01-01

    The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

  2. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  3. Post abortion contraception.

    Science.gov (United States)

    Gemzell-Danielsson, Kristina; Kopp, Helena Kallner

    2015-11-01

    A safe induced abortion has no impact on future fertility. Ovulation may resume as early as 8 days after the abortion. There is no difference in return to fertility after medical or surgical abortion. Most women resume sexual activity soon after an abortion. Contraceptive counseling and provision should therefore be an integrated part of the abortion services to help women avoid another unintended pregnancy and risk, in many cases an unsafe, abortion. Long-acting reversible contraceptive methods that includes implants and intrauterine contraception have been shown to be the most effective contraceptive methods to help women prevent unintended pregnancy following an abortion. However, starting any method is better than starting no method at all. This Special Report will give a short guide to available methods and when they can be started after an induced abortion.

  4. [Hormonal contraception].

    Science.gov (United States)

    Prilepskaia, V N

    1991-12-01

    Effective contraceptives contribute to the regulation of births, protect the health of women, reduce maternal and perinatal mortality and gynecological diseases, and prevent abortion-related complications. Complications after abortion average 30%, and among primigravidas the rate reaches 45%. Abortion can result in sterility and in the inability to carry out the pregnancy. Oral contraceptives (OCs) are used by 150 million globally. In new preparations ethinyl estradiol (EE) and levonorgestrel (LNG) are the most common components. In the 2-phase and 3-phase preparations Sequilar, Anteovin, and lipid profile safe Triquilar the gestagen component was reduced 40%. Continuin and Famulen are minipills, and Postinor is a postcoital contraceptive. Absolute contraindications of OCs include thromboembolytic diseases, severe cardiovascular system diseases, liver disorders, cirrhosis, cerebral vascular diseases, grave diabetes, jaundice, and malignant tumors of the mammae and sexual organs. Rigevidon, Triquilar, and Trisiston have high steroid content with minimal side effects. The protective effect of OCs are: 2-3 times lower risk of inflammation of the small pelvis, lower risk of malignant and benign ovarian tumors that lasts even after discontinuation, uterine cancer prevention (antiproliferation effect on the endometrium and inhibition of mitotic activity of the myometrium), and reduced risk of benign breast neoplasms. The finding that estrogen-induced risk of breast cancer increases with longterm contraceptive use in young nulliparas has not been persuasively proven. The optimal duration of uninterrupted OC use is 1-1.5 years. Monophasic estrogen-gestagen preparations include Bisecurin, Non-Ovlon, Ovidon, Rigevidon, Minisiston, and Demulen with low dosages of EE, LNG, norethisterone acetate, and diacetate ethonodiol. Norplant is a subdermal silastic capsule with effectiveness for up to 5 years.

  5. Exercise in obese pregnant women: The role of social factors, lifestyle and pregnancy symptoms

    Directory of Open Access Journals (Sweden)

    McIntyre H

    2011-01-01

    Full Text Available Abstract Background Physical activity may reduce the risk of adverse maternal outcomes, yet there are very few studies that have examined the correlates of exercise amongst obese women during pregnancy. We examined which relevant sociodemographic, obstetric, and health behaviour variables and pregnancy symptoms were associated with exercise in a small sample of obese pregnant women. Methods This was a secondary analysis using data from an exercise intervention for the prevention of gestational diabetes in obese pregnant women. Using the Pregnancy Physical Activity Questionnaire (PPAQ, 50 obese pregnant women were classified as "Exercisers" if they achieved ≥900 kcal/wk of exercise and "Non-Exercisers" if they did not meet this criterion. Analyses examined which relevant variables were associated with exercise status at 12, 20, 28 and 36 weeks gestation. Results Obese pregnant women with a history of miscarriage; who had children living at home; who had a lower pre-pregnancy weight; reported no nausea and vomiting; and who had no lower back pain, were those women who were most likely to have exercised in early pregnancy. Exercise in late pregnancy was most common among tertiary educated women. Conclusions Offering greater support to women from disadvantaged backgrounds and closely monitoring women who report persistent nausea and vomiting or lower back pain in early pregnancy may be important. The findings may be particularly useful for other interventions aimed at reducing or controlling weight gain in obese pregnant women.

  6. Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives

    DEFF Research Database (Denmark)

    Nielsen, C H; Poulsen, H K; Teisner, B

    1993-01-01

    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood...

  7. Contraceptive practices and awareness of emergency contraception among Muslim women of urban slum of Raichur, Karnataka

    Directory of Open Access Journals (Sweden)

    Anju D. Ade

    2014-02-01

    Conclusions: Despite 76.8% literacy and 86.5% of awareness of the various methods of contraception, contraceptive practices were low among women. 32 (39.0% women didn’t use any contraceptive till they completed family. There is a gap between awareness and practice. Awareness of emergency contraception is quite low among women (13.4%. Emphasis has to be laid on delaying marriage and first pregnancy and education on planning and spacing children and reproductive contraceptive options, especially emergency contraception since all contraceptive methods can have potential failure; the use of emergency contraceptive of plays an important role in preventing unplanned pregnancies. There is a need to improve women\\'s education about EC. The primary health care providers can play a major role in informing their patients about emergency contraception. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 70-74

  8. Teen motherhood and pregnancy prototypes: the role of social context in changing young African American mothers' risk images and contraceptive expectations.

    Science.gov (United States)

    Barr, Ashley B; Simons, Ronald L; Simons, Leslie Gordon; Gibbons, Frederick X; Gerrard, Meg

    2013-12-01

    Despite the declining rate of teen pregnancies in the United States, academic and public health experts have expressed concern over the still relatively high rate of rapid repeat pregnancies among adolescents, particularly among minority youth. Using a sample of over 300 African American female adolescents, the current study used insights from the prototype/willingness model of adolescent risk behavior to explore this risk. More specifically, it assessed the relationship between entry into unwed motherhood during mid-to-late adolescence and changes in prototypes of unmarried pregnant teens. Further, it explored the extent to which these changing prototypes accounted for young mothers' later contraceptive expectations. We tested the possibility that social images were affected not only by personal experience (the birth of a child) but also by the family and community context in which this experience took place. The findings show that the early entrance into teen motherhood was associated with a shift toward more favorable prototypes of unwed pregnant teens, but that this was only the case for young mothers in disadvantaged contexts. Given this, prototype changes helped to explain the link between teen motherhood and contraceptive expectations only for those in disadvantaged contexts. We discuss these findings in terms of their practical and theoretical implications.

  9. Pregnancy is associated with psychiatric symptoms in a low-income countryside community of Brazil

    Directory of Open Access Journals (Sweden)

    Dias FMV

    2011-11-01

    Full Text Available Fernando MV Dias1–3, Claudio SD Junior4, Glaura C Franco5, Antônio L Teixeira3, Angela M Ribeiro21Department of Medicine and Nursing, Federal University of Viçosa, Viçosa; 2Graduate Program in Neurosciences, Laboratory of Molecular and Behavioral Neuroscience (LaNeC; 3Graduate Program in Neurosciences, Neuropsychiatric Branch Research; 4Department of Sociology and Anthropology; 5Department of Statistics, Federal University of Minas Gerais, Belo Horrizonte, BrazilBackground: Psychiatric symptoms during pregnancy induce an increase in morbidity and also in the mortality levels among women and children. However, the real association between pregnancy and psychiatric disorders and the peculiarities of the phenomenology of symptoms in underprivileged countryside communities remain uncertain.Objective: To verify the association between psychiatric disorder, symptoms, and pregnancy among women from a low-income countryside community and to determine the specific cutoff points for major depression diagnosis according to Beck Depression Inventory for the different trimesters of pregnancy in this population.Methods: Ninety-four pregnant women and 38 healthy women from the Conceição do Mato Dentro health service, a rural low-income community in Brazil, participated in the present study. Psychiatric examination included a structured clinical interview for psychiatric disorders according to Mini International Neuropsychiatric Interview and psychometric scales such as the Yale–Brown Obsessive Scale, the Beck Depression Inventory, and the Hamilton Anxiety Scale. The cutoff points for Beck Depression Inventory were determined through the application of receiver operating characteristic curves considering the diagnosis of major depression according to Mini International Neuropsychiatric Interview.Results: The pregnant women had a higher frequency of psychiatric disorders and depression and anxiety symptoms. All cutoff points of Beck Depression Inventory

  10. [Adolescent contraception. Current trends].

    Science.gov (United States)

    Anthuber, Sabine

    2005-10-01

    Despite easy availability of contraception, Germany is confronted with the problem of increasing rates of pregnancies and abortions in minors. Prescription of contraceptives that do not rely on compliance and are acceptable to adolescents is required in addition to improved counseling. For that purpose, adherence to the guidelines for the use of contraceptives in minors written by the consortium for legislation in medicine (AG Medizinrecht) is essential. Oral contraceptives are the most commonly prescribed form of birth control, advantages include reversibility as well as a good tolerance and safety profile. New developments are low-dose compounds, novel progestins, prevention of ovulation by pure gestagen pills and the long-term use of low-dose monophasic micro pills. Long-term contraceptives like subdermally implantable depot compounds or hormone-releasing pessaries in utero have been used on a regular basis and seem a convenient alternative for birth control for longer periods, also in adolescents. The easy-to-use intravaginal ring and the birth control patch have expanded the spectrum of hormone-releasing contraceptive systems. Studies show improved compliance and a possible reduction of unintentional pregnancies due to application errors. Amelioration of the range of highly effective birth control products different modes of application will hopefully lead to drop in the rate of unplanned pregnancies, especially in adolescents.

  11. Contraceptive care for the adolescent.

    Science.gov (United States)

    Feldman, Elizabeth

    2006-06-01

    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.

  12. Risk of postpartum depressive symptoms with elevated corticotropin-releasing hormone in human pregnancy.

    Science.gov (United States)

    Yim, Ilona S; Glynn, Laura M; Dunkel-Schetter, Christine; Hobel, Calvin J; Chicz-DeMet, Aleksandra; Sandman, Curt A

    2009-02-01

    Postpartum depression (PPD) is common and has serious implications for the mother and her newborn infant. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been hypothesized, but empirical evidence is lacking. To determine whether accelerated increases in pCRH throughout pregnancy are associated with PPD symptoms. Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31, and 37 weeks' gestational age (GA) for assessment of pCRH, cortisol, and adrenocorticotropic hormone (ACTH). Depressive symptoms were assessed with a standardized questionnaire at the last 4 pregnancy visits and post partum. Subjects were recruited from 2 southern California medical centers, and visits were conducted in research laboratories. One hundred adult women with a singleton pregnancy. Main Outcome Measure Symptoms of PPD were assessed at a mean (SD) of 8.7 (2.94) weeks after delivery with the Edinburgh Postnatal Depression Scale. Sixteen women developed PPD symptoms. At 25 weeks' GA, pCRH was a strong predictor of PPD symptoms (R(2) = 0.21; beta = 0.46 [P < .001]), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver operating characteristic curve analyses revealed that pCRH at 25 weeks' GA is a possible diagnostic tool (area under the curve, 0.78 [P = .001]). Sensitivity (0.75) and specificity (0.74) at the ideal cutoff point (pCRH, 56.86 pg/mL) were moderate. Growth curve analyses indicated that the trajectories of pCRH in women with PPD symptoms are significantly accelerated from 23 to 26 weeks' GA. At a critical period in midpregnancy, pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for the identification and treatment of pregnant women at risk for PPD.

  13. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy.

    Science.gov (United States)

    Hauer, Beatrijs J A; Wessel, Ineke; Engelhard, Iris M; Peeters, Louis L; Dalgleish, Tim

    2009-07-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So far, no reported studies have tested the predictive value of memory specificity at the onset of a potentially traumatic situation. Therefore the aim of the present study was to investigate whether prenatal memory specificity would predict post-traumatic stress after complicated pregnancy. The results demonstrate that women who retrieved fewer specific memories with a pregnancy-related content to positive cues during pregnancy (i.e., directly after hospitalisation) reported more post-traumatic stress 6 weeks after giving birth. This relationship remained significant after controlling for variables that were related to both baseline autobiographical memory specificity and later post-traumatic stress. A similar pattern was found for depression symptomatology, even when somatic symptoms were excluded from the analyses. Taken together, these data suggest that the relationship of memory specificity with later depression can be generalised to post-traumatic stress symptoms.

  14. The Symptoms Get Worse after Pregnancy in Sheehan's Syndrome: A Case Report.

    Science.gov (United States)

    Hao, Jingwen; Liu, Min; Mo, Zhaohui

    2012-01-01

    Sheehan's syndrome, which is pituitary necrosis after severe postpartum hemorrhage and hypovolemia, may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. We report an unusual case, in which a 55-year-old woman with Sheehan's syndrome got worse symptoms after spontaneous labor. In 1998, she had severe postpartum hemorrhage and pituitary necrosis during the third delivery, thus it was diagnosed as Sheehan's syndrome by clinical manifestations, laboratory tests, and magnetic resonance imaging. She was treated by replacement therapy including hydrocortisone and levothyroxine sodium. However, she had the fourth spontaneous pregnancy in 2000 and got worse symptoms after delivery. We carefully concluded that pregnancy provided no evidence against the diagnosis of Sheehan's syndrome because pregnancy might improve hypopituitarism by stimulating the pituitary remnant to undergo hyperplasia and irritating the placenta to secrete hormone. However, pregnancy might aggravate the symptoms by inducing autoimmunity as well. All in all, early diagnosis and adequate medical treatment are important to provide a good prognosis of Sheehan's syndrome.

  15. The Symptoms Get Worse after Pregnancy in Sheehan's Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Jingwen Hao

    2012-01-01

    Full Text Available Sheehan’s syndrome, which is pituitary necrosis after severe postpartum hemorrhage and hypovolemia, may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. We report an unusual case, in which a 55-year-old woman with Sheehan's syndrome got worse symptoms after spontaneous labor. In 1998, she had severe postpartum hemorrhage and pituitary necrosis during the third delivery, thus it was diagnosed as Sheehan’s syndrome by clinical manifestations, laboratory tests, and magnetic resonance imaging. She was treated by replacement therapy including hydrocortisone and levothyroxine sodium. However, she had the fourth spontaneous pregnancy in 2000 and got worse symptoms after delivery. We carefully concluded that pregnancy provided no evidence against the diagnosis of Sheehan’s syndrome because pregnancy might improve hypopituitarism by stimulating the pituitary remnant to undergo hyperplasia and irritating the placenta to secrete hormone. However, pregnancy might aggravate the symptoms by inducing autoimmunity as well. All in all, early diagnosis and adequate medical treatment are important to provide a good prognosis of Sheehan’s syndrome.

  16. Knowledge of contraceptive effectiveness.

    Science.gov (United States)

    Eisenberg, David L; Secura, Gina M; Madden, Tessa E; Allsworth, Jenifer E; Zhao, Qiuhong; Peipert, Jeffrey F

    2012-06-01

    The purpose of this study was to determine women's knowledge of contraceptive effectiveness. We performed a cross-sectional analysis of a contraceptive knowledge questionnaire that had been completed by 4144 women who were enrolled in the Contraceptive CHOICE Project before they received comprehensive contraceptive counseling and chose their method. For each contraceptive method, women were asked "what percentage would get pregnant in a year: 10%, don't know." Overall, 86% of subjects knew that the annual risk of pregnancy is >10% if no contraception is used. More than 45% of women overestimate the effectiveness of depo-medroxyprogesterone acetate, pills, the patch, the ring, and condoms. After adjustment for age, education, and contraceptive history, the data showed that women who chose the intrauterine device (adjusted relative risk, 6.9; 95% confidence interval, 5.6-8.5) or implant (adjusted relative risk, 5.9; 95% confidence interval, 4.7-7.3) were significantly more likely to identify the effectiveness of their method accurately compared with women who chose either the pill, patch, or ring. This cohort demonstrated significant knowledge gaps regarding contraceptive effectiveness and over-estimated the effectiveness of pills, the patch, the ring, depo-medroxyprogesterone acetate, and condoms. Copyright © 2012 Mosby, Inc. All rights reserved.

  17. [Weariness of contraception].

    Science.gov (United States)

    Borg, V

    1979-07-01

    Mechanical methods of contraception tend nowadays to be considered as unsafe and the "modern" contraceptives are more popular. The advantage of the intrauterine device is that once it has been placed, one can forget about it. However it is necessary for the woman to undergo checkups and have the device replaced regularly. IUD's are not always very well tolerated psychologically. Women are influenced by information, the fear of the risks, the opinion of their friends and families and the media, and they end up getting tired of this method of contraception. Oral contraceptives are 100% safe but only provided one does not forget to take it: it imposes a daily routine which disturbs many women after a certain time. They then tend to relate all their problems to the pill. Women are aware of the risks contained in oral contraceptives, and they refuse to run these risks by themselves. Whichever method of contraception one chooses, it liberates the woman from the fear of unwanted pregnancy. A good contraception should do this, plus separate the idea of procreation from the sexual intercourse. This seems to be going well for a few years, but after a while a weariness appears. The answer may be to find a contraception suitable to both partners, so that they could make their own decision.

  18. Oral contraceptives.

    Science.gov (United States)

    Maclennan, A H

    1987-12-01

    Over 60 million women use highly efficient and safe modern combined oral contraceptives (OCs) every day. A women who takes the oral contraceptive for 5 years before the age of 30 will actually live 12 days longer, although a woman taking the pill for the 1st time for 5 years after the age of 30 will have her life span reduced on the average by 80 days. OC related morbidity and mortality mostly occur in women over 35 who smoke. Combined low dose OCs are safe for women who do not smoke, at least to 45 years of age and probably to the menopause. The prescription of OCs is also safe to the young adolescent. The pill does not interfere with maturation of the hypothalamic-pituitary ovarian axis and does not increase the incidence of amenorrhoea, oligomenorrhoea or infertility in later life. Patients with contraindications to estrogen therapy are excluded from OC use (history of thromboembolism, major heart disease, liver disease, breast cancer). Low-dose (30-35 mcg estrogen-containing monophasic or triphasic) pills are recommended. Combined oral contraceptives contain either ethinyl estradiol (1.7 to 2 times more potent) or mestranol. After absorption the progestagens, norethisterone acetate, ethynodiol diacetate and lynoestrenol are all metabolized to norethisterone. The progestagen-only pill has about a 2% failure rate and poorer cycle control than the combined pill, but it lacks estrogenic, progestagenic and androgenic side effects. This pill is suitable for the lactating mother, for smokers over 35, for hypertensive patients, and for those with a history of thrombosis. The efficacy of the progestagen-only pill is restored in 3 days of pill taking. Postcoital contraception is an alternative: treatment can be given for at least 72 hours after intercourse. The Yuzpe method calls for the patient to take 2 combined oral contraceptive tablets containing levonorgestrel and ethinyl estradiol (Eugynon or Ovral) followed by a further 2 tablets 12 hours later. This regimen

  19. Depressive Symptoms Prior to Pregnancy and Infant Low Birth Weight in South Africa.

    Science.gov (United States)

    Tomita, Andrew; Labys, Charlotte A; Burns, Jonathan K

    2015-10-01

    Despite improvements in service delivery and patient management, low birth weight among infants has been a persistent challenge in South Africa. The study aimed to explore the relationship between depression before pregnancy and the low birth weight (LBW) of infants in post-apartheid South Africa. This study utilized data from Waves 1 and 2 of the South African National Income Dynamics Study, the main outcome being a dichotomous measure of child LBW (<2500 g) drawn from the Wave 2 child questionnaire. Depressive symptoms of non-pregnant women was the main predictor drawn from the Wave 1 adult questionnaire. Depressive symptoms were screened using the 10-item four-point Likert version of the Center for Epidemiologic Studies Depression Scale (CES-D) instrument. A total score of 10 or greater on the CES-D indicates a positive screen for depressive symptoms. An adjusted logistic regression model was used to examine the relationship between women's depression before pregnancy and infant LBW. A sample size of 651 women in Wave 1 was linked to 672 newborns in Wave 2. The results of the adjusted logistic regression model indicated depressive symptoms (CES-D ≥ 10) prior to pregnancy were associated with infant LBW (adjusted OR 2.84, 95 % CI 1.08-7.46). Another significant covariate in the model was multiple childbirths. Our finding indicates that women's depressive symptoms prior to pregnancy are associated with the low birth weight of newborns and suggests that this association may not be limited to depression present during the ante-natal phase.

  20. Unintended Pregnancies Observed With Combined Use of the Levonorgestrel Contraceptive Implant and Efavirenz-based Antiretroviral Therapy: A Three-Arm Pharmacokinetic Evaluation Over 48 Weeks.

    Science.gov (United States)

    Scarsi, Kimberly K; Darin, Kristin M; Nakalema, Shadia; Back, David J; Byakika-Kibwika, Pauline; Else, Laura J; Dilly Penchala, Sujan; Buzibye, Allan; Cohn, Susan E; Merry, Concepta; Lamorde, Mohammed

    2016-03-15

    Levonorgestrel subdermal implants are preferred contraceptives with an expected failure rate of implants were inserted at baseline in all women. Blood was collected at 1, 4, 12, 24, 36, and 48 weeks. The primary endpoint was week 24 levonorgestrel concentrations, compared between the ART-naive group and each ART group by geometric mean ratio (GMR) with 90% confidence interval (CI). Secondary endpoints included week 48 levonorgestrel concentrations and unintended pregnancies. Week 24 geometric mean levonorgestrel concentrations were 528, 280, and 710 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.53; 90% CI, .50, .55 and nevirapine: ART-naive GMR, 1.35; 90% CI, 1.29, 1.43). Week 48 levonorgestrel concentrations were 580, 247, and 664 pg/mL in the ART-naive, efavirenz, and nevirapine groups, respectively (efavirenz: ART-naive GMR, 0.43; 90% CI, .42, .44 and nevirapine: ART-naive GMR, 1.14; 90% CI, 1.14, 1.16). Three pregnancies (3/20, 15%) occurred in the efavirenz group between weeks 36 and 48. No pregnancies occurred in the ART-naive or nevirapine groups. Within 1 year of combined use, levonorgestrel exposure was markedly reduced in participants who received efavirenz-based ART, accompanied by contraceptive failures. In contrast, nevirapine-based ART did not adversely affect levonorgestrel exposure or efficacy. NCT01789879. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  1. Forgettable contraception.

    Science.gov (United States)

    Grimes, David A

    2009-12-01

    The term "forgettable contraception" has received less attention in family planning than has "long-acting reversible contraception." Defined here as a method requiring attention no more often than every 3 years, forgettable contraception includes sterilization (female or male), intrauterine devices, and implants. Five principal factors determine contraceptive effectiveness: efficacy, compliance, continuation, fecundity, and the timing of coitus. Of these, compliance and continuation dominate; the key determinants of contraceptive effectiveness are human, not pharmacological. Human nature undermines methods with high theoretical efficacy, such as oral contraceptives and injectable contraceptives. By obviating the need to think about contraception for long intervals, forgettable contraception can help overcome our human fallibility. As a result, all forgettable contraception methods provide first-tier effectiveness (contraceptives today with exclusively first-tier effectiveness is the one that can be started -- and then forgotten for years.

  2. Examining the links between perceived impact of pregnancy, depressive symptoms, and quality of life during adolescent pregnancy: the buffering role of social support.

    Science.gov (United States)

    Pires, Raquel; Araújo-Pedrosa, Anabela; Canavarro, Maria Cristina

    2014-05-01

    The aims of the current study were to examine the indirect effect of the perceived impact of pregnancy on quality of life (QoL) through the severity of depressive symptoms among a sample of pregnant adolescents, and to explore whether adolescents' satisfaction with support from their mothers (SM) or partners (SP) was a buffer of this effect. Demographic and pregnancy-related data were collected for 395 pregnant adolescents age 12-19 and were controlled for testing the proposed indirect effect. SM and SP were tested as moderators of the links between perceived impact of pregnancy and depressive symptoms and between depressive symptoms and QoL. A computational tool for path analysis-based moderation and mediation analysis as well as their combination was used to test indirect and interaction effects (PROCESS). A significant indirect effect of the perceived impact of pregnancy on QoL through the severity of depressive symptoms was found (0.51, CI = 0.29/0.78). There was no significant direct effect of the perceived impact of pregnancy on QoL after controlling for the severity of depressive symptoms. SM and SP buffered the indirect effect by weakening the association between a negative perception of the impact of pregnancy and higher severity of depressive symptoms. Identifying adolescents with a negative perception of the impact of pregnancy, improving the quality of their relations with their mothers and partners, and promoting satisfactory support from these figures may be extremely important to prevent and treat depressive symptoms and, in so doing, improve adolescents' QoL during pregnancy.

  3. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods

    Directory of Open Access Journals (Sweden)

    Rosa María Núñez-Urquiza

    2003-01-01

    potencial de cobertura aún no alcanzado entre el grupo de adolescentes, especialmente entre las que viven en áreas suburbanas y entre las no derechohabientes de la seguridad social. Asimismo, sugiere la necesidad de insistir en la promoción de la utilización de métodos anticonceptivos posparto en este grupo considerado de alto riesgo reproductivo. Además, se evidencia la necesidad de investigar sobre métodos de educación sexual y reproductiva que puedan introducirse en el sistema escolar desde el nivel primario.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

  4. Prenatal depressive symptoms and abnormalities of glucose tolerance during pregnancy among Hispanic women.

    Science.gov (United States)

    Ertel, Karen A; Silveira, Marushka; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn; Chasan-Taber, Lisa

    2014-02-01

    The aim of this study is to prospectively examine the association between maternal depressive symptoms in early pregnancy and risk of abnormal glucose tolerance (AGT) and impaired glucose tolerance (IGT) in mid-pregnancy. We evaluated this association among 934 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. Depressive symptoms were assessed in early pregnancy using the 10-item Edinburgh Postnatal Depression Scale. Scores ≥13 indicated at least probable minor depression and scores ≥15 indicated probable major depression. AGT and IGT were diagnosed using American Diabetes Association criteria. In early pregnancy, 247 (26.5 %) participants experienced at least minor depression and 163 (17.4 %) experienced major depression. A total of 123 (13.2 %) were classified with AGT and 56 (6.0 %) were classified with IGT. In fully-adjusted models, the odds ratio for AGT associated with minor depression was 1.20 (95 % CI 0.77-1.89) and for major depression was 1.34 (95 % CI 0.81-2.23). The odds ratio for IGT associated with minor depression was 1.22 (95 % CI 0.62-2.40) and for major depression was 1.53 (95 % CI 0.73-3.22). We did not observe an association with continuous screening glucose measures. Findings in this prospective cohort of Hispanic women did not indicate a statistically significant association between minor or major depression in early pregnancy and AGT or screening glucose values in mid-pregnancy. Due to the small number of cases of IGT, our ability to evaluate the association between depression and IGT risk was constrained.

  5. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms.

    Science.gov (United States)

    Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert

    2016-08-01

    During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.

  6. The contraceptive knowledge and contraceptive behavior influence factors of unmarried female with accidental pregnancy%意外妊娠未婚女性避孕知识认知情况及其避孕行为影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李瑞爱; 卢伟燕; 施玲玲; 梁银萍

    2015-01-01

    目的::探讨意外妊娠未婚女性对避孕知识认知情况及其避孕行为的影响因素分析。方法:选择我站计生科2008年1月~2013年12月就诊的375例意外妊娠的未婚女性为观察对象,采用自编问卷收集意外妊娠未婚女性的临床资料,并分析意外妊娠未婚女性避孕行为的影响因素。结果:意外妊娠的未婚女性避孕知识知晓情况高,但有38.67%的人群未采取避孕措施。回归分析显示文化程度高、很了解人工流产风险和男友积极避孕是意外妊娠未婚女性出现避孕行为的保护因素。结论:意外妊娠的未婚女性避孕知识知晓率较高,避孕知识多通过书刊或媒体等方式获得,多抱有侥幸心理,为了减少女性重复人工流产的发生,必须加强育龄男女青年避孕知识和避孕技巧普及,强调和推动男性参与避孕,减少未婚女性意外妊娠的发生。%Objective:To investigate the contraceptive knowledge and contraceptive behavior influence factors of unmarried female with accidental pregnan-cy. Methods:375 cases unmarried female with accidental pregnancy treated in the family planning department in our family planning station from January 2008 to December 2013 were chosen as the research objects,the clinical data of them were collected by self-made questionnaire. They were analysed by de-scriptive statistics and binary classification logistic regression analysis of SPSS 18. 0 statistical package to find out the contraceptive knowledge and contra-ceptive behavior influence factors of unmarried female with accidental pregnancy. Results:The unmarried female with accidental pregnancy knew less knowl-edge about contraception. Multiariable logistic regression analysis revealed that low degree of culture,know a lot about abortion risk and her boyfriend positive contraception were postoperative factors of contraceptive behavior in unmarried female with accidental pregnancy. Conclusion

  7. Personality, depressive symptoms during pregnancy and their influence on postnatal depression in Spanish pregnant Spanish women

    Directory of Open Access Journals (Sweden)

    Dolores Marín-Morales

    2014-10-01

    Full Text Available The aim of this study was to analyse the influence of personality factors and antenatal depressive symptomatology in postnatal depression. A prospective ex post facto design was carried out. The sample consisted of 116 women, recruited in their first trimester of pregnancy and followed up until four months postpartum. The measurement instruments used were the Edinburg Postnatal Depression Scale (EPDS to assess postpartum depression, the NEO-Five Factor Inventory (NEO-FFI to analyse personality traits and the depression subscale of the Symptoms Check List 90 (SCL-90-R to assess depressive symptomatology in the first half of pregnancy. Socio-demographic variables (age, parity, educational level, employment status, and planned pregnancy and clinical variables (neonatal Apgar score and mode of delivery were also taken into account. A positive correlation was found between postpartum depression and depressive symptomatology in the first trimester; however after the regression analysis neuroticism was the only factor that predicted postpartum depressive symptoms, explaining 24.8% of the variance. Neuroticism significantly influences psychological health during life events such as motherhood. Due to its stable condition, personality could be assessed from the beginning of pregnancy, contributing to the care of pregnant women with high scores in neuroticism, to prevent, detect and treat early postnatal depression.

  8. Immediate start of hormonal contraceptives for contraception.

    Science.gov (United States)

    Lopez, Laureen M; Newmann, Sara J; Grimes, David A; Nanda, Kavita; Schulz, Kenneth F

    2012-12-12

    Health care providers often tell women to wait until the next menses to begin hormonal contraception. The intent is to avoid contraceptive use during an undetected pregnancy. An alternative is to start hormonal contraception immediately with back-up birth control for the first seven days. Immediate initiation was introduced with combined oral contraceptives (COCs), and has expanded to other hormonal contraceptives. At the time of the initial review, how immediate start compared to conventional menses-dependent start was unclear regarding effectiveness, continuation, and acceptability. The immediate-start approach may improve women's access to, and continuation of, hormonal contraception. This review examined randomized controlled trials (RCTs) of immediate-start hormonal contraception for differences in effectiveness, continuation, and acceptability. In August 2012, we searched MEDLINE, CENTRAL, POPLINE, LILACS, ClinicalTrials.gov, and ICTRP for trials of immediate-start hormonal contraceptives. We contacted researchers to find other studies. Earlier searches also included EMBASE. We included RCTs that compared immediate start to conventional start of hormonal contraception. Also included were trials that compared immediate start of different hormonal contraceptive methods with each other. Data were abstracted by two authors and entered into RevMan. The Peto odds ratio (OR) with 95% confidence interval (CI) was calculated. Five studies were included. No new eligible studies have been found since the review was initially conducted. Method discontinuation was similar between groups in all trials. Bleeding patterns and side effects were similar in trials that compared immediate with conventional start. In a study of depot medroxyprogesterone acetate (DMPA), immediate start of DMPA showed fewer pregnancies than a 'bridge' method before DMPA (OR 0.36; 95% CI 0.16 to 0.84). Further, more women in the immediate-DMPA group were very satisfied versus those with a 'bridge

  9. Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives

    DEFF Research Database (Denmark)

    Nielsen, Claus Henrik; Poulsen, Henning Kvist; Teisner, Børge

    1993-01-01

    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood...... presumably enhances fibrinolysis, and that LNg has higher anti-estrogenicity and androgenicity than DSG. Udgivelsesdato: 1993-Sep...

  10. Changes in blood levels of proteinase inhibitors, pregnancy zone protein, steroid carriers and complement factors induced by oral contraceptives

    DEFF Research Database (Denmark)

    Nielsen, C H; Poulsen, H K; Teisner, B

    1993-01-01

    Three low-dose oral contraceptives Trinordiol, Gynatrol, and Marvelon, containing ethinylestradiol (EE) in combination with triphasic levonorgestrel (LNg), monophasic levonorgestrel, and monophasic desogestrel (DGS), respectively, were given to 65 healthy women, n = 21-22 in each group. Blood...... presumably enhances fibrinolysis, and that LNg has higher anti-estrogenicity and androgenicity than DSG....

  11. Intra-uterine contraceptive devices.

    Science.gov (United States)

    Elias, J

    1985-05-01

    Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

  12. Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

    Directory of Open Access Journals (Sweden)

    William Simpson

    Full Text Available Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1 to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2 to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3 to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL-6, IL-10, tumor necrosis factor alpha (TNF-α, and C-reactive protein (CRP at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001, IL-6 (p = 0.025, and IL-10 (p = 0.006 were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

  13. The identification, selection and use of oral contraceptives.

    Science.gov (United States)

    Flowers, C E; Griffith, S F

    1975-01-01

    Facts about oral contraceptives and their use are provided for the practcing generalist and specialist. Identification of oral contraceptives is given in chart form including company, name, contents, pill color, number in pack and special markings. Section 2 entitled "facts that may be helpful in prescribing or changing the prescription of oral contraceptives" includes potency of progestins and estrogens and symptoms indicating excessive or deficient progestin and estrogen activity. Contraindications such as migraine headaches, epilepsy, hepatic disease, renal disease and hypertension are among the reasons for obtaining a complete family history prior to prescription of oral contraceptives. This information provides the basis for choice of contraception tailored to the individual. A 100 pound 17 year old with a normal menstrual history and with adequate estrogen production would be safest with a medication low in estrogen and progestin. An older heavier woman with prolonged menstruation and cramps would require a pill which is potent in progestins since these are excellent for causing endometrium regression and vascular reduction. Length of time on oral c ontraceptives depends upon the patient's general health. If responding well to contraceptives the patient should continue to use them because 1) the body is programmed for lengthy periods of ovulation suppression; 2) the patient becomes accustomed to infertility and 3) too many unplanned pregnancies occur during rest intervals. Complaints of nausea, migraine headaches, change in libido, chloasma or thrombophlebitis determine the termination of the drug.

  14. Contraception - Update and Trends

    Directory of Open Access Journals (Sweden)

    Rabe T

    2010-01-01

    Full Text Available Fertility control in the future will focus on the improvement of existing methods (efficacy, side effects, easy use, duration of action, manufacturing process, costs, on new approaches (mode of action bringing additional health benefits, and on new targets for nonhormonal contraception. Counselling of women in view to contraceptive choices based on the individual risk (e. g. cardiovascular disease, thrombophilia, family risk of breast cancer, sexually transmitted diseases will gain more and more importance. Only a few companies can afford research in contraception such as Bayer-Schering-Pharma, and MSD. Female contraception: Ovulation inhibition: preselection of patients to minimize the individual risk. New oral contraceptive (OC regimen, OC with new progestins, OC with estradiol or estradiol esters, new ovulation inhibitors with new progestins and new regimen including long cycles and continuous delivery of steroidal contraceptives, new contraceptive patches, vaginal rings andsprayon contraceptives. Recently identified genes involved in the ovulation process as new targets for ovulation inhibitors. Fertilisation inhibition: new intrauterine systems have been developed: a smaller Mirena intrauterine system releasing levonorgestrel (LNG and a new frameless progestinreleasing intrauterine systems (IUS. Various new contraceptive barriers have been introduced. Research is ongoing on substances acting both as spermicide and as microbicides as a dualprotection method reducing both the risk of unwanted pregnancy and the risk of sexually transmitted diseases. New implantable systems and improved injectables (with improved pharmacokinetic profile, decreased side effects and a safer delivery system have been made available recently. Various new approaches in female sterilisation include non invasive method of tubal occlusion Immunocontraception for the female will not be available in the near future. Implantation inhibition: selective progesterone

  15. Female contraception over 40

    DEFF Research Database (Denmark)

    2009-01-01

    of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS: MEDLINE searches were...... done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS: The decline in fecundity in the fifth decade...... is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special...

  16. Unhealthy behaviors during pregnancy : who continues to smoke and consume alcohol, and is treatment of anxiety and depressive symptoms effective?

    NARCIS (Netherlands)

    Beijers, Chantal

    2014-01-01

    This thesis investigated continued smoking and alcohol consumption during pregnancy, and treatment of anxiety and depressive symptoms during pregnancy using cognitive behavioral therapy. Data from a large prospective population-based cohort study and a randomized controlled trial were used. Regardin

  17. Childhood Sexual Violence and Consistent, Effective Contraception Use among Young, Sexually Active Urban Women

    Directory of Open Access Journals (Sweden)

    Deborah B. Nelson

    2015-05-01

    Full Text Available Unintended pregnancy (UP is a significant public health problem. The consistent use of effective contraception is the primary method to prevent UP. We examined the role of childhood sexual and physical violence and current interpersonal violence on the risk of unintended pregnancy among young, urban, sexually active women. In particular, we were interested in examining the role of childhood violence and interpersonal violence while recognizing the psychological correlates of experiencing violence (i.e., high depressive symptoms and low self-esteem and consistent use of contraception. For this assessment, 315 sexually active women living in Philadelphia PA were recruited from family planning clinics in 2013. A self-administered, computer-assisted interview was used to collect data on method of contraception use in the past month, consistency of use, experiences with violence, levels of depressive symptoms, self-esteem and sexual self-efficacy, substance use and health services utilization. Fifty percent of young sexually active women reported inconsistent or no contraception use in the past month. Inconsistent users were significantly more likely to report at least one prior episode of childhood sexual violence and were significantly less likely to have received a prescription for contraception from a health care provider. Inconsistent contraception users also reported significantly higher levels of depressive symptoms and significantly lower levels of self-esteem. The relation between childhood sexual violence and UP remained unchanged in the multivariate models adjusting for self-esteem or depressive symptoms. These findings highlight the long-term consequences of childhood sexual violence, independent of current depressive symptoms and low self-esteem, on consistent use of contraception.

  18. [Post-abortion contraception: effects of contraception services and reproductive intention].

    Science.gov (United States)

    Borges, Ana Luiza Vilela

    2016-02-01

    Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact.

  19. Agreeableness and pregnancy: Relations with coping and psychiatric symptoms, a longitudinal study on Spanish pregnant women.

    Science.gov (United States)

    Peñacoba, Cecilia; Rodríguez, Laura; Carmona, Javier; Marín, Dolores

    2017-01-19

    Agreeableness is associated with good mental health during pregnancy. Although different studies have indicated that agreeableness is related to adaptive coping, this relation has scarcely been studied in pregnant women. The aim of this study was to analyze the possible differences between high and low agreeableness in relation to coping strategies and psychiatric symptoms in pregnant women. We conducted a longitudinal prospective study between October 2009 and January 2013. Pregnant women (n = 285) were assessed in the first trimester of pregnancy, and 122 of them were assessed during the third. Data were collected using the Coping Strategies Questionnaire, the Symptom Check List 90-R, and the agreeableness subscale of the NEO-FFI. Using the SPSS 21 statistics package, binary logistic regression, two-way mixed analysis of variance, and multiple regression analyses and a Sobel test were conducted. Higher levels of agreeableness were associated with positive reappraisal and problem-solving, and lower levels of agreeableness were associated with overt emotional expression and negative self-focused coping. Women with low agreeableness had poorer mental health, especially in the first trimester. These findings should be taken into account to improve women's experiences during pregnancy. Nevertheless, given the scarcity of data, additional studies are needed.

  20. Improving research on parental involvement in sexuality education: Findings from the Irish Contraception and Crisis Pregnancy Survey – 2010

    OpenAIRE

    Kelleher, Caroline; Boduszek, Daniel; Bourke, Ashling; McBride, Orla; Morgan, Karen

    2013-01-01

    Sexuality education research has highlighted the importance of parental involvement2. Parents largely concur with the idea that they should play a fundamental role in their children’s sexuality education; indeed, 95% of parents in one national UK study felt that discussing contraception with their children was primarily their responsibility3. However, only 58% of those parents had actually done so, suggesting that these beliefs are not always reflected in practice3. Investigating sexuality ed...

  1. The role of emergency contraception.

    Science.gov (United States)

    Trussell, James; Ellertson, Charlotte; Stewart, Felicia; Raymond, Elizabeth G; Shochet, Tara

    2004-04-01

    Emergency contraception is an underused therapeutic option for women in the event of unprotected sexual intercourse. Available postcoital contraceptives include emergency contraceptive pills (ECPs) both with and without estrogen, and copper-bearing intrauterine devices. Each method has its individual efficacy, safety, and side effect profile. Most patients will experience prevention of pregnancy, providing they follow the treatment regimen carefully. There are concerns that women who use ECPs may become lax with their regular birth control methods; however, reported evidence indicates that making ECPs more readily available would ultimately reduce the incidence of unintended pregnancies. In addition, it is typically conscientious contraceptive users who are most likely to seek emergency treatment. Patient education is paramount in the reduction of unintended pregnancies and there are numerous medical resources available to women to assist them in this endeavor. Finally, ECPs are associated with financial and psychologic advantages that benefit both the individual patient and society at large.

  2. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women--A Nationwide Survey.

    Directory of Open Access Journals (Sweden)

    Helena Kopp Kallner

    Full Text Available To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies.Telephone survey.National survey of women living in Sweden.Women between 16 and 49 years.The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy.Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies.A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1% currently used contraception whereas 268/1001 (26.8% women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women. A total of 781 (78% women had never experienced an unintended pregnancy whereas 220 (22% women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness.Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies.

  3. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women - A Nationwide Survey

    Science.gov (United States)

    Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina

    2015-01-01

    Objective To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Design Telephone survey. Setting National survey of women living in Sweden. Population Women between 16 and 49 years. Methods The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Main Outcome Measures Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. Results A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Conclusions Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies. PMID:25992901

  4. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women--A Nationwide Survey.

    Science.gov (United States)

    Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina

    2015-01-01

    To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Telephone survey. National survey of women living in Sweden. Women between 16 and 49 years. The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies.

  5. [Contraception in the future].

    Science.gov (United States)

    Hamzaoui, R; Boukhris, M

    1994-02-01

    In the last decade, global use of contraceptive methods has increased. About 50% of couples of childbearing age use a modern contraceptive method. This evolution and a positive change in attitude towards male contraception has encouraged research in fertility regulation to enlarge and to improve acceptance of the contraceptive mix. Current injectable contraceptives interfere with the menstrual cycle. Research is exploring ways to minimize such secondary effects by reducing the total hormone dose and by changing the way the active product is delivered (e.g., microspheres). An injectable prototype is an analogue of levonorgestrel (HRP 002). A new IUD is made of leather suspended by a nylon suture which has been inserted into the uterine muscle. RU-486, often used to interrupt early pregnancy, is being tested as an oral contraceptive (OC). It inhibits secretion of gonadotropins and ovulation. It holds promise as an OC with no estrogen component. Since it also inhibits endometrial development and thus prevents implantation, it may someday be used for emergency contraception (i.e., postcoital contraception). New contraceptive implants under study include Norplant RII (2 rods of levonorgestrel lasting for 3 years), Implanon (desogestrel), and Capranor (biodegradable implant lasting 2 years). The female condom consists of a flexible polyurethane sheath with a flexible ring at each end. It has the potential to protect against sexually transmitted diseases since it covers the labial lips and is impermeable to HIV. France and Switzerland have both approved its use. It will enter the UK market at the end of the year. Approval for marketing has been sought in the US.

  6. The influence of sociodemografic and medical variables on severity of anxiety and depressive symptoms during particular trimesters of pregnancy

    Directory of Open Access Journals (Sweden)

    Morylowska-Topolska, Justyna

    2014-02-01

    Full Text Available Aim. The aim of the study was to research the effect of selected socio-demographic and medical variables on the severity of symptoms of anxiety and depression in different trimesters of pregnancy. Materials and methods. The study was prospective, longitudinal, the group consisted of 314 adult pregnant women. To assess the prevalence of depressive and anxiety symptoms the Hospital Anxiety and Depression Scale (HADS was used. The results were statistically analyzed. To assess the normal distribution the Shapiro-Wilk test was used. Non-parametric tests: Mann Whitney U test and Kruskal Wallis ANOVA were used due to the distribution of the variables tested against the intergroup comparisons that deviate from the normal distribution. Results. Only the assessment of the financial and housing situation given by the respondents was related to the severity of symptoms of anxiety and depression in the course of the entire pregnancy. The unmarried respondents had greater severity of depressive symptoms in the first and third trimesters. Other socio-demographic variables were not associated with the severity of symptoms of anxiety and depression in different trimesters of pregnancy. Medical variables (associated with an obstetric-gynecological history, such as a history of miscarriage, complications in a previous pregnancy, the mode of delivery in a previous pregnancy, generally did not affect the severity of symptoms of anxiety and depression during pregnancy. Only major symptoms of depression during the third trimester were associated with complications in a previous pregnancy. An unplanned pregnancy turned out to be one of the most crucial variables determining higher severity of anxiety and depression during pregnancy. Conclusions. The knowledge of socio-demographic and medical factors associated with the severity of symptoms of anxiety and depression during pregnancy may facilitate better monitoring the groups of women being particularly vulnerable to

  7. The role of previous contraception education and moral judgment in contraceptive use.

    Science.gov (United States)

    Bader, Valerie; Kelly, Patricia J; Cheng, An-Lin; Witt, Jackie

    2014-01-01

    The knowledge and attitudes that lead to nonuse of contraception are not well understood. The goal of this study was to determine whether an association exists between contraceptive use and specific knowledge and attitudinal factors. We conducted a secondary analysis of data from a nationally representative telephone survey of 897 unmarried women aged 18 to 29 years to examine the relationship between contraceptive use and comprehensive sex education, attitude toward pregnancy prevention, perceived infertility, distrust toward the health care system or contraception, and moral attitude toward contraception. Both ever having made a visit to a physician or clinic for women's health care and ever having used any method of contraception to prevent pregnancy were significantly impacted by more comprehensive sex education and less likelihood to view contraception as morally wrong. Consistent with other research, we found no association between the desire to avoid pregnancy and contraceptive use. We found an association between health system distrust and contraceptive use, but health system distrust did not predict contraceptive use. Our findings show that contraceptive use among a sample of young women is influenced by previous contraceptive education and moral attitudes toward contraception. Clinicians should be cognizant of these realities, which may need to be addressed in both clinical and nonclinical venues. © 2014 by the American College of Nurse-Midwives.

  8. Employment, income, and education and prevalence of depressive symptoms during pregnancy: the Kyushu Okinawa Maternal and Child Health Study

    Directory of Open Access Journals (Sweden)

    Miyake Yoshihiro

    2012-08-01

    Full Text Available Abstract Background Epidemiological evidence for the association of socioeconomic status with prenatal depression has been inconsistent. The current cross-sectional study examined the association between employment, job type, household income, and educational level and the prevalence of depressive symptoms during pregnancy. Methods Subjects were 1741 Japanese women. Depressive symptoms were defined as present when subjects had a Center for Epidemiologic Studies Depression Scale score of 16 or higher. Adjustment was made for age, gestation, region of residence, family structure, personal and family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, and education. Results The prevalence of depressive symptoms during pregnancy was 19.3%. Compared with unemployment, employment, part-time employment, and full-time employment were significantly associated with a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios (ORs were 0.65 (95% confidence interval [CI]: 0.50 − 0.86, 0.66 (95% CI: 0.46 − 0.95, and 0.66 (95% CI: 0.48 − 0.90, respectively. Regarding the job type held, women with a professional or technical job and those with a clerical or related occupation had a significantly lower prevalence of depressive symptoms during pregnancy: the adjusted ORs were 0.67 (95% CI: 0.47 − 0.96 and 0.62 (95% CI: 0.43 − 0.90, respectively. Sales, service, production, and other occupations were not significantly related to the prevalence of depressive symptoms during pregnancy. There were no relationships between household income or education and the prevalence of depressive symptoms during pregnancy. Conclusions Employment, whether full-time or part-time, and holding a professional or technical job or a clerical or related occupation may be inversely associated with the prevalence of depressive symptoms during pregnancy.

  9. Acculturative stress negatively impacts maternal depressive symptoms in Mexican-American women during pregnancy.

    Science.gov (United States)

    D'Anna-Hernandez, Kimberly L; Aleman, Brenda; Flores, Ana-Mercedes

    2015-05-01

    Mexican-American women exhibit high rates of prenatal maternal depressive symptoms relative to the general population. Though pregnant acculturated Mexican-American women experience cultural stressors such as acculturation, acculturative stress and discrimination that may contribute to elevated depressive symptoms, the contribution of these socio-cultural correlates to depressive symptomology is unknown. Ninety-eight pregnant women of Mexican descent were recruited from a community hospital clinic during their first trimester. Women completed surveys about acculturation, acculturative stress, perceived discrimination, general perceived stress, and maternal depressive symptoms as well as the potential protective factor of Mexican cultural values. Women who experienced greater acculturative and perceived stress, but not perceived discrimination or acculturation, reported significantly elevated depressive symptoms during pregnancy. Also, women who experienced greater acculturative stress identified with a mixture of Mexican and American cultural values. However, only the Mexican cultural value of respect was protective against maternal depressive symptoms while adhering to the Anglo value of independence and self-reliance was a risk factor. A limitation in the study is the cross-sectional and descriptive self-report nature of the work, underscoring the need for additional research. Moreover, physiological measures of stress were not analyzed in the current study. Results point to acculturative stress, above other cultural stressors, as a potential intervention target in culturally competent obstetric care. These findings have implications for maternal mental health treatment during pregnancy, which likely affects maternal-fetal programming and may favorably affect perinatal outcomes in the vulnerable Mexican-American population. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. [Contraceptive compliance - why is contraceptive failure still so frequent?].

    Science.gov (United States)

    Bitzer, Johannes

    2009-02-01

    Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits.

  11. [Post-abortion contraception].

    Science.gov (United States)

    Ohannessian, A; Jamin, C

    2016-12-01

    To establish guidelines of the French National College of Gynecologists and Obstetricians about post-abortion contraception. A systematic review of the literature about post-abortion contraception was performed on Medline and Cochrane Database between 1978 and March 2016. The guidelines of the French and foreign scientific societies were also consulted. After an abortion, if the woman wishes to use a contraception, it should be started as soon as possible because of the very early ovulation resumption. The contraception choice must be done in accordance with the woman's expectations and lifestyle. The contraindications of each contraception must be respected. The long-acting reversible contraception, intra-uterine device (IUD) and implant, could be preferred (grade C) as the efficacy is not dependent on compliance. Thus, they could better prevent repeat abortion (LE3). In case of surgical abortion, IUD should be proposed and inserted immediately after the procedure (grade A), as well as the implant (grade B). In case of medical abortion, the implant can be inserted from the day of mifépristone, the IUD after an ultrasound examination confirming the success of the abortion (no continuing pregnancy or retained sac) (grade C). Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Contraceptive implants: current perspectives

    Directory of Open Access Journals (Sweden)

    Rowlands S

    2014-09-01

    Full Text Available Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost-effective form of long-acting reversible contraception. They are the most effective reversible contraceptives and are of a similar effectiveness to sterilization. Pregnancies are rare in women using this method of contraception, and those that do occur must be fully investigated, with an ultrasound scan of the arm and serum etonogestrel level if the implant cannot be located. There are very few contraindications to use of implants, and they have an excellent safety profile. Both acceptability and continuation with the method are high. Noncontraceptive benefits include improvements in dysmenorrhea, ovulatory pain, and endometriosis. Problematic bleeding is a relatively common adverse effect that must be covered in preinsertion information-giving and supported adequately if it occurs. Recognized training for both insertion and removal should be undertaken. Care needs to be taken at both insertion and removal to avoid neurovascular injury. Implants should always be palpable; if they are not, noninsertion should be assumed until disproven. Etonogestrel implants are now radiopaque, which aids localization. Anticipated difficult removals should be performed by specially trained experts. Keywords: contraceptive, subdermal implant, etonogestrel, levonorgestrel, progestin-only, long-acting reversible contraception

  13. Contraception: traditional and religious attitudes.

    Science.gov (United States)

    Schenker, J G; Rabenou, V

    1993-04-01

    Humans have tried to control fertility for centuries. Primitive, preliterate societies practiced infanticide and abortion. When primitive women understood the advantages of conception control, they tried, when possible, to use contraception. In the 4th century B.C., Plato and Aristotle advocated a one-child family. Greek medical literature reported a hollow tube inserted through the cervix into the uterus and a potion as contraceptives. Islamic physicians had much knowledge about conception control. The attitudes toward contraception. In the 5th century B.C., Saint Augustine condemned contraception, even among married couples. The condom emerged in the early modern period. Yet, they were usually worn to protect against disease, e.g., bilharzia in Egypt and syphilis in Europe. The cervical cap and the diaphragm are examples of occlusive pessaries. By 1880, contraceptives and spermicides were advertised. In 1928, the IUD joined the existing contraceptives. Today we have combined oral contraceptives. Judaic law requires husbands to fulfill their wives sexual needs, separate from their duty to procreate. It also calls men, not women, to procreate and forbids men from masturbating, thus Judaic law does not forbid women from practicing contraception. The Roman Catholic church forbids contraceptive use because it is a sin against nature. Some Protestant denominations have allowed contraceptive use. Islamic law states that children are gifts from Allah. Some Moslems believe that they must have many children, but Allah and the Prophet state that children have rights to education and future security. These rights allow couples to prevent pregnancy. Neither Hinduism nor Buddhism prohibit contraceptive use. Differences in husband-wife communication, sex roles, access to contraceptives, and traditional family values will have more of an effect on contraceptive use and fertility than theological barriers or the social class of religious groups.

  14. IMAP statement on contraceptive efficacy.

    Science.gov (United States)

    1994-08-01

    Unwanted pregnancy may have serious negative effects upon the health and well-being of individuals and families. The use of effective contraception is therefore important. Efficacy, however, is not the only factor considered by clients when choosing a contraceptive method, so counsellors and service providers should not promote methods on the sole basis of their efficacy, irrespective of client preference. With regard to method efficacy, important considerations which may affect the choice of a method are the availability of emergency contraception and access to safe abortion services in the event of method failure. Biological factors such as age, parity, and whether a woman is breast feeding may affect contraceptive efficacy and should be a consideration when choosing a method. Contraceptive efficacy is usually measured in terms of failure rates calculated from the number of pregnancies which occur during a specified period of contraceptive use. Method failure is that attributable to the method, while user failure is that attributable to incorrect use of the method in addition to method failure. The failure rates for specific methods of contraception reported in the literature vary, sometimes substantially. The article briefly considers the measurement of efficacy and human factors affecting contraceptive efficacy with regard to clients, providers, and managers.

  15. Risk factors for depressive symptoms in adolescent pregnancy in a late-teen subsample.

    Science.gov (United States)

    Koleva, Hristina; Stuart, Scott

    2014-04-01

    Depression in adolescent pregnancy is common but underrecognized and can be associated with negative medical outcomes. This brief report examines the relationship between depressive symptoms and various demographic and obstetrical risk factors, as well as the use of antidepressants in pregnant adolescents of late teenage years. Data were derived from a relatively large sample (506 women) recruited from university-based and community mental health centers in Iowa. A cross-sectional analysis did not reveal significant statistical associations between the risk factors and depressive symptoms (Beck Depression Inventory). Antidepressant use was very low (3.7 %), and adolescents with higher depression scores were more likely to take medications. In conclusion, screening for depression in pregnant adolescents should be universal, regardless of demographic and obstetrical risk factors, and promptly addressed.

  16. Contraceptive Development.

    Science.gov (United States)

    Troen, Philip; And Others

    This report provides an overview of research activities and needs in the area of contraceptive development. In a review of the present state, discussions are offered on the effectiveness and drawbacks of oral contraceptives, intrauterine devices, barrier methods, natural family planning, and sterilization. Methods of contraception that are in the…

  17. Intimate partner violence before and during pregnancy: related demographic and psychosocial factors and postpartum depressive symptoms among Mexican American women.

    Science.gov (United States)

    Jackson, Corrie L; Ciciolla, Lucia; Crnic, Keith A; Luecken, Linda J; Gonzales, Nancy A; Coonrod, Dean V

    2015-02-01

    Although research examining intimate partner violence (IPV) has expanded in recent years, there has been relatively little examination of the related demographic and psychosocial factors, as well as mental health outcomes, for IPV before and during pregnancy, especially in a Mexican American population. The current study provides a snapshot of the occurrence of IPV in a community sample of low-income, perinatal Mexican American women (n = 320). Results indicated that 13.1% of the women reported IPV before pregnancy and 11.3% reported IPV during pregnancy. For both IPV before and during pregnancy, women born in the United States were more likely to report IPV than foreign-born women. For IPV before pregnancy, women who were not in a serious romantic relationship or reported a history of childhood trauma were also more likely to report IPV. For IPV during pregnancy, women who reported higher general stress and lower social support were also more likely to report IPV. Finally, the current study provided strong evidence that a history of IPV predicted elevated postpartum depressive symptoms, above and beyond the impact of prenatal depressive symptoms. This study brings greater awareness to a complex and harmful situation in an understudied population. Results are discussed in terms of the relation between demographic and psychosocial risk for IPV before and during pregnancy, acculturation, and postpartum depressive symptoms, as well as the implications for the development of future prevention and intervention programs.

  18. Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness - United States, 2011-2013 and 2015.

    Science.gov (United States)

    Boulet, Sheree L; D'Angelo, Denise V; Morrow, Brian; Zapata, Lauren; Berry-Bibee, Erin; Rivera, Maria; Ellington, Sascha; Romero, Lisa; Lathrop, Eva; Frey, Meghan; Williams, Tanya; Goldberg, Howard; Warner, Lee; Harrison, Leslie; Cox, Shanna; Pazol, Karen; Barfield, Wanda; Jamieson, Denise J; Honein, Margaret A; Kroelinger, Charlan D

    2016-08-05

    Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1,2). Since 2015, Zika virus has been spreading through much of the World Health Organization's Region of the Americas, including U.S. territories. Zika virus is spread through the bite of Aedes aegypti or Aedes albopictus mosquitoes, by sex with an infected partner, or from a pregnant woman to her fetus during pregnancy.* CDC estimates that 41 states are in the potential range of Aedes aegypti or Aedes albopictus mosquitoes (3), and on July 29, 2016, the Florida Department of Health identified an area in one neighborhood of Miami where Zika virus infections in multiple persons are being spread by bites of local mosquitoes. These are the first known cases of local mosquito-borne Zika virus transmission in the continental United States.(†) CDC prevention efforts include mosquito surveillance and control, targeted education about Zika virus and condom use to prevent sexual transmission, and guidance for providers on contraceptive counseling to reduce unintended pregnancy. To estimate the prevalence of contraceptive use among nonpregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students living in the 41 states where mosquito-borne transmission might be possible, CDC used 2011-2013 and 2015 survey data from four state-based surveillance systems: the Behavioral Risk Factor Surveillance System (BRFSS, 2011-2013), which surveys adult women; the Pregnancy Risk Assessment Monitoring System (PRAMS, 2013) and the Maternal and Infant Health Assessment (MIHA, 2013), which surveys women with a recent live birth; and the Youth Risk Behavior Survey (YRBS, 2015), which surveys students in grades 9-12. CDC defines an unintended pregnancy as one that is either unwanted (i.e., the pregnancy occurred when no children, or no more children, were desired) or mistimed (i.e., the pregnancy occurred earlier than desired). The proportion of

  19. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease

    DEFF Research Database (Denmark)

    Lidegaard, O

    1995-01-01

    OBJECTIVE: To assess the risk of developing cerebral thromboembolism among pregnant women and among fertile women with hypertension, migraine, diabetes, and previous thrombotic disease, and to investigate the interaction of these risk factors with the use of oral contraceptives. DESIGN: A retrosp......OBJECTIVE: To assess the risk of developing cerebral thromboembolism among pregnant women and among fertile women with hypertension, migraine, diabetes, and previous thrombotic disease, and to investigate the interaction of these risk factors with the use of oral contraceptives. DESIGN......-matched, randomly selected controls. RESPONSE: Of the 692 case and 1584 control questionnaires sent out, 590 (85.1%) and 1396 (88.1%), respectively, were returned. Of the 590 cases, nine had had cerebral thrombosis before 1980, 15 refused to participate, 44 had a revised diagnosis (primarily multiple sclerosis......) and 25 had an unreliable diagnosis, leaving 497 with a reliable cerebral thromboembolic diagnosis. Among the 1396 controls, 26 either refused to participate, were mentally handicapped, lived abroad or returned an uncompleted questionnaire, leaving 1370 controls included in the study. RESULTS: After...

  20. Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception.

    Science.gov (United States)

    Darney, P D; Callegari, L S; Swift, A; Atkinson, E S; Robert, A M

    1999-04-01

    The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. To investigate ongoing condom behavior in teens using levonorgestrel (Norplant) contraceptive implants, oral contraceptives, and condoms alone, we examined data from a 2-year prospective cohort study of 399 urban teens. The study consisted of 3 clinic-based cohorts of adolescent female contraceptive users: Norplant contraceptive implants (n = 200), oral contraceptives (n = 100), and condoms alone (n = 99). Data were collected at an admission interview and at 1- and 2-year follow-up from method continuers. Norplant contraceptive implant users were less likely than oral contraceptive or condom users to report condom use at last sex or consistent condom use at 1- and 2-year follow-up. The implant group showed a significant decrease in condom use from admission to 2 years after method initiation. The proportion of implant users self-reporting new sexually transmitted infections at 2-year follow-up, however, was not significantly greater than that of oral contraceptive or condom users. Our findings indicate that teen users of Norplant contraceptive implants are less likely to use condoms than teens who choose oral contraceptives but, probably because of differences in sexual behavior, are no more likely to self-report sexually transmitted infections. Our findings also indicate that teens who choose oral contraceptives and condoms do not use them consistently enough to avoid pregnancies or sexually transmitted infections.

  1. Contraceptive Coverage and the Affordable Care Act.

    Science.gov (United States)

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception.

  2. The Current Status of Oral Contraceptives: Progress and Recent Innovations.

    Science.gov (United States)

    Golobof, Alexandra; Kiley, Jessica

    2016-05-01

    Millions of women in the United States and abroad use oral contraceptive pills. These popular contraceptives are the most common reversible birth control method in the United States, and a wide variety of pills are available for prescription. Oral contraceptives provide safe and effective protection against pregnancy and offer several noncontraceptive benefits. Over the years, advances in the laboratory and knowledge gained through epidemiologic data promoted the development of new contraceptive preparations. Generations of oral contraceptives emerged over time, containing lower doses of estrogens and new and novel progestins. The current review discusses the clinical characteristics of oral contraceptives, with emphasis on basic pharmacology and the evolution of various contraceptive formulations and regimens.

  3. Contraception for adolescents with lupus

    Directory of Open Access Journals (Sweden)

    Wagner-Weiner Linda

    2010-03-01

    Full Text Available Abstract Sexually active adolescents, including young women with lupus, are at high risk for unplanned pregnancy. Unplanned pregnancy among teens with lupus is associated with an elevated risk of poor maternal and fetal outcomes. The provision of effective contraception is a crucial element of care for a sexually-active young woman with lupus. Unfortunately, providers may be hesitant to prescribe contraception to this group due to concerns about increasing the risk of lupus complications. This article reviews the risks and benefits of currently-available contraceptives for young women with lupus. Providers are encouraged to consider long-term, highly-effective contraception, such as implantables and intrauterine devices, for appropriately selected adolescents with lupus.

  4. Emergency contraception in Wisconsin: a review.

    Science.gov (United States)

    Sabo, Laura; Schrager, Sarina

    2006-07-01

    Emergency contraception is used to prevent pregnancy in the event of unprotected sexual intercourse. The most common methods of emergency contraception are combination and progestin-only oral contraceptive pills. They are effective, safe, and have few side effects. Most physicians are aware of emergency contraception, yet it is not widely prescribed or used. The American Medical Association and the American College of Obstetricians and Gynecologists recommend providing information and access to emergency contraceptive pills at routine gynecologic visits. Evidence has shown that women provided with advance supplies of emergency contraceptive pills were more likely to use them. There is no evidence of increased sexual risk-taking behavior or reduction in use of regular birth control methods. It is estimated that with wider use of emergency contraceptive, nearly half of unplanned pregnancies and abortions could be prevented. Access and knowledge of emergency contraception are the biggest barriers to use. Many emergency departments in Wisconsin do not prescribe emergency contraception, making access for women in rural areas difficult. By increasing use of emergency contraceptive pills by improving access and improving patient knowledge, unplanned pregnancies and abortions may be reduced.

  5. Emergency contraception: different bioethical perspectives

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2007-10-01

    Full Text Available Emergency contraceptives, in this case post-morning pills, are contraceptive methods used to avoid an unwanted pregnancy after an unprotected sexual intercourse. Their use is feeding a strong ethical debate between subjects for and against their prescription and leading some health professionals to conscientious objection. Among people contrary to prescription some oppose to it because of a general refuse of all contraceptive methods, others considering post-morning pills as abortive. Among people supporting prescription, some consider emergency contraception necessary to assure fundamental women’s rights, in particular the right to sexual auto-determination, while others prescribe emergency contraception only to avoid a greater demand for abortion. It is up to the Italian National Health Service warranting a correct balance between the two opposite positions, that can protect women’s right of access to health services.

  6. Contraception in perimenopause.

    Science.gov (United States)

    Taneepanichskul, Surasak; Dusitsin, Nikorn

    2003-06-01

    Women in their forties are still potentially fertile, and pregnancy in this age group is attended with increased maternal mortality, spontaneous abortion, fetal anomalies and perinatal mortality. Contraception for women in this age group has special risks and benefits; both should be balanced to choose between the different options available. Recent epidemiological and clinical pharmacology studies have indicated the safety of extending the use of combined oral contraceptives (COCs) beyond the age of 35 years and up to menopause. Women who have reasons for avoiding COCs can use progestogen-only contraceptives like pills, depot injectables and implants. Implant combines high efficacy and long-term effect. Both copper-releasing and levonorgestrel-releasing intrauterine contraceptive device (LNG-IUD) combine the advantages of high efficacy and long-term effect. The reduced fecundity above the age of forty can allow extending the use beyond the accepted term, and up to one or two years beyond the menopause without the need for replacement. The levonorgestrel IUD has the advantage of reducing the amount of menstrual bleeding. The condom has the added benefit of protection against sexual transmitted diseases (STDs). Male or female sterilization is an excellent contraceptive option, provided that this approach is culturally acceptable and available at reasonable cost and low risk.

  7. Contraceptive advertising in the United States.

    Science.gov (United States)

    Lebow, M A

    1994-01-01

    are media reluctance, government regulation, lack of consistent effort on the part of advertisers, and a lack of consensus in society about the importance of this issue. These limits are the symptoms of a society which has an unrealistic view of sexual activity. Therefore, contraceptive advertising alone will not change the US's high unintended pregnancy and abortion rates.

  8. [Contraception in adolescents. Taking responsibility and indications].

    Science.gov (United States)

    Thibaud, E

    1988-02-01

    Although information on contraception is readily available and a 1974 French law allows adolescents to receive contraceptives in family planning centers at no cost and without parental consent, over 1/2 of French adolescents have their 1st sexual intercourse with contraceptive protection and 13,000 adolescents under 17 become pregnant each year. Factors in the imperfect access of adolescents to contraception include conflicts with adult sources of contraception information, faulty perception of the risk of pregnancy, and presentation of contraceptive information in rational and technical terms to the exclusion of affective and relational aspects. Practical difficulties in finding a physician and paying for the consultation and fear of the examination itself are obstacles for some adolescents. The ambivalence of family planning providers faced with very young clients can be a significant barrier to access. At the 1st consultation, the adolescent should be seen alone. A complete medical consultation should be carried out including discussion of the adolescent's activities, habits, and affective life. Information on sexually transmitted diseases should be provided in a straightforward way, with possible symptoms included. The consultation usually ends in prescription of a combined oral contraceptive (OC), but for undecided adolescents or those with episodic sex lives several prescriptions may be given to provide a choice between OCs, condoms and spermicides, or the morning-after pill. Follow-up usually entails evaluation of weight and blood pressure, a gynecological examination with annual Pap smear, and management of secondary effects. A breast examination is necessary because of the sensitivity of breasts to estrogen at this age. OCs with a progestin dominance should be chosen for adolescents. In case of menstrual headaches the OC should be modified or terminated. Minor side effects such as acne are often the cause of termination and should not be ignored. Follow

  9. Pharmacologic development of male hormonal contraceptive agents.

    Science.gov (United States)

    Roth, M Y; Amory, J K

    2011-01-01

    The world population continues to increase dramatically despite the existence of contraceptive technology. The use of male hormonal contraception may help in preventing un intended pregnancies and managing future population growth. Male hormonal contraception relies on the administration of exogenous hormones to suppress spermatogenesis. Clinical trials have tested several regimens using testosterone, alone or in combination with a progestin. These regimens were shown to be >90% effective in preventing conception and were not associated with serious adverse events.

  10. Emergency contraception: what teens need to know.

    Science.gov (United States)

    1997-01-01

    Emergency contraception is contraception used soon after unprotected sexual intercourse. The following types of emergency contraception are currently available in the US: ordinary birth control pills containing estrogen and progestin, birth control pills which contain no estrogen and smaller amounts of progestin, and the copper-T IUD. Each of these forms of contraception require a physician's prescription. A woman may need emergency contraception if her regular contraceptive method has failed, if she did not use contraception, or if she has been sexually assaulted. Young women need to be told that emergency contraception exists and can be used when needed. However, they also need to be warned against using such contraception in lieu of the regular use of non-emergency contraception. Non-emergency contraception should still be used. Were emergency contraception widely used, it could prevent up to 2.3 million unintended pregnancies in America each year, 1 million of which are now terminated by abortion. RU-486 (mifepristone) is not generally available in the US.

  11. Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception.

    Science.gov (United States)

    Cwiak, Carrie; Howard, Brandon; Hsieh, Jennifer; Ricciotti, Nancy; Sucato, Gina S

    2016-12-01

    Unintended pregnancy rates in the United States remain high among adolescents. Emergency contraception (EC) provides the only option for pregnancy prevention after unprotected sex. To better define the population of adolescents who request and use EC pills, we performed a post hoc analysis of an over-the-counter simulation study of EC pills. Teen reproductive health clinics in 5 cities. Adolescents between the ages of 13 and 17 years who requested EC. Single-tablet levonorgestrel 1.5 mg. We calculated the correlations between age and baseline sexual and contraceptive behaviors. χ(2) Tests were used to compare behaviors of first-time and repeat EC users. Overall, the most commonly reported contraceptive methods ever used were condoms, oral contraceptives, none, and withdrawal; the most common method ever used in each age group was no method for 13- to 14-year-olds and condom for 15-, 16-, and 17-year-olds. The percentage of participants who had never used contraception before requesting EC decreased with age (53% [20/28] of 13- to 14-year-olds vs 15% [10/65] of 17-year-olds). First-time EC users were more likely to report no previous contraceptive use compared with repeat EC users (42% [88/208] vs 10% [13/135]; P < .001). Regardless of age, the most commonly reported reason for requesting EC was nonuse of any contraceptive method (ie, "unprotected sex"). Adolescents who requested EC most commonly reported ever-use of contraceptive methods that rely on user adherence or no method at all, with younger adolescents more likely than older adolescents to have used no previous method. The provision of EC presents an opportunity to provide education and access to highly effective, long-term contraceptive methods. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  12. Intake of dairy products and calcium and prevalence of depressive symptoms during pregnancy in Japan: a cross-sectional study.

    Science.gov (United States)

    Miyake, Y; Tanaka, K; Okubo, H; Sasaki, S; Arakawa, M

    2015-02-01

    To examine the relationship between the intake of dairy products and calcium and the prevalence of depressive symptoms during pregnancy. Cross-sectional study. Kyushu Okinawa Maternal and Child Health Study (KOMCHS). A cohort of 1745 pregnant Japanese women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Scores of 16 or higher on the Center for Epidemiologic Studies Depression Scale denoted depressive symptoms. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, job type, household income, education, and body mass index. In our analyses regarding dairy products in general, adjustment was also made for fish intake; in our analysis regarding calcium, adjustment was also made for the intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, and vitamin D. Depressive symptoms during pregnancy. Higher intake levels of yogurt and calcium were independently related to a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios between extreme quartiles were 0.69 (95% CI 0.48-0.99, P for trend = 0.03) and 0.59 (95% CI 0.40-0.88, P for trend = 0.006), respectively. No relationships were observed between the intake of all dairy products, milk, or cheese and depressive symptoms during pregnancy. The current results suggest that a higher intake of yogurt and calcium may be associated with a lower prevalence of depressive symptoms during pregnancy. © 2014 Royal College of Obstetricians and Gynaecologists.

  13. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  14. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  15. Knowledge, attitude and practice of emergency contraceptives ...

    African Journals Online (AJOL)

    admin

    Background: Young and unmarried women constitute a high risk group for unplanned pregnancies and unsafe abortions. It has been estimated that widespread use of emergency contraception (EC) may significantly ... single women, teenagers and students (3). ... contraceptive method and their sexual behavior is rather.

  16. Adolescents and oral contraceptives.

    Science.gov (United States)

    Sanfilippo, J S

    1991-01-01

    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development

  17. Gravidez ectópica após uso de contracepção de emergência: relato de caso Ectopic pregnancy after use of hormonal emergency contraception: a case report

    Directory of Open Access Journals (Sweden)

    Renato Monteiro Zucchi

    2004-10-01

    Full Text Available Gravidez ectópica é a implantação e o desenvolvimento do ovo fora da cavidade uterina; impõe diagnóstico precoce e assistência de urgência. Gravidez ectópica com corpo lúteo contralateral presume ocorrência de transmigração do zigoto para a tuba uterina do lado oposto, o que pode ser responsável pela sua ocorrência. Em 1994, o levonorgestrel teve sua eficácia comprovada como superior à dos outros métodos para contracepção de emergência. É relatado caso de paciente de 27 anos que apresentou gravidez ectópica, de localização tubária, com corpo lúteo contralateral, após uso de contracepção de emergência por falha do método anticoncepcional de escolha (preservativo masculino. Foi realizado tratamento cirúrgico conservador por videolaparoscopia, com boa evolução após a cirurgia.Ectopic pregnancy is the implantation and development of the ovum outside the uterine cavity; it needs a quick diagnosis and an urgent treatment. The presence of the corpus luteum in the ovary that is contralateral to the ectopic pregnancy is presumptive evidence for ovum transmigration, which may be the cause of ectopic pregnancy. In 1994, a multinational clinical trial proved the superiority of levonorgestrel over the existing emergency contraceptive products. In the present study, we describe the case of a 27-year-old woman with ectopic pregnancy and a contralateral corpus luteum after use of hormonal emergency contraception (levonorgestrel, because of failure of the used contraception method (condom. The patient was treated with laparoscopic surgery that was successful.

  18. Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis.

    Science.gov (United States)

    Oliveira, Aline Gaudard E Silva de; Reichenheim, Michael Eduardo; Moraes, Claudia Leite; Howard, Louise Michele; Lobato, Gustavo

    2016-12-28

    The aim of the study was to explore the pathways by which childhood sexual abuse (CSA), psychological and physical intimate partner violence (IPV) during pregnancy, and other covariates relate to each other and to posttraumatic stress disorder (PTSD) symptoms in the postpartum period. The sample comprised 456 women who gave birth at a maternity service for high-risk pregnancies in Rio de Janeiro, Brazil, interviewed at 6-8 weeks after birth. A path analysis was carried out to explore the postulated pathways between exposures and outcome. Trauma History Questionnaire, Conflict Tactics Scales and Posttraumatic Stress Disorder Checklist were used to assess information about exposures of main interest and outcome. The link between CSA and PTSD symptoms was mediated by history of trauma, psychiatric history, psychological IPV, and fear of childbirth during pregnancy. Physical IPV was directly associated with postnatal PTSD symptoms, whereas psychological IPV connection seemed to be partially mediated by physical abuse and fear of childbirth during pregnancy. The role of CSA, IPV, and other psychosocial characteristics on the occurrence of PTSD symptoms following childbirth as well as the intricate network of these events should be acknowledged in clinic and intervention approaches.

  19. Quality of life, anxiety and depression symptoms in early and late pregnancy in women with pregestational diabetes

    DEFF Research Database (Denmark)

    Do, Nicoline C; Secher, Anna L; Cramon, Per

    2017-01-01

    INTRODUCTION: The aim of this study was to explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes. MATERIAL AND METHODS: An observational cohort study including 137 pregnant women with pregestational diabetes (110 ...

  20. Association between signs and symptoms of temporomandibular disorders and pregnancy (case control study).

    Science.gov (United States)

    Mayoral, Verónica A; Espinosa, Irene A; Montiel, Alvaro J

    2013-01-01

    Temporomandibular disorders (TMD) are a combination of multifactoral etiological muscular-skeletal symptoms. Prevalence is greater in women, where sexual hormones are important in pathogenesis, and its behavior at different stages of the reproductive life of women has never been fully documented. The general objective was to determine the association between signs and symptoms of temporomandibular disorders and pregnancy. A case-control study was conducted on 66 pregnant patients who met with a medical specialist and 66 non-pregnant women paired by age, who visited the General Regional Hospital 36 of Mexico's Social Security Institute (IMSS). These patients were examined for the Temporomandibular (TMD) research project to establish the prevalence of TMD in both groups. Descriptive variables were calculated through him SPSS 17 program and the association between groups with Xi Square and Ratio Possibilities (OR), The average age was 28.23 +/- 5.9 years in both groups, with median gestation 32.97 weeks. Most of the participants had a domestic partner. The prevalence of TDM in the non-pregnant group was 45.5% and only 15.2% in the pregnant group (chi2 = 14.34, p disorders.

  1. Dietary patterns and depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi

    2018-01-01

    Only one Brazilian study has examined the association between dietary patterns and depressive symptoms during pregnancy. The current cross-sectional study examined this issue in Japan. Study subjects were 1744 pregnant women. Between April 2007 and March 2008, information under study was obtained. Dietary patterns were derived from a factor analysis of 33 predefined food groups based on a self-administered diet history questionnaire. Depressive symptoms were defined as a Center for Epidemiological Studies Depression Scale score ≥ 16. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure, employment, household income, education, and body mass index. Three dietary patterns were identified: 'healthy', characterized by high intake of green and yellow vegetables, other vegetables, mushrooms, pulses, seaweed, potatoes, fish, sea products, miso soup, sugar, and shellfish; 'Japanese', characterized by high intake of rice and miso soup; and 'Western', characterized by high intake of beef and pork, processed meat, vegetable oil, chicken, eggs, shellfish, and salt-containing seasonings. The healthy and Japanese patterns were independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratios (95% confidence intervals, P for trend) between extreme quartiles were 0.56 (0.43-0.73, < 0.0001) and 0.72 (0.55-0.94, 0.008), respectively. No association was observed between the Western pattern and depressive symptoms during pregnancy. Information was obtained between the 5th and 39th week of pregnancy. The healthy and Japanese dietary patterns may be inversely associated with depressive symptoms during pregnancy. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. 再次意外妊娠妇女避孕节育知识和行为的干预性研究%Intervention study of contraceptive knowledge and behavior of women with recurrent unplanned pregnancy

    Institute of Scientific and Technical Information of China (English)

    邹晓璇; 周钰

    2011-01-01

    目的 探讨干预措施对再次发生意外妊娠的妇女避孕节育知识水平和行为的作用,以寻求降低重复人工流产率的对策.方法 采用干预性研究方法,对北京市海淀区969名发生再次意外妊娠的妇女进行随访1年的研究.结果 干预后,短效避孕知识知晓和掌握评分均增加了高分组;完全不掌握长效避孕方法构成比下降了11.35%,掌握1种长效避孕方法者增加了12.38%;紧急避孕知识评分5分组构成比增加了64.19%.干预前和干预后的1个月、3个月、6个月、12个月避孕节育率分别为45.20%、60.06%、94.07%、96.95%和96.96%,随着干预时间的延长,避孕节育率显著增加(趋势χ2=1 116.92,P=0.000).结论 对流产后妇女进行避孕节育知识和行为的干预,可有效地提高避孕节育知识水平和避孕节育行为,且最佳开展干预时间在术后3个月内.%Objective To assess the impact of interventions of contraceptive knowledge and behavior on women with recurrent unplanned pregnancy, so as to seek measures to reduce the rate of repeated reduced abortion. Methods An intervention study was conducted on 969 women with recurrent unplanned pregnancy for one year follow-up in the Haidian District. Results After the intervention, awareness and mastery of short-acting contraceptive knowledge scores increased in the high score group. The constituent ratio of non-mastery of long-acting contraceptive knowledge reduced by 11. 35% , while that of mastery of one long-acting contraceptive method increased by 12. 38% . The constituent ratio of emergency contraception knowledge of 5 score group increased by 64. 19%. The contraception rates were 45. 20% , 60.06% , 94.07% , 96. 95% and 96. 96% respectively in the time of before intervention, 1 month after intervention, 3 months after intervention, 6 months after intervention and 12 months after intervention. As the increasing of intervention time, the contraception rate increased

  3. Midwifery tutors' capacity and willingness to teach contraception, post-abortion care, and legal pregnancy termination in Ghana

    Directory of Open Access Journals (Sweden)

    Mitchell Ellen

    2010-02-01

    Full Text Available Abstract Background Ghana has a high maternal mortality rate of 540 per 100 000. Although abortion complications usually are treatable, the risks of morbidity and death increase when treatment is delayed. Delay in care may occur when women have difficulty accessing treatment because health care providers are not trained, equipped, or willing to treat the complications of abortion. Gaps in the midwifery tutors' knowledge on comprehensive abortion care (CAC have resulted in most midwives in Ghana not knowing the legal indications under which safe abortion care can be provided, and lacking the skills and competencies for CAC services. The aim of this study is to assess the capacity and willingness of midwifery tutors to teach contraception, post abortion care and legal termination in Ghana. Methods This study focused on all 14 midwifery schools in the country. A total of 74 midwifery tutors were interviewed for this study. Structured self-administered questionnaires were used for data collection. The data were entered and checked for consistencies using Epiinfo 6.04 and analyzed using Stata 8. Descriptive analysis was used and frequencies reported with percentages. Results In total, 74 midwifery tutors were interviewed. Of these, 66 (89.2% were females. The tutors had mainly been trained as midwives (51.4% and graduate nurses (33.8%. Respondents were predominantly Christians (97.3%. The study discovered that only 18.9% of the tutors knew all the legal indications under which safe abortion care could be provided. The content of pre-service training of tutors did not include uterine evacuation with manual vacuum aspirator (MVA. The study also highlighted some factors that influence midwifery tutors' willingness to teach comprehensive abortion care. It was also revealed that personal and religious beliefs greatly influence teaching of Comprehensive Abortion Care. Conclusion The findings of this survey suggest that the majority of tutors did not know

  4. 护理专业女生避孕和意外妊娠认知状况%Survey on the knowledge of contraception and unintentional pregnancy among nursing female students

    Institute of Scientific and Technical Information of China (English)

    苏琳; 田玲; 张利; 蒋玉敏; 孙翾

    2012-01-01

    Objective To understand nursing female students' knowledge on contraception and unintentional pregnancy for the purpose of formulating appropriate contraceptive education strategies. Methods A total of 326 female nursing students of Bengbu Medical College, were employed in the survey. Self-administered questionnaire involving personal information, pregnancy, contraception, emergency contraception knowledge, attitude and practice of unintentional pregnancy were analyzed. Results A-bout 91.72% , 76.07% and 76.38% of the students respectively knew the feature, early signs and early diagnosis of pregnancy well. As for contraceptive knowledge including the best time of conceive in the menstrual cycle, occasional sexual intercourse resulting pregnancy and contraceptive methods, the participants did know little. Only 23. 00% of the samples can calculate sexual rhythm, 13.50% accept contraceptive contraception. 83.74% of the students encountered unwanted pregnancy undergo anxiety a-bout unwanted pregnancy resulting abortion (the risk of abortion 48.77% , abortion complications 34.97% ) and more than half of them will prefer terminating an unwanted pregnancy ( artificial abortion 31.90% , medical abortion 23. 62% ). They usually seek to family (41.72%) or schoolmates (26.07%) after encountered unwanted pregnancy. About 71.47% of the students realize rather psychological harm than unwanted pregnancies resulting in long-term effects such as gynecological inflammation and infertility. Conclusion Continued efforts are needed to develop nursing female students' knowledge on contraception and unintentional pregnancy.%目的 了解护理专业女生避孕知识及对意外妊娠的认知情况,为制定有针对性的避孕教育策略提供依据.方法 采用自编问卷,对蚌埠医学院326名护理专业女生进行问卷调查,内容包括个人信息、对妊娠的认识、避孕知识及紧急事后避孕、对意外妊娠的担心和处理意愿等.结果 在326

  5. 孕期体操运动对不良症状改善的效果%Effect of pregnancy gymnastic exercises on improving adverse symptoms during pregnancy

    Institute of Scientific and Technical Information of China (English)

    游川; 刘军; 杨兴华

    2014-01-01

    目的:研究孕期体操运动对不良症状的改善作用,为开展孕期体操提供理论依据。方法选择北京市5个孕妇学校的孕25~34周孕妇为研究对象,采用专家研发的孕期体操,观察孕期不良症状的改善效果。结果孕妇通过体操干预,便秘症状改善率为81.2%,失眠改善率为82.8%,腿抽筋症状改善率为89.3%,浮肿症状改善率为53.3%,腰背疼痛感改善率为72.5%,血糖控制改善率为50%,髋关节打开程度改善率为90.6%。结论孕期体操运动能够有效改善孕期便秘、失眠、腿抽筋、浮肿、腰背疼痛等不良症状,孕妇养生保健体操是安全有效,值得进一步研究和推广的。%Objective To study the effect of pregnancy gymnastic exercises on improving adverse symptoms during pregnancy , so as to provide theoretical basis for research and development of pregnancy gymnastic exercises .Methods Pregnant women with gestational age of 25-34 weeks in 5 pregnant schools in Beijing were selected for the study , and pregnancy gymnastic exercises developed by experts were adopted to observe the improving effect on adverse symptoms .Results Through the intervention of gymnastic exercises , the improving rate of constipation symptoms, insomnia, leg cramps, swelling, lower back pain, blood sugar control and hip joint open degree was 81.2%, 82.8%, 89.3%, 53.3%, 72.5%, 50% and 90.6%, respectively.Conclusion The pregnancy gymnastic exercises can effectively improve pregnancy constipation , insomnia, leg cramps, swelling, back pain and other adverse symptoms .They deserve further study and spread because of safety and effect .

  6. Quality of life, anxiety and depression symptoms in early and late pregnancy in women with pregestational diabetes.

    Science.gov (United States)

    Do, Nicoline C; Secher, Anna L; Cramon, Per; Ringholm, Lene; Watt, Torquil; Damm, Peter; Mathiesen, Elisabeth R

    2017-02-01

    The aim of this study was to explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes. An observational cohort study including 137 pregnant women with pregestational diabetes (110 with type 1 and 27 with type 2). To evaluate changes from early to late pregnancy, the internationally validated questionnaires 36-Item Short-Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were completed at 8 and 33 gestational weeks. From early to late pregnancy, the SF-36 scales Physical Function, Role Physical, Bodily Pain and Physical Component Summary worsened (p anxiety score improved slightly from 5.0 (3.3) to 4.5 (3.4) (p = 0.04) whereas the HADS depression score remained unchanged. The prevalence of women with HADS anxiety or depression score ≥8 did not change. Physical quality of life deteriorated whereas mental quality of life improved slightly during pregnancy in women with pregestational diabetes. A minor reduction in anxiety and stable depression symptoms was observed. The results on mental health are reassuring, considering the great demands that pregnancy places on women with pregestational diabetes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Première consultation de contraception chez les adolescentes

    OpenAIRE

    Beliard, Aude

    2016-01-01

    Adequate contraception prescription is mandatory for teenagers to avoid any unwanted pregnancy. Counselling and description of side effect improve compliance. Use of condom is important to avoid sexually transmitted infections. Combined estroprogestin contraception has multiple non-contraceptive benefits, e.g. dysmenorrhea improvement. Familial and personal history is needed before contraception prescription. Further consultation 3 months later has to be planned to evaluate compliance, side e...

  8. A natural contraceptive.

    Science.gov (United States)

    Shirkie, R

    1982-07-01

    Breastfeeding is a natural contraceptive against another pregnancy. The longer the mother nurses, the longer she delays the return of fertility. A natural mechanism triggered by breastfeeding interrupted Ms. El-Hady's monthly cycle of ovulation and menstruation. Depending on how long and how often she suckles her child, this infertility, termed lactational amenorrhea, could last as long as 2 years. This traditional method of spacing births offers protection against pregnancy to more women than all other methods of contraception combined, according to family planning researchers. With growing trends away from breastfeeding, the traditional practice is losing its impact on fertility. Not many women in Egypt use modern contraceptives. There is little understanding of lactational amenorrhea, but researchers are giving it more attention as they continue to search for effective family planning methods appropriate to the needs and circumstances of the rural population. They know that the effect is only temporary and varies from woman to woman. Ms. El-Hady has been amenorrheic for 15 months, but other women experience much shorter periods of amenorrhea, and some none at all. The secretion of milk is promoted by a hormone called prolactin that the anterior pituitary gland produces in large quantities during pregnancy. The frequency and duration of breastfeeding appear to determine the length of amenorrhea, although the mother's nutrition and any other type of contraceptive used may also play a role. Each month for 2 years, Dr. Olfat Darwish, professor of nutrition at the University of Alexandria's High Institute of Public Health, has visited 260 rural mothers and 290 urban mothers to gather data on diet, breastfeeding practices, state of amenorrhea, and use of contraception. The length of the breastfeeding period was found to affect the duration of amenorrhea. Early weaning brought an earlier return of ovulation and menstruation, and thus of fertility. The nutritional

  9. The prevention of teenage pregnancy in adolescent's view

    National Research Council Canada - National Science Library

    Fiedler, Milla Wildemberg; Araújo, Alisson; Souza, Márcia Christina Caetano de

    2015-01-01

    ...: perception about the importance of preventing teenage pregnancy, knowledge about the use of contraception methods, use of contraceptives methods, barriers to access to health services for the prevention of pregnancy...

  10. Emergency contraception – a neglected option for birth control

    OpenAIRE

    2013-01-01

    Emergency contraception (EC) is any method of contraception which is used after intercourse and before the potential time of implantation, in order to prevent pregnancy after an unprotected or inadequately protected sexual intercourse, or cases of rape. Use of emergency contraception could halve the number of unintended pregnancies and the consequent need for abortion, but unfortunately many medical professionals and the public are not aware of it. Two methods are available for emergency cont...

  11. Emergency contraception - Potential for women′s health

    Directory of Open Access Journals (Sweden)

    Suneeta Mittal

    2014-01-01

    Full Text Available Emergency contraception (EC is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

  12. Preconception counseling and contraception after gestational diabetes

    DEFF Research Database (Denmark)

    Mølsted-Pedersen, L; Skouby, S O; Damm, P

    1991-01-01

    a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels......-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective......Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during...

  13. Preconception counseling and contraception after gestational diabetes

    DEFF Research Database (Denmark)

    Mølsted-Pedersen, L; Skouby, S O; Damm, P

    1991-01-01

    a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels......Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during......-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective...

  14. A Comparative Efficacy of Low-Dose Combined Oral Contraceptives Containing Desogestrel and Drospirenone in Premenstrual Symptoms

    Directory of Open Access Journals (Sweden)

    Jirath Wichianpitaya

    2013-01-01

    Full Text Available Objective. To compare the efficacy of low-dose COC containing desogestrel (DSG with drospirenone (DRSP in the changes of premenstrual symptoms. Methods. In an open-label randomized controlled trial, 90 women with premenstrual syndrome who required COC were randomly recruited and allocated equally to receive either 6 cycles of 20 micrograms ethinyl estradiol (EE/150 micrograms DSG (DSG group or 20 micrograms EE/3 mg DRSP (DRSP group in 24/4 extended regimen. Analysis of covariance and repeated analysis of variance were used to determine the difference of mean Women's Health Assessment Questionnaire (WHAQ scores changes between groups, within group, and in premenstrual, menstrual, and postmenstrual phases. Results. Baseline characteristics and WHAQ scores were comparable. At the ends of the 3rd and the 6th cycles, mean WHAQ scores of all the 3 phases in DRSP group showed significant reduction and were significantly lower than those in DSG group. DSG group showed significant reduction in both premenstrual and menstrual phases after the 6th cycle. Adverse effects were comparable in both groups. In conclusion, low-dose COC containing either DSG or DRSP reduced premenstrual symptoms, but the latter showed greater efficacy and earlier reduction.

  15. Contraception and the Adolescent Diabetic.

    Science.gov (United States)

    Fennoy, Ilene

    1989-01-01

    Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

  16. Maternal use of oral contraceptives and risk of fetal death

    DEFF Research Database (Denmark)

    Jellesen, Rikke; Strandberg-Larsen, Katrine; Jørgensen, Tina;

    2008-01-01

    Intrauterine exposure to artificial sex hormones such as oral contraceptives may be associated with an increased risk of fetal death. Between 1996 and 2002, a total of 92 719 women were recruited to The Danish National Birth Cohort and interviewed about exposures during pregnancy. Outcome.......2%) women took oral contraceptives during pregnancy. Use of combined oestrogen and progesterone oral contraceptives (COC) or progesterone-only oral contraceptives (POC) during pregnancy was not associated with increased hazard ratios of fetal death compared with non-users, HR 1.01 [95% CI 0.71, 1.45] and HR...... 1.37 [95% CI 0.65, 2.89] respectively. Neither use of COC nor POC prior to pregnancy was associated with fetal death. Stratification by maternal age and smoking showed elevated risks of fetal death for women contraception during pregnancy, but the interactions were...

  17. Students' perceptions of contraceptives in university of ghana.

    Directory of Open Access Journals (Sweden)

    Nana Nimo Appiah-Agyekum

    2013-03-01

    Full Text Available This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives.Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments.Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users.Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students.

  18. Contraceptive options for women living with HIV.

    Science.gov (United States)

    Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

    2014-08-01

    Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women.

  19. Maternal Mild Thyroid Hormone Insufficiency in Early Pregnancy and Attention-Deficit/Hyperactivity Disorder Symptoms in Children.

    Science.gov (United States)

    Modesto, Thiago; Tiemeier, Henning; Peeters, Robin P; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Ghassabian, Akhgar

    2015-09-01

    Maternal thyroid hormone insufficiency during pregnancy can affect children's cognitive development. Nevertheless, the behavioral outcomes of children exposed prenatally to mild thyroid hormone insufficiency are understudied. To examine whether exposure to maternal mild thyroid hormone insufficiency in early pregnancy was related to symptoms of attention-deficit/hyperactivity disorder (ADHD) in children at 8 years of age. The study was embedded within the Generation R, a population-based birth cohort in the Netherlands. Children in the Generation R Study are followed up from birth (April 1, 2002, through January 31, 2006) until young adulthood. Of the 4997 eligible mother-child pairs with data on maternal thyroid levels (excluding twins), 3873 pairs of children and caregivers (77.5%) visited the Generation R research center for in-depth assessments and were included in the main analyses. Data collection in Generation R started December 1, 2001 (enrollment of pregnant women), and is ongoing. For this study, we used the data that were collected until January 1, 2014. Data analyses started on January 31 and finished June 30, 2014. Maternal hypothyroxinemia, characterized by low levels of free thyroxine coexisting with reference thyrotropin levels, and children's symptoms of ADHD. Maternal thyroid hormone levels (thyrotropin, free thyroxine, thyroid peroxidase antibodies) were measured at a mean (SD) of 13.6 (1.9) weeks of gestation. Children's ADHD symptoms were assessed at 8 years of age using the Conners' Parent Rating Scale-Revised Short Form; higher scores indicate more ADHD symptoms (possible range, 0-36). Maternal hypothyroxinemia (n = 127) in early pregnancy was associated with higher scores for ADHD symptoms in children at 8 years of age after adjustments for child and maternal factors (ie, sex, ethnicity, maternal age, maternal educational level, and income) (increase in ADHD scores, 7% [95% CI, 0.3%-15%]). The results remained essentially unchanged when

  20. Impaired executive function mediates the association between maternal pre-pregnancy body mass index and child ADHD symptoms.

    Science.gov (United States)

    Buss, Claudia; Entringer, Sonja; Davis, Elysia Poggi; Hobel, Calvin J; Swanson, James M; Wadhwa, Pathik D; Sandman, Curt A

    2012-01-01

    Increasing evidence suggests exposure to adverse conditions in intrauterine life may increase the risk of developing attention-deficit/hyperactivity disorder (ADHD) in childhood. High maternal pre-pregnancy body mass index (BMI) has been shown to predict child ADHD symptoms, however the neurocognitive processes underlying this relationship are not known. The aim of the present study was to test the hypothesis that this association is mediated by alterations in child executive function. A population-based cohort of 174 children (mean age = 7.3 ± 0.9 (SD) yrs, 55% girls) was evaluated for ADHD symptoms using the Child Behavior Checklist, and for neurocognitive function using the Go/No-go task. This cohort had been followed prospectively from early gestation and birth through infancy and childhood with serial measures of maternal and child prenatal and postnatal factors. Maternal pre-pregnancy BMI was a significant predictor of child ADHD symptoms (F((1,158)) = 4.80, p = 0.03) and of child performance on the Go/No-go task (F((1,157)) = 8.37, p = 0.004) after controlling for key potential confounding variables. A test of the mediation model revealed that the association between higher maternal pre-pregnancy BMI and child ADHD symptoms was mediated by impaired executive function (inefficient/less attentive processing; Sobel Test: t = 2.39 (± 0.002, SEM), p = 0.02). To the best of our knowledge this is the first study to report that maternal pre-pregnancy BMI-related alterations in child neurocognitive function may mediate its effects on ADHD risk. The finding is clinically significant and may extrapolate to an approximately 2.8-fold increase in the prevalence of ADHD among children of obese compared to those of non-obese mothers. These results add further evidence to the growing awareness that neurodevelopmental disorders such as ADHD may have their foundations very early in life.

  1. "Pregnancy and labour cause more deaths than oral contraceptives": The debate on the pill in the Spanish press in the 1960s and 1970s.

    Science.gov (United States)

    Ortiz-Gómez, Teresa; Ignaciuk, Agata

    2015-08-01

    From 1941 to 1978, Franco's regime in Spain banned all contraceptive methods. The pill started circulating in Spain from the 1960s, officially as a drug used in gynaecological therapy. However, in the following decade it was also increasingly used and prescribed as a contraceptive. This paper analyses debates about the contraceptive pill in the Spanish daily newspaper ABC and in two magazines, Blanco y Negro and Triunfo, in the 1960s and 1970s. It concludes that the debate on this contraceptive method was much more heterogeneous than might be expected given the Catholic-conservative character of the dictatorship. The daily press focused on the adverse effects of the drug and magazines concentrated on the ethical and religious aspects of the pill and discussed it in a generally positive light. Male doctors and Catholic authors dominated the debate.

  2. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  3. Strategies for communicating contraceptive effectiveness.

    Science.gov (United States)

    Lopez, Laureen M; Steiner, Markus; Grimes, David A; Hilgenberg, Deborah; Schulz, Kenneth F

    2013-04-30

    Knowledge of contraceptive effectiveness is crucial to making an informed choice. The consumer has to comprehend the pros and cons of the contraceptive methods being considered. Choice may be influenced by understanding the likelihood of pregnancy with each method and factors that influence effectiveness. To review all randomized controlled trials comparing strategies for communicating to consumers the effectiveness of contraceptives in preventing pregnancy. Through February 2013, we searched the computerized databases of MEDLINE, POPLINE, CENTRAL, PsycINFO and CINAHL, ClinicalTrials.gov, and ICTRP. Previous searches also included EMBASE. We also examined references lists of relevant articles. For the initial review, we wrote to known investigators for information about other published or unpublished trials. We included randomized controlled trials that compared methods for communicating contraceptive effectiveness to consumers. The comparison could be usual practice or an alternative to the experimental intervention.Outcome measures were knowledge of contraceptive effectiveness, attitude about contraception or toward any particular contraceptive, and choice or use of contraceptive method. For the initial review, two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. For the update, an author and a research associate extracted, entered, and checked the data.For dichotomous variables, we calculated the Mantel-Haenszel odds ratio with 95% confidence intervals (CI). For continuous variables, we computed the mean difference (MD) with 95% CI. Seven trials met the inclusion criteria and had a total of 4526 women. Five were multi-site studies. Four trials were conducted in the USA, while Nigeria and Zambia were represented by one study each, and one trial was done in both Jamaica and India.Two trials provided multiple sessions for participants. In one study that examined contraceptive choice, women in

  4. The impact of neighborhood quality, perceived stress, and social support on depressive symptoms during pregnancy in African American women.

    Science.gov (United States)

    Giurgescu, Carmen; Misra, Dawn P; Sealy-Jefferson, Shawnita; Caldwell, Cleopatra H; Templin, Thomas N; Slaughter-Acey, Jaime C; Osypuk, Theresa L

    2015-04-01

    Living in a lower-quality neighborhood is associated with higher levels of depressive symptoms in the general population as well as among pregnant and postpartum women. However, little is known of the important pathways by which this association occurs. We proposed a model in which perceived stress and social support mediated the effects of neighborhood quality on depressive symptoms during pregnancy (measured by the 20-item Center for Epidemiologic Studies-Depression, CES-D, scale) in a sample of 1383 African American women from the Detroit metropolitan area interviewed during their delivery hospitalization. Using structural equation modeling (SEM), we built a latent variable of neighborhood quality using 4 measures (neighborhood disorder, neighborhood safety/danger, walking environment, overall rating). We then tested two SEM mediation models. We found that lower neighborhood quality was associated with higher prevalence of depressive symptoms during pregnancy (standardized total effect = .16, p = .011). We found that perceived stress partially mediated the neighborhood quality association with depressive symptoms. Although the association of social support with depressive symptoms was negligible, social support mediated associations of neighborhood quality with perceived stress [standardized path coefficient = .38 (.02), p = .009]. Our results point to the need for public health, health care, as well as non-health related interventions (e.g. crime prevention programs) to decrease overall exposure to stressors, as well as stress levels of women living in poor quality neighborhoods. Interventions that increase the levels of social support of women during pregnancy are also needed for their potential to decrease stress and ultimately improve mental health at this important time in the life course. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Successful outcome in a patient with glioma of brain with twin pregnancy

    Directory of Open Access Journals (Sweden)

    Anjali Rani

    2014-06-01

    Full Text Available We present a case of glioma in pregnant female with twin pregnancy. Gliomas during pregnancy are rare. Gliomas during pregnancy pose a risk to maternal and fetal life. The benefit-to-risk ratio should be carefully evaluated and discussed prior to get marriage and pregnancy. In present case, patient had non-specific symptom like seizure and no any focal neurological deficit, Caesarean Section (CS was done at term with multidisciplinary group, including a neurosurgeon, obstetrician, anesthesiologist and neonatologist. She has been followed up to the present date and remains in good health. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 827-830

  6. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.

    Science.gov (United States)

    Secura, Gina M; Allsworth, Jenifer E; Madden, Tessa; Mullersman, Jennifer L; Peipert, Jeffrey F

    2010-08-01

    To introduce and promote the use of long-acting reversible methods of contraception (LARC; intrauterine contraceptives and subdermal implant) by removing financial and knowledge barriers. The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible contraception. Women screened for this study are read a script regarding long-acting reversible methods of contraception to increase awareness of these options. Participants choose their contraceptive method that is provided at no cost. We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008. Sixty-seven percent of women enrolled (95% confidence interval, 65.3-69.0) chose long-acting methods. Fifty-six percent selected intrauterine contraception and 11% selected the subdermal implant. Once financial barriers were removed and long-acting reversible methods of contraception were introduced to all potential participants as a first-line contraceptive option, two-thirds chose long-acting reversible methods of contraception. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  7. [Morality and contraception].

    Science.gov (United States)

    Gakwaya, D

    1988-08-01

    The conflict of morality and natural law come into focus when contraception and procreation are examined despite the religious pronouncements of Charles de Koninck. Man, having mastered nature, confronts interminable new problems in the pursuit of physical, economic, moral, and material happiness. The population explosion in Rwanda make it indispensable that the prevention of undesired pregnancy is the right of a man and a women choosing the appropriate method. Man's morality allows the violation of natural law in order to pursue one's own goal of survival using counterbalancing means whenever under- or overpopulation may threaten its existence or portend extinction. Natural law could be the guiding principle in man's moral development.

  8. Prescribing contraceptives for women with schizophrenia.

    Science.gov (United States)

    Seeman, Mary V; Ross, Ruth

    2011-07-01

    Although women with serious mental illness have high rates of lifetime sexual partners, they infrequently use contraception. Consequently, the prevalence of sexually transmitted infections is high in this population. In addition, while the overall rate of pregnancy in women with schizophrenia of child-bearing age is lower than in the general population, the percentage of pregnancies that are unwanted is higher than that in the general population. The objective of this paper is to help clinicians explore knowledge of appropriate methods of contraception for women who suffer from schizophrenia. The authors reviewed recent literature on the use of contraceptive methods by women with schizophrenia treated with antipsychotic and adjunctive medications. Contraceptive counseling to women and their partners is an important part of comprehensive care for women with serious and persistent mental illness. Women with schizophrenia who smoke, are overweight, or have diabetes, migraine, cardiovascular disease, or a family history of breast cancer should be offered non-hormonal contraception. Women with more than one sexual partner should be advised on barrier methods in addition to any other contraceptive measures they are using. Clinicians should be alert for potential interactions among oral hormonal contraceptives, smoking, and therapeutic drugs. Long-lasting contraceptive methods, such as intrauterine devices, progesterone depot injections, or tubal ligation are reasonable options for women having no wish to further expand their families.

  9. Effects of Personality on Psychiatric and Somatic Symptoms in Pregnant Women: The Role of Pregnancy Worries

    Science.gov (United States)

    Puente, Cecilia Penacoba; Monge, Francisco Javier Carmona; Abellan, Isabel Carretero; Morales, Dolores Marin

    2011-01-01

    The authors examined the effects of personality and pregnancy worries on pregnant women's mental and physical health with 154 women in the first half of their gestational period. Self-report questionnaires were used to collect information about control variables, sociodemographic (age, educational level, and work), and pregnancy variables…

  10. Effects of Personality on Psychiatric and Somatic Symptoms in Pregnant Women: The Role of Pregnancy Worries

    Science.gov (United States)

    Puente, Cecilia Penacoba; Monge, Francisco Javier Carmona; Abellan, Isabel Carretero; Morales, Dolores Marin

    2011-01-01

    The authors examined the effects of personality and pregnancy worries on pregnant women's mental and physical health with 154 women in the first half of their gestational period. Self-report questionnaires were used to collect information about control variables, sociodemographic (age, educational level, and work), and pregnancy variables…

  11. The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception.

    Science.gov (United States)

    Dermish, Amna I; Turok, David K

    2013-07-01

    Worldwide, 40% of all pregnancies are unintended. Widespread, over-the-counter availability of oral emergency contraception (EC) has not reduced unintended pregnancy rates. The EC visit presents an opportunity to initiate a highly effective method of contraception in a population at high risk of unintended pregnancy who are actively seeking to avoid pregnancy. The copper intrauterine device (IUD), the most effective method of EC, continues to provide contraception as effective as sterilization for up to 12 years, and it should be offered as the first-line method of EC wherever possible. Increased demand for and supply of the copper IUD for EC may have an important role in reducing rates of unintended pregnancy. The EC visit should include access to the copper IUD as optimal care but should ideally include access to all highly effective methods of contraception.

  12. The unwanted pregnancy.

    Science.gov (United States)

    Diggory, P

    1977-01-01

    Unwanted pregnancy is a measure of contraceptive failure - either method failure, motivation failure, or contraceptive inaccessibility. Unwanted pregnancies can end in criminal abortion, therapeutic abortion, forced marriage, or illegitimate birth. Figures for these occurrences in Great Britain in 1969 are cited. The figures make no allowance for unsuccessful attempts at self-abortion and unwanted but accepted pregnancies within marriage. It is estimated that approximately 1/4 of all British and American women married more than 10 years have at least 1 unwanted child. Contraception must be provided by the British National Health Service.

  13. Oral contraception for women of middle age.

    Science.gov (United States)

    Ruan, Xiangyan; Mueck, Alfred O

    2015-11-01

    Women at middle age have decreased fertility and their pregnancies are higher risk. Combined oral contraceptives (COC) are effective but confer increased risk of age-related diseases, especially cardiovascular diseases. These risks are lower, however, with progestogen-only pills (POP). Therefore, other than the levonorgestrel intrauterine device (LNG-IUD), POP are usually the first choice, even though they do often lead to bleeding problems, which are already frequent in the perimenopause. However, the main risk of COC, venous thromboembolism, seems not to be relevant in (non-hospitalized) Chinese women and perhaps also other Asian women. COC may therefore be in fact a better choice than POP for these groups. In contrast to POP and IUDs, they have a variety of benefits especially important for middle-aged women, including a large decrease of the risk of ovarian, endometrial and colorectal cancer, an improvement in bleeding irregularities, a reduction of climacteric symptoms and some protection against bone loss. Further research is needed into individualized and safe contraception that takes into account ethnicity, as well as other factors.

  14. The vaginal contraceptive sponge.

    Science.gov (United States)

    Edelman, D A

    1984-06-01

    The vaginal contraceptive sponge, approved on April 1, 1983 by the US Food Administration (FDA) for sale in the US as a single use, disposable, over-the-counter contraceptive, is made of polyurethane and designed to be biocompatible with the vaginal environment. The sponge is available in a single size, is round, and about 5.5 cm in diameter and 2.5 cm thick. An indentation on 1 side helps to ensure the sponge's correct placement against the cervix. A polyester retrieval loop attached to the sponge facilitates removal. Postcoital tests of the sponge without the spermicide indicated that it was ineffective in preventing sperm from entering the cervical canal. Before insertion, the contraceptive sponge is moistened with tap water to activate the spermicide and is inserted into the vagina with the indentation placed against the cervis. The sponge has been designed to provide continuous protection against pregnancy for at least 24 hours after insertion. Following a successful phase ii clinical trail of the sponge, in 1979 comparative phase iii clinical trials were initiated by Family Health International. The following trials were conducted: sponge versus the diaphragm (arcing-spring) used with a spermicide (nonoxynol-9) at 13 clinics in the US (1439 subjects) and at 2 clinics in Canada and the UK (502 subjects); sponge versus a foaming spermicidal (menfegol) suppository at 5 clinics in Yugoslavia, Taiwan, and Bangladesh (1386) subjects); and sponge versus spermicidal (nonoxynol-9) foam at 2 clinics in Israel and Thailand (366 subjects). In all trials the contraceptive methods were raondomly assigned. Clinics were required to follow up subjects for 1 year. Only the US study has been completed. In the comparative trials of the sponge and diaphragm (both US based and overseas) the pregnancy rates were significantly higher for the sponge. In the comparative trials of the sponge and foaming suppositories or spermicidal foam there were no significant differences between the

  15. 产后1年内意外妊娠避孕情况调查分析%Accidental pregnancy within 1 year postpartum contraception situation investigation and analysis

    Institute of Scientific and Technical Information of China (English)

    彭福英

    2015-01-01

    目的:调查产后1年内意外妊娠情况,探讨影响因素。方法:收集179名产后1年内意外妊娠妇女资料作为研究组,212名同期未怀孕妇女资料作对照组,进行统计检验。结果:研究组与对照组在受教育水平上差异显著,在家庭经济来源上差异显著。研究组获取避孕知识的来源主要为他人经验,对照组为医院正规培训,且获取正确知识的渠道多于研究组。结论:研究组中采取避孕措施的多为使用避孕药和避孕套,但可能欠缺规范和坚持导致意外妊娠。%ObjectiveWithin 1 year postpartum accidental pregnancies, influence factors are discussed. Methods 179 accidental pregnancy within 1 year postpartum women information collected as a team, 212 during the same period not pregnant women data for the control group, with statistical tests. Results Group and the control group significant difference on the education level, significant difference in family sources. Team for main sources of contraceptive knowledge experience for others, the control for hospital formal training, and obtain correct channel than the team of knowledge.Conclusion Using contraception in the team for the use of birth control pills and condoms, but may lack of specification and persistence lead to unintended pregnancies.

  16. Contraception in the Developing World: Special Considerations.

    Science.gov (United States)

    Schivone, Gillian B; Blumenthal, Paul D

    2016-05-01

    The United States Agency for International Development (USAID) estimates that there are 225 million women and girls with unmet contraceptive need yearly. Unmet need for contraception is defined as women who desire a delay in childbearing and are not using a modern method of contraception. It is projected that providing contraception to these women would avert 36 million abortions, 70,000 maternal deaths, and 52 million unintended pregnancies overall. In the past 30 years, there has been an increase both in population and in contraception use in the developing world. As a result, it is estimated that in 2015 there were 500 million contraceptive users in developing countries, which is nearly double the prevalence in 2000. Unfortunately, women and girls in developing nations still face many obstacles in obtaining modern methods of contraception. Particular challenges in the developing world include lack of access due to inadequate number of trained providers, fewer method options, and "stock-outs" of contraceptive supplies. Innovative strategies for decreasing unmet need will have to address these challenges, and will necessarily involve programmatic solutions such as community-based distribution and social marketing campaigns. Additionally, increasing uptake of long-acting reversible contraceptive methods will be essential for achieving the goal of decreasing unmet need.

  17. Depressive symptoms and gestational length among pregnant adolescents: Cluster randomized control trial of CenteringPregnancy® plus group prenatal care.

    Science.gov (United States)

    Felder, Jennifer N; Epel, Elissa; Lewis, Jessica B; Cunningham, Shayna D; Tobin, Jonathan N; Rising, Sharon Schindler; Thomas, Melanie; Ickovics, Jeannette R

    2017-06-01

    Depressive symptoms are associated with preterm birth among adults. Pregnant adolescents have high rates of depressive symptoms and low rates of treatment; however, few interventions have targeted this vulnerable group. Objectives are to: (a) examine impact of CenteringPregnancy® Plus group prenatal care on perinatal depressive symptoms compared to individual prenatal care; and (b) determine effects of depressive symptoms on gestational age and preterm birth among pregnant adolescents. This cluster-randomized controlled trial was conducted in 14 community health centers and hospitals in New York City. Clinical sites were randomized to receive standard individual prenatal care (n = 7) or CenteringPregnancy® Plus group prenatal care (n = 7). Pregnant adolescents (ages 14-21, N = 1,135) completed the Center for Epidemiologic Studies Depression Scale during pregnancy (second and third trimesters) and postpartum (6 and 12 months). Gestational age was obtained from medical records, based on ultrasound dating. Intention to treat analyses were used to examine objectives. Adolescents at clinical sites randomized to CenteringPregnancy® Plus experienced greater reductions in perinatal depressive symptoms compared to those at clinical sites randomized to individual care (p = .003). Increased depressive symptoms from second to third pregnancy trimester were associated with shorter gestational age at delivery and preterm birth (prenatal care may be an effective nonpharmacological option for reducing depressive symptoms among perinatal adolescents. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. [Adolescent pregnancy].

    Science.gov (United States)

    Lachcar, P

    1990-01-01

    The number of adolescent pregnancies brought to term in France has continued to decline while the number of abortions remains stable. Adolescent pregnancies cannot be considered "accidents" either in their social or psychological aspects. Pregnant adolescents carrying to term tend to be more disadvantaged than those seeking abortions. Early pregnancy may be a response to difficult life conditions. Despite appearing to constitute an infraction of a social code, adolescent pregnancy may in fact represent an attempt at social integration through motherhood. Adolescents failing in school, with poor employment prospects and feeling family pressures may view pregnancy as a means of social recognition. But such factors by themselves do not explain pregnancy; the primordial role of psychological factors must be examined. For some adolescents, pregnancy may represent an attempt to understand their own sexual identity as the transformations of puberty unsettle their previous self-images. Or they may be failing to perceive or actively denying the possibility of pregnancy. Adolescent pregnancies may be the result of transgressions of prohibitions. The traditional prohibition of sexual activity has relaxed to the degree that it is being replaced by a new prohibition on adolescent pregnancy and a prescription to use contraception. But contraception deprives an adolescent in search of sexual identity of proof of fertility as well as of the image of spontaneity and naturalness. Use of contraception is in conflict with the questions, doubts, and anxieties of adolescence. For adolescents in a reactivated oedipal stage, heterosexuality is often at the service of incestuous fantasies involving the mother. Abortion and perhaps pregnancy itself may assume the character of a rite of passage into adulthood for some adolescents. The important thing for many is the ability to become pregnant, to be a mother like their own mother.

  19. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices.

    Science.gov (United States)

    Rivera, R; Yacobson, I; Grimes, D

    1999-11-01

    Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action. The precise mechanism of intrauterine contraceptive devices is unclear. Current evidence indicates they exert their primary effect before fertilization, reducing the opportunity of sperm to fertilize an ovum.

  20. Nonbarrier contraceptives and vaginitis and vaginosis.

    Science.gov (United States)

    Roy, S

    1991-10-01

    Within the limitations of the available data, it has been reported that oral contraceptive use versus other contraceptive methods is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of chlamydia trachomatis, and a reduced frequency of bacterial vaginosis and trichomoniasis. The impact of contraceptive steroids on cellular and humoral immunologic factors may explain these observations. Intrauterine contraceptive device use is reported to be associated with an increased rate of bacterial vaginosis and anaerobic organism recovery from the vagina regardless of symptoms. Patients having a contraceptive vaginal ring were found to have the same number and types of vaginal organisms as oral contraceptive users. Levonorgestrel-releasing subdermal implant (Norplant, Wyeth-Ayerst, Philadelphia, Pa.) users have been reported to have approximately half the rate of vaginitis and vaginosis compared with that of Copper T-200 intrauterine device users.

  1. Fish and fat intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Arakawa, Masashi

    2013-05-01

    The present study aimed to examine the relationship between consumption of meat, fish, and specific types of fatty acids and the prevalence of depressive symptoms during pregnancy in Japan. Study subjects were 1745 pregnant women. Depressive symptoms were defined as present when subjects had a Center for Epidemiologic Studies Depression Scale score of 16 or higher. Information on dietary factors was collected using a self-administered diet history questionnaire. The prevalence of depressive symptoms during pregnancy was 19.3%. Higher intake levels of fish, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were independently associated with a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios (ORs) between extreme quartiles (95% confidence intervals [CIs], P for trend) were 0.61 (0.42-0.87, 0.01), 0.66 (0.46-0.95, 0.02) and 0.64 (0.44-0.93, 0.007), respectively. Higher intake levels of total fat and saturated fatty acids were independently related to a higher prevalence of depressive symptoms during pregnancy: the adjusted ORs between extreme quartiles (95% CIs, P for trend) were 1.42 (1.00-2.03, 0.06) and 1.74 (1.22-2.49, 0.001), respectively. There were no significant associations between intake of monounsaturated fatty acids, n-3 polyunsaturated fatty acids (PUFAs), α-linolenic acid, n-6 PUFAs, linoleic acid, arachidonic acid, or cholesterol or the ratio of n-3 to n-6 PUFA intake and depressive symptoms during pregnancy. Intake levels of fish, EPA, and DHA may be inversely associated with depressive symptoms during pregnancy while intake levels of total fat and saturated fatty acids may be positively related to depressive symptoms during pregnancy.

  2. [Resistance and compliance to contraception in adolescents].

    Science.gov (United States)

    Pichot, F; Dayan-lintzer, M

    1985-10-01

    Although inadequate information on sex and contraception is frequently believed to account for contraceptive failure in adolescents, other factors including resistence to contraception or poor compliance with method requirements have been invoked to explain contraceptive failures in well-informed adolescents. Sexual relations are beginning at ever-younger ages in France; a 1980 survey indicated that 50% had their 1st sexual relations before age 17. Sexual activity is sporadic and irregular but usually occurs with the same partner. At least 50% of 1st sexual relations are unprotected by contraception, and half of adolescent pregnancies occur in the 1st 6th months of sexual activity. 6-12 months pass on average before sexually active adolescents begin to use contraception. Rates of pregnancy and abortion have increased especially among adolescents under 16, and in 1979 almost 20% of all abortions were in women under 20 years old. In 1980, only 20% of adolescents used contraception, with 17.3% using oral contraceptives. Few statistics exist on the complex phenomenon of conscious or subconscious contraceptive resistence in adolescence, and clinical experience serves as a better guide. A frequent attitude among adolescents is that sexual relations should be spontaneous and romantic, traits viewed as incompatible with contraception. "Magical thinking", failure to appreciate the real risk of pregnancy, and dissociation of sex and pregnancy are common. Adolescents who doubt their fecundity may engage in unprotected relations to reassure themselves, while some seeking to assert their femininity may use pills although they have no need for contraception. Guilt and ambivalence may be unconscious motivations for poor contraceptive use. Young girls in cold, uncaring, neglectful, or conflict-ridden homes may seek affection from a sexual partner and wish to have a baby to demonstrate their attachment. Such situations often lead to well-accepted pregnancies and may also

  3. Emergency contraception – a neglected option for birth control

    Directory of Open Access Journals (Sweden)

    Eka R. Gunardi

    2013-12-01

    Full Text Available Emergency contraception (EC is any method of contraception which is used after intercourse and before the potential time of implantation, in order to prevent pregnancy after an unprotected or inadequately protected sexual intercourse, or cases of rape. Use of emergency contraception could halve the number of unintended pregnancies and the consequent need for abortion, but unfortunately many medical professionals and the public are not aware of it. Two methods are available for emergency contraception, namely emergency contraception pills (ECPs and copper-bearing intrauterine devices (Cu-IUDs. There are two regimens of ECP, the levonorgestrel regimen and combined regimen. The levonorgestrel regimen is preferred as it is more effective and causes less side effects. ECPs should be administered as soon as possible after unprotected or inadequately protected sex, being most effective if initiated within 24 hours. Cu-IUDs can be inserted up to 5 days after unprotected sexual intercourse. Emergency contraception mainly works by preventing fertilization, and does not interrupt and established pregnancy. Emergency contraception is very safe, therefore can be offered to women who have had unprotected intercourse and wish to prevent pregnancy. It must only be used as a backup method of birth control. (Med J Indones. 2013;22:248-52. doi: 10.13181/mji.v22i4.609Keywords: Birth control, copper-IUD, emergency contraception, emergency contraceptive pills, levonorgestrel

  4. Contraception in Obese Women

    Directory of Open Access Journals (Sweden)

    Merki Feld G

    2015-01-01

    Full Text Available Today obesity is an epidemic. Within Europe the prevalence of obesity is 20–30% with a tendency to increase further. Obesity is associated with severe complications like diabetes mellitus, cardiovascular disease increased risk for venous thromboembolism (VTE and metabolic syndrome. Especially availability of efficient methods which do not further enhance the cardiovascular and thromboembolic risk in obese women is an important point. Using contraception to prevent unwanted pregnancies is recommended to all women whatever their weight, as it reduces the risks of unplanned pregnancy, which is higher in women with overweight. Progestin-only contraceptives and IUDs have no or minimal metabolic effects and are first choices options, also it has to be taken in account that oral progestins and the implant might have lower efficacy in very obese women. CHC are associated with a higher risk for VTE in obese women,but should be used if other methods are not acceptable. A long-cycle or use of preparations with 30 mcg EE can contribute to improve efficacy.

  5. Advantages and disadvantages of emergency postcoital contraception

    OpenAIRE

    Goločorbin-Kon, Svetlana; Kučević, Berina; Lalić-Popović, Mladena; Pavlović, Nebojša; Perišić-Jeremić, Nataša; Perišić, Milena; MOMIR M. MIKOV

    2016-01-01

    Emergency postcoital contraception (EPC) also known as 'emergency contraception' and 'morning after pill' is an easy way to prevent conceiving and it can be purchased in many countries without any prescription. EPC offers an important chance to prevent an unintended pregnancy when a regular method fails, no method was used, or sex was forced. The currently available options include an estrogen-progestin combination (ethinyl estradiol with levonorgestrel), progestin alone (levonorgestrel), the...

  6. Is oral contraceptive associated with genital warts?

    OpenAIRE

    Ross, J. D.

    1996-01-01

    OBJECTIVE: To measure the association between oral contraceptive use and the prevalence of genital warts in women. METHODS: Cross sectional case control study comparing oral contraceptive use in women with and without genital warts attending a city centre genitourinary medicine clinic controlling for recent sexual activity, the presence of other sexually transmitted infections, socio-economic class and history of pregnancy using a multivariate logistic regression model. RESULTS: After control...

  7. Introducing reproductive life plan-based information in contraceptive counselling: an RCT

    National Research Council Canada - National Science Library

    Stern, J; Larsson, M; Kristiansson, P; Tydén, T

    2013-01-01

    Can reproductive life plan (RLP)-based information in contraceptive counselling before pregnancy increase women's knowledge of reproduction, and of the importance of folic acid intake in particular...

  8. Impaired executive function mediates the association between maternal pre-pregnancy body mass index and child ADHD symptoms.

    Directory of Open Access Journals (Sweden)

    Claudia Buss

    Full Text Available BACKGROUND: Increasing evidence suggests exposure to adverse conditions in intrauterine life may increase the risk of developing attention-deficit/hyperactivity disorder (ADHD in childhood. High maternal pre-pregnancy body mass index (BMI has been shown to predict child ADHD symptoms, however the neurocognitive processes underlying this relationship are not known. The aim of the present study was to test the hypothesis that this association is mediated by alterations in child executive function. METHODOLOGY/PRINCIPAL FINDINGS: A population-based cohort of 174 children (mean age = 7.3 ± 0.9 (SD yrs, 55% girls was evaluated for ADHD symptoms using the Child Behavior Checklist, and for neurocognitive function using the Go/No-go task. This cohort had been followed prospectively from early gestation and birth through infancy and childhood with serial measures of maternal and child prenatal and postnatal factors. Maternal pre-pregnancy BMI was a significant predictor of child ADHD symptoms (F((1,158 = 4.80, p = 0.03 and of child performance on the Go/No-go task (F((1,157 = 8.37, p = 0.004 after controlling for key potential confounding variables. A test of the mediation model revealed that the association between higher maternal pre-pregnancy BMI and child ADHD symptoms was mediated by impaired executive function (inefficient/less attentive processing; Sobel Test: t = 2.39 (± 0.002, SEM, p = 0.02. CONCLUSIONS/SIGNIFICANCE: To the best of our knowledge this is the first study to report that maternal pre-pregnancy BMI-related alterations in child neurocognitive function may mediate its effects on ADHD risk. The finding is clinically significant and may extrapolate to an approximately 2.8-fold increase in the prevalence of ADHD among children of obese compared to those of non-obese mothers. These results add further evidence to the growing awareness that neurodevelopmental disorders such as ADHD may have their foundations very early in life.

  9. Manganese intake is inversely associated with depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi

    2017-03-15

    One epidemiological study in Canada has addressed the association between zinc intake and depressive symptoms during pregnancy while another epidemiological study in Korea has examined the association between iron intake and depressive symptoms during pregnancy. The present cross-sectional study in Japan examined the association between intake of zinc, magnesium, iron, copper, and manganese and depressive symptoms during pregnancy. Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones. In crude analysis, significant inverse associations were observed between intake levels of zinc, magnesium, iron, copper, and manganese and the prevalence of depressive symptoms during pregnancy. After adjustment for confounding factors, only manganese intake was independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratio between extreme quartiles was 0.74 (95% confidence interval:0.56-0.97, P for trend=0.046). Information was obtained between the 5th and 39th week of pregnancy. The current cross-sectional study of Japanese women demonstrated higher manganese intake to be independently associated with a lower prevalence of depressive symptoms during pregnancy. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Ong Jason

    2012-12-01

    Full Text Available Abstract Background Unintended pregnancy (mistimed or unwanted remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review. Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use was calculated through backward elimination with statistical significance set at Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods or never using contraception (8%. On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were 1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6. These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5; felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0; were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8; were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9 but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1. Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective

  11. Abortion and contraceptive practices in eastern Europe.

    Science.gov (United States)

    Kovács, L

    1997-07-01

    In countries of the CCEE region (Countries of Central and Eastern Europe) the very high incidence of pregnancy termination is characteristic of family planning and the notion 'contraception instead of abortion' has not yet been achieved. The causes and consequences of this unfortunate situation will be reviewed: the reproductive health indicators in the area; the status of contraceptive use and of abortion; the impact of legislation in the different countries; and the efforts to achieve changes. The conclusions of the 'Szeged Declaration' which led to an increase in contraceptive prevalence will be discussed.

  12. Contraception for women with diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth; Clausen, Tine Dalsgaard

    2005-01-01

    Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...

  13. Contraception for women with diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth; Clausen, Tine Dalsgaard

    2005-01-01

    Planned pregnancy is mandatory in women with diabetes, and their need for contraception is essential. Basically, the same methods can be used as in women without diabetes, but a number of specific conditions have to be considered when guiding these women, as we discuss in this review. Unfortunately......, the field is limited in studies in certain areas, especially considering contraception for women with type 1 diabetes and late diabetic complications and women with type 2 diabetes. Thus, in the real clinical world, the choice of contraceptive often will be a kind of compromise, balancing pro and cons...

  14. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  15. Contraception and abortion in Romania.

    Science.gov (United States)

    Johnson, B R; Horga, M; Andronache, L

    1993-04-03

    After the downfall of the Ceausescu regime in December, 1989, the new Government of Romania abolished the law that prohibited abortions on request. Subsequently, the rate of legally induced abortions increased significantly while the rate of maternal mortality declined dramatically. Despite the large number of women who request induced abortions, most women and gynaecologists say that they would prefer to prevent unwanted pregnancies through the use of modern contraception. In this paper we examine factors that contribute to the disparity between women's desire to use modern contraception to prevent unwanted pregnancies and their practice of having induced abortions to prevent unwanted births. The results show that women (and suggest that men) need a wide choice of dependably available high-quality contraceptives; they need to be able to obtain information, counselling, and methods from a wide range of sources/health-care providers; both women's and men's perceptions about, and use of, modern contraception could be positively affected through sexual education started in secondary school; and, to reduce repeat abortions, women's post-abortion family-planning needs must not be neglected.

  16. The combined oral contraceptive pill -- recent developments, risks and benefits.

    Science.gov (United States)

    Dragoman, Monica V

    2014-08-01

    The introduction of the birth control pill as an effective, coitally-independent method of contraception was a public health milestone of the last century. Over time, combined oral contraception (COC) formulations and pill-taking regimens have evolved with improved safety and tolerability while maintaining contraceptive efficacy. In addition to protection against pregnancy, use of combined oral contraception confers a number of significant non-contraceptive benefits to users. COC use is also associated with well-studied risks. Common side effects are generally self-limiting and improve with increasing duration of use while serious adverse events, including venous thromboembolism, are rare among healthy COC users. Contraceptive decision-making should include consideration of both the risks and benefits of a given method versus the real consequences of unintended pregnancy.

  17. Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Gemzell-Danielsson K

    2010-01-01

    Full Text Available There have been numerous attempts to control fertility after unprotected sexual intercourse. From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel, known as the Yuzpe regimen. The first dose had to be taken within 72 hours of unprotected intercourse, a second one 12 hours later. Later on, levonorgestrel alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart showed to be more successful, eventually resulting in the development of a 1.5 mg levonorgestrel pill that combined good efficacy with a high ease of use. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for emergency contraception, which show a high efficacy. Their disadvantages lie in the fact that emergency contraception is considered an off label use and that they might not be acceptable for every patient. Mifepristone in doses of 10 or 25 mg is being used successfully as an emergency contraceptive in China, but has never received any significant consideration in Western countries. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate in the dosage of 30 mg for emergency contraception up to 5 days after unprotected intercourse, combining the safe and easy application of the single dose levonorgestrel pill with an even higher efficacy. Several efficacious and easy to use methods for emergency contraception are available on the market today with the most widely spread being levonorgestrel in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each for administration up to 3 days after

  18. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  19. Contraceptive practices.

    Science.gov (United States)

    Morgenthau, J E; Rao, P S

    1976-08-01

    A family life education program (FLEP) providing contraceptive services within a comprehensive health care organization for low-income, inner-city adolescents is described. Each female patient attending in the July 1-September 30, 1974, period was included in a study undertaken to identify and serve the unmet needs of the teen-age population in the community of East Harlem. Of the 334 females interviewed, almost 1/2 were black, 37% were Hispanic, 12% were white, and 2% were Oriental, totals representative of the surrounding community. The questionnaire included information on demographic and social background, sexual history, reproductive history, and contraceptive experience. Comparisons are made on the answers between groups. Personal contacts and school outreach were the 2 main sources of referral to the clinic. Sexual history was found to be associated with social background rather than physiological factors. More than 1/2 the teen-agers had never used contraception prior to their 1st clinic visit and another 1/4 of the girls were using unreliable methods. The study indicated that teen-agers will use good programs which are designed to meet their needs. For teen-agers, a free-standing clinic offering comprehensive health care is the ideal situation.

  20. Drug interactions between hormonal contraceptives and antiretrovirals

    Science.gov (United States)

    Nanda, Kavita; Stuart, Gretchen S.; Robinson, Jennifer; Gray, Andrew L.; Tepper, Naomi K.; Gaffield, Mary E.

    2017-01-01

    Objective: To summarize published evidence on drug interactions between hormonal contraceptives and antiretrovirals. Design: Systematic review of the published literature. Methods: We searched PubMed, POPLINE, and EMBASE for peer-reviewed publications of studies (in any language) from inception to 21 September 2015. We included studies of women using hormonal contraceptives and antiretrovirals concurrently. Outcomes of interest were effectiveness of either therapy, toxicity, or pharmacokinetics. We used standard abstraction forms to summarize and assess strengths and weaknesses. Results: Fifty reports from 46 studies were included. Most antiretrovirals whether used for therapy or prevention, have limited interactions with hormonal contraceptive methods, with the exception of efavirenz. Although depot medroxyprogesterone acetate is not affected, limited data on implants and combined oral contraceptive pills suggest that efavirenz-containing combination antiretroviral therapy may compromise contraceptive effectiveness of these methods. However, implants remain very effective despite such drug interactions. Antiretroviral plasma concentrations and effectiveness are generally not affected by hormonal contraceptives. Conclusion: Women taking antiretrovirals, for treatment or prevention, should not be denied access to the full range of hormonal contraceptive options, but should be counseled on the expected rates of unplanned pregnancy associated with all contraceptive methods, in order to make their own informed choices. PMID:28060009

  1. Mid-pregnancy corticotropin-releasing hormone levels in association with postpartum depressive symptoms

    NARCIS (Netherlands)

    Iliadis, Stavros I; Sylvén, Sara; Hellgren, Charlotte; Olivier, Jocelien D.; Schijven, Dick; Comasco, Erika; Chrousos, George P; Sundström Poromaa, Inger; Skalkidou, Alkistis

    2016-01-01

    BACKGROUND: Peripartum depression is a common cause of pregnancy- and postpartum-related morbidity. The production of corticotropin-releasing hormone (CRH) from the placenta alters the profile of hypothalamus-pituitary-adrenal axis hormones and may be associated with postpartum depression. The purpo

  2. Contraception in women with epilepsy: pharmacokinetic interactions, contraceptive options, and management.

    Science.gov (United States)

    Dutton, Caryn; Foldvary-Schaefer, Nancy

    2008-01-01

    Contraceptive counseling is a critical component of the management of the female patient with epilepsy because of the increased risk of pregnancy associated with epilepsy and the multitude of interactions between antiepileptic drugs (AEDs) and hormonal contraception. Steroid hormones and many of the AEDs are substrates for the cytochrome P450 enzyme system, in particular, the 3A4 isoenzyme. As a result, concomitant use of hormonal contraceptives and AEDs may pose a risk for unexpected pregnancy, seizures, and drug-related adverse effects. The risk of combined oral contraceptive (COC) failure is slightly increased in the presence of cytochrome P450 3A4 enzyme-inducing AEDs. Several AEDs induce the production of sex hormone binding globulin (SHBG) to which the progestins are tightly bound, resulting in lower concentrations of free progestin that may also lead to COC failure. There is no increase in the risk of COC failure in women taking nonenzyme-inducing AEDs. Oral contraceptives significantly increase the metabolism of lamotrigine, posing a risk of seizures when hormonal agents are initiated and/or toxicity during pill-free weeks. There is no evidence that COCs increase seizures in women with epilepsy. While higher dose COCs are one contraceptive option for women on enzyme-inducing AEDs, a variety of other options are available. Injectable contraception (depot medroxyprogesterone acetate) appears effective with AED use, but the potential for bone mineral density loss is a concern. Intrauterine devices (IUDs) and barrier methods do not rely on hormonal components for contraceptive efficacy, and are therefore appropriate to recommend for use in women using enzyme-inducing medications. This chapter reviews the evidence regarding the pharmacokinetic interaction between AEDs and oral contraceptive hormones, the known or potential interactions with alternative contraceptive methods, and provides practical advice for management of contraceptive needs in reproductive

  3. Risks and protective factors associated with symptoms of depression in low-income African American and Caucasian women during pregnancy.

    Science.gov (United States)

    Jesse, D Elizabeth; Walcott-McQuigg, Jacqueline; Mariella, Anne; Swanson, Melvin S

    2005-01-01

    This article describes the risks and protective factors for symptoms of depression in pregnancy among low-income African American and Caucasian women. Data were collected from 130 women who were between 16 and 28 weeks' gestation and enrolled in an urban prenatal clinic. The questionnaires used in the face-to-face interviews consisted of sociodemographic items, the Beck Depression Inventory (BDI-II), the Prenatal Psychosocial Profile (PPP), 3 items from the Jarel Spiritual Well-Being Scale, the Spiritual Perspective Scale, and 4 items on health risk behaviors. Twenty-seven percent of the women reported depressive symptoms at levels indicating risk for clinical depression. However, there were no significant differences between African American and Caucasian women. Sociodemographic factors accounted for 13% of the variance (P self-esteem and social support, and higher religiosity had a significant relationship with more symptoms of depression. This supports the need to routinely screen for and to assess factors associated with depressive symptoms in pregnant low-income women.

  4. Postpartum and Post-Abortion Contraception: From Research to Programs.

    Science.gov (United States)

    Shah, Iqbal H; Santhya, K G; Cleland, John

    2015-12-01

    Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use.

  5. [Male contraception].

    Science.gov (United States)

    Demoulin, A

    1984-04-01

    Among the reasons why male hormonal contraception has lagged behind female methods are the necessity of preserving virility, the fact that spermatogenesis is a continuous process, the need to control secondary effects and toxicity, and the requirement that modes of administration be acceptable to both partners. Among currently available reversible mehtods, withdrawal is undoubtedly the most ancient. It is still widespread but cannot be recommended because of its limited effectiveness. The condom is used by about 10% of couples worldwide as a principal or temporary method, but its inter-ference with sensation has limited its acceptance. Condoms are nevertheless highly effective when used with a spermicide. Various androgens are currently under investigation. High doses of testosterone can induce azoospermia without affecting libido but their side effects may be serious. The use of combinations of steroids permits doses to be reduced and offers promise for the future. The combination of oral medroxyprogesterone acetate and percutaneous testosterone is one of the better approaches; the combination is effective and nontoxic but has the disadvantage of percutaneous administration. Gossypol, a pigment extracted from the cotton plant, has been used as a contraceptive in China with a reported efficacy of 99.89%, recovery of fertility within 3 months, and no effect on future fertility. However, its toxicity appears to be significant in the animal and its reversibility is uncertain. A search is on for analogs which would preserve the contraceptive effects while eliminating toxic effects. Several gonadotropin releasing hormone (GnRH) analogs under investigation for their interference with spermatogenesis have given promising results. Several chemicals tested for contraceptive effects have had unacceptably high toxicity. Chinese investigators have reported good results with various physical methods of interfering with sperm production, but their reversibility and innocuity

  6. Managing adverse effects of hormonal contraceptives.

    Science.gov (United States)

    Grossman Barr, Nancy

    2010-12-15

    Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only hormonal contraceptive that is consistently associated with weight gain; other hormonal methods are unlikely to increase weight independent of lifestyle choices. Switching com- bined oral contraceptives is not effective in treating headaches, nor is the use of multivitamins or diuretics. There are no significant differences among various combined oral contraceptives in terms of breast tenderness, mood changes, and nausea. Breakthrough bleeding is common in the first months of combined oral contraceptive use. If significant abnormal bleeding persists beyond three months, other methods can be considered, and the patient may need to be evaluated for other causes. Studies of adverse sexual effects in women using hormonal contraceptives are inconsistent, and the pharmacologic basis for these symptoms is unclear. If acne develops or worsens with progestin-only contra- ceptives, the patient should be switched to a combination method if she is medically eligible. There is insufficient evidence of any effect of hormonal contraceptives on breast milk quantity and quality. Patient education should be encouraged to decrease the chance of unanticipated adverse effects. Women can also be assessed for medical eligibility before and during the use of hormonal contraceptives.

  7. Maternal symptoms of anxiety during pregnancy affect infant neuromotor development: the generation R study

    NARCIS (Netherlands)

    van Batenburg-Eddes, T.; de Groot, L.; Huizink, A.C.; Steegers, E.A.P.; Hofman, A.; Jaddoe, V.W.V.; Verhulst, F.C.; Tiemeier, H.

    2009-01-01

    Several studies found that maternal symptoms of anxiety or depression are related to functioning and development of the offspring. Within a population-based study of 2,724 children, we investigated the effect of maternal anxiety or depression on infant neuromotor development. Symptoms of anxiety and

  8. Teen pregnancy: an update.

    Science.gov (United States)

    McCracken, Katherine A; Loveless, Meredith

    2014-10-01

    To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention as one of its top six priorities, which is increasing research and intervention data. Long-acting contraceptive methods are acceptable to teens and have been shown to reduce teen birth rates. Pregnant teens need special attention to counseling on pregnancy options and reducing risk during pregnancy with regular prenatal care. Postpartum teens should be encouraged and supported to breastfeed, monitored for depression, and have access to reliable contraception to avoid repeat undesired pregnancy. This review highlights important issues for all providers caring for female adolescents and those who may encounter teen pregnancy. Foremost prevention of teen pregnancy by comprehensive sexual education and access to contraception is the priority. Educating patients and healthcare providers about safety and efficacy of long-acting reversible contraception is a good step to reducing undesired teen pregnancies. Rates of postpartum depression are greater in adolescents than in adults, and adolescent mothers need to be screened and monitored for depression. Strategies to avoid another undesired pregnancy shortly after delivery should be implemented.

  9. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    Science.gov (United States)

    Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

    2007-01-01

    Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

  10. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    Science.gov (United States)

    Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

    2007-01-01

    Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

  11. Knowledge, Perceptions and Ever Use of Modern Contraception ...

    African Journals Online (AJOL)

    Erah

    Contraception among Women in the Ga East District, Ghana. Aryeetey R1 .... why there was an increasing trend of adolescent pregnancy ... 120 adult and adolescent respondents per community .... emergency contraceptive pill, was less commonly known by ..... and knowledge of benefits regarding family planning methods ...

  12. Contraception and Induced Abortion in the West Indies: A Review

    NARCIS (Netherlands)

    Boersma, A.A.; Bruijn, de J.G.M.

    2011-01-01

    Abstract BACKGROUND: Most islands in the West Indies do not have liberal laws on abortion, nor laws on pregnancy prevention programmes (contraception). We present results of a literature review about the attitude of healthcare providers and women toward (emergency) contraception and induced

  13. Denial of women's rights to contraception in southeastern Nigeria.

    Science.gov (United States)

    Chigbu, Chibuike O; Onyebuchi, Azubuike K; Onwudiwe, Elijah N; Iwuji, Stella E

    2013-05-01

    To evaluate the opinions and experiences of married women in southeastern Nigeria regarding their rights to contraception, in addition to the impact of the denial of women's contraceptive rights on unplanned pregnancy rate. A cross-sectional survey of women who registered for prenatal care at 2 federal tertiary healthcare facilities in southeastern Nigeria was conducted. Randomly selected samples of participants were interviewed via a structured, pretested questionnaire. In total, 1204 women participated in the survey. Overall, 526 (43.7%) were unaware of their rights to contraception. Denial of contraceptive rights was reported by 522 (43.4%) women. In total, 174/317 (54.9%) women with unplanned pregnancies blamed denial of access to contraception for their pregnancies. Among the women who had used contraception previously, 61.9% reported that the decision to do so was taken by their spouse. Formal education seemed to increase women's level of awareness of their rights to contraception (P=0.001) but it did not influence the exercising of such rights. A considerable proportion of women in southeastern Nigeria are being denied their rights to contraception, mainly owing to a culture of male dominance. There may be significant health implications for women with unplanned pregnancies arising from such denials. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Contraception and Induced Abortion in the West Indies: A Review

    NARCIS (Netherlands)

    Boersma, A.A.; Bruijn, de J.G.M.

    2011-01-01

    Abstract BACKGROUND: Most islands in the West Indies do not have liberal laws on abortion, nor laws on pregnancy prevention programmes (contraception). We present results of a literature review about the attitude of healthcare providers and women toward (emergency) contraception and induced abortion

  15. Promoting safe use of isotretinoin by increasing contraceptive knowledge.

    Science.gov (United States)

    Werner, Carly A; Papic, Melissa J; Ferris, Laura K; Schwarz, Eleanor B

    2015-04-01

    Isotretinoin, a known teratogen, is strictly regulated through the iPLEDGE program. However, isotretinoin-exposed pregnancies continue to occur. To evaluate an information sheet's effect on women's contraceptive knowledge. Women aged 18 to 45 years visiting a dermatology practice completed anonymous surveys assessing their knowledge of the typical effectiveness of 8 contraceptive methods before and after reviewing an educational information sheet. Participants categorized each contraceptive as "most effective, >99% effective," "medium effective, 92%-97% effective," or "least effective, contraceptive effectiveness knowledge and change in contraceptive effectiveness knowledge after viewing the educational tool. Prior to viewing the contraceptive information sheet, more than half of women overestimated the typical effectiveness of condoms (75%), contraceptive injections (57%), and oral contraceptives (51%). Thirty-four percent had never heard of contraceptive implants, whereas 16% had never heard of an intrauterine contraceptive device (IUD). Participants correctly identified the typical effectiveness of only a mean (SD) of 3.8 (1.9) of the 8 contraceptives that they were asked about. Only 3% of participating women were able to correctly identify the typical effectiveness of all available contraceptives. On average, women spent less than 1 minute reviewing the contraceptive information sheet (mean [SD], 31 [27] seconds). After viewing the educational handout, the proportions of participants able to correctly identify the typical effectiveness of contraceptives increased for almost all methods (subdermal implant, 45% to 78% [P contraceptive information sheet can significantly improve patients' contraceptive knowledge and may be a useful addition to efforts to prevent isotretinoin-induced birth defects.

  16. 21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device...

  17. Knowledge, behaviors of nurses and midwives with emergency contraception

    Directory of Open Access Journals (Sweden)

    Nülüfer Erbil

    2010-10-01

    Full Text Available Aim: The using of emergency contraception may play important role for preventing unplanned pregnancies and induced abortion. The aim of this study was to determine the knowledge and behaviors of nurses and midwives with emergency contraception. Material and Methods: Sample of this descriptive and cross-sectional study were voluntary 89 nurses and 100 midwives. The data of study were collected using face-to-face interwiev methods via questionnarie. This study was made 1st-15th February, 2005.Results: It was determined that 46.6% of nurses and midwives heard emergency contraception. Of the nurses and midwives who completed the sample 74.1% reported that they did not know about what used for emergency contraception and 77.2% of them did not know about beginning time to emergency contraception. It was found that rate of using the emergency contraception among nurses and midwives was 4.2%. Half of nurses and midwives who used emergency contraception reported that emergency contraception prevented their pregnancy. It was found that occupation (p=0.000 and institution (p=0.000 of participants effected hearing of emergency contraception by nurses and midwives the differences were significant. Conclusion: Knowledge and behaviors of nurses and midwives with emergency contraception are not adequate. The education should prepare to health care providers for the presenting of knowledge and behavior about this subject. Advance researches into knowledge, attitude and behaviors of health professionals are advised.

  18. High maternal cortisol levels during pregnancy are associated with more psychiatric symptoms in offspring at age of nine - A prospective study from Nicaragua.

    Science.gov (United States)

    Isaksson, J; Lindblad, F; Valladares, E; Högberg, U

    2015-12-01

    Maternal exposure to stress or adversity during pregnancy has been associated with negative health effects for the offspring including psychiatric symptoms. Programming of the hypothalamic-pituitary-adrenal (HPA) axis has been suggested as one mediating process. In order to investigate possible long term effects of stressors during pregnancy, we followed 70 children and their mothers from pregnancy up to nine years aiming to investigate if maternal cortisol levels and distress/exposure to partner violence were associated with child psychiatric symptoms and child cortisol levels at follow-up. Maternal distress was evaluated using The Self Reporting Questionnaire, exposure to partner violence by an instrument from WHO and child psychiatric symptoms with Child Behavior Checklist (CBCL). We adjusted the analyses for gestational week, gender, SES, perinatal data and maternal distress/exposure to partner violence at child age of nine years. Elevated maternal cortisol levels during pregnancy, as a possible marker of maternal stress load, were correlated with higher CBCL-ratings, especially concerning externalizing symptoms. Maternal cortisol levels during pregnancy were not associated with child cortisol levels at child age of nine years. Maternal distress and exposure to partner violence during pregnancy were neither associated with child psychiatric symptoms nor child cortisol levels. To conclude, intrauterine exposure to elevated cortisol levels was associated with higher ratings on offspring psychopathology at nine years of age. The lack of association between maternal cortisol levels during pregnancy and child cortisol levels does not support the hypothesis of fetal programming of the HPA-axis, but reliability problems may have contributed to this negative finding.

  19. Late occurrence of a congenital diaphragmatic hernia complicating pregnancy: A case report

    Directory of Open Access Journals (Sweden)

    Jyoti Singh

    2012-12-01

    Full Text Available Diaphragmatic hernia complicating pregnancy is rare and results in a high fetal and maternal mortality particularly if early surgical intervention is not undertaken. A very high degree of suspicion in needed for diagnosis as the symptoms produced by this hernia are seen in normal pregnancy also. We present here a patient with CDH who became acutely symptomatic for the first time during the pregnancy and was managed successfully. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 47-49

  20. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Jennifer A. Robinson

    2012-01-01

    Full Text Available Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman’s overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs and antiretroviral drugs (ARVs. We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA and the levonorgestrel intrauterine system (LNG-IUS were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs.

  1. Expanding contraceptive options.

    Science.gov (United States)

    1989-01-01

    The goals of Family Health International (FHI) have been to introduce a variety of birth control options to people in developing countries, and to provide information to the user on the advantages and disadvantages of each method. FHI has worked with many developing countries in clinical trials of established as well as new contraceptive methods. These trials played an important part in making 2 sterilization procedures, laparoscopy and minilaparotomy popular for women. Further research improved the methods and have made them the most popular in the world, chosen by 130 million users. FHI is doing clinical trials on a new IUD, that is a copper bearing T-shaped device called the TCu380A. they have collected data on over 10,000 women using IUD's and early analysis indicates TCu380A is more effective than others. FHI is also evaluating devices such as Norplant that will prevent pregnancy up to 5 years by implanting the capsules in the arm. More than 8,000 women are being tested to determine the acceptability of implants in different geographical locations. Other research groups are doing work in 10 additional countries: Bangladesh will expand its program to 24,000 women and Nepal to 8,000 women. Trials are also being conducted on progestogen pills, since they do not lesson the volume of milk in breast feeding. FHI has also worked to introduce creative community-based distribution channels. In one case, specially trained health workers delivered contraceptives door-to-door in over 150,000 households. They found that 2 of 3 women accepted the pills and in a follow up survey 90% were still using them. FHI is now focusing on ways to improve moving new contraceptives from clinical testing on everyday use. They will coordinate training programs, educational material, media campaigns, and efforts with other international organizations, government agencies, and family planning groups.

  2. Contraceptive supply and fertility outcomes: evidence from Ghana

    OpenAIRE

    2013-01-01

    Total fertility rates in Sub-Saharan Africa are nearly double that of any other region in the world. Evidence is mixed on whether providing contraceptives has an impact on fertility. I exploit exogenous, intermittent reductions in contraceptive supply in Ghana, resulting from cuts in U.S. funding, to examine impacts on pregnancy, abortion, and births. Women are unable to fully compensate for the 22% supply reduction using traditional methods for preventing pregnancy, which increases by 10%. O...

  3. Young Women's Contraceptive Decision Making: Do Preferences for Contraceptive Attributes Align with Method Choice?

    Science.gov (United States)

    Marshall, Cassondra; Guendelman, Sylvia; Mauldon, Jane; Nuru-Jeter, Amani

    2016-09-01

    Understanding how women's preferences for certain attributes of contraceptive methods relate to their method choice can inform the content of contraceptive counseling. Data from 715 women aged 18-29 who had ever used contraceptives were drawn from the 2009 National Survey of Reproductive and Contraceptive Knowledge. Chi-square tests and multivariable logistic regression analyses were used to examine how women's preferences for specific contraceptive attributes were related to their social and demographic characteristics and their current contraceptive choice. The majority of women considered it extremely important for a method to be very effective at preventing pregnancy (79%) and to be effective at preventing HIV and STDs (67%); fewer than one-quarter felt similarly about a method's being hormone-free (22%). Women who felt it was quite or extremely important for a method to be very effective at preventing pregnancy were not more likely to use the most effective methods than were women who considered this attribute not at all or only slightly important. Women who considered it quite or extremely important for a method to be hormone-free were less likely than others to use hormonal methods (odds ratio, 0.4), and women who considered STD protection quite or extremely important had elevated odds of relying on condoms alone, rather than on an effective contraceptive method alone (3.6). Most women desire a very effective method for pregnancy prevention, but it is unclear how this translates to their contraceptive use. The associations between women's preferred contraceptive attributes and method choice warrant further attention. Copyright © 2016 by the Guttmacher Institute.

  4. Progress with contraceptives and abortifacients.

    Science.gov (United States)

    Macpherson, A

    1992-10-01

    In Canada and most other comparatively rich countries, the total fertility rate (TFR) declined from approximately 2.5 in 1970 to 1.6-1.9 in 1990. The reduction was even greater in some countries such as China, Korea, Singapore, Mauritius, Barbados, Cuba, Guadeloupe, and Puerto Rico. TFR, however, has fallen little, if at all, in many poor countries; it remains at 8.1 in Kenya and has increased from already previously high levels in Somalia, Benin, Malawi, and Rwanda. The use of contraception has been instrumental in reducing fertility. An estimated 70% of married women in rich countries use contraceptives, and a larger proportion in Eastern Asia, but only less than 15% in Africa. Education for women generally increases the level of contraceptive use. Rates, however, depend upon the degree of both acceptance and availability. An estimated 20% of births in developing countries are unwanted, so it would seem that greater availability and variety of contraceptives could lead to reductions in fertility. Research into better contraceptive technology is frustrated by paternalism, most organized religions, concern over possible future legal liability, and fear of adverse health side effects, especially in North America. Depo-Provera and RU-486, for example, have yet to be licensed in Canada for use as contraceptive agents. Research nonetheless moves forward. A vaccine against pregnancy is reportedly being developed which may be available before the turn of the century. Clinical trials have been held, and the vaccine has been found to be effective in most women, lacking in side effects, and reversible. The prototype requires a series of injections. Elsewhere, the Alza Corporation of California is working on a transdermal patch to control fertility, while some success has been reported in trials of testosterone, alone or combined with a gonadotropin-releasing hormone, to suppress sperm production in men.

  5. Abortion and contraceptive failure.

    Science.gov (United States)

    1998-01-01

    Persona, marketed by Unipath, is a new method of natural family planning which has been on the market since 1996. It works by measuring the hormone levels in a woman's urine and letting her know when she is not fertile and may have sex without using a barrier method of contraception. The British Pregnancy Advisory Service (BPAS) found that their surveyed clients who reported using Persona had 188 abortions in 3 months and concluded that there was a need for better information and more advice for couples who plan to use the method. The other major non-NHS abortion provider, Marie Stopes International, reported similar findings, with about 60 women per month visiting their clinics for abortions after having used the method. The BPAS survey also showed that 43% of the women who had an abortion after using Persona were aged 24 years or younger even though Persona is intended for use by women aged 25-40 years in stable relationships. A similar proportion also reported having sex on days when the method told them that they were most fertile. These latter women were not asked if they used another method of contraception on fertile days. An additional 13% reported ignoring the instructions to wait for 3 natural periods after terminating pill use before beginning to use Persona.

  6. Immediate versus delayed postpartum insertion of contraceptive implant for contraception.

    Science.gov (United States)

    Sothornwit, Jen; Werawatakul, Yuthapong; Kaewrudee, Srinaree; Lumbiganon, Pisake; Laopaiboon, Malinee

    2017-04-22

    The spacing of pregnancies has a positive impact on maternal and newborn health. The progestin contraceptive implant, which is a long-acting, reversible method of contraception, has a well-established low failure rate that is compatible with tubal sterilization. The standard provision of contraceptive methods on the first postpartum visit may put some women at risk of unintended pregnancy, either due to loss to follow-up or having sexual intercourse prior to receiving contraception. Therefore, the immediate administration of contraception prior to discharge from the hospital that has high efficacy may improve contraceptive prevalence and prevent unintended pregnancy. To compare the initiation rate, effectiveness, and side effects of immediate versus delayed postpartum insertion of implant for contraception. We searched for eligible studies up to 28 October 2016 in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and POPLINE. We examined review articles and contacted investigators. We also checked registers of ongoing clinical trials, citation lists of included studies, key textbooks, grey literature, and previous systematic reviews for potentially relevant studies. We sought randomised controlled trials (RCTs) that compared immediate postpartum versus delayed insertion of contraceptive implant for contraception. Two review authors (JS, YW) independently screened titles and abstracts of the search results, and assessed the full-text articles of potentially relevant studies for inclusion. They extracted data from the included studies, assessed risk of bias, compared results, and resolved disagreements by consulting a third review author (PL or SK). We contacted investigators for additional data, where possible. We computed the Mantel-Haenszel risk ratio (RR) with 95% confidence interval (CI) for binary outcomes and the mean difference (MD) with 95% CI for continuous variables. Three studies that included 410 participants met the

  7. Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak--Puerto Rico, 2016.

    Science.gov (United States)

    Tepper, Naomi K; Goldberg, Howard I; Bernal, Manuel I Vargas; Rivera, Brenda; Frey, Meghan T; Malave, Claritsa; Renquist, Christina M; Bracero, Nabal Jose; Dominguez, Kenneth L; Sanchez, Ramon E; Shapiro-Mendoza, Carrie K; Rodriguez, Blanca R Cuevas; Simeone, Regina M; Pesik, Nicki T; Barfield, Wanda D; Ko, Jean Y; Galang, Romeo R; Perez-Padilla, Janice; Polen, Kara N D; Honein, Margaret A; Rasmussen, Sonja A; Jamieson, Denise J

    2016-04-01

    Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes, including pregnancy loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, and other fetal abnormalities. The virus has also been determined to be sexually transmitted. Because of the potential risks associated with Zika virus infection during pregnancy, CDC has recommended that health care providers discuss prevention of unintended pregnancy with women and couples who reside in areas of active Zika virus transmission and do not want to become pregnant. However, limitations in access to contraception in some of these areas might affect the ability to prevent an unintended pregnancy. As of March 16, 2016, the highest number of Zika virus disease cases in the United States and U.S. territories were reported from Puerto Rico. The number of cases will likely rise with increasing mosquito activity in affected areas, resulting in increased risk for transmission to pregnant women. High rates of unintended and adolescent pregnancies in Puerto Rico suggest that, in the context of this outbreak, access to contraception might need to be improved. CDC estimates that 138,000 women of reproductive age (aged 15-44 years) in Puerto Rico do not desire pregnancy and are not using one of the most effective or moderately effective contraceptive methods, and therefore might experience an unintended pregnancy. CDC and other federal and local partners are seeking to expand access to contraception for these persons. Such efforts have the potential to increase contraceptive access and use, reduce unintended pregnancies, and lead to fewer adverse pregnancy and birth outcomes associated with Zika virus infection during pregnancy. The assessment of challenges and resources related to contraceptive access in Puerto Rico might be a useful model for other areas with active transmission

  8. Soy isoflavone intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi

    2016-10-15

    Several observational studies and trials examined the relationship between isoflavones or soybeans and depressive symptoms among peri- and postmenopausal women. We cross-sectionally evaluated the associations between intake of soy products and isoflavones and depressive symptoms during pregnancy in Japan. Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale. Higher intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones was independently related to a lower prevalence of depressive symptoms during pregnancy: The adjusted prevalence ratios (95 % confidence intervals, P for trend) between extreme quartiles were 0.63 (0.47-0.85, 0.002), 0.72 (0.54-0.96, 0.007), 0.74 (0.56-0.98, 0.04), 0.57 (0.42-0.76, <0.0001), 0.73 (0.55-0.98, 0.03), 0.65 (0.49-0.87, 0.003), and 0.63 (0.46-0.86, 0.002), respectively. A significant positive exposure-response relationship was found between miso intake and depressive symptoms during pregnancy. No material relationship was observed between soymilk intake and depressive symptoms during pregnancy. Our study is the first to show independent inverse relationships between intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones and depressive symptoms during pregnancy.

  9. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    OpenAIRE

    2012-01-01

    Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and Februar...

  10. Oral contraceptives after myomectomy: a short term trial.

    Science.gov (United States)

    Luisi, Stefano; Ciani, Valentina; Gabbanini, Massimo; Sollazzi, Sofia; Torricelli, Michela; Calonaci, Francesco; Petraglia, Felice

    2009-01-01

    Following myomectomy the rate of fertility is restored and pregnancy may be attempted with a good outcome. In the present study a 3 month treatment with OCs in a group of women after a myomectomy was evaluated. The drug compliance and side effects, the benefits of OC in order to reduce symptoms, to increase post-surgical hemoglobin levels and to avoid an early pregnancy after myomectomy were analyzed. A group of women (n = 55) each with myoma >/=5 cm was recruited: they presented menorrhagia, pelvic pain, dyspareunia and dysmenorrhae. After laparotomic myomectomy the women were divided into 3 groups. Group 1: women (n = 16) treated with pill A (15 mcg of ethynilestradiol + 60 mcg of gestodene); group 2: women (n = 23) treated with pill B (20 mcg of ethynilestradiol + 100 mcg of levonorgestrel); group 3: women (n = 16) treated with a placebo (oral calcium). After three months from myomectomy and treatment patients in each group reported a reduced menorrhagia, dismenorrhea and pelvic pain. Serum haemoglobin levels increased in all women (P < .05). No pregnancy occurred in any group and the compliance was good. A post surgery treatment by using oral contraceptives guarentees pregnancy prevention, associated with reduction of pain, and improvement of haematologic conditions.

  11. A qualitative exploration of contraceptive practice and decision making of Malaysian women who had induced abortion: a case study.

    Science.gov (United States)

    Tong, Wen Ting; Low, Wah Yun; Wong, Yut Lin; Choong, Sim Poey; Jegasothy, Ravindran

    2014-09-01

    This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.

  12. [Contraception and pelvic infection in women].

    Science.gov (United States)

    Keith, L; Berger, G S; Brown, E R

    1986-01-01

    Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of

  13. Young adults' contraceptive practices: an investigation of influences.

    Science.gov (United States)

    Lowe, C S; Radius, S M

    1987-01-01

    This study investigated young adults' contraceptive behaviors and attitudes through application of a comprehensive, theoretical framework. Specifically, a social-psychological approach to understanding preventive behaviors (e.g., contraceptive practices), was developed, incorporating the Health Belief Model and other factors, which offered a means for evaluating the extent to which contraceptive behaviors were influenced by individual and group characteristics. The study group consisted of 283 unmarried students at several schools who were, on average, 19 years of age. Results suggested that effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to their use of contraception, their maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with effective contraceptive behavior. Findings also underlined a need for continuing education about sexuality and contraception. Dangerous misinformation prevailed regarding respondents' knowledge of areas that include anatomy, physiology, and appropriate use of effective contraceptive methods. Finally, results implied a need to consider broad behavioral, social, and interpersonal issues as they relate to young adults' effective contraceptive behavior. Future studies of contraceptive risk taking are encouraged to examine both individual and social factors affecting sexual and contraceptive practices if unplanned pregnancy is to be minimized, if not eliminated.

  14. Preferences of eligible women from an Indian medical college hospital for adapting contraceptives

    Directory of Open Access Journals (Sweden)

    Sandhya Gadre

    2016-01-01

    Conclusions: The contraceptive methods are poorly practiced. The users do not use any temporary contraception effectively and adequately. A negligible percentage of eligible women practice contraception before first pregnancy. Very few women practice temporary methods any time before they get sterilization done. Overall, the concept of spacing is lacking. Women are more inclined towards permanent methods. Male sterilization is very rarely chosen by the couples. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 35-40

  15. Utilization of modern contraceptives among female traders in Jos South LGA of Plateau state, Nigeria

    OpenAIRE

    Envuladu E.A; Agbo H.A; Mohammed A; Chia L; Kigbu J.H; Zoakah A.I

    2012-01-01

    Background: Contraceptive use is seen as pivotal to protecting women’s health and rights, contraception when accepted and used by majority of women in any given community has been shown to reduce unwanted pregnancy, high parity and consequently maternal mortality. Aim: The study aimed at determining the level of awareness, utilization, preferred methods of contraceptives and factors affecting contraceptive use among female traders of Jos south Local government area of Plateau state. Materials...

  16. Effects of maternal pregnancy intention, depressive symptoms and social support on risk of low birth weight: a prospective study from southwestern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Yohannes Dibaba Wado

    Full Text Available BACKGROUND: Low birth weight (LBW is the principal risk factor for neonatal and infant mortality in developing countries. This study examines the effects of unwanted pregnancy, prenatal depression and social support on the risk of low birth weight in rural southwestern Ethiopia. We hypothesized that unwanted pregnancy and prenatal depression increase the risk of low birth weight, while social support mediates this association. METHODS: Data for the study comes from a prospective study in which women were followed from pregnancy through to delivery. Six hundred twenty two women were followed and 537 birth weights were measured within 72 hours. Multivariable log binomial regression was used to model the risk of low birth weight. RESULTS: The mean birth weight was 2989 grams (SD ± 504 grams, and the incidence of LBW was 17.88%. The mean birth weight of babies after unwanted pregnancy was 114 g lower compared to births from intended pregnancy. Similarly, mean birth weight for babies among women with symptoms of antenatal depression was 116 grams lower. Results of unadjusted log-binomial regression showed that unwanted pregnancy, prenatal depression and social support were associated with LBW. The relationship between antenatal depressive symptoms and LBW was mediated by the presence of social support, while the association between LBW and unwanted pregnancy remained after multivariable adjustment. CONCLUSION: The incidence of low birth weight is high in the study area. Poverty, nonuse of antenatal care, low social support and unwanted pregnancy contribute to this high incidence of low birth weight. Hence, identifying women's pregnancy intention during antenatal care visits, and providing appropriate counseling and social support will help improve birth outcomes.

  17. Controversies in contraception for women with epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjeev V Thomas

    2015-01-01

    Full Text Available Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE is determined by the type of anti-epileptic drugs (AEDs that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent. Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE.

  18. Controversies in contraception for women with epilepsy.

    Science.gov (United States)

    Thomas, Sanjeev V

    2015-01-01

    Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent). Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE.

  19. Contraception in diabetic women: an Italian study.

    Science.gov (United States)

    Napoli, A; Colatrella, A; Botta, R; Di Cianni, G; Fresa, R; Gamba, S; Italia, S; Mannino, D; Piva, I; Suraci, C; Tonutti, L; Torlone, E; Tortul, C; Lapolla, A

    2005-03-01

    Over 1 year, a survey on contraception and obstetric history was performed on a cohort of 667 Caucasian fertile diabetic women (446, type 1 and 201, type 2) living in Italy. Of these women, 30.4% used hormonal contraceptives, 12.0% intra-uterine device (IUD), 10.7% declared they used no contraception, 47.0% only utilised barrier and/or natural methods. However, irrespective of their previous contraceptive strategy, 7.2% of all the studied population was surgically sterilized during caesarean section. Of these women, 60.4% was prescribed by a gynaecologist, 11.2% by a diabetologist, 15% by both of them and 13.4% by others. The proportion using oral contraception was similar among types 1 and 2 women (29.4% versus 27.8%, chi(2) = ns). Of women taking hormonal contraception, 30.0% were smokers. University graduates (37.1%), high school leaves (32.2%), secondary school (28.2%) and primary school leaves (15.5%) used oral contraceptives (OC). The mean number of deliveries was 1.14 +/- 1.1, of miscarriages was 1.3 +/- 0.7 and of induced abortions 0.17 +/- 0.5. Planning of at least one pregnancy was reported in 29.4% of patients.

  20. Predicting Postpartum Depressive Symptoms in New Mothers: The Role of Optimism and Stress Frequency during Pregnancy

    Science.gov (United States)

    Grote, Nancy K.; Bledsoe, Sarah E.

    2007-01-01

    During the transition to motherhood, women typically show favorable psychological adjustment after the first child is born, whereas 10 percent to 26 percent of women are at risk of developing clinically significant postpartum depressive symptoms. Little is known about which individuals are especially protected against the emergence of postpartum…

  1. Social media messaging in pregnancy: comparing content of Text4baby to content of free smart phone applications of pregnancy.

    Science.gov (United States)

    Lewkowitz, Adam K; O'Donnell, Betsy E; Nakagawa, Sanae; Vargas, Juan E; Zlatnik, Marya G

    2016-03-01

    Text4baby is the only free text-message program for pregnancy available. Our objective was to determine whether content differed between Text4baby and popular pregnancy smart phone applications (apps). Researchers enrolled in Text4baby in 2012 and downloaded the four most-popular free pregnancy smart phone apps in July 2013; content was re-extracted in February 2014. Messages were assigned thematic codes. Two researchers coded messages independently before reviewing all the codes jointly to ensure consistency. Logistic regression modeling determined statistical differences between Text4baby and smart phone apps. About 1399 messages were delivered. Of these, 333 messages had content related to more than one theme and were coded as such, resulting in 1820 codes analyzed. Compared to smart phone apps, Text4baby was significantly more likely to have content regarding Postpartum Planning, Seeking Care, Recruitment and Prevention and significantly less likely to mention Normal Pregnancy Symptoms. No messaging program included content regarding postpartum contraception. To improve content without increasing text message number, Text4baby could replace messages on recruitment with messages regarding normal pregnancy symptoms, fetal development and postpartum contraception.

  2. Current challenges in contraception in adolescents and young women.

    Science.gov (United States)

    Cornet, Ariana

    2013-03-01

    Although developing countries have made much progress in expanding the availability and use of family planning services, the need for effective contraception is large, and growing because the largest cohorts in human history are entering their reproductive years. Not only regarding developing countries but also in developed countries, where the usual contraceptive methods, such as the oral contraceptives, intrauterine devices (IUDs) and condoms, have been available for decades, there have been many new advances in contraceptive technology in the last several years. New formulations of oral contraceptives, extended and continuous use of oral contraceptives and long-acting reversible contraceptives (LARC) may have a wider role in contraception and their increased implementation could help to reduce unintended pregnancy. Today's oral contraceptive regimens are safer and more tolerable, with equal or improved efficacy as compared to early formulations. Incremental decreases in the estrogen dosage have helped to alleviate some of the unwanted estrogenic side effects of combined hormonal contraceptives. Progestogens have also been controversial in connection with findings of increased venous thromboembolism risks but they have evolved over time, and, in general, newer generations of progestins have minimal side effects. Currently available 'LARC' methods, such as IUDs, the intrauterine system, injectable contraceptives and implants require administration less than once per cycle or month. They are more cost effective than the combined oral contraceptive pill even at 1 year of use. Increasing the access and availability of new formulations of oral contraceptives and LARC methods will reduce the number of unintended pregnancies. Evidence-based guidelines about the safety of contraceptive methods among women with comorbid medical conditions can help guide providers in determining the best method of contraception for each woman, depending on whether they are in their

  3. A social learning model of adolescent contraceptive behavior.

    Science.gov (United States)

    Balassone, M L

    1991-12-01

    Decision making and socialization models have advanced our knowledge of adolescent contraceptive behavior. They also show the vital role values, attitudes, and beliefs play in contraceptive use. A social work professor builds on these models and adds values, attitudes, and beliefs to a new social learning model of contraceptive behavior to improve on the weaknesses of those models. This new model considers contraceptive behavior an active response instead of a passive response. It uses 3 major components to explain how adolescents learn and preserve contraceptive behaviors. They include environmental context, cognitive influences, and behavior executive constraints. Accurate sexuality information, available contraceptive services, and availability of role models constitute the environmental context. These environmental factors either support or limit contraceptive use. Perception of need and consequences is a cognitive influence and embraces judgment of immediate and delayed consequences and probability and susceptibility to pregnancy and sexually transmitted diseases (STDs); perception of pregnancy/STD seriousness; and expectation regarding personal mastery. The other cognitive influence is decision making processed which involved generating, evaluating, and selecting alternatives. Advantages of this model are its flexibility to apply it to different groups of adolescents and its emphasis on reducing the risk of acquiring an STD as well as pregnancy prevention. Researchers of contraceptive behavior among adolescents should consider all 3 model components when designing research that aims to predict birth control behavior.

  4. Adolescents: contraceptive knowledge and use, a Brazilian study.

    Science.gov (United States)

    Correia, Divanise S; Pontes, Ana C P; Cavalcante, Jairo C; Egito, E Sócrates T; Maia, Eulália M C

    2009-01-18

    The purpose of this study was to identify the knowledge and use of contraceptive methods by female adolescent students. The study was cross-sectional and quantitative, using a semi-structured questionnaire that was administered to 12- to 19-year-old female students in Maceió, Brazil. A representative and randomized sample was calculated, taking into account the number of hospital admissions for curettage. This study was approved by the Human Research Ethics Committee, and Epi Info software was used for data and result evaluation using the mean and chi-square statistical test. Our results show that the majority of students know of some contraceptive methods (95.5%), with the barrier/hormonal methods being the most mentioned (72.4%). Abortion and aborting drugs were inaccurately described as contraceptives, and 37.9% of the sexually active girls did not make use of any method. The barrier methods were the most used (35.85%). A significant association was found in the total sample (2,592) between pregnancy and the use of any contraceptive method. This association was not found, however, in the group having an active sexual life (559). The study points to a knowledge of contraceptive methods, especially by teenagers who have already been pregnant, but contraceptives were not adequately used. The low use of chemical methods of contraception brings the risk of pregnancy. Since abortion and aborting drugs were incorrectly cited as contraceptive methods, this implies a nonpreventive attitude towards pregnancy.

  5. Adolescents: Contraceptive Knowledge and Use, a Brazilian Study

    Directory of Open Access Journals (Sweden)

    Divanise S. Correia

    2009-01-01

    Full Text Available The purpose of this study was to identify the knowledge and use of contraceptive methods by female adolescent students. The study was cross-sectional and quantitative, using a semi-structured questionnaire that was administered to 12- to 19-year-old female students in Maceió, Brazil. A representative and randomized sample was calculated, taking into account the number of hospital admissions for curettage. This study was approved by the Human Research Ethics Committee, and Epi InfoTM software was used for data and result evaluation using the mean and chi-square statistical test. Our results show that the majority of students know of some contraceptive methods (95.5%, with the barrier/hormonal methods being the most mentioned (72.4%. Abortion and aborting drugs were inaccurately described as contraceptives, and 37.9% of the sexually active girls did not make use of any method. The barrier methods were the most used (35.85%. A significant association was found in the total sample (2,592 between pregnancy and the use of any contraceptive method. This association was not found, however, in the group having an active sexual life (559. The study points to a knowledge of contraceptive methods, especially by teenagers who have already been pregnant, but contraceptives were not adequately used. The low use of chemical methods of contraception brings the risk of pregnancy. Since abortion and aborting drugs were incorrectly cited as contraceptive methods, this implies a nonpreventive attitude towards pregnancy.

  6. Seaweed consumption and prevalence of depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Arakawa, Masashi

    2014-09-03

    Seaweed is a popular traditional food in Japan and is a rich source of bioactive metabolites. The neuroprotective properties of seaweed have attracted attention; to date, however, there has been no epidemiological evidence regarding the relationship between seaweed consumption and depression. The current cross-sectional study investigated the association between seaweed consumption and depressive symptoms during pregnancy in Japan. Study subjects were 1745 pregnant women. Depressive symptoms were defined as present when subjects had a Center for Epidemiologic Studies Depression Scale score of 16 or higher. Dietary consumption during the preceding month was assessed using a self-administered diet history questionnaire. Adjustment was made for age; gestation; region of residence; number of children; family structure; history of depression; family history of depression; smoking; secondhand smoke exposure at home and at work; job type; household income; education; body mass index; and intake of fish and yogurt. The prevalence of depressive symptoms during pregnancy was 19.3%. After adjustment for possible dietary and non-dietary confounding factors, higher seaweed consumption was independently associated with a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios (95% confidence intervals) for depressive symptoms during pregnancy in the first, second, third, and fourth quartiles of seaweed consumption were 1 (reference), 0.72 (0.51 - 1.004), 0.71 (0.50 - 1.01), and 0.68 (0.47 - 0.96), respectively (P for trend = 0.03). The present results suggest that seaweed consumption may be inversely associated with the prevalence of depressive symptoms during pregnancy in Japanese women.

  7. Milk intake during pregnancy is inversely associated with the risk of postpartum depressive symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study.

    Science.gov (United States)

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Furukawa, Shinya; Arakawa, Masashi

    2016-09-01

    Only one epidemiologic study has investigated the association between dairy product intake during pregnancy and postpartum depressive symptoms. Epidemiologic evidence on the relationships between calcium and vitamin D intake during pregnancy and postpartum depressive symptoms is also lacking. The present prospective study examined these issues in Japan. Study subjects were 1319 women. During pregnancy, dietary intake during the preceding month was assessed using a self-administered diet history questionnaire in the baseline survey. Postpartum depressive symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 9 or higher between 3 and 4 months postpartum. Adjustment was made for age, gestation at baseline, region of residence, number of children, family structure, history of depression, family history of depression, job type, education, body mass index, having smoked during pregnancy, cesarean delivery, baby's sex, baby's birth weight, and total energy intake. After adjustment for the confounding factors, compared with milk intake in the lowest quartile, intake levels in the second and fourth quartiles were independently associated with a reduced risk of postpartum depressive symptoms, although the inverse exposure-response relationship was not significant: the adjusted odds ratio between extreme quartiles was 0.51 (95% confidence interval, 0.28-0.93; P for trend = .12). No material relationships were observed between intake of total dairy products, yogurt, cheese, calcium, or vitamin D and the risk of postpartum depressive symptoms. The present prospective cohort study in Japan suggests that higher milk intake during pregnancy is associated with a reduced risk of postpartum depressive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Use of IUDs for emergency contraception: current perspectives

    Directory of Open Access Journals (Sweden)

    McKay R

    2014-08-01

    Full Text Available Rebecca McKay,1 Lynne Gilbert2 1Department of Obstetrics and Gynaecology, Peterborough City Hospital, Peterborough, Cambridgeshire, United Kingdom; 2Department of Contraception and Sexual Health, Cambridgeshire Community Services NHS Trust, Cambridge, Cambridgeshire, United Kingdom Abstract: Emergency contraception is an essential intervention for the prevention of unplanned pregnancy worldwide. The copper intrauterine device (IUD is highly effective at preventing pregnancy after unprotected sex or contraceptive failure. Unfortunately, its usage in this context is low and far exceeded by hormonal forms of emergency contraception. These have higher failure rates and, unlike the IUD, are not effective post-fertilization. This review aims to summarize the literature surrounding IUD use as emergency contraception, contrast it with the hormonal options, and provide suggestions for increased usage. Keywords: levonorgestrel, ulipristal acetate, copper intrauterine device

  9. Herbal or modern methods of contraception! choice is yours

    Directory of Open Access Journals (Sweden)

    Amrendra Kumar Anand

    2015-08-01

    Full Text Available Contraception generally means prevention of pregnancy. There are a variety of methods ranging from natural to scientific available in accordance to its nature of use. Some methods provide short term birth control facility whereas some other provides permanent or long term birth control facility. But all the methods have some advantages and disadvantages associated with them. For example, male condoms which is made of latex, is 97% effective if used properly though some people may have allergic reaction to latex. Oral contraceptives are also widely used but it causes heart attacks, cancer, and depression among pills user women. Herbal contraception offer alternate ways for women to avoid pregnancy and it is also free from any side effects but the reliability of herbal contraceptive remains uncertain. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 947-953

  10. Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study.

    Science.gov (United States)

    Ajayi, Anthony Idowu; Nwokocha, Ezebunwa Ethelbert; Akpan, Wilson; Adeniyi, Oladele Vincent

    2016-10-04

    Emergency contraception (EC) can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. This paper brings together the findings from several focus groups (N = 5) and in-depth interviews (N = 20) conducted amongst unmarried female undergraduate students in two Nigerian universities. Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, "Alabukun", salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents' narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria.

  11. Long-acting reversible contraceptives: intrauterine devices and the contraceptive implant.

    Science.gov (United States)

    Espey, Eve; Ogburn, Tony

    2011-03-01

    The provision of effective contraception is fundamental to the practice of women's health care. The most effective methods of reversible contraception are the so-called long-acting reversible contraceptives, intrauterine devices and implants. These methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to 10 years. Despite the advantages of long-acting reversible contraceptive methods, they are infrequently used in the United States. Short-acting methods, specifically oral contraceptives and condoms, are by far the most commonly used reversible methods. A shift from the use of short-acting methods to long-acting reversible contraceptive methods could help reduce the high rate of unintended pregnancy in the United States. In this review of long-acting reversible contraceptive methods, we discuss the intrauterine devices and the contraceptive implant available in the United States, and we describe candidates for each method, noncontraceptive benefits, and management of complications.

  12. KNOWLEDGE OF EMERGENCY CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE GROUP

    Directory of Open Access Journals (Sweden)

    Singh

    2016-04-01

    Full Text Available BACKGROUND As per data from WHO, 21.6 million unsafe abortions occurred globally in 2008, out of which 47,000 women died from abortionrelated complications, contributing to 13% of global maternal mortality. (1 Emergency contraceptive can be used after intercourse to prevent pregnancy in case of unprotected intercourse, contraceptive failure or sexual assault. A considerable proportion of these abortions can be prevented by the timely use of emergency contraception. OBJECTIVES To study the knowledge of emergency contraceptives among women of reproductive age group. METHODS This is a government hospital-based prospective study done for a period of 3 months. The study included 500 women of reproductive age group (16 years to 40 years attending OPD of Obstetrics and Gynaecology Department of IGMC and RI, Pondicherry. A predesigned questionnaire is provided to women asking about awareness regarding emergency contraceptives. RESULTS Majority of them were between 20 and 30 years of age, 59.6% were from urban background and 86.8% were educated; 66% of them had used regular method of contraception some time in their life, but the awareness level of emergency contraceptives was found to be only 5.4% of which only 2% (n=10 had ever used emergency contraceptives. CONCLUSION Emergency contraceptives is an effective means of preventing unwanted pregnancies, but unfortunately majority of women lack awareness about the emergency methods. Efforts should be focused on providing health education regarding EC among females through media and health professionals.

  13. Interactions between hormonal contraception and antiepileptic drugs

    DEFF Research Database (Denmark)

    Reimers, Arne; Brodtkorb, Eylert; Sabers, Anne

    2015-01-01

    Antiepileptic drugs (AEDs) and hormonal contraceptives may affect each other's metabolism and clinical efficacy. Loss of seizure control and unplanned pregnancy may occur when these compounds are used concomitantly. Although a large number of available preparations yield a plethora of possible dr...

  14. Knowledge and Practice of Emergency Contraception Among ...

    African Journals Online (AJOL)

    is 15% with the male condom being the most used method. The most commonly ... 10 years and 19 years) and are a vulnerable group for unwanted pregnancy. This is ... contraception, 21.5% (75/348) got their information from a health care ...

  15. Contraception and Birth Control: Other FAQs

    Science.gov (United States)

    ... other than preventing pregnancy? Yes. Use of oral contraceptives can also reduce severe menstrual cramps, make menstrual bleeding lighter, and clear up acne. There is also evidence that use of the pill can reduce the risk of endometrial,ovarian, and colon cancer, reduce the ...

  16. Preventing Teenage Pregnancy: A Team Approach

    OpenAIRE

    Anderson, Cheryl

    1986-01-01

    By age 16 one in three adolescents have experienced sexual intercourse. Because one-third of these sexually active teens never use contraception, they have a five-times greater risk of pregnancy than teenagers who take contraceptive measures. In 1982, one in 23 Canadian teenage girls became pregnant. Teenagers' reasons for not using contraceptives include fear of parents learning about their sexual activity, lack of knowledge about contraception, and lack of self-esteem. Parents, educators an...

  17. Preventing Teenage Pregnancy: A Team Approach

    OpenAIRE

    Anderson, Cheryl

    1986-01-01

    By age 16 one in three adolescents have experienced sexual intercourse. Because one-third of these sexually active teens never use contraception, they have a five-times greater risk of pregnancy than teenagers who take contraceptive measures. In 1982, one in 23 Canadian teenage girls became pregnant. Teenagers' reasons for not using contraceptives include fear of parents learning about their sexual activity, lack of knowledge about contraception, and lack of self-esteem. Parents, educators an...

  18. The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011

    Science.gov (United States)

    Gauthreaux, Christina; Negron, Jenesis; Castellanos, Daniel; Ward-Peterson, Melissa; Castro, Grettel; Rodríguez de la Vega, Pura; Acuña, Juan Manuel

    2017-01-01

    Abstract Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD. A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS’ complex sampling design. Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1–1.3), 30% (AOR = 1.3; 95% CI: 1.2–1.4), and 50% (AOR = 1.5; 95% CI: 1.3–1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of <27 weeks (AOR = 3.1; 95% CI: 2.5–4.0), having a previous history of depression (AOR = 1.8; 95% CI: 1.6–2.0), and being abused during or before pregnancy (AOR = 1.6; 95% CI: 1.4–2.0). We found that women with

  19. [Contraception and hepatogastroenterology].

    Science.gov (United States)

    Grimaud, J C; Bourliere, M

    1989-05-01

    Complications of oral contraceptives (OCs) affecting the gastrointestinal tract, liver and pancreas are rare but potentially serious. Hepatobiliary complications are by far the most frequent and varied. Hepatic lesions will probably decline in frequency as low-dose OCs replace higher dosed pills. Intrahepatic cholestasis induced by OCs resembles that of pregnancy. There may be a genetic predisposition to both conditions involving a dose-dependent estrogen effect of decreasing bile secretion. Intrahepatic cholestasis appears within 6 cycles of OC use. Symptoms include pruritus with anorexia, asthenia, vomiting, and weight loss without fever, rash or abdominal pain. Termination of OCs clears the condition without sequelae within 1-3 months, sometimes after a temporary aggravation. A moderate and asymptomatic cytolysis may appear when OC treatment is begun. Sinusoidal dilatation has been conclusively linked to OCs although few cases have been published. Clinical manifestations other than hepatomegaly are variable. Abdominal pain and fever are the most common. The condition is not related to duration of use and disappears 5-15 days after OC use is terminated. The relative risk of Budd-Chiari syndrome in OC users is estimated at 2.37. OCs increase the prevalence of hepatic adenomas as a function of duration of treatment. They are usually discovered fortuitously but may be revealed by vague abdominal pains. Hemorrhagic complications are more likely in OC users. It may be difficult to distinguish between adenomas, hepatocellular carcinoma, and focal nodular hyperplasia. A puncture biopsy guided by sonography may aid diagnosis. The natural history of adenomas is poorly understood and treatment remains controversial. OCs do not appear to increase the risk of focal nodular hyperplasia but they increase the size of the tumor and the risk of hemorrhage. OCs should be terminated because of risk of hemorrhage. Surgical resection is not indicated unless there are complication or

  20. Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome.

    Science.gov (United States)

    Sammaritano, L R

    2014-10-01

    Contraceptive choice in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) is challenging but important. Long-acting forms of contraception such as the progesterone intrauterine device (IUD) or subdermal implant are preferable for most patients. Estrogen-containing hormonal contraceptives may be used in stable, inactive SLE patients but are contraindicated in patients with positive antiphospholipid antibodies (aPL). The levonorgestrel IUD is a good alternative for many APS patients and often decreases menstrual blood loss. It is prudent to avoid depot medroxyprogesterone acetate (DMPA) in corticosteroid-treated or other patients at risk for osteoporosis because of the inhibition of ovulation. Effective and safe contraception in patients with SLE and APS permits planning for pregnancy during inactive disease and while on pregnancy-compatible medications, preventing a poorly timed pregnancy that may jeopardize maternal and/or fetal health.

  1. Oral contraception following abortion

    Science.gov (United States)

    Che, Yan; Liu, Xiaoting; Zhang, Bin; Cheng, Linan

    2016-01-01

    Abstract Oral contraceptives (OCs) following induced abortion offer a reliable method to avoid repeated abortion. However, limited data exist supporting the effective use of OCs postabortion. We conducted this systematic review and meta-analysis in the present study reported immediate administration of OCs or combined OCs postabortion may reduce vaginal bleeding time and amount, shorten the menstruation recovery period, increase endometrial thickness 2 to 3 weeks after abortion, and reduce the risk of complications and unintended pregnancies. A total of 8 major authorized Chinese and English databases were screened from January 1960 to November 2014. Randomized controlled trials in which patients had undergone medical or surgical abortions were included. Chinese studies that met the inclusion criteria were divided into 3 groups: administration of OC postmedical abortion (group I; n = 1712), administration of OC postsurgical abortion (group II; n = 8788), and administration of OC in combination with traditional Chinese medicine postsurgical abortion (group III; n = 19,707). In total, 119 of 6160 publications were included in this analysis. Significant difference was observed in group I for vaginal bleeding time (P = 0.0001), the amount of vaginal bleeding (P = 0.03), and menstruation recovery period (P abortion (P abortion, and reduce the risk of complications and unintended pregnancies. PMID:27399060

  2. 带器宫内外同时妊娠4例报道%The report of heterotopic pregnancy with intrauterine contraceptive device in 4 cases

    Institute of Scientific and Technical Information of China (English)

    施成翠; 李德琼

    2010-01-01

    @@ 近年来,随着计划生育工作的广泛开展,宫内节育器(intrauterine contraceptive device,IUD)的放置更为普遍.随着IUD的广泛应用,异位妊娠发生率增高.IUD本身并不增加异位妊娠的发生率,但若IUD避孕失败而受孕时,则发生异位妊娠的机会较大[1].现将笔者曾诊治的4例带器宫内宫外同时妊娠(heterotopicpregnancy,HP)的病例报道如下.

  3. Contraception in the latter part of reproductive life.

    Science.gov (United States)

    Robinson, G E

    1992-10-01

    Contraception in the latter part of reproductive life is particularly important because of the increased fetal and maternal mortality associated with pregnancy in this age group. The combined pill can be continued until the menopause in healthy, non-smoking women with no additional risk. The advantages of the combined pill include protection against menopausal symptoms as well as some of the common gynecological disorders. Progestogen-only formulations can now be administered by both oral and non-oral routes. The levonorgestrel-releasing IUD is an exciting new development, especially suited to this age group because of the reduction in menstrual loss. Although barrier methods often prove unacceptable if used for the first time in the late thirties and forties, they have no serious adverse effects and in addition provide protection against cervical intraepithelial neoplasia and sexually transmitted disease.

  4. Benefits and risks of hormonal contraception for women

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-08-01

    Full Text Available Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception, among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings, progestogen-only contraceptives (pills, injections, implants, hormone spirals and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and risks of hormonal contraceptives, their economic effects as well as their ethical-social and legal implications.MethodsA systematic literature search was conducted in April 2006 starting from 2000. The evaluation is primarily based on systematic reviews. Results: In perfect use, all hormonal contraceptives excluding emergency contraceptives proved to be the most effective reversible contraceptive methods (rate of unintended pregnancies 0.05% to 0.3%. However, the typical use of oral contraceptives, injections, skin patches, and vaginal rings, which also considers possible application errors, showed a lower contraceptive efficacy (rate of unintended pregnancies 3% to 8%. It was lower than that of copper spirals. The risk of venous thromboembolism increased three to six times in users of hormonal contraceptives, the risks of stroke and myocardial infarction two to three times. The risk declined after discontinuation of use. The effects were estrogen-dose and progestogen-type dependent. The use of hormonal contraceptives showed a relative risk of ovarian and endometrial carcinomas of approximately 0.5 or 0.7, of breast and cervical cancer of approximately 1.2 or 1.6. The effect remained several years after discontinuation of use. The results concerning hepatocellular carcinoma suggested a carcinogenic effect. In women with acne, an improvement due to use of hormonal contraceptives was proven. Cervical chlamydial infections were more frequent in users of hormonal

  5. Oral steroid contraception.

    Science.gov (United States)

    Sech, Laura A; Mishell, Daniel R

    2015-11-01

    Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval. Despite the popularity of oral steroid contraception, there has been much criticism regarding the associated risks of venous thromboembolism and stroke. Despite these established, yet uncommon risks, oral steroid contraception has many important health benefits. This review highlights the available formulations of oral contraceptives along with their evidence-based associated risks and benefits. Highlights regarding future directions for development of novel oral contraceptives are also addressed.

  6. Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study.

    Science.gov (United States)

    Nwebube, Chineze; Glover, Vivette; Stewart, Lauren

    2017-05-08

    Prenatal anxiety and depression are distressing for the expectant mother and can have adverse effects on her fetus and subsequently, her child. This study aimed to determine whether listening to specially composed songs would be an effective intervention for reducing symptoms of prenatal anxiety and depression. Pregnant women were recruited online and randomly assigned to one of two groups: the music group (daily listening to specially composed songs) or control group (daily relaxation) for 12 weeks each. Self-report questionnaires were used to assess symptoms of State and Trait anxiety (Spielberger) and depression (Edinburgh Postnatal Depression Scale (EPDS)). Trait anxiety was measured as the primary outcome, while State anxiety and depression were the secondary outcomes. 111 participants were randomised to each group. 20 participants in the intervention group and 16 participants in the active control group completed the study. The music group demonstrated lower Trait Anxiety (p = .0001) (effect size 0.80), State Anxiety (p = .02) (effect size 0.64), and EPDS (p = .002) (effect size 0.92) scores at week 12 compared to baseline, by paired t test. There were no such changes in the control group. Though this pilot study had high levels of attrition, the results do suggest that regular listening to relaxing music should be explored further as an effective non-pharmacological means for reducing prenatal anxiety and depression. ClinicalTrials.gov NCT02776293 LV-001. Registered 17 May 2016. Retrospectively registered.

  7. Narcolepsy and pregnancy

    DEFF Research Database (Denmark)

    Maurovich-Horvat, Eszter; Kemlink, David; Högl, Birgit

    2013-01-01

    In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms...... of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P ...

  8. Attitude toward contraception and abortion among Curaçao women. Ineffective contraception due to limited sexual education?

    Directory of Open Access Journals (Sweden)

    Meyboom-de Jong Betty

    2011-06-01

    Full Text Available Abstract Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92% participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse

  9. Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Nasreen Hashima E

    2010-08-01

    Full Text Available Abstract Background There is a high prevalence of antepartum depression and low birth weight (LBW in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. There is no research on the association between maternal mental disorders and LBW in Bangladesh. This study aims to investigate the independent effect of maternal antepartum depressive and anxiety symptoms on infant LBW among women in a rural district of Bangladesh. Methods A population-based sample of 720 pregnant women from two rural subdistricts was assessed for symptoms of antepartum depression, using the Edinburgh Postpartum Depression Scale (EPDS, and antepartum anxiety, using the State Trait Anxiety Inventory (STAI, and followed for 6-8 months postpartum. Infant birth weight of 583 (81% singleton live babies born at term (≥37 weeks of pregnancy was measured within 48 hours of delivery. Baseline data provided socioeconomic, anthropometric, reproductive, obstetric, and social support information. Trained female interviewers carried out structured interviews. Chi-square, Fisher's exact, and independent-sample t tests were done as descriptive statistics, and a multiple logistic regression model was used to identify predictors of LBW. Results After adjusting for potential confounders, depressive (OR = 2.24; 95% CI 1.37-3.68 and anxiety (OR = 2.08; 95% CI 1.30-3.25 symptoms were significantly associated with LBW (≤2.5 kg. Poverty, maternal malnutrition, and support during pregnancy were also associated with LBW. Conclusions This study provides evidence that maternal depressive and anxiety symptoms during pregnancy predict the LBW of newborns and replicates results found in other South Asian countries. Policies aimed at the detection and effective management of depressive and anxiety symptoms during pregnancy may reduce the burden on mothers and also act as an important measure in the prevention of LBW

  10. The role of maternal anxiety and depressive disorders prior to and during pregnancy and perinatal psychopathological symptoms for early infant diseases and drug administration.

    Science.gov (United States)

    Krause, Linda; Einsle, Franziska; Petzoldt, Johanna; Wittchen, Hans-Ulrich; Martini, Julia

    2017-06-01

    Maternal mental health prior to and during pregnancy has been shown to be associated with inflammatory diseases and gastrointestinal complaints in the offspring. Unfortunately, many studies merely focused on perinatal distress without consideration of lifetime anxiety and depressive disorders. To prospectively investigate associations of anxiety and depressive disorders prior to and during pregnancy as well as perinatal distress with infants' inflammatory diseases, gastrointestinal complaints and corresponding drug administration. Prospective-longitudinal study initiated in 2009/2010. N=306 (expectant) mothers with and without DSM-IV lifetime anxiety and depressive disorders (Composite International Diagnostic Interview for Women) and low vs. high severity of psychopathological symptoms during pregnancy (Brief Symptom Inventory) enrolled in early pregnancy and repeatedly assessed during peripartum period. Infant inflammatory diseases, gastrointestinal complaints and drug administration assessed via questionnaire (maternal report) at four months postpartum (n=279). Severe psychopathological symptoms during pregnancy were associated with inflammatory diseases and anti-infective medication, whereas anxiety and depressive disorders prior to and during pregnancy were related to gastrointestinal complaints (diarrhea, colic complaints) and corresponding medication. These results have to be discussed with caution, because information on infants' diseases were based exclusively on maternal self-reports. However, they suggest promising directions regarding our current knowledge about the relevance of maternal perinatal distress for infant inflammatory diseases (e.g. fetal programming). Moreover, the association between maternal anxiety and depressive disorders and infant gastrointestinal complaints may be explained by an anxious misinterpretation of 'normal' infant signals or a transmission of adverse gut microbiota, respectively. Copyright © 2017 Elsevier B.V. All rights

  11. About Implantable Contraception

    Science.gov (United States)

    ... a tube was inserted, and get a new contraceptive implant on schedule or switch to another method of ... continue Possible Side Effects Young women who get contraceptive implants might notice such side effects as: irregular or ...

  12. Multiple Method Contraception Use among African American Adolescents in Four US Cities

    Directory of Open Access Journals (Sweden)

    Jennifer L. Brown

    2011-01-01

    Full Text Available We report on African American adolescents' (N=850; M age = 15.4 contraceptive practices and type of contraception utilized during their last sexual encounter. Respondents completed measures of demographics, contraceptive use, sexual partner type, and ability to select “safe” sexual partners. 40% endorsed use of dual or multiple contraceptive methods; a total of 35 different contraceptive combinations were reported. Perceived ability to select “safe” partners was associated with not using contraception (OR = 1.25, using less effective contraceptive methods (OR = 1.23, or hormonal birth control (OR = 1.50. Female gender predicted hormonal birth control use (OR = 2.33, use of less effective contraceptive methods (e.g., withdrawal; OR = 2.47, and using no contraception (OR = 2.37. Respondents' age and partner type did not predict contraception use. Adolescents used contraceptive methods with limited ability to prevent both unintended pregnancies and STD/HIV. Adolescents who believed their partners posed low risk were more likely to use contraceptive practices other than condoms or no contraception. Reproductive health practitioners are encouraged to help youth negotiate contraceptive use with partners, regardless of the partner's perceived riskiness.

  13. Contraception in HIV-positive female adolescents

    Directory of Open Access Journals (Sweden)

    Ananworanich Jintanat

    2011-06-01

    Full Text Available Abstract Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

  14. Contraception and induced abortion in the West Indies: a review.

    Science.gov (United States)

    Boersma, A A; de Bruijn, J G M

    2011-10-01

    Most islands in the West Indies do not have liberal laws on abortion, nor laws on pregnancy prevention programmes (contraception). We present results of a literature review about the attitude of healthcare providers and women toward (emergency) contraception and induced abortion, prevalence, methods and juridical aspects of induced abortion and prevention policies. Articles were obtained from PubMed, EMBASE, MEDLINE, PsychlNFO and Soclndex (1999 to 2010) using as keywords contraception, induced abortion, termination of pregnancy, medical abortion and West Indies. Thirty-seven articles met the inclusion criteria: 18 on contraception, 17 on induced abortion and two on both subjects. Main results indicated that healthcare providers' knowledge of emergency contraception was low. Studies showed a poor knowledge of contraception, but counselling increased its effective use. Exact numbers about prevalence of abortion were not found. The total annual number of abortions in the West Indies is estimated at 300 000; one in four pregnancies ends in an abortion. The use of misoprostol diminished the complications of unsafe abortions. Legislation of abortion varies widely in the different islands in the West Indies: Cuba, Puerto Rico, Martinique, Guadeloupe and St Martin have legal abortions. Barbados was the first English-speaking island with liberal legislation on abortion. All other islands have restrictive laws. Despite high estimated numbers of abortion, research on prevalence of abortion is missing. Studies showed a poor knowledge of contraception and low use among adolescents. Most West Indian islands have restrictive laws on abortion.

  15. Study of 50 cases of modern management of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Rajita S. Jani

    2014-04-01

    Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte. These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases. Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 374-379

  16. Dietary patterns, n-3 fatty acids intake from seafood and high levels of anxiety symptoms during pregnancy: findings from the Avon Longitudinal Study of Parents and Children.

    Directory of Open Access Journals (Sweden)

    Juliana dos Santos Vaz

    Full Text Available Little is known about relationships between dietary patterns, n-3 polyunsaturated fatty acids (PUFA intake and excessive anxiety during pregnancy.To examine whether dietary patterns and n-3 PUFA intake from seafood are associated with high levels of anxiety during pregnancy.Pregnant women enrolled from 1991-1992 in ALSPAC (n 9,530. Dietary patterns were established from a food frequency questionnaire using principal component analysis. Total intake of n-3 PUFA (grams/week from seafood was also examined. Symptoms of anxiety were measured at 32 weeks of gestation with the Crown-Crisp Experiential Index; scores ≥ 9 corresponding to the 85(th percentile was defined as high anxiety symptoms. Multivariate logistic regression models were used to estimate the OR and 95% CI, adjusted by socioeconomic and lifestyle variables.Multivariate results showed that women in the highest tertile of the health-conscious (OR 0.77; 0.65-0.93 and the traditional (OR 0.84; 0.73-0.97 pattern scores were less likely to report high levels of anxiety symptoms. Women in the highest tertile of the vegetarian pattern score (OR 1.25; 1.08-1.44 were more likely to have high levels of anxiety, as well as those with no n-3 PUFA intake from seafood (OR 1.53; 1.25-1.87 when compared with those with intake of >1.5 grams/week.The present study provides evidence of a relationship between dietary patterns, fish intake or n-3 PUFA intake from seafood and symptoms of anxiety in pregnancy, and suggests that dietary interventions could be used to reduce high anxiety symptoms during pregnancy.

  17. Contraception for women with diabetes: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Robinson A

    2016-03-01

    Full Text Available Ann Robinson, Chidiebere Nwolise, Jill Shawe School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK Abstract: Diabetes mellitus (DM, the most common of metabolic disorders, is a global public health concern. Numbers are rising with 383 million adults currently diagnosed with DM and another 175 million as yet undiagnosed. The rise in cases includes increasing numbers of women of a reproductive age whose reproductive health and contraception need careful consideration. Unintended pregnancy with poor glycemic control at the time of conception increases the chance of adverse pregnancy outcomes including stillbirth, congenital abnormalities, and perinatal mortality. In order to minimize complications, safe and effective contraception is paramount for all women with DM. This is a challenge as women have been found to be reticent to ask for advice, appear to lack understanding of risks, and are less likely to be using contraception than women without DM. The World Health Organization has developed Medical Eligibility Criteria to guide contraceptive choice. Women with DM without complications can choose from the full range of contraceptive methods including hormonal contraception as the advantages of use outweigh any risk. Women with diabetic complications may need specialist advice to assess the risk–benefit equation, particularly in respect of hormonal contraception. Women should be aware that there is no restriction to the use of oral and copper intrauterine emergency contraception methods. There is a need for an integrated approach to diabetes and reproductive health with improved communication between women with DM and their health care providers. Women need to be aware of advice and services and should make their own choice of contraception based on their needs and associated risk factors. Practitioners can offer nonjudgmental guidance working in partnership with women. This will enable discussion of

  18. Effects of relationship context on contraceptive use among young women.

    Science.gov (United States)

    Upadhyay, Ushma D; Raifman, Sarah; Raine-Bennett, Tina

    2016-07-01

    To understand how relationship status influences contraceptive use among young people. Data were collected as part of a longitudinal study on hormonal contraception among unmarried adolescent and young women who wanted to avoid pregnancy for at least one year, recruited at family planning clinics in the San Francisco Bay Area. Follow-up surveys were completed at 3, 6, and 12months. Longitudinal analysis was used to examine whether relationship characteristics, including type and length of sexual relationship are associated with current use of effective contraception. Among women with a partner at baseline, 78%, 70%, and 61% had the same partner at 3, 6, and 12months follow up, respectively. Women in casual relationships were less likely to use effective contraceptive methods, compared to women in consistent relationships (AOR=0.67, pWomen in new relationships (0-3months) were less likely to use effective contraceptive methods (AOR=0.60, pwomen in relationships more than one year in length. Younger women (AOR=0.76, pwomen (AOR=0.67, pwomen (AOR=0.73, pRelationship type and length are independently significantly associated with current effective contraceptive use among adolescent and young women. Women in casual relationships and new relationships were significantly less likely to use effective contraceptive methods. Family planning providers should discuss women's relationship context and association with contraceptive use in order to help women think of contraception as a long-term personal strategy. Since relationship status affects contraceptive use, providers and programs that aim to reduce unintended pregnancy can consider strategies to create a paradigm shift around contraceptive use that focuses on the woman's reproductive goals, current life stage, and life goals. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [ORAL CONTRACEPTIVES AND MOOD/SEXUAL DISORDERS IN WOMEN].

    Science.gov (United States)

    Sirakov, M; Tomova, E

    2015-01-01

    Oral contraceptives are used since more than 50 years and are very popular due to offering more than 99% confidence in preventing pregnancy. Over 100 million women worldwide use oral contraceptives. In the UK 27% of women between 16 and 49 y. use pills. In the United States they are about 30%, in Germany - 40%, and in The Netherlands - 60%. According to a study by B. Pehlivanov, 2008, in Bulgaria only 4% of women use OC. (1) Despite the convenience and security, in the U.S.A. 29% of women taking OC interrupt prematurely their use (2), while the percentage of adolescents appears to be higher (3) Earlier studies of the reasons for refusal of OC focus on their influence on the menstrual cycle, as well as on some physical side effects such as the appearance of hair growth, weight gain, bloating etc. They paid very little attention to their impact on mood and sexual behavior of women (4). Newer studies suggest that the side effects associated with mood and sexual behavior proved more powerful factor leading to early termination of the use of OC (5). This paper is a review of the literature and evaluation of the facts presented in studies from different countries. They found a high incidence of symptoms such as anxiety, susceptibility to stress, mood changes, incl. depression, anxiety, increased irritability and affection of sexual desire of women. (6) There are many indications that OC-users are at increased risk of suicide and mental illnesses. (9).

  20. Current contraceptive status among women aged 15-44: United States, 2011-2013.

    Science.gov (United States)

    Daniels, Kimberly; Daugherty, Jill; Jones, Jo

    2014-12-01

    Nearly all women use contraception at some point in their lifetimes, although at any given time they may not be using contraception for reasons such as seeking pregnancy, being pregnant, or not being sexually active. Using data from the 2011-2013 National Survey of Family Growth (NSFG) on contraceptive use in the month of the interview, this report provides a snapshot of current contraceptive status among women aged 15-44 in the United States. In addition to describing use of any method by age, Hispanic origin and race, and educational attainment, patterns of use are described for the four most commonly used contraceptive methods: the oral contraceptive pill, female sterilization, the male condom, and long-acting reversible contraceptives, which include contraceptive implants and intrauterine devices.

  1. Keep Calm and Contracept! Addressing Young Women's Pleasure in Sexual Health and Contraception Consultations

    Science.gov (United States)

    Hanbury, Ali; Eastham, Rachael

    2016-01-01

    Clinical sexual health consultations with young women often focus on avoiding "risks;" namely pregnancy and sexually transmitted infection transmission. They also typically fail to explore how contraception use can impact on the capacity to enjoy sexual relationships. In contrast, this paper argues that sexual pleasure should be a…

  2. Acceptance of contraceptives among women who had an unsafe abortion in Dar es Salaam

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Massawe, Siriel; Yambesi, Fortunata

    2004-01-01

    OBJECTIVE: To assess the need for post-abortion contraception and to determine if women who had an unsafe abortion will use a contraceptive method to avoid repeated unwanted pregnancies and STDs/HIV. METHOD: Women attending Temeke Municipal Hospital, Dar es Salaam, after an unsafe abortion...... or an induced abortion performed at the hospital (n=788) were counselled about contraception and the risk of contracting STDs/HIV. A free ward-based contraceptive service was offered and the women were asked to return for follow-up. RESULTS: Participants (90%) accepted the post-abortion contraceptive service...

  3. Budget impact analysis of 8 hormonal contraceptive options.

    Science.gov (United States)

    Crespi, Simone; Kerrigan, Matthew; Sood, Vipan

    2013-07-01

    To develop a model comparing costs of 8 hormonal contraceptives and determine whether acquisition costs for implants and intrauterine devices (IUDs) were offset by decreased pregnancy-related costs over a 3-year time horizon from a managed care perspective. A model was developed to assess the budget impact of branded or generic oral contraceptives (OCs), quarterly intramuscular depot medroxyprogesterone, etonogestrel/ethinyl estradiol vaginal ring, etonogestrel implant, levonorgestrel IUD, norelgestromin/ethinyl estradiol transdermal contraceptive, and ethinyl estradiol/levonorgestrel extended-cycle OC. Major variables included drug costs, typical use failure rates, discontinuation rates, and pregnancy costs. The base case assessed costs for 1000 women initiating each of the hormonal contraceptives. The etonogestrel implant and levonorgestrel IUD resulted in the fewest pregnancies, 63 and 85, respectively, and the least cost, $1.75 million and $2.0 million, respectively. In comparison, generic OC users accounted for a total of 243 pregnancies and $3.4 million in costs. At the end of year 1, costs for the etonogestrel implant ($800,471) and levonorgestrel IUD ($949,721) were already lower than those for generic OCs ($1,146,890). Sensitivity analysis showed that the cost of pregnancies, not product acquisition cost, was the primary cost driver. Higher initial acquisition costs for the etonogestrel implant and levonorgestrel IUD were offset within 1 year by lower contraceptive failure rates and consequent pregnancy costs. Thus, after accounting for typical use failure rates of contraceptive products, the etonogestrel implant and levonorgestrel IUD emerged as the least expensive hormonal contraceptives.

  4. Clinically silent polymicrobial amnionitis and intrauterine fetal death associated with a Cu-7 intrauterine contraceptive device.

    Science.gov (United States)

    Waites, K B; Bobo, R A; Davis, R O; Brookings, E S; Cassell, G H

    1984-12-15

    This article presents a case of silent polymicrobial amnionitis with subsequent intrauterine fetal death in a 34-year old woman who conceived with a Cu-7 IUD in place. There were no apparent pregnancy complications or symptoms of uterine infection during early pregnancy. At 16 weeks gestation, the patient underwent amniocentesis for cytogenetic studies. 5 different microorganisms--Corynebacterium, Staphylococcus warneri, Staphylococcus epidermidis, Streptococcus mitis, and Ureaplasma urealyticum--were isolated from the amniotic fluid. 2 week later, intrauterine fetal death was detected. U. urealyticum was at this point isolated from the cervix and placental and fetal tissues. This organism, which has been associated with chorioamnionitis, spontaneous abortion, and neonatal death, is suspected to have contributed to the fetal death in this case. U. urealyticum can invade the amniotic sac with fetal membranes intact and persist for 8 weeks without overt effects. This case illustrates the risks associated with nonremoval of an IUD after contraceptive failure.

  5. Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Tesfaye Tatek

    2012-03-01

    Full Text Available Abstract Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH. Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48 were from urban area and 41 were from rural area.46 (51.7% of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

  6. 复方短效口服避孕药、左炔诺孕酮宫内缓释系统和安全套在剖宫产瘢痕妊娠清宫术后的避孕效果比较%A comparative contraceptive effect among compound short-acting oral contraceptives,levonorgestrel releasing intrauterine system and condoms after cesarean scar pregnancy curettage

    Institute of Scientific and Technical Information of China (English)

    万金华; 朱艳琼

    2016-01-01

    Objective To explore the contraceptive efficacy and safety of compound short-acting oral contraceptives,levonorgestrel re-leasing intrauterine system and condoms after cesarean scar pregnancy curettage.Methods Totally 112 CSP patients,who were treated uterine artery embolization combined with curettage,were randomized into 3 groups.Patients (39 cases)in the contraceptive pill group were treated with compound short-acting contraceptives,patients (37 cases)in mirena group were placed Mirena (levonorgestrel-relea-sing intrauterine system)after curettage immediately,and patients (36 cases)in condom group were given condoms contraception. Three groups of patients were followed up to compare ultrasonic examination results,unexpected pregnancy and menstrual flow change. Results Patients were followed up for 1 year.The total effective rates of patients in contraceptive pill group,Mirena patient group and condoms contraception group were 94.88%,100.00% and 86.11%,respectively.There wasn’t significant difference in total contracep-tive effective rate among the three groups.There was 1 case of recurrent CSP in contraceptive pills group and condoms group respectively, but there was no recurrence in Mirena group.Ultrasonic examination showed there were noincision rupture or damage,no increase in the a-mount of menstruation in the 3 groups.With chi-square division method,the menstrual changes of the three groups were compared.The de-crease of menstruation in the patients of Mirena group was significantly higher than those of the condom group and the contraceptive pill group (P <0.017)at 3,6 and 12 months postoperatively.The menstrual blood loss decreased significantly in contraceptive pill group at 3 months after curettage compared with the other two groups (P <0.017).There were no serious adverse events and complaints about asexu-al life in the 3 groups.Conclusions After uterine artery embolization combined with uterine curettage CSP patients can take marvelon and Mirena

  7. Profile of abortion seekers and decision makers of post abortion contraceptive acceptability in Andaman and Nicobar Islands, India

    Directory of Open Access Journals (Sweden)

    Anita Yadav

    2016-10-01

    Conclusions: All MTP seekers should be provided information and counseling for post abortal contraceptive use and enable these women and their spouse to make an informed and voluntary choice and thus avoid the need of a repeat abortion. Contraceptive services should also include emergency contraception to prevent unwanted pregnancy due to unprotected sex. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3491-3495

  8. [Social and psychological aspects of contraception in adolescents].

    Science.gov (United States)

    Fortier, L

    1976-09-01

    Reasons for the high adolescent birthrate in the U.S., medical, psychological, and social repercussions of teenage pregnancy, and facts and myths about sex education and contraception for young people are discussed. About 30% of U.S. women under 20 become pregnant outside marriage, and many more are pregnant when they marry. The reasons for the high pregnancy rates in young people include recent early menarch, which accounts for 94% fertility in 17.5-year-olds, better health, and ignorance about contraception and basic facts about reproduction. Pregnant adolescents risk toxemia, anemia, puerperal morbidity, prematurity, neonatal mortality, and congenital defects such as mental retardation in the baby. They face family alienation, loss of educational and employment opportunities, forced marriage, and high suicide rates in addition to the trials of puberty. Many girls believe that their fertile period is during menses, that pills are dangerous, that they are not fertile. Studies have shown that sex education can lower repeat pregnancies 67%. Recent research has negated the belief that many young women desire pregnancy unconsciously. Current information shows that supplying contraception will not encourage young people to begin having intercourse. Most sex education courses in the U.S. are given after the average teenagers become active sexually. It is believed that contraception should be provided universally for young people, and that parental authorization of contraception would probably mend family ties, certainly better than would unwanted pregnancy.

  9. Benefits of meeting the contraceptive needs of Cameroonian women.

    Science.gov (United States)

    Vlassoff, Michael; Jerman, Jenna; Beninguisse, G; Kamgaing, Floriane; Zinvi-Dossou, F

    2014-01-01

    (1) In 2013, an estimated 40% of pregnancies in Cameroon were unintended. (2) More than six in 10 women who want to avoid pregnancy either do not practice contraception or use a relatively ineffective traditional method. These women can be said to have an unmet need for modern contraception. (3) Meeting just half of this unmet need would prevent 187,000 unplanned pregnancies each year, resulting in 65,000 fewer unsafe abortions and 600 fewer maternal deaths annually. (4) If all unmet need for modern methods were satisfied, maternal mortality would drop by more than one-fifth, and unintended births and unsafe abortions would decline by 75%. (5) Investing in contraceptive commodities and services to fulfill all unmet need among women who want to avoid pregnancy would result in a net annual savings of US$5.4 million (2.7 billion CFA francs) over what would otherwise be spent on medical costs associated with unintended pregnancies and their consequences. (6) Expanding contraceptive services confers substantial benefits to women, their families and society. All stakeholders, including the Cameroon government and the private sector, should increase their investment in modern contraceptive services.

  10. Ovarian pregnancy: an unusual presentation

    Directory of Open Access Journals (Sweden)

    Ayesha Arif Hussain

    2016-08-01

    Full Text Available Ovarian pregnancy is a rare type of ectopic pregnancy and usually, it ends with rupture before the end of the first trimester. The clinical picture generally mimics that of ruptured tubal ectopic pregnancy and hemorrhagic ovarian cyst. Transvaginal sonography may be helpful. We report a rare primary ruptured ovarian pregnancy in a 23 years lady. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2888-2890

  11. Contraceptive use and the role of contraceptive counseling in reproductive-aged women with cancer.

    Science.gov (United States)

    Maslow, Bat-Sheva L; Morse, Christopher B; Schanne, Allison; Loren, Alison; Domchek, Susan M; Gracia, Clarisa R

    2014-07-01

    Few data on contraceptive choices in women with cancer exist. Contraception is challenging for women with cancer, particularly those with breast cancer, who are limited to nonhormonal methods. This study characterized contraceptive use during cancer treatment in a group of reproductive-aged women with a recent cancer diagnosis and assessed the impact of contraceptive counseling on the methods they selected. Cross-sectional, survey study of reproductive-aged women at a large tertiary care health system with a recent cancer diagnosis. A total of 107 women completed the survey. Eighty-two women reported 101 contraceptive choices. Twenty-seven percent (27/101) of all methods selected were Tier I/II, and 35% (35/101) were Tier III/IV. Only 4 used an intrauterine device (IUD). Among women reporting sexual activity after diagnosis, 19 (27%) of 71 reported using Tier I/II methods, 21 (30%) of 71 reported using Tier III/IV methods, 16 (23%) of 71 reported abstinence and 10 (14%) of 71 reported using no method. Factors significantly associated with Tier I/II use in the multivariable model included not having a college degree [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.05-0.92, p=.038], intercourse during treatment (OR 5.92, 95% CI 1.48-23.66, p=.012) and non-breast cancer (OR 3.60, 95% CI 1.03-12.64, p=.046). Report of contraceptive counseling was positively associated with Tier I/II contraceptive use during cancer treatment (OR 6.92, 95% CI 1.14-42.11, p=.036). Reproductive-aged women diagnosed with cancer underutilized Tier I/II contraceptive agents, especially IUDs. Contraceptive counseling by physicians increases contraceptive use, particularly methods most effective at preventing pregnancy. The study uniquely described the contraceptive practices of over 100 women with cancer. The study sample commonly reported abstinence and use of contraceptive methods with high failure rates. Our data suggest that contraceptive counseling from a health care provider may

  12. Recent innovations in oral contraception.

    Science.gov (United States)

    Cremer, Miriam; Phan-Weston, Scarlett; Jacobs, Adam

    2010-03-01

    Traditional forms of oral contraception contain 21 days of hormone-containing pills and 7 days of placebo during the hormone-free interval (HFI). Since 2003, the Food and Drug Administration has approved 24/4, 84/7, and 365-day regimens. These regimens shorten the HFI in an attempt to decrease bleeding and menstrual-associated side effects. Safety and efficacy of these regimens is comparable with traditional 21/7 dosing. Extended regimens are associated with high patient satisfaction. Bleeding patterns are similar or shorter in women using extended regimens, along with improvement in menstrual symptoms. One of the new formulations contains the new progestin drospirenone, which has antimineralocorticoid and antiandrogenic properties. This review summarizes the data about new formulations of oral contraception available in the United Sates and also provides a summary of the current literature on drospirenone.

  13. Contraception - Update and Trends

    Directory of Open Access Journals (Sweden)

    Rabe T

    2007-01-01

    Full Text Available In the future, fertility control will focus on the improvement of existing methods (efficacy, side effects, easy use, duration of action, manufacturing process, costs, on new approaches (mode of action and on new targets for contraception. Counselling of women in view of contraceptive choices based on individual risks (e. g. cardiovascular disease, thrombophilia, family risk of breast cancer, sexually transmitted diseases will gain more and more importance. Only a few companies can afford research in contraception such as Bayer-Schering-Pharma, Wyeth-Ayerst, Ortho-McNeil and Organon. Female contraception: Ovulation inhibition: In the future, a focus will be placed on the preselection of patients to minimize their individual risk, new oral contraceptive (OC regimen, OC with new progestins, OC with estradiol or estradiolesters, new ovulation inhibitors with new progestins and new regimens including long cycles and continuous steroidal contraceptives, new contraceptive patches, vaginal rings, spray-on contraceptives, recently identified genes involved in the ovulation process as new targets for ovulation inhibitors. Fertilisation inhibition: New intrauterine systems will comprise: a smaller Mirena intrauterine system releasing levonorgestrel (LNG and new frameless progestin-releasing intrauterine systems (IUS. Various new contraceptive barriers have been introduced. Research is ongoing on substances acting both as spermicides and as microbicides, reducing the risk of sexually transmitted diseases. New implantables and injectables will feature an improved pharmacokinetic profile, decreased side effects and a safer delivery system. Additionally, there are various new approaches in female sterilisation. Immunocontraception for the female will not be available in the near future. Implantation inhibition: Selective progesterone receptor modulators (SPRMs are tested for postcoital contraception. New targets are analysed for immunocontraceptives. Male

  14. Hormonal contraception in obesity, the metabolic syndrome, and diabetes

    DEFF Research Database (Denmark)

    Skouby, S.O.

    2010-01-01

    The rate of obesity worldwide is currently at epidemic proportions. As part of obesity, the metabolic syndrome describes a clustering of metabolic abnormalities that increase the cardiovascular and diabetes risk. In particular, women from developing countries have diabetes in the reproductive age...... resulting in more pregnancies where both the mother and the fetus are at high risk. Consequently, use of safe and effective contraceptive methods is of paramount importance. Paradoxically, both obese and diabetic women are less likely to use contraception as compared to women of normal weight. Modern types...... of hormonal contraceptives are safe and provide important noncontraceptive benefits. The impact of obesity on drug pharmacokinetics may result in lower blood levels of steroid contraceptives that reduce their ability to prevent pregnancy, but the actual change is probably minimal. In women with uncomplicated...

  15. Hormonal Contraception in obestiy, the metabolic syndrome, and diabetes

    DEFF Research Database (Denmark)

    Skouby, Sven O.

    2010-01-01

    The rate of obesity worldwide is currently at epidemic proportions. As part of obesity, the metabolic syndrome describes a clustering of metabolic abnormalities that increase the cardiovascular and diabetes risk. In particular, women from developing countries have diabetes in the reproductive age...... resulting in more pregnancies where both the mother and the fetus are at high risk. Consequently, use of safe and effective contraceptive methods is of paramount importance. Paradoxically, both obese and diabetic women are less likely to use contraception as compared to women of normal weight. Modern types...... of hormonal contraceptives are safe and provide important noncontraceptive benefits. The impact of obesity on drug pharmacokinetics may result in lower blood levels of steroid contraceptives that reduce their ability to prevent pregnancy, but the actual change is probably minimal. In women with uncomplicated...

  16. As the world grows: contraception in the 21st century

    Science.gov (United States)

    Aitken, R. John; Baker, Mark A.; Doncel, Gustavo F.; Matzuk, Martin M.; Mauck, Christine K.; Harper, Michael J.K.

    2008-01-01

    Contraceptives that are readily available and acceptable are required in many poorer countries to reduce population growth and in all countries to prevent maternal morbidity and mortality arising from unintended pregnancies. Most available methods use hormonal steroids or are variations of barrier methods. Reports from several fora over the last 12 years have emphasized the number of unwanted pregnancies and resultant abortions, which indicate an unmet need for safe, acceptable, and inexpensive contraceptive methods. This unmet need can be assuaged, in part, by development of new nonhormonal contraceptive methods. This Review addresses the contribution that the “omic” revolution can make to the identification of novel contraceptive targets, as well as the progress that has been made for different target molecules under development. PMID:18382745

  17. [Experience with gestodene-containing hormonal contraceptive].

    Science.gov (United States)

    Szabó, L; Nagy, K; Godó, G

    1998-03-01

    An oral contraceptive containing gestodene (Minulet) was examined in collaborating with the Richter-Wyeth Pharmaceutical Factory. The authors present their experiences of monitoring of 591 cycles of a hundred women between 18 and 35 years of age. There were no pregnancy and severe side effects during that period. Irregular bleeding occurred in 17.5% of women in the beginning of the treatment, however it gradually decreased and ceased by the fifth cycle. Both the length and the quantity of the withdrawal bleeding decreased by the end of the sixth cycle. During the observation there was no amenorrhoea and the dysmenorrhoea presented a decreasing tendency, expressing in per cent of the cycles. Their own data support, that the oral contraceptives containing gestodene meet requirements of today's medical science, and beyond the low hormone content they also fulfil the next demands: reliable contraceptive effect, efficacy, excellent cycle control, good tolerability and limited side effects.

  18. Modern Intrauterine Contraception: a Better Option

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Users of oral contraceptives have an increased risk of developing venous throm boembolism as well as mammary cancer. This raises the question as to whether locally applied (intrauterine) contraceptives can offer a valuable alternative with respect to efficiency and safety. During the past decade the use of modern intrauterine devices (IUDs) has made substantial progress in comparison with the IUDs during the 1970s and 1980s. Modern IUDs have become more efficient than oral contraception. Argu ments against the use of IUDs (problems and complications in IUD insertion, the risk of pelvic inflammatory disease, ectopic pregnancy and infertility as well as side effects such as menorrhagia, pelvic cramps and IUD expulsion) generally appear to be based on a lack of awareness with respect to recent developments and on misunder standings derived from bad experiences during the 1980s and earlier.

  19. Contraceptive Use and Method Choice at Initial Sexamong Married Reproductive Women

    Institute of Scientific and Technical Information of China (English)

    周利锋; 钟烨; 丁吟秋; 高尔生

    2000-01-01

    Objective To investigate whether the contraceptives were used and how effective the contraceptives were at the initial sex among reproductive women.Data & Methods Data employed in this paper were derived from “The national survey on population and reproductive health in 1997”, launched by State Family Planning Commission of China (SFPCC). This paper used only a part of the collected data, namely initial sex of married reproductive women.Results Only 6. 45 percent of married reproductive women used contraceptives at their initial sex. Most contraceptive methods used at initial sex were condom, oral contraceptives and rhythm. Intention of pregnancy, forgetting orignorance of using contraceptive were main reasons for not using contraceptives at initial sex. The married reproductive women with lower proportion of using contraceptives at initial sex were of the following characteristics: living in rural area, aged, with lower education or husband of lower education level, not taking courses for newly married couple, not having heard of HIV/AIDs and with lower contraceptive knowledge marks. Contraceptives choice at initial sex among married reproductive women was associated with women's registered permanent residence, age, education level, contraceptive knowledge, initial marriage age, having taken courses for newly-married, having heard of STDs or HIV/AIDs.Conclusion The key points of maternal and children care are reinforcing contraceptive knowledge education among the unmarried and newly-married women, promoting contraceptive awareness and spreading knowledge to those who have no pregnant intention.

  20. Ectopic pregnancy after two times tubal ligation: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-06-01

    Full Text Available Background: Tubal sterilization is the permanent and effective contraception method. This can be performed at any time, but at least half are performed in conjunction with cesarean or vaginal delivery and are termed puerperal. The most complication after tubal ligation is ectopic pregnancy. Ectopic pregnancy is the leading cause of maternal death in first trimester.Case presentation: We present a 33 years old woman gravida5, para4, all normal vaginal delivery, presented with complaints of delayed menstrual period, pelvic pain and spotting. She underwent tubal ligation for two times. For the first time she had puerperal Pomeroy tubal sterilization after third child delivery. Intra uterine pregnancy occurred three years later. One day after vaginal delivery of fourth child, she underwent post partum tubal ligation with the Parkland method. Tubal pregnancy occurred nine months later. Physical examination identified acute abdomen. Pelvic ultrasound showed no gestational sac in uterine cavity. The sac with fetal pole was in right adnexa. Beta-HCG was 2840mIU/ml. She underwent laparotomy. Surgical management included salpingectomy with cornual resection in both sides. The surgery identified Ectopic pregnancy.Conclusion: Any symptoms of pregnancy in a woman after tubal ligation must be investigated; an ectopic pregnancy should be excluded. Ectopic pregnancy must be considered, in any woman with lower abdominal pain, missed period and vaginal bleed-ing. Conception after tubal sterilization can be explained by fistula formation and re-canalization of fallopian tube.

  1. Contraception. Slow train gathers speed.

    Science.gov (United States)

    Hampton, N; Kubba, A

    The otherwise slow pace of contraceptive research developments has recently quickened, with new products developed, more on the way, and encouraging new data emerging about existing methods. While the 1995 UK pill scare called attention to a differential in the risk of venous thromboembolism (VTE) between pills containing levonorgestrel or norethisterone and those containing desogestrel or gestodene, there is only an extremely small level of excess mortality attributable to third-generation progestogens, less than 2 per million women per year. Tentative evidence suggests that pills with less anti-estrogenic progestogens are neutral with regard to coronary artery disease. The pill remains extremely safe for healthy young women, although additional research with larger numbers of participants is warranted. Salient research findings are that the combined oral contraceptive pill may protect against colon cancer, the pill appears to offer no protection against bone fractures, new products contain less estrogen and have a shortened pill-free interval, a WHO paper showed no significant association between cardiovascular disease and the use of oral or injectable progestogens, a UK study showed no correlation between bone density and plasma estrogen concentrations among long-term users of depot medroxyprogesterone acetate, and a WHO controlled trial found a progestogen-only method of emergency contraception to be considerably more effective in preventing expected pregnancies than the Yuzpe regimen. The T 380 copper IUD provides very high protection against intrauterine and extrauterine pregnancies for 10 years and is now available in an improved inserting mechanism, the Mirena levonorgestrel-releasing IUD system is now licensed for 5 years, and the GyneFIX IUD implant is a frameless device fixed during insertion to the fundal myometrium.

  2. Social Action Research and Prevention of Unplanned Pregnancies.

    Science.gov (United States)

    Bailey, Bruce E.; And Others

    Many teenagers have unplanned, unwanted pregnancies. Research has shown that effective contraceptive use is hampered by a lack of knowledge and by negative attitudes. Providing accurate information does not necessarily lead to contraceptive use. This two-phase study attempted to assess contraceptive behavior, knowledge, and beliefs. In the first…

  3. Contraceptive problems unique to the United States.

    Science.gov (United States)

    Tyrer, L B; Salas, J E

    1989-06-01

    An overview of the distinctive milieu regarding contraceptive methods available in the U.S. considers declining method options, future prospects, reasons for the poor current climate, factors affecting future options, global ramifications, and proposed reforms that may improve the U.S. situation. In the last 3 years, the U.S. lost 3 safe IUDs, and lawsuits now threaten the existence of both spermicides and their associated barrier methods. Meanwhile 2 new IUDs and the cervical cap have been introduced. Future possible methods include Norplant, transdermal patches and a disposable spermicide-releasing diaphragm. The chief reason for loss of contraceptives is the legal system in the U.S. which permits peer juries to evaluate a method's side effects relative to the claimant's former health, rather than actual risk- benefit ratios or medical data. Adverse legal decisions have escalated or eliminated liability insurance. The public is ignorant of the benefits of contraceptives, but misinformed by prominent coverage in the media of preliminary adverse findings. Even the F.D.A., for unstated political reasons, has failed on 2 occasions to approve Depo-Provera, used safely in over 80 countries and approved by the drug agencies of most western nations. Other political factors have cut government funding for contraceptive development steadily for 15 years. Apathy for contraceptive research extends from congress to donor support to numbers of new Ph.D.s entering the field. Ramifications include the highest unplanned pregnancy rate, abortion rate and adolescent pregnancy rate in the developed world in the U.S., and a suspicious stance on the part of developed countries toward U.S. contraceptives, especially those not approved here. Proposed ways of reversing the legal and insurance blocks include reform of tort law and no-fault compensation decided by arbitration.

  4. Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania

    Science.gov (United States)

    Sweya, Mussa N; Msuya, Sia E; Mahande, Michael J; Manongi, Rachel

    2016-01-01

    Background Previous studies have shown that knowledge of contraceptives, especially among the youth in universities, remains limited, and the rate of premarital sexual activity, unwanted pregnancies, and illegal abortions remains higher among university students. This study aimed to assess contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania. Methods A cross-sectional analytical study was conducted from May to June 2015 among undergraduate female students in four universities in Kilimanjaro region. A self-administered questionnaire was given to the participants. Data analysis was performed using Statistical Package for Social Sciences. Descriptive statistics were used to summarize the data. An odds ratio with 95% confidence interval for factors associated with modern contraceptive use was computed using multiple logistic regression models. A P-value of students were involved in the study. Two-thirds (260, 64.8%) of the participants had had sexual intercourse. The majority (93.8%) of the participants had knowledge of contraception. One hundred and seventy-five (43.6%) sexually active women reported that they used contraceptives in the past, while 162 (40.4%) were current contraceptive users. More than half (54.2%) of the sexually active group started sexual activity between the ages of 20–24 years. The most popular methods of contraception used were condoms, withdrawal, and periodic abstinence. The main sources of information about contraception were friends, television, and health care workers (44.8%, 40.3%, and 39.0%, respectively). Conclusion Most of the participants had knowledge of contraception. However, the rate of contraceptive use was low. The majority of the respondents were sexually active and started sexual activity at >18 years of age. Hence, advocacy for adolescent reproductive health education to promote the use of the available

  5. Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia.

    Science.gov (United States)

    Shiely, Frances; Saifuddin, Mohammed Syafiek

    2014-03-01

    More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying.

  6. Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania.

    Science.gov (United States)

    Sweya, Mussa N; Msuya, Sia E; Mahande, Michael J; Manongi, Rachel

    2016-01-01

    Previous studies have shown that knowledge of contraceptives, especially among the youth in universities, remains limited, and the rate of premarital sexual activity, unwanted pregnancies, and illegal abortions remains higher among university students. This study aimed to assess contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania. A cross-sectional analytical study was conducted from May to June 2015 among undergraduate female students in four universities in Kilimanjaro region. A self-administered questionnaire was given to the participants. Data analysis was performed using Statistical Package for Social Sciences. Descriptive statistics were used to summarize the data. An odds ratio with 95% confidence interval for factors associated with modern contraceptive use was computed using multiple logistic regression models. A P-value of 18 years of age. Hence, advocacy for adolescent reproductive health education to promote the use of the available contraceptive services among university students is needed.

  7. Acute lymphoblastic leukemia with pregnancy: a rare case

    Directory of Open Access Journals (Sweden)

    Surbhi Bhargava

    2015-06-01

    Full Text Available Pregnancy complicated with leukemia is rare. Validated data out of which conclusions may be drawn regarding management of pregnancy with leukemia are sparse. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 887-888

  8. Acute lymphoblastic leukemia with pregnancy: a rare case

    OpenAIRE

    2015-01-01

    Pregnancy complicated with leukemia is rare. Validated data out of which conclusions may be drawn regarding management of pregnancy with leukemia are sparse. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000): 887-888

  9. Heterotopic Pregnancy in a Natural Conception Following Failed ...

    African Journals Online (AJOL)

    2011-02-23

    Feb 23, 2011 ... Heterotopic Pregnancy in a Natural Conception Following Failed. Contraceptive Practice ... her husband vehemently rejected surgical treatment of the ectopic pregnancy ... He also posited that her doctor only referred her for.

  10. [Combined hormonal contraception in cycles artificially extended].

    Science.gov (United States)

    Bustillos-Alamilla, Edgardo; Zepeda-Zaragoza, J; Hernández-Ruiz, M A; Briones-Landa, Carlos Humberto

    2010-01-01

    To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX. Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens. Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle. Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.

  11. Female sexual dysfunction with combined oral contraceptive use.

    Science.gov (United States)

    Lee, Jean Jasmin M L; Tan, Thiam Chye; Ang, Seng Bin

    2017-06-01

    Combined oral contraceptive pills (COCs) remain one of the most popular forms of contraception to prevent unwanted pregnancy in women. While it is known that COCs can cause sexual dysfunction in women, there is currently no recommendation to screen for sexual function before and after initiation of COCs. We propose that, based on the evidence available, assessment of sexual function should be done at initiation of COCs, as well as at regular intervals thereafter. This would allow COC-related sexual dysfunction to be managed early, such as by switching the patient to newer-generation COCs or other forms of contraception. Copyright: © Singapore Medical Association.

  12. The conscientious objection: debate on emergency contraception.

    Science.gov (United States)

    Montanari Vergallo, G; Zaami, S; Di Luca, N M; Marinelli, E

    2017-01-01

    The authors discuss the emergency contraception (EC) topic, assessing scientific and ethical aspects. The almost totality of the studies carried out tends to report on the use of drugs as an emergency measure to prevent pregnancy. However, it is not yet completely excluded that emergency contraceptives can induce medical abortion. The debate on side effects of EC continues to be a highly emotional and controversial issue both for advocates who believe they will lower considerably the number of unintended pregnancies and abortions, and for opponents who believe that using emergency contraception amounts to an abortion. This latter hypothesis highlights the conflicting aspect of the conscientious objection to abortion of physicians and pharmacists. This research work is aimed at investigating the emergency contraception issue, paying particular attention to the medico-legal and regulatory aspects of this subject. Particularly, the authors focus on the conscientious objection in order to assess, if any, legal protection for physicians and pharmacists who claim a right to conscientious objection. Inappropriate use of EC could be resolved through a registry of user. This registry, of course, would not have the intention of persecution, but would only serve to detect possible cases of subjugation, exploitation and harassment.

  13. Prenatal contraceptive counseling and method provision after childbirth

    Directory of Open Access Journals (Sweden)

    Nelson AL

    2015-05-01

    Full Text Available Anita L Nelson Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA Abstract: Postpartum contraception is undergoing major changes, not only in timing, but also in content. Failure to provide immediate postpartum contraception contributes to the problems of unintended pregnancies and rapid repeat pregnancy because often the highest-risk women do not return for postpartum care. If they do attend that visit, they have often lost the insurance coverage that would enable them to use the most effective forms of birth control. Most of the issues surrounding early initiation of progestin-only methods and breastfeeding have been favorably resolved. In some cases, insurance coverage for delivery has been expanded to cover the costs of providing intrauterine devices and implants before the woman is discharged home. All of these new opportunities shift the burden of counseling about postpartum contraception onto the shoulders of the prenatal care provider. This article provides information about the advantages and disadvantages of providing immediate postpartum contraception with each of the eligible methods so clinicians can provide the needed counseling both during pregnancy and during hospitalization for delivery. It also provides guidance for initiation of bridging contraception, if needed, to initiate a method for a woman later in the postpartum period. Keywords: postpartum contraception, counseling, breastfeeding, implants, IUDs, hormonal methods

  14. Unmarried Mother's Knowledge and Attitudes toward Emergency Contraceptive Pills

    Directory of Open Access Journals (Sweden)

    Gyeong Mi Lee

    2013-06-01

    Full Text Available PurposeThis study was conducted to identify relationships among knowledge and attitudes of unmarried mothers toward emergency contraceptive pills.MethodsData were collected through structured questionnaires from 135 unmarried mothers enrolled in 7 single mothers' facilities nationwide. Data were analyzed using the SPSS/WIN 17.0 program for descriptive statistics, t-test, ANOVA, Scheffe-test, and Pearson correlation coefficients.ResultsFor knowledge about emergency contraceptive pills, there were significant differences among who live with her before pregnancy, experience of past pregnancies, state of present pregnancy and preparation in using contraceptives. For attitude toward emergency contraceptive pills, there were significant differences according to age, education level and religion. There were significant positive relationships between knowledge and attitudes toward emergency contraceptive pills.ConclusionThe results of this study suggest that unmarried women should be better informed about emergency contraceptive pills, and reassured about their safety. Efforts are needed to disseminate up-to-date information to experts in sex education including nurses.

  15. Contraceptive experiences among adolescents who experience unintended birth.

    Science.gov (United States)

    Coles, Mandy S; Makino, Kevin K; Stanwood, Nancy L

    2011-12-01

    Adolescents are at high risk of unintended pregnancy due to contraceptive nonuse and inconsistent use. We examined associations between contraception and mistimed/unwanted birth among adolescents. For contraceptive nonusers, we analyzed factors contributing to unintended birth. Half of adolescents with unintended births did not use contraception at conception. Those ambivalent about pregnancy reported fewer unwanted [relative risk (RR)=0.06] compared to wanted births. Amongst contraceptive nonusers, difficulty accessing birth control was the only factor associated with more unwanted birth (RR=3.05). For Black adolescents, concerns of side effects (RR=7.03), access issues (RR=10.95) and perceived sterility (RR=3.20) were associated with unwanted birth. For younger teens, falsely perceived subfertility increased unwanted birth (RR=2.74), whereas access issues were significant for older teens (RR=3.97). Access issues and misconceptions around contraceptive side effects and fertility place adolescents at higher risk for unintended pregnancy, especially among younger and Black teens. Ambivalence represents an additional area for intervention. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling

    Directory of Open Access Journals (Sweden)

    Costescu DJ

    2016-10-01

    Full Text Available Dustin J Costescu Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada Abstract: Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS; however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception. Keywords: LNG IUS, long-acting contraception, intrauterine contraception, levonorgestrel, contraception, family planning

  17. The Effectiveness of Vaginal Contraceptive Sponge

    Institute of Scientific and Technical Information of China (English)

    金毓翠; 丁家佩; 董吟秋; 董炳麟; 许雪芬

    1994-01-01

    The vaginal contraceptive sponge is made of polyurethane containing 1 g of nonoxynot-9, The gross cumulative twelve month life table pregnancy rate of 352 cases using vaginal contraceptive sponge was 5.7/ 100 women and the method pregnancy rate was 2. 3/ 100 women. The gross cumulative continuation rate per 100 women was 74. Only 2 patients (1,0/ 100 women) suffering from vaginitis and itching of vulva no longer wished to continue in the stud). Over the course of the study no significant changes were observed in any of the laboratory parameters such as vagina & cervix smear etc. that had been monitored. This modality associated with few side effects and its effectiveness rate and also indicated a protection from the risk of acquring of sex-transmitted diseases.

  18. Combined oral contraceptives: health benefits beyond contraception.

    Science.gov (United States)

    Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M

    2014-09-01

    It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists.

  19. The contraceptive vaginal ring.

    Science.gov (United States)

    Edwardson, Jill; Jamshidi, Roxanne

    2010-03-01

    The contraceptive vaginal ring offers effective contraception that is self-administered, requires less frequent dosing than many other forms of contraception, and provides low doses of hormones. NuvaRing (Organon, Oss, The Netherlands), the only contraceptive vaginal ring approved for use in the United States, contains etonogestrel and ethinyl estradiol. It is inserted into the vagina for 3 weeks, followed by a 1-week ring-free period, and works by inhibiting ovulation. Most women note a beneficial effect on bleeding profiles and are satisfied with NuvaRing. Commonly reported adverse events include vaginitis, leukorrhea, headaches, and device-related events such as discomfort. Serious adverse events are rare. In Chile and Peru, progesterone-only vaginal contraceptive rings are available for nursing women. Studies are ongoing examining new formulations of vaginal contraceptive rings.

  20. FastStats: Contraceptive Use

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Contraceptive Use Recommend on Facebook Tweet Share Compartir Data ... using long-acting reversible contraception (Intrauterine device or contraceptive implant) 7.2% Percent of women aged 15- ...

  1. [Contraception and adolescence].

    Science.gov (United States)

    Amate, P; Luton, D; Davitian, C

    2013-06-01

    The mean age of first sexual intercourse is still around 17 in France, but a lot of teenagers are concerned by contraception before, with approximately 25% of sexually active 15-year-old girls. The contraceptive method must take into consideration some typical features of this population, as sporadic and non-planned sexual activity, with several sexual partners in a short period of time. In 2004, the "Haute Autorité de santé" has recommended, as first-line method, combined oral contraceptive (COC) pills, in association with male condoms. Copper-containing intrauterine contraceptive devices (IUCD) and etonogestrel-containing subcutaneous implant have been suggested but not recommended. However, oral contraceptive pill, as a user-based method, carries an important typical-use failure rate, because remembering taking a daily pill, and dealing with stop periods, may be challenging. Some easier-to-use method should be kept in mind, as 28-day COC packs, transdermal contraceptive patches, and vaginal contraceptive rings. Moreover, American studies have shown that long-acting reversible contraceptives (LARC), i.e. IUCD and implant, have many advantages for teenagers: very effective, safe, invisible. They seem well-fitted for this population, with high satisfaction and continuation rates, as long as side effects are well explained. Thus, LARC methods should be proposed more widely to teenagers. Anyway, before prescribing a contraceptive method, it is important to determine the specific situation of every teenager, to let them choose the method that they consider as appropriate in their own case, and to think about the availability of the chosen method. It is necessary to explain how to handle mistakes or misses with user-based contraceptive methods, and emergency contraception can be anticipated and prescribed in advanced provision. The use of male condoms should be encouraged for adolescents, with another effective contraceptive method, in order to reduce the high risk

  2. Pregnancy and melanoma.

    Science.gov (United States)

    Driscoll, Marcia S; Martires, Kathryn; Bieber, Amy Kalowitz; Pomeranz, Miriam Keltz; Grant-Kels, Jane M; Stein, Jennifer A

    2016-10-01

    Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma. The impact of hormonal changes during pregnancy and from iatrogenic hormones on melanoma is controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. In addition, hormone receptors are found on some melanomas. In spite of these observations, the preponderance of evidence does not support a poorer prognosis for pregnancy-associated melanomas. There is also a lack of evidence that oral contraceptives or hormone replacement therapy worsens melanoma prognosis.

  3. [Myocardial infarction associated with oral contraceptive use, smoking and elevated cholesterol level in a young patient].

    Science.gov (United States)

    Krasznai, Zsuzsa; Tóth, Péter

    2011-09-04

    Oral hormonal contraceptives are the safest methods for young patients to avoid unwanted pregnancy. They are well accepted and have certain beneficial effects; however, physicians should pay attention to risk factors even when applied in young age. Obesity, dyslipidemia, smoking and oral contraceptive pills alone or in combination may lead to serious adverse events. Authors present a young woman who developed acute myocardial infarction in association with several unconsidered risk factors including the use of contraceptive pills.

  4. Use of contraceptives among adolescents in Kintampo, Ghana: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Boamah EA

    2014-05-01

    Full Text Available Ellen Abrafi Boamah, Kwaku Poku Asante, Emmanuel Mahama, Grace Manu, Emmanuel Kwesi Ayipah, Elisha Adeniji, Seth Owusu-Agyei Kintampo Health Research Center, Ghana Health Service, Kintampo, Ghana Introduction: The use of contraceptives is essential in preventing unwanted pregnancies, unsafe abortions, and abortion-related complications that expose adolescents to health-related risks such as infertility and sometimes death. Objective: To assess contraceptive use among adolescents as evidence to develop appropriate interventions for adolescent sexual health programs. Methods: A cross-sectional survey using both quantitative and qualitative methods was conducted among 793 male and female adolescents (aged 15–19 years in the Kintampo area of Ghana from October 2010–May 2011. Results: Knowledge of at least one contraceptive method was high (88.9% among adolescents of both sexes (males 92.1% and females 86.6%. Knowledge of male condoms was highest (84.0%, and it was the most common contraceptive method used (82.0%. The use of other methods such as pills (7.9%, injection (0.9%, and foam (0.3%, amongst others, was low. About 22.9% of adolescents used contraceptives consistently. Among adolescents, consistent contraceptive use was significantly associated with discussions of contraceptive use between partners (P<0.01. Adolescents who discussed contraceptive use before their first sexual encounter were more likely to use contraceptives consistently when compared to those who had never discussed contraceptive use (odds ratio =0.06; 95% confidence interval: 0.02–0.17; P<0.01. Among sexually active adolescents, 30.0% had experienced pregnancy, with 34.0% of pregnancies resulting in abortions. Pregnancy was high among adolescents who did not use contraceptives consistently, as compared to those who did (6.4% versus 93.6%; P<0.01. The most common source of contraceptives was the chemical seller's/pharmacy shop (62.1%. Conclusion: Though a high number of

  5. Current issues in contraception

    Directory of Open Access Journals (Sweden)

    Drača Petar D.

    2005-01-01

    Full Text Available Introduction. The authors analyze contemporary methods of contraception. Regarding oral contraception, they point to agents which decrease the efficacy of oral contraception. They also deal with agents which increase the level of estrogen, thus increasing side effects (paracetamol, vitamin C. Oral contraceptives Oral contraceptives may also have an impact on the efficacy of some medications (anticonvulsants, antidepressants. Health risks of oral contraceptives are also mentioned, as well as WHO's, guidelines for women using contraceptives based on risks and benefits. Other methods of contraception The authors also offer criteria for use of bioactive intrauterine devices (IUD, with recommendations of WHO. Besides men's, there are women's condoms, which are very reliable protection against infections, but their negative side is that they are rather expensive. Bad sides of vaginal wash are also emphasized, although this method is rather widespread in the world. Conclusion. At the end, the authors quote the International Family Planning Fund (IFPF which considers IUD to be the most reliable method of contraception nowadays. .

  6. Nomegestrol acetate-17b-estradiol for oral contraception

    Directory of Open Access Journals (Sweden)

    Burke A

    2013-06-01

    Full Text Available Anne Burke Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC 2.5 mg + 17b-estradiol (E2 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile.Keywords: oral contraception, nomegestrol acetate, estradiol

  7. [Liver transplantation and pregnancy].

    Science.gov (United States)

    Goarin, A-C; Homer, L

    2010-11-01

    Management during their sexual life of patients with a liver transplantation is a more or less common situation depending centers. Based on literature review, a focus on management of recipient women was conducted, from contraception to pregnancy, describing the complications related to the status of transplant recipient, but also those that may be related to immunosuppressive agents. If fertility and access to contraception are only slightly modified by graft, complications related to graft or immunosuppressive drugs can affect the pregnancy. On the maternal side, hypertension and preeclampsia are more common, as well as renal dysfunction, iatrogenic diabetes and bacterial or viral infections, acute rejection and graft loss do not appear to be influenced by pregnancy. The fetus is also exposed to risks such as induced prematurity and IUGR. Pregnancy in recipients of hepatic grafts therefore requires joint follow-up by transplant specialist and perinatologist, which leads in most cases to successful outcome for mother and child.

  8. Causes and consequences of unwanted pregnancy from Asian women's perspectives.

    Science.gov (United States)

    Kabir, S M

    1989-01-01

    Shortcomings of contraceptives and of family planning delivery systems are major reasons for unwanted pregnancy and unsafe abortion in Third World countries. Family planning and health programs should provide empathetic counseling for contraceptive choices and pregnancy termination, adjust management systems and procedures to facilitate women's access to services and information, and offer comprehensive services to meet their multiple reproductive health needs.

  9. Knowledge, attitudes and practice of secondary school girls towards contraception in Limpopo Province

    Directory of Open Access Journals (Sweden)

    Dorah U. Ramathuba

    2012-05-01

    Full Text Available Unplanned teenage pregnancy constitutes an important health problem, whilst contraceptive services are free throughout South Africa and the number of Termination of Pregnancy (TOP services is increasing. The purpose of this study was to assess the knowledge, attitudes and practices of secondary school girls towards contraception in Thulamela Municipality of Limpopo Province, South Africa. A quantitative descriptive study design was used and respondents were selected by convenience sampling from a population of secondary school girls, the sample consisting of 273 girls in Grades 10–12. A self-administered questionnaire was used to collect data and analysed by computing frequencies and percentages using the Statistical Package for Social Sciences. Findings showed that respondents were aware of different contraceptive methods that can prevent pregnancy. However, most did not have knowledge of the emergency contraceptive, intra-uterine device and female condom. Pressure from male partners, fear of parental reaction to the use of contraceptives, reluctance to use contraceptives, poor contraceptive education and lack of counselling were seen as the main causes of ineffective contraceptive use and non-utilisation. Possible modalities of intervention deal with providing contraceptive counselling and care to empower these school girls to make informed choices on reproductive health. 

  10. Effective factors contraceptive use by logistic regression model in Tehran, 1996

    Directory of Open Access Journals (Sweden)

    Ramezani F

    1999-07-01

    Full Text Available Despite unwillingness to fertility, about 30% of couples do not use any kind of contraception and this will lead to unwanted pregnancy. In this clinical trial study, 4177 subjects who had at least one alive child, and delivered in one of the 12 university hospitals in Tehran were recruited. This study was conducted in 1996. The questionnaire included some questions about contraceptive use, their attitudes about unwantedness or wantedness of their current pregnancies. Data were analysed using a Logistic Regrassion Model. Results showed that 20.3% of those who had no fertility intention, did not use any kind of contraception methods, 41.1% of the subjects who were using a contraception method before pregnancy, had got pregnant unwantedly. Based on Logistic Regression Model; age, education, previous familiarity of women with contraception methods and husband's education were the most significant factors in contraceptive use. Subjects who were 20 years old and less or 35 years old and more and illeterate subjects were at higher risk for unuse of contraception methods. This risk was not related to the gender of their children that suggests a positive change in their perspectives towards sex and the number of children. It is suggested that health politicians choose an appropriate model to enhance the literacy, education and counseling for the correct usage of contraceptives and prevention of unwanted pregnancy.

  11. Attitudes of College Students toward Contraceptives: A Consideration of Gender Differences

    Science.gov (United States)

    Lance, Larry M.

    2004-01-01

    There exists a "contraceptive gap" among young people. That is, while a large majority of young males and females become sexually active, there is a time lapse between the onset of sexual activity and the use of contraceptives. As a result of this lack of sexual responsibility, there are over 1,000,000 teenage pregnancies each year in the American…

  12. Contraceptive Use Patterns across Teens' Sexual Relationships. Fact Sheet. Publication #2008-07

    Science.gov (United States)

    Holcombe, Emily; Carrier, David; Manlove, Jennifer; Ryan, Suzanne

    2008-01-01

    Teens typically fail to use contraceptives consistently, which contributes to high rates of unintended pregnancy and sexually transmitted infections (STIs) among this age group. Existing research has focused primarily on how teens' own characteristics are related to contraceptive use, but has paid less attention to how the characteristics of…

  13. Factors that influence contraceptive use amongst women in Vanga health district, Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Kangale Izale

    2014-01-01

    Full Text Available Background: Contraception is often necessary in order to plan for children and without it there is a risk of unplanned pregnancies. In the Democratic Republic of Congo, this often results in abortions by untrained persons with resultant morbidity and mortality. Aim: To investigate the factors that influence contraceptive use amongst women of childbearing age in the Vanga health zone. Methods: Cross-sectional survey using interviewer-administered questionnaires. Results: Of the 384 women recruited, a majority (46.1% were in the 31–40 year age group;52% had reached primary school and 88% did not have formal employment. One hundredand forty of the participants reported current use of contraception, with 60% of them using modern methods of contraception; 36.1% of them had begun using contraception before the age of 20; and the most common methods were oral contraceptive pills and injection, each accounting for 22.9%. There was variation in the duration of contraceptive use and the main reason for using contraception was to space children. Of the participants, 20.7% had been using contraception for more than two years. Seventy-seven (31.5% of the women reported they did not use contraception because of a fear of side effects. Forty-four (18% reported that they are unable to afford contraception, 38 (15.6% had husbands who disapproved of contraceptive usage, 26 (10.6% had a fear of infertility, 18 (7.4% practised a religion that did not allow them to use contraception and 12 of the women (4.9% did not use contraception because it was unavailable to them. Conclusion: Barriers to contraception in our study were fears of side effects and infertility, cost, male partner’s objection, unavailability of contraception and religious beliefs.

  14. Bleeding during Pregnancy

    Science.gov (United States)

    ... FAQ090 “Early Pregnancy Loss”). What is an ectopic pregnancy? An ectopic pregnancy occurs when the fertilized egg does not implant ... vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder ...

  15. Woman's contraceptive needs and preferences in the postpartum period: an Italian study.

    Science.gov (United States)

    Di Giacomo, Patrizia; Sbarlati, Alessia; Bagnasco, Annamaria; Sasso, Loredana

    2013-12-01

    To describe what puerperal women know about postpartum contraception and to identify their related needs and expectations. Puerperal women face the problem of beginning or resuming contraception, the choice of the right method of contraception and the right time to start it. This choice becomes particularly important in case they breastfeed since the contraceptive method should not interfere with breastfeeding. Different factors, such as the level of knowledge women have about various contraceptive methods, their individual preferences or their desire to have a baby, can strongly influence this choice. A cross-sectional study had been carried out within the period of six months, from November 2011-February 2012. Three hundred puerperal women were interviewed before their discharge from a Maternity Home. The women were asked for their personal characteristics, their maternity history, the information they had received, their knowledge and expectations about postpartum contraception and their intention to use contraception. During pregnancy and postpartum, 45.5% of the women reported that they had received adequate information about contraception. Of these ones, 64.3% reported their intention to use contraception either to avoid pregnancy or to space out future births, even if they did not always have appropriate knowledge about fertility and the use of contraceptive methods during postpartum. During this study, we also discovered that women's intention to use contraception was proportional to their level of education. Women need more and appropriate information about postpartum contraception, to make a conscious choice in relation to their needs and without putting their health at risk. To promote awareness of the choices related to postpartum contraception, it is important to understand the personal characteristics that influence or hinder this choice. Midwives can play a very important role in informing women and in developing educational interventions to support

  16. Evidence based approach to unani contraceptives: a review

    Directory of Open Access Journals (Sweden)

    Saba Mohd Athar Khan

    2016-02-01

    Full Text Available Contraception is a process or technique for preventing pregnancy by means of medication, device or method that blocks or alters one or more of the processes of reproduction in such a way that sexual union can occur without impregnation. Promotion of family planning is central to the World Health Organization work on improving maternal health and is core to achieve the Millennium Development Goal. It is estimated that 90% of abortion related and 20% of pregnancy related morbidity and mortality, could be prevented by the use of effective contraception. Population explosion is the leading cause of poverty and pollution in developing countries which has detrimental effect on the life supporting system. Hence it is necessary to control the population by the use of contraceptives. Available contraceptives in conventional medicines have many adverse effects. Therefore, there is a need for research of newer, less expensive, less toxic, self-administered, completely reversible contraceptives. Much of these properties are observed in contraceptives as mentioned in classical Unani text. Unani physician has mentioned the various medicines and techniques of contraceptives. Scientific research has confirmed the efficacy of most of the herbal drugs like Ruta graveolans (Suddab, Juniperus communis (Abhal, Piper longum (Filfil daraz, Mentha arvensis (Pudina, Azadirachta indica (Neem, Punica granatum (Anar, Alium cepa (Piyaz and Daucus carota (wild carrot etc. Therefore, the aim of this article is to review the ancient concept of contraception in Unani System of Medicine in the light of available scientific research. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 268-275

  17. Utilization and discontinuation of contraceptive methods: the University of Calabar Teaching Hospital (UCTH experience

    Directory of Open Access Journals (Sweden)

    Njoku CO

    2014-09-01

    Full Text Available Background: Contraception has an important role to play in reducing the high rate of maternal morbidity and mortality in developing countries. Objective: The objective is to determine the prevalence rate, methods and reasons for discontinuation of contraceptive methods at UCTH, Calabar. Method: This was a retrospective study of all clients that utilised different forms of contraceptives at UCTH, Calabar from 1st January, 2009 to 31st December, 2013. Results: A total of 5,381 clients used various methods of contraception while 13,492 live births were recorded giving the prevalence rate of 39.9% of total live birth. Common methods were intrauterine contraceptive device (IUCD 1,745(32.8% and injectable contraceptives 1,268(23.8%. Most clients 1,876(35.2% were graduates while 81(1.5% had no formal education. A total of 535(10.1% clients discontinued different family planning method commonly due to desire for pregnancy and side effects. IUCD had the highest discontinuation rate. Conclusion: The study revealed low prevalence rate of contraceptive use which was more among teenagers and illiterate women. The main reasons for discontinuation of different methods were desire for pregnancy, side effects and menopause. Creating more contraceptive awareness, improvement in contraceptive counselling and female education will help to improve contraceptive utilisation rate and reduce discontinuation rate.

  18. Male Adolescent Contraceptive Utilization.

    Science.gov (United States)

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  19. Social marketing of contraceptives.

    Science.gov (United States)

    Schellstede, W P; Derr, B B

    1986-12-01

    Application of commercial marketing techniques has not only increased awareness, acceptability, and use of modern contraceptives in developing countries, but also overcome logistic problems in service delivery. The ability of contraceptive social marketing to reach large numbers and to treat contraceptives as common consumer products has helped to diminish social and religious constraints associated with family planning. Each contraceptive social marketing program is built around a theme tailored to meet specific cultural, social, and management requirements. The primary target populations are those who cannot afford regular commercial products and those who are not adequately reached by government programs. In countries such as Sri Lanka and Jamaica, profit is not a primary sales objective and retail prices are highly subsidized to make products affordable to low-income people. In contrast, the Colombian and Thai programs use contraceptive social marketing to help offset the operating costs of rural community-based programs and seek profits. The most impressive contraceptive social marketing sales performances have been recorded in Bangladesh, Colombia, Egypt, and Jamaica. The main reason contraceptive social marketing is more cost-efficient than other modes of contraceptive distribution is that the cost of product delivery is assumed by the commercial system. Although there has been some interest in making these programs self-sufficient financially, this step has tended to undermine the purpose of serving lower income groups.

  20. Contraception or abortion? Inaccurate descriptions of emergency contraception in newspaper articles, 1992-2002.

    Science.gov (United States)

    Pruitt, Sandi L; Mullen, Patricia Dolan

    2005-01-01

    Media portrayals of emergency contraception (EC) may influence public health policy and the public's acceptance of this reproductive health option. We investigated the accuracy of newspaper coverage of EC, 1992-2002. We conducted a content analysis of a sample of 1077 articles in 113 newspapers discussing both EC and abortion and determined the frequency of confusion between the two. Of all articles, 44.5% (n = 479) included at least one instance of confusion between EC and medical abortion. Inaccurate portrayal of the mode of action of EC as medical abortion occurred in 31.8% (n = 343) of articles; 13.1% (n = 141) inappropriately applied terms such as "abortifacient postcoital contraceptives" for EC. Errors were prevalent, persisted over time and may have contributed to incorrect beliefs about a form of contraception that is used infrequently, despite its potential to deter unintended pregnancy and abortion.

  1. Emergency Contraception – An Overview

    Directory of Open Access Journals (Sweden)

    Berger C

    2015-01-01

    Full Text Available The ability to control fertility through the use of effective and safe contraception is essential in preventive medicine. EC offers a second chance to prevent an unwanted pregnancy after the event of an UPSI, contraceptive failure or after rape. Health care providers should routinely and more frequently recognize and inform women about the risk of an unintended pregnancy and EC options to avoid this and women should be provided the correct information about the mechanism of action of various EC options. Lack of knowledge on the mechanisms of action obstructs wide spread access and use globally. Currently, the three most commonly licensed methods of EC are insertion of a Cu-IUD or the hormonal pills UPA 30 mg or LNG 1.5 mg. All EC methods are safe with almost no contraindications and minimal side effects. Considering that ovulation and the fertile window are difficult to assess, it is recommended that EC is administered after an UPSI, regardless of cycle day.br With an extremely low failure rate, the Cu-IUD is an attractive option for EC regardless of the woman’s weight or concomitant medication and has the additional propensity to serve as a long-term contraceptive after insertion including if further acts of UPSI should take place in the same cycle. A Cu-IUD inserted within 5 days after ovulation, or when not known 5 days after UPSI, should be the first method of choice if available and suitable. The additional post-ovulatory effect makes the Cu-IUD a superior EC method.br Of the available hormonal EC treatments, UPA 30 mg should be the first choice being the most effective option with a wider window of effect than LNG. UPA has the ability to delay or inhibit ovulation beyond the life span of sperm even when given at an advanced follicular phase when the risk of pregnancy is high. In comparison, LNG has a narrower window of effect on ovulation with no effect after LH has started to rise, but LNG in a dose of 1.5 mg is recommended where UPA is

  2. Contraceptive failure in China.

    Science.gov (United States)

    Wang, Duolao

    2002-09-01

    This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

  3. [Community marketing of contraceptives].

    Science.gov (United States)

    Urrutia, J M

    1987-09-01

    The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for

  4. The myth about contraceptives and breast cancer.

    Science.gov (United States)

    Ibekwe, J

    1993-03-18

    Science and modern medicine accord us many advantages, e.g., contraceptive drugs, but many people still do not use them. Contraceptive drugs include oral contraceptives and injectables. OCs are very effective and are associated with minor side effects (e.g., mood changes, breast tenderness, nausea, and changes in weight, mild headache, and spotting between periods), perhaps explaining why they are one of the most often used contraceptive in essentially every country. Women who smoke; are 35 years old; or either have or have a family history of hypertension, diabetes, cardiovascular disease and use OCs are at higher risk of a cardiovascular episode. On the other hand, OCs protect against ovarian and endometrial cancers. Research does not yet confirm or disprove their effect on breast cancer development. OCs appear not to be linked to breast cancer through age 59. Yet, studies of women 45 years old suggest that OCs increases the breast cancer risk in these women who had their first menses before age 13 and used OCs for a long time before their first pregnancy. OCs may facilitate growth of breast tumors that other causes activated, and therefore, do not likely increase the overall risk. Researchers recognize the death of knowledge about breast cancer development, so they call for more research, including basic molecular, cellular, and biochemical studies. In Nigeria, breast cancer is rare, while deaths due to pregnancy and childbirth are common, indicating that OC use can prevent many female deaths. Prolonged breast feeding; later age at first menses; earlier age at menopause; earlier age at first full-term pregnancy larger families; low fat, high fiber diets; and thinness, all of which are common in developing countries, have a protective effect against breast cancer. Further, women in developing countries begin OC use later than women in developed countries.

  5. Diphenhydramine and Pregnancy

    Science.gov (United States)

    ... few reports of withdrawal symptoms in infants whose mothers took diphenhydramine daily throughout pregnancy. Is there anyone who should avoid taking diphenhydramine during pregnancy? A single human report and animal data have suggested that ...

  6. Adolescent women's contraceptive decision making.

    Science.gov (United States)

    Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C

    1991-06-01

    A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

  7. Postpartum Visit Attendance Increases the Use of Modern Contraceptives

    Directory of Open Access Journals (Sweden)

    Saba W. Masho

    2016-01-01

    Full Text Available Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012. Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619. Routine PPCV (yes, no and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8% and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72. Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates.

  8. Contraceptive Methods Accessed in Volta Region, Ghana, 2009–2014

    Directory of Open Access Journals (Sweden)

    Himiede W. Wilson

    2017-01-01

    Full Text Available Introduction. In 2016, Volta Region was one of the two regions in Ghana that recorded a high prevalence of teenage pregnancy, accounting for 15.5% of all adolescent pregnancies in the country. This study aimed to determine the prevalence of contraceptive methods accessed by person, place, and time in Volta Region, Ghana, 2009–2014. Method. We carried out a secondary analysis of contraceptive use data derived from the District Health Information Management System (DHIMS 2 for Volta Region, between 2009 and 2014. We calculated proportions and described trends. Results. Over the five-year period, there were 673,409 (75.0% acceptors of family planning out of a total 897, 645 males and females of reproductive age. The proportion of family planning acceptors increased gradually from 18% in 2009 to 23% in 2014. Contraceptive methods were most commonly accessed by male and female between 20 and 29 years. The most common methods of contraceptives accessed were injectables among females accounting for about 70% and condoms accounting for over 90% among males. Conclusion. All the districts in Volta Region did not access contraceptives adequately. The Volta Regional Health Directorate should encourage and support research to ascertain factors influencing uptake of contraceptive methods in all the districts.

  9. [Teenage pregnancy].

    Science.gov (United States)

    Mora-Cancino, María; Hernández-Valencia, Varcelino

    2015-05-01

    In Mexico, 20% of the annual births are presented in women younger than 20 years old. Pregnancy in adolescents puts at risk mother and child health. This risk is major while the woman is younger, especially when the social and economic conditions are not favorable, which is decisive in later psychosocial development. It has been pointed out that the youths with low education, with minor academic and laboral expectations, with low self-esteem and assertiveness, tend to begin early their active sexual life, to use less frequently contraceptives, and in the case of younger women, to be pregnant, with the risk of abortion because they cannot to make the best decision. It is important to take into account the social context and the special characteristics of the family to understand situation of adolescent at risk of pregnancy.

  10. The 1998 Canadian Contraception Study.

    Science.gov (United States)

    Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.

    1999-01-01

    Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

  11. Review of newer contraceptive agents.

    Science.gov (United States)

    Qureshi, M; Attaran, M

    1999-06-01

    Advances in contraceptive technology have made birth control more effective, convenient, and safe. We review the newer products and some under development, including the latest oral contraceptives, injectable progesterone, subdermal progestin implants, progesterone-releasing IUDs, emergency contraception, and male contraception.

  12. A mixed-methods exploration of the contraceptive experiences of female teens with epilepsy.

    Science.gov (United States)

    Manski, Ruth; Dennis, Amanda

    2014-09-01

    We explored the contraceptive experiences of female teens with epilepsy, including their knowledge and perceptions of interactions between antiepileptic drugs and hormonal contraception and contraceptive decision-making processes. From November 2012 to May 2013, we conducted one online survey (n=114) and 12 online focus group discussions (n=26) with female teens with epilepsy about their contraceptive experiences and unmet needs. Survey data were analyzed using descriptive statistics and focus group transcripts were analyzed thematically using modified grounded theory methods. Both survey and focus group participants reported believing that interactions between epilepsy medications and hormonal contraceptives could lead to reductions in contraceptive efficacy and seizure control. However, their knowledge about these types of medication interactions was often incomplete. Many study participants viewed contraceptive decision making as a difficult process, and some participants reported avoiding hormonal contraceptives because of potential interactions with antiepileptic drugs. Study participants reported relying on health care providers and parents for contraceptive decision-making support. Focus group participants also reported they wanted health care providers to provide more in-depth and comprehensive counseling about contraception, and that they desired peer support with contraceptive decisions. The ability to make informed contraceptive decisions is important for teens with epilepsy as interactions between anti-epileptic drugs and hormonal contraceptives can impact seizure occurrence and lead to an increased risk of unplanned pregnancy. Guidance for providers offering contraceptive care to this population is needed, as well as a contraceptive support tool that empowers teens with epilepsy to advocate for desired health care. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  13. ORMELOXIFEN HCL VS. COMBINED ORAL CONTRACEPTIVE PILL IN TREATMENT OF DUB

    Directory of Open Access Journals (Sweden)

    Veena

    2014-01-01

    Full Text Available INTRODUCTION : DUB is defined as a state of abnormal uterine bleeding without any clinically detectable organic pelvic pathology - tumor , inflammation or pregnancy. The present study was conducted to compare the effect of ormeloxifene HCL ( SERM and combined oral contraceptive pills in medical treatment of DUB. MATERIAL & METHOD: This study is based on 100 cases of DUB from age group of 20 to 50 years , out of which fifty cases were prescribed Ormeloxifen HCL (Drug A and another 50 cases were given Combined Contrac eptive pills. (Drug B Ormeloxifen HCL was given in doses of 60mg biweekly for 12 weeks and from 13 th week one tablet weekly for another 12 weeks. CC pills (Levonorgestrel 0.15mg & Ethinyloestradiol 0.03mg – One tablet from 5th day of menses for 21 days g iven cyclically for six months. Regular cyclic follow - up was done to assess response , compliance tolerance and recurrence of the symptoms and side effects of every patient. RESULT : The study revealed marked decrease in PBAC score 82% vs. 35% , reduction in percentage of bleeding 100%vs 68% , regularization of menstrual cycle100%vs74% , recurrence of symptoms in the form of excessive bleeding 4% vs. 64% and irregular cycle 0%vs 68% in drug A vs. drug B and side effects were comparable in both the groups. CONCL USION : Ormeloxifen HCL is more effective , well tolerated with superior compliance than combined oral contraceptive pills in medical treatment of DUB.

  14. CONTRACEPTION NEEDS AND ITS USAGE AMONGST RURAL WOMEN OF INDIA

    Directory of Open Access Journals (Sweden)

    Poonam

    2014-11-01

    highlights that there is a need to increase knowledge and awareness but knowledge and awareness do not always lead to a positive attitude towards the use of contraceptives. To increase the number of couples using contraception there has to be a combined approach to increase knowledge, awareness, positive attitude and great motivation and support from health department. There appears a need for continuing education about sexuality and contraception. Also there is a need to motivate the youth for effective and appropriate use of contraceptives and arrest the trend towards unwanted pregnancy and increase in population. There is need for focused awareness program based on the knowledge gaps reported among women in reproductive age group

  15. [Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth].

    Science.gov (United States)

    Kowalska, Joanna; Olszowa, Daria; Markowska, Dominika; Teplik, Marzena; Rymaszewska, Joanna

    2014-01-01

    The aim of this study was to answer the question of whether physical activity during pregnancy and participation in childbirth classes prepare women for childbirth; further, does it influence the levels of perceived stress and the occurrence of depressed mood. 100 women participated in the study. Half of the women had taken part in the childbirth classes before giving birth. A questionnaires of own authorship, Edinburgh Postnatal Depressioni Scale (EPDS) and Perceived Stress Scale (PSS-10) were used. There was no significant relationship observed between participation in childbirth classes and the results of EPDS and PSS-10. The mood of women after childbirth correlated significantly with the level of stress in the whole study group (pstress were observed in women who stayed in a relationship (p =0.0029, p = 0.0008). Women physically active during pregnancy were also characterized by better mood and lower levels of perceived stress (6.7 and 14.4 vs. 8.4 and 16.0). Among women exercising during pregnancy the participants in childbirth classes was far more numerous (ppregnancy was linked to lower levels of stress experienced by women and less severe depressive symptoms after childbirth,; espe- cially in the group of childbirth classes participants.

  16. International survey to assess women's attitudes regarding choice of daily versus nondaily female hormonal contraception

    Directory of Open Access Journals (Sweden)

    Mansour D

    2014-04-01

    Full Text Available Diana Mansour New Croft Centre, Newcastle Hospitals Community Health, Newcastle upon Tyne, UK Background: The availability of reliable contraception tailored to suit women's needs and lifestyles is an essential step in addressing unintended pregnancy and its substantial human and financial costs. The daily combined oral contraceptive pill has been the short-acting hormonal contraceptive of choice for the last 50 years. However, for some women, this may be neither suitable nor optimal. Methods: Here we report the findings of a large, online, questionnaire-based study conducted in Brazil, France, Germany, Italy, and the USA. The study was designed to assess women's attitudes, beliefs, and unmet needs regarding current hormonal contraceptive options via an anonymous online survey. Women eligible for contraception were required to respond to questions using either a binary (yes/no or seven-point scale (1, complete disagreement; 7, complete agreement. Women were also asked about other relevant issues, such as lifestyle, perception of menstruation and pregnancy, level of education, and relationship with their health care professional. Results: In total, 12,094 women were questioned, of whom 68% required contraception. Overall, 28% of women expressed an interest in novel contraceptive products, and 49% stated that they would prefer a nondaily method. Although many women expressed satisfaction with the pill, daily intake was thought to be burdensome, resulting in irregular and ineffective usage. However, many women continued to choose the pill due to lack of consideration of and education about other options. Approximately half of the women wished to conceive in the near future. Conclusion: The findings indicate that nearly half of respondents would prefer a nondaily form of contraception. Furthermore, approximately half of respondents wished to conceive in the near future, suggesting that they are unlikely to favor long-acting options. Effective

  17. [Disease and contraception. Recent aspects].

    Science.gov (United States)

    Rozenbaum, H

    1985-01-01

    This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that

  18. [Emergency oral contraception policy: the Peruvian experience].

    Science.gov (United States)

    Pretell-Zárate, Eduardo A

    2013-07-01

    Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru.

  19. Antibiotics, the pill, and pregnancy.

    OpenAIRE

    Mastrantonio, M; Minhas, H; Gammon, A.

    1999-01-01

    OBJECTIVES: To establish if advice concerning risks of pregnancy when taking oral contraceptive pill and antibiotics is being offered. METHOD: A retrospective audit of notes of 100 female patients aged 15-39 who were prescribed antibiotics. RESULTS: Documentation of use of contraception was noted in 3% of patients. Advice concerning risks and further precautions was noted in this 3% but not in any other records. CONCLUSION: The audit identified a gap in documentation and/or clinical practice ...

  20. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling.

    Science.gov (United States)

    Costescu, Dustin J

    2016-01-01

    Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception.

  1. Emergency contraception: ¿how, when and with what?

    Directory of Open Access Journals (Sweden)

    Álvaro Monterrosa Castro

    2006-04-01

    Full Text Available Emergency contraception is a valid birth-control strategy that articulated and immers d in its real dimension makes a good influenceover the negative social-demographic, biological and economicreverberations that unwanted pregnancy and abortions in riskconditions generate. Due to all the implications that this has, it isimportant that professionals that attend sexual and reproductivehealth, have a clear level of theoretical knowledge based on scientific concepts, be convinced of its advantages and have a serious compromise with the society. Because the abortion is not legal in Colombia, even in rape cases, incest, life risk and woman health, and because the provoked abortion and its complications is the third cause of maternal death, all the actions, including emergency contraception, that prevent unwanted pregnancy and abortion have great importance. Every health professional must know when, with what tools and how administrate emergency contraception.

  2. Present and future contraception: does discovery of targets lead to new contraceptives?

    Science.gov (United States)

    Jensen, Jeffrey T

    2015-01-01

    Although many highly effective methods of reversible contraception are available, high rates of unintended pregnancy and abortion provide evidence that current methods do not meet the needs of all couples. In recent years, a number of highly specific targets have been identified in key pathways that regulate the development of male and female gametes. Support for development of novel approaches has moved from industry to governmental and foundation funders. Continued public funding will be needed to move promising leads into clinical trials.

  3. AWARENESS ABOUT EMERGENCY CONTRACEPTIVE PILLS VERSUS CONVENTIONAL CONTRACEPTIVE METHODS AMONG MOTHERS ATTENDING MATERNAL AND CHILD HEALTH (MCH CLINIC, BAPUJI HOSPITAL, DAVANGERE, KARNATAKA

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

    Full Text Available BACKGROUND: Unwanted pregnancies are a major public health problem for both developing and developed nations, which generally results from ineffective use of contraceptives and end up in induced abortions. Emergency contraception sometimes called “morning after”, “postcoital” or “second chance pills” can be used to prevent pregnancy after an unprotected sex. Attention has been focused on the potential for emergency contraception to reduce the number of unwanted pregnancies and thus abortion rate. OBJECTIVES: 1 . To compare the awareness about emergency contraceptive pills and conventional contraceptive methods among mothers attending MCH clinic, Bapuji Hospital, Davangere. 2. To study the socio - demographic profile of the above group. METHODS: A pre - tested, semi - structured questionnaire was used to know the awareness about emergency contraceptive pills versus conventional contraceptive methods among mothers attending MCH clinic, Bapuji hospital, Davangere from 1 st October 2011 to 31 st December 2011. Data was entered into Excel sheet and was analysed using SPSS software version 17. Data was described as proportions, categorical data using chi square test. RESULTS: A total of 500 mothers were included in the study for duration of 3months. Approximately 80% of the respondents were in the age group of 21 - 30yrs, 72.8% from urban background, 83.4% were Hindus, 55% were from joint family. Approximately 49% belonged to socioeconomic class II and III, 97.2% were literate and 86.6% were housewives. 31.8% had knowledge about emergency contraception which is very less when compared to 84.2% of conventional methods. 6.2% have practiced emergency contraception which is very poor when compared to 47.5% of conventional methods. 77.8% were aware of female sterilization. The most common known temporary method of contrac eption was Cu - T (71% followed by OCP (60.6%. Most common method used by couples was condom (21.8% followed by Cu - T (19

  4. Trends in contraceptive use among women with human immunodeficiency virus.

    Science.gov (United States)

    Sun, Mengyang; Peipert, Jeffrey F; Zhao, Qiuhong; Wilson, Tracey E; Weber, Kathleen M; Sanchez-Keeland, Lorraine; DʼSouza, Gypsyamber; Young, Mary; Watts, D Heather; Keller, Marla J; Cohan, Deborah; Massad, L Stewart

    2012-10-01

    To estimate trends in contraceptive use, especially long-acting reversible contraceptives (LARCs) and condoms, among human immunodeficiency virus (HIV)-seropositive and HIV-seronegative women. Human immunodeficiency virus-seropositive and HIV-seronegative women in a multicenter longitudinal cohort were interviewed semiannually between 1998 and 2010 about sexual behaviors and contraceptive use. Trends in contraceptive use by women aged 18-45 years who were at risk for unintended pregnancy but not trying to conceive were analyzed using generalized estimating equations. Condoms were the dominant form of contraception for HIV-seropositive women and showed little change across time. Less than 15% of these women used no contraception. Between 1998 and 2010, LARC use increased among HIV-seronegative women from 4.8% (6 of 126) to 13.5% (19 of 141, P=.02), but not significantly among seropositive women (0.9% [4 of 438] to 2.8% [6 of 213], P=.09). Use of highly effective contraceptives, including pills, patches, rings, injectable progestin, implants, and intrauterine devices, ranged from 15.2% (53 of 348) in 1998 to 17.4% (37 of 213) in 2010 (P=.55). Human immunodeficiency virus-seronegative but not HIV-seropositive LARC users were less likely than nonusers to use condoms consistently (hazard ratio 0.51, 95% confidence interval [CI] 0.32-0.81, P=.004 for seronegative women; hazard ratio 1.09, 95% CI 0.96-1.23 for seropositive women). Although most HIV-seropositive women use contraception, they rely primarily on condoms and have not experienced the increase in LARC use seen among seronegative women. Strategies to improve simultaneous use of condoms and LARC are needed to minimize risk of unintended pregnancy as well as HIV transmission and acquisition of sexually transmitted infections. II.

  5. [The women and the right to contraceptives].

    Science.gov (United States)

    Charchafche, Helena; Nilsson, Peter M

    2007-01-01

    During the first decades of the 20th century, many Swedish women were severely injured or died in complications following illegal abortions. Since legal abortion was forbidden, contraceptives were the only way to avoid pregnancy. But in the year 1910, a new Swedish law "Preventivlagen" prohibited any kind of advertising och public information considering contraceptives. They could still be sold in pharmacies or special medical stores, but it was no longer allowed to speak publicly about contraceptives in a leading manner. The punishment for disobeying was prison or fines. Some physicians and people involved in women liberation, public health and/or public education, claimed that the law brought negative medical, social and economic consequences, while others opposed the law being too soft. The law made the more than 100 years old question about contraceptives or not, a part of the medical, political and social agenda for the society. Some argument against contraceptives was concerned about the decreasing nativity rate--more use of contraceptives could make an even worse situation. Another reason was the fear of an increasing promiscuity if the contraceptives were more available. Still, many physicians and womens liberators did not se this as any big and important problems. They were more concerned about the women's health and her right to give birth to children at the time she wanted. Women had their right to be in charge of their lives, and should no longer be seen as victims of their biological nature. The right to contraceptives was not the only topic to be discussed during the late 19th century and the first decades of the 20th century. Another central right to be claimed, was the possibility for people, especially young people, to be educated in sexual questions. Many women and also women physicians fought for young peoples right to this information. The law "Preventivlagen" was abolished in 1938. After that, women hade their legal right to choose for

  6. Clinical pharmacokinetics of contraceptive steroids. An update.

    Science.gov (United States)

    Shenfield, G M; Griffin, J M

    1991-01-01

    concentrations of contraceptive steroids are decreased by griseofulvin, which induces their hepatic metabolism. The role of other antibiotics remains controversial but there is probably a group of susceptible women who have lower plasma contraceptive hormone concentrations and experience breakthrough bleeding or pregnancy when given broad spectrum antibiotics. This may relate to interruption of the enterohepatic recirculation of ethinylestradiol. Anticonvulsants, other than valproic acid, all induce contraceptive steroid metabolism and therefore lower plasma hormone concentrations, thus reducing contraceptive effectiveness.

  7. Oral Contraceptives and Bone Health in Female Runners

    Science.gov (United States)

    2007-08-01

    SUBJECT TERMS bone mass, oral contraceptives, runners, randomized trial, epidemiology, stress fracture, osteoporosis 16. SECURITY CLASSIFICATION OF...irregularity, and osteopenia/ osteoporosis , is of concern among female athletes. Because of the interrelationships among dietary, exercise, and...Figure 1). Reasons for withdrawing included: geographic relocation, pregnancy , illness, and lack of time. Of the remaining 127 participants, 42 (33

  8. Antibiotics and oral contraceptive failure - a case-crossover study

    NARCIS (Netherlands)

    Toh, Sengwee; Mitchell, Allen A.; Anderka, Marlene; de Jong-van den Berg, Lolkje T. W.; Hernandez-Diaz, Sonia

    2011-01-01

    Background: Evidence on the association between antibiotic use and combined oral contraceptive (COC) failure is controversial. We examined the effect of concomitant antibiotic treatment on the risk of breakthrough pregnancy among COC users. Study Designs: We performed a case-crossover study of 1330

  9. Emergency contraception use and non-use in young women: the application of a contextual and dynamic model.

    Science.gov (United States)

    Free, Caroline; Ogden, Jane

    2005-05-01

    There have been many approaches to understanding contraception use including social cognition models which have been criticised for their individualistic approach and their static nature. The present quantitative study developed and refined a contextual and dynamic model of contraception use that was derived using qualitative research. This model conceptualizes the predictors of contraception use in terms of the meaning and importance of a range of social goals, perceptions of vulnerability, and constraints on or facilitators of contraception use each of which changes over time. The present study operationalized this model in relation to emergency contraception and explored differences between users and non-users and between episodes of use and non-use. In terms of users and non-users, the results showed that the users of emergency contraception showed a more positive view of an emergency contraception user, perceived greater support from their partner for emergency contraception use, rated themselves more at risk of pregnancy, and felt more confident about asking for emergency contraception. In terms of use and non-use, use was related to an increased belief about the risk of pregnancy, increased partner support, increased concern about health care professionals and the side-effects of the drug, and a more positive identity of an emergency contraception. The study has helped to develop and refine the model and has identified some key factors that are specifically relevant to emergency contraception use in a sample of women in education in and around London.

  10. Pregnancy and Rheumatic Disease

    Science.gov (United States)

    ... diseases vary by condition. Rheumatoid arthritis (RA) , systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) typically are modified by pregnancy. For example, RA symptoms often improve in pregnant ...

  11. Noncontraceptive benefits of the estradiol valerate/dienogest combined oral contraceptive: a review of the literature

    Directory of Open Access Journals (Sweden)

    Nappi RE

    2014-08-01

    Full Text Available Rossella E Nappi,1 Marco Serrani,2 Jeffrey T Jensen3 1Department of Obstetrics and Gynecology, Research Centre for Reproductive Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy; 2Global Medical Affairs Women's Healthcare, Bayer HealthCare Pharmaceuticals, Berlin, Germany; 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA Abstract: Combined oral contraceptives formulated to include estradiol (E2 have recently become available for the indication of pregnancy prevention. A combined estradiol valerate and dienogest pill (E2V/DNG, designed to be administered using an estrogen step-down and a progestin step-up regimen over 26 days of active treatment followed by 2 days of placebo (26/2-day regimen, has also undergone research to assess the potential for additional noncontraceptive benefits. Randomized, placebo-controlled studies have demonstrated that E2V/DNG is an effective treatment for heavy menstrual bleeding – a reduction in median menstrual blood loss approaching 90% occurs after 6 months of treatment. To date, E2V/DNG is the only oral contraceptive approved for this indication. Comparator studies have also demonstrated a reduction in hormone withdrawal-associated symptoms in users of E2V/DNG compared with a conventional 21/7-day regimen of ethinylestradiol/levonorgestrel. Other potential noncontraceptive benefits associated with E2V/DNG, like improvement in dysmenorrhea, sexual function, and quality of life, are comparable with those associated with other combined oral contraceptives and are discussed further in this review. Keywords: heavy menstrual bleeding, hormone withdrawal-associated symptoms, quality of life

  12. Acute intermittent porphyria and pregnancy: an obstetric challenge

    Directory of Open Access Journals (Sweden)

    Pragati Meena

    2016-02-01

    Full Text Available Acute intermittent porphyria is a rare autosomal dominant disease caused by a mutation in the gene coding for the porphobillinogen deaminase enzymes in heam biosynthesis. The disease manifests as acute attacks of neuropsychiatric dysfunction and neurovisceral manifestations presenting as acute abdomen. In pregnancy, 54% patient has exacerbation of attacks in the form of seizures and acute abdomen occurs due to hormonal changes. Prevalence of acute intermittent porphyria is 1-2/200000 in general. Here we report a case of 36 year old women, G4P1L2A2 presenting at 10+4 weeks of gestation requesting pregnancy termination. Patient was diagnosed as case of acute intermittent porphyria with porphyic polyneuropathy 6 months back. At that time her main symptoms were acute pain abdomen with numbness and weakness in all four limbs. Her urinary porphobillinogen and 5 ALA raised. Her CECT of brain and nerve conduction studies were normal. Since then she is on Tablet Gabapentin 300 mg H.S. She underwent successful pregnancy termination by suction and evacuation under spinal anesthesia and she refused for copper-T insertion. Only safe drugs were used for procedure and she was discharged with advice of barrier contraception. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 542-544

  13. Advertising of contraception.

    Science.gov (United States)

    1978-04-01

    It is estimated that 1.7 million fertile and sexually active women in Great Britain do not use any reliable form of contraception. There is a need for better information regarding contraception, a need which could be filled by commercial advertising of family planning in general and specific contraceptive products in particular. Mass media and public advertising of family planning services is permitted in Britain. Funds available for such purposes are inadequate for continued advertising. The law should be changed to allow advertising for specific brands of condoms, spermicides, and pills. IUDs and diaphragms are used in too small numbers to make advertising worthwhile. The objection to contraceptive advertising is that it would be offensive to the public. However, public opinion research confounds this theory.

  14. Contraception during lactation.

    Science.gov (United States)

    Badraoui, M H; Hefnawi, F; Bahgat, R; Fawzi, G; El Gaali, O; Ismail, H; Hegab, M

    1982-01-01

    Seven hundred and seventy-two lactating mothers were studied from delivery for 1 year to select the best contraceptive method (oral drug, injected drug, or IUD) which did not affect lactation. Ten groups of mothers were studied, including 234 control subjects. The injectable progestational contraceptives caused an improvement in the amount of milk and its protein concentration, whereas the IUCDs did not influence the lactation pattern. Sulpiride was an ineffective contraceptive but a potent lactation stimulant. The side effects of each method (effects on milk yield, protein content and prolactin concentrations) were also noted; it was concluded that IUCDs are the ideal contraceptive method during lactation, with the use of a lactation stimulant when indicated.

  15. Use of Emergency Contraception could Halve Induced Abortion Rate in Shanghai,China

    Institute of Scientific and Technical Information of China (English)

    Chao-hua LOU; Shuang-ling ZHAO; Er-sheng GAO

    2004-01-01

    Objective To investigate and estimate the proportion of the induced abortion that could have been prevented by using emergency contraception in Shanghai Method Structured interviews were conducted in 606 women (413 married and 193unmarried) aged 18-49 years, who were attending three health care centers in Shanghai for termination of first trimester pregnancy.Results A total of 98.2% of the pregnancies were unwanted, and 63.7% of the women recognized that they were at risk of pregnancy soon after the intercourse. It is estimated that 52.2% of the induced abortion could have been prevented if the women had used levonorgestrel-only emergency contraception. Only 28.5% of the respondents were aware of emergency contraception. The most important sources of information about emergency contraception identified by respondents were books/newspapers/periodicals (38.2%), and relatives/friends (30.6%). Family planning health education on emergency contraception was noted by 28.9% of married women but only by 5.8% of unmarried women. A portion of 85.5% of all respondents reported they would be willing to use emergency contraception when needed. Those more willing to use emergency contraception included younger, better educated, and unmarried women experiencing their first pregnancy. Women preferred drugstores (60.1%) than hospitals (30.2%)for obtaining emergency contraception.Conclusion Women's needs for emergency contraception were enormous. Promotion of emergency contraception by providing information and improving service could have a substantial impact on reducing the rate of induced abortion in Shanghai.

  16. Intrauterine Contraceptive Device Migrated into the Urinary Bladder and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Orhan Zorba

    2013-08-01

    Full Text Available Intrauterine contraceptive devices are being used in clinical practice since 1962. Due to their efficiency and low cost, intrauterine contraceptive devices are the most popular method of reversible contraception in developing countries. The incidence of migration of an intrauterine contraceptive device, and related uterine perforation ranges from 0.003% to 0.87%. Intrauterine contraceptive device may migrate into urinary bladder, appendix, rectum, colon, peritoneum, anterior abdominal wall or ovary. Foreign bodies like sutures, stents, and needles in the urinary bladder act as niduses for calculi formation. Intrauterine contraceptive device migrated into the bladder can also become a nidus for a stone formation.Herein we report about a case whose intrauterine contraceptive devices had migrated into the bladder, and presented with lower urinary tract symptoms and suprapubic discomfort 6 years after its insertion.

  17. "My religion picked my birth control": the influence of religion on contraceptive use.

    Science.gov (United States)

    Hill, Nicholas J; Siwatu, Mxolisi; Robinson, Alexander K

    2014-06-01

    This research investigates the influence of religious preference and practice on the use of contraception. Much of earlier research examines the level of religiosity on sexual activity. This research extends this reasoning by suggesting that peer group effects create a willingness to mask the level of sexuality through the use of contraception. While it is understood that certain religions, that is, Catholicism does not condone the use of contraceptives, this research finds that Catholics are more likely to use certain methods of contraception than other religious groups. With data on contraceptive use from the Center for Disease Control's Family Growth Survey, a likelihood probability model is employed to investigate the impact religious affiliation on contraception use. Findings suggest a preference for methods that ensure non-pregnancy while preventing feelings of shame and condemnation in their religious communities.

  18. [Some aspects of contraception in 1975].

    Science.gov (United States)

    Rosenthal, C; Renaud, R

    1976-01-01

    Developments in the area of IUDs and experiments on male contraception are reviewed, the mechanisms of action of IUDs, including the copper types, and the importance of their shape and size, as well as that of the position of the copper in the uterine cavity are described, and possible contraindications, insertion techniques, subsequent examinations, the durability of IUDs, the possibility of expulsion and of complictions (perforation and infection), and the risk of abortion and extrauterine pregnancy in case of IUD failure are discussed. With respect to male contraception, still at an experimental stage, the methods reviewed are the administration of an androgen-progesterone combination (orally, by injection or implant), the administration of long-acting steroids (testosterone propionate, testosterone enanthate, medroxyprogesterone acetate), or of andantiandrogen to prevent the maturation of sperm, the reversible occlusion of the vas deferens and the insertion of foreign bodies in the vas deferens, as well as their side effects.

  19. Contraception and endometriosis: challenges, efficacy, and therapeutic importance

    Directory of Open Access Journals (Sweden)

    Weisberg E

    2015-07-01

    Full Text Available Edith Weisberg,1 Ian S Fraser2 1Family Planning NSW, 2School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia Abstract: Endometriosis is a benign gynecological condition that is estimated to affect 10% of women in the general population and appears to be increasing in incidence. It is an estrogen-dependent inflammatory disease, and is primarily characterized by dysmenorrhea, deep dyspareunia, chronic pelvic pain, and variable effects on fertility. The symptoms may greatly affect quality of life, and symptom control may be the primary aim of initial management, while contraceptive effect is often secondary. It is estimated that 30%–50% of women with endometriosis have an infertility problem, so a considerable number of endometriosis sufferers will require effective, planned contraception to maximize “protection of fertility” and prevent progression of the endometriotic condition. Ideally, this contraception should also provide symptom relief and improvement of physical, mental, and social well-being. At the present time, long-term progestogens appear to be the most effective choice for meeting all of these requirements,