To evaluate reasons for non-fulfillment and ongoing contraceptive plans of patients who desired but did not receive inpatient postpartum permanent contraception (PC).
Multi-site retrospective cohort ...study of 1254 patients with unfulfilled inpatient postpartum PC. We analyzed the reason for PC non-fulfillment, documented contraceptive plan, and method prescription or provision at hospital discharge, six-weeks, and one-year postpartum.
In our cohort, 44.3% of patients with unfulfilled inpatient PC did not receive any highly- or moderately-effective contraception within one year postpartum.
Removing barriers to PC fulfillment as well as contraceptive counseling that acknowledges these barriers is imperative.
Objective
The authors aimed to identify factors associated with long‐acting reversible contraception (LARC) usage.
Methods
The current cross‐sectional study used data from the National Survey of ...Family Growth from 2011 to 2019. Respondents aged 15 to 44 years were included. Those with previous sterilization, infertility, or pregnant were excluded. The outcome evaluated was use of a LARC.
Results
Of 61 543 814 women, 44 287 911 (72.0%) met inclusion criteria. The rate of LARC use was 13.4%. Factors associated with an increased likelihood of LARC usage were married/living with a partner (adjusted relative risk aRR, 1.18 95% CI, 1.02–1.37), perceived good health (aRR, 1.44 95% CI, 1.13–1.84), year of survey 2017 to 2019 (aRR, 1.53, 95% CI, 1.28–1.83), one or two past pregnancies (aRR, 1.62 95% CI, 1.24–2.12) or three or more past pregnancies (aRR, 1.67 95% CI, 1.22–2.28), age at first live birth <20 years (aRR, 1.58 95% CI, 1.20–2.08) or 20 to 24 years (aRR, 1.45 95% CI, 1.13–1.87), age at onset of sexual activity 13–19 years (aRR, 1.50 95% CI, 1.26–1.78), and a 0‐ to 5‐month period of nonintercourse in the past year (aRR, 1.63 95% CI, 1.40–1.90). Factors associated with decreased LARC usage were age ≥ 35 years (aRR, 0.74 95% CI, 0.65–0.85), being non‐Hispanic Black (aRR, 0.75 95% CI, 0.62–0.89) or non‐Hispanic other (aRR, 0.72 95% CI, 0.59–0.88), intending to have children (aRR, 0.65 95% CI, 0.57–0.74), and never being sexually active (aRR, 0.10 95% CI, 0.06–0.16).
Conclusions
Using a nationally representative sample of women in the United States, the authors identified modifiable factors associated with LARC use. Results may be used to plan interventional trials to increase LARC usage.
Synopsis
Several modifiable factors are associated with the use of long‐acting reversible contraception, used in only about 1 in 10 individuals as a contraceptive method.
Please cite this paper as: Cameron S, Glasier A, Chen Z, Johnstone A, Dunlop C, Heller R. Effect of contraception provided at termination of pregnancy and incidence of subsequent termination of ...pregnancy. BJOG 2012;119:1074–1080.
Objective To determine the incidence of subsequent termination of pregnancy (TOP) within a 2‐year period in relation to the method of contraception provided to women following the index TOP.
Design Case note review.
Setting NHS hospital TOP service, Edinburgh, UK.
Population Nine hundred and eighty‐six women requesting a TOP in 2008.
Methods Case notes were reviewed to determine the contraception provided at index TOP and whether women had subsequent TOP at the same hospital within 2 years.
Main outcome measures Incidence of subsequent TOP within 2 years amongst women receiving different contraceptive methods.
Results One hundred and twenty‐one women (12.3%) of the 986 who attended the clinic requesting a TOP returned requesting another TOP in the subsequent 2 years. Both intrauterine contraception and the progestogen‐only implant were associated with the lowest incidence of subsequent TOP. Using the combined oral contraceptive pill as the reference method, the odds ratios (ORs) and 95% confidence intervals (CIs) of a further TOP within 2 years with intrauterine contraception and the implant were OR = 0.05 (95% CI, 0.01–0.41; P < 0.001) and OR = 0.06 (95% CI, 0.01–0.23; P < 0.001), respectively. Women choosing the implant were significantly younger than those choosing the intrauterine method (P < 0.001).
Conclusion Women undergoing a TOP who wish to avoid another unintended pregnancy should consider immediate initiation of either intrauterine contraception or the progestogen‐only implant. Service providers should be trained and supported to provide these methods to women at the time of TOP.
Depression is common during pregnancy and the year following childbirth (the perinatal period). This study assessed the association of depressive symptoms and contraception decisions in perinatal ...individuals.
We conducted a secondary analysis using data from the PRogram in Support of Moms (PRISM) study, a cluster randomized controlled trial of active interventions which aimed to address perinatal depression. This analysis included 191 individuals aged 18–45 who screened positive for depression on the Edinburgh Postnatal Depression Scale (EPDS, score ≥10) during pregnancy or up to 3 months postpartum. We assessed contraception intent and method choice at 1–3 months postpartum. At 5–7 months postpartum, we assessed contraceptive method used and EPDS depression scores. We used logistic regressions to examine the relationship between depression and contraceptive use/method.
At 1–3 months postpartum, the majority of participants (76.4%) expressed an intention to use contraception. Of those, over half (53.4%) indicated a preference for higher effectiveness contraception methods. Participants with persistent depression symptoms (positive EPDS) at 5–7 months were significantly less likely to report using higher effectiveness contraceptive methods (aOR = 0.28, 95% CI = 0.11–0.70) compared to those without. Among participants with persistent depressive symptoms, 21.1% reported using a contraception method of lower effectiveness than had originally intended.
Perinatal individuals with persistent depressive symptoms at 5–7 months postpartum reported greater use of less-effective contraception methods than originally planned.
We found associations between perinatal depression and use of less effective contraception use. Provider discussions regarding contraception planning is important, particularly in those with perinatal depression symptoms.
Reproductive coercion is a behavior that interferes with the autonomous decision-making of a woman, with regard to reproductive health. It may take the form of birth control sabotage, pregnancy ...coercion, or controlling the outcome of a pregnancy. The objectives of this article are to address the questions: (1) What is known about reproductive coercion, its prevalence, and correlates? (2) What strategies do women use to preserve their reproductive autonomy when experiencing reproductive coercion? (3) What interventions are effective to decrease reproductive coercion? In this review of 27 research studies, 12 contained findings regarding the general phenomenon of reproductive coercion and 19 contained findings about at least one component of reproductive coercion. Additionally, 11 studies contained findings related to the intersection of intimate partner violence (IPV) and reproductive coercion, 6 presented data on strategies women use to resist reproductive coercion, and 3 included intervention data. Variation in measurement makes synthesis of prevalence and correlate data challenging. The reviewed literature presents reproductive coercion as a phenomenon that disproportionately affects women experiencing concurrent IPV, women of lower socioeconomic status, single women, and African American, Latina and multiracial women. Women who experience reproductive coercion were found to present frequently for certain health services. Most data on reproductive coercion are descriptive, and there is need for further research to examine the co-occurrence with related phenomena such as IPV and unintended pregnancy. More research is also needed on the strategies women use to resist reproductive coercion as well as interventions aimed at survivors and perpetrators of reproductive coercion and health-care providers who encounter them.
Postpartum contraception is essential to sexual and reproductive health (SRH) care because it encourages healthy spacing between births, helps women avoid unwanted pregnancies, and lessens the risks ...of health problems for mothers and babies. Sub-Saharan African immigrant and refugee populations are rapidly increasing in the United States, and they come from a wide range of cultural, linguistic, religious, and social origins, which may pose challenges in timely access to culturally acceptable SRH care, for preventing mistimed or unwanted childbearing. The objective of this scoping review is to assess the extent of the available literature on postpartum contraception among sub-Saharan African immigrant and refugee women living in the United States.
We developed preliminary search terms with the help of an expert librarian, consisting of keywords including birth intervals, birth spacing, contraception, postpartum contraception or family planning, and USA or America, and sub-Saharan African immigrants, or emigrants. The study will include the following electronic databases: PubMed/MEDLINE, PsycINFO, CINAHL, EMBASE, and the Global Health Database. The sources will include studies on postpartum care and contraceptive access and utilization among sub-Saharan African immigrants living in the US. Citations, abstracts, and full texts will be independently screened by two reviewers. We will use narrative synthesis to analyze the data using quantitative and qualitative methods. Factors associated with postpartum contraception will be organized using the domains and constructs of the PEN-3 Model as a guiding framework.
This scoping review will map the research on postpartum contraception among sub-Saharan African immigrant and refugee women living in the US. We expect to identify knowledge gaps, and barriers and facilitators of postpartum contraception in this population. Based on the findings of the review, recommendations will be made for advocacy and program and policy development toward optimizing interpregnancy intervals in sub-Saharan African immigrants living in the US.
Review registration Open Science Framework: https://osf.io/s385j.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Controlling population expansion and reducing unintended pregnancies through the use of modern contraceptives is a cost-effective strategy. In recent years, the rate of modern contraceptive use in ...Bangladesh has been declining. So, this study aimed to investigate the associated factors of the deterioration in modern contraceptive usage.
This study used data from two successive Bangladesh Demographic and Health Surveys (2014 and 2017-18) and applied the Blinder-Oaxaca decomposition analysis to understand the drivers. A popular binary logistic regression model is fitted to determine the factors that influence the use of modern contraceptive methods over the years.
This study revealed that highly educated women were more likely to use modern contraception methods, and their use increased by 3 percent over the years. Factors such as women's working status, husband's education, number of living children, and fertility preference were found significantly associated with decreased usage of modern contraception methods over years. The result of the Blinder-Oaxaca (BO) decomposition analysis found a significant decrease between 2014 and 2018. Respondent's age, working status, husband's age, opinion on decision making, region, and media exposure were the most significant contributors to explaining the shift between 2014 and 2018. The two factors that contributed most to narrowing the difference between the two surveys were women's decision on own health (26%), and employment status (35%).
The factors that influence modern contraceptive prevalence are important to know for policy implication purposes in Bangladesh. The findings indicate the need for further improvement of factors for balancing the usage of modern contraception methods.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities ...across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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