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Existing studies show a mixed relationship between intimate partner violence (IPV) and contraceptive use. This study assesses the association between women’s exposure to IPV and contraceptive use in India. Furthermore, we aim to determine whether husband’s controlling behaviors play a moderating role in the IPV-contraception link. We used nationally representative data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. In this study, the use of contraceptives is the outcome variable, categorized into three groups: no/traditional methods, modern methods, and female sterilization. Women’s exposure to IPV in the past year is the key exposure of interest. Socio-economic and demographic variables were used as covariates. Multinomial logistic regression models were performed to examine the association between women’s exposure to IPV and contraceptive use. Of the total participants ( N = 58,891), approximately one in every four women (24.1%) experienced any form of IPV in the past year. Slightly over half (50.8%) reported using either traditional methods of contraception or no contraceptive at all. About 14% of the respondents were using modern methods of contraception and 34.9% had undergone sterilization. After controlling for confounding factors, women who experienced IPV were 8% (95% CI [.87, .99]) less likely to report using modern contraceptives than those who did not face any IPV. Conversely, women who faced IPV were 14% (95% CI [1.09, 1.20]) more likely to undergo sterilization. Furthermore, women who experienced any form of IPV and whose husbands endorse controlling attitudes were 12% (95% CI [.81, .95]) less likely to report using modern contraceptives and 11% (95% CI [1.04, 1.17]) more likely to undergo sterilization. Interventions should be made to prevent violence against women that would increase their ability to choose appropriate contraception methods to avoid unintended pregnancies.

Data from National Family Health Survey (2015-2016) was analyzed to examine the contraceptive acceptance, discontinuation rates, and associated factors among reproductive age women in India over one year. Findings revealed that 11.7% accepted modern methods of which 68% were for spacing. Only 5% switched to other methods. Discontinuation rate was high among condom (56.8%) and oral contraceptive pill users (34.5%), among women aged less than 25 years, with parity less than 2, belonging to rural area, and having no education. Health concerns/side effects, husband’s disapproval, or method failure were most common reasons cited for discontinuation. The data show high discontinuation rates among some subgroups of women and for certain methods. Hence, women need to be provided options to switch methods to meet changing contraceptive needs and health priorities. Continuum of care with follow-up and counselling can facilitate sustained contraceptive use to avert unintended pregnancies.

The present study attempts to understand how the interplay between differential stopping behavior and contraceptive use dynamics may have resulted in the convergence of rural-urban fertility in West Bengal, India. Using data from the National Family Health Surveys and employing sequential logit regressions, we were able to confirm that differential stopping behavior, particularly among the rural women—by adopting contraception at first parity after having a boy, or choosing modern methods over natural methods at second parity after having two successive boys—may be one of the factors that led to the rural-urban convergence of fertility.

Family planning refers to the practices that help individuals or couples avoid unwanted births, regulate the intervals between pregnancies, and determine the number of children in the family. The present study was undertaken to know the extent of knowledge, attitude, and adoption of family planning methods among the married women of Jowai town, West Jaintia Hills District, Meghalaya. An attempt has also been made to find out the sociodemographic factors influencing the use of contraceptive methods among the studied population. The information on awareness as well as the use of contraceptives was collected from 719 married women of the reproductive age group 15–49 years using a structured scheduled. Among the women in Jowai town, the knowledge of family planning methods is widespread. In addition, a majority of the women have a favorable attitude towards family planning. However, there exists a gap between the knowledge and the practice of contraceptive methods among the women of Jowai town. Ingesting an oral contraceptive pill is the most preferred contraceptive method among the women. Contraceptive use among women is seen to be positively correlated with educational level and income (significant at p < 0.01), and negatively correlated with current age, age at marriage, number of live births, and family type (significant at p < 0.01). Bivariate analysis substantiates the role of women’s education, household income, current age, age at marriage, number of live births, and family type in influencing the utilization of contraceptive methods.

Despite extensive evidence that fundamental causes of health, such as socioeconomic status (SES) and race/ethnicity, often interact, the potential importance of such interactions has received limited attention in the contraceptive use literature. Even fewer studies have explicitly considered how interacting systems of power may structure contraceptive use with an intersectional framework. Drawing on the female ( N = 8,744) and male ( N = 5,826) samples of the 2006–15 National Survey of Family Growth (NSFG), this study relies on an intersectional approach to examine if education gradients in female and male sterilization vary by race/ethnicity. For non-Hispanic white respondents, results confirm the negative education gradient in female sterilization, and positive gradient in male sterilization. For non-Hispanic black and Hispanic respondents, education gradients tend to be less steep for female sterilization, but steeper for male sterilization. This indicates that different forms of oppression combine, overlap, and intersect to shape individuals’ unique social positions and experiences—including their contraceptive use.

Introduction: Unplanned pregnancy continues to be a global reproductive and public health concern among women. This study aimed to investigate whether factors associated with modern contraceptive use differ by age-group among young and older women of reproductive age. Methods: This was a cross-sectional study conducted among 433 women of reproductive age, with the median age of 25 years (interquartile range: 21–28), and aged between 18 and 49. Data were collected from 10 public health care clinics in Umlazi Township, KwaZulu-Natal, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson’s chi-square test and logistic regression models were employed to assess the level of the association between the predictor and outcome variables, and the p-value of 0.05 or lower was considered statistically significant. Results: Most women in the sample (n = 351, 81%) had obtained a secondary level of education, while 53% (n = 230) were unemployed and 89% (n = 387) were single. We found that women with secondary level of education (AOR: 2.89, 95% CI: 0.99–5.38) or a tertiary level of education (AOR 3.80, 95% CI: 1.07–3.53) were more likely to use contraceptive methods compared to women with lower education. Women who experienced unplanned pregnancy (AOR 0.51, 95% CI: 0.22–3.79) were more likely to use contraceptives. Women aged 25–49 years who experienced pregnancy, whether planned (AOR 3.87, 95% CI: 1.08–3.89) or unplanned (AOR 3.60, 95% CI: 2.15–4.19), were more likely to use a contraceptive method. Results showed that the level of education (p = 0.942) and whether one experienced unplanned pregnancy (p = 0.913) were not significant predictors of contraceptive use among women aged 18–24 years. Conclusion: Concerted educational efforts to addressing existing barriers deterring women from accessing contraception among young women are necessary. Different groups of women should be targeted with family planning interventions specific to their needs.

Recent research suggests oral contraceptive use is associated with altered memory for emotional story information, blunted stress hormone responses to emotional stimuli, and altered structure or function of the amygdala and hippocampus. This study examined the extent to which oral contraceptives influence relative recall of (a) the spatial location of emotional versus neutral stimuli and (b) positive versus negative emotional stimuli. Participants (58 oral contraceptive users, 40 nonusers, and 37 men) completed an Emotional Spatial Memory test and were evaluated on short-term recall and long-term (one week) recall. There was no evidence for group differences in recall of the locations of emotional versus neutral stimuli. However, oral contraceptive users remembered relatively more positive than negative items compared with nonusers and men on the spatial memory test. This effect was driven by oral contraceptive users recalling fewer negative items than free cyclers. The results indicate that hormonal contraceptives may decrease immediate recall of negative emotional stimuli.

Introduction: Women’s decision-making autonomy has a positive effect on the scale-up of contraceptive use. In Ethiopia, evidence regarding women’s decision-making autonomy on contraceptive use and associated factors is limited and inconclusive. Therefore, this study was intended to assess married women’s decision-making autonomy on contraceptive use and associated factors in Ethiopia using a multilevel logistic regression model. Methods: The study used data from the 2016 Ethiopia Demographic and Health Survey that comprised of a weighted sample of 3668 married reproductive age women (15–49 years) currently using contraceptives. A multilevel logistic regression model was fitted to identify factors affecting married women’s decision-making autonomy on contraceptive use. Akaike’s information criterion was used to select the best-fitted model. Results: Overall, 21.6% (95% confidence interval = 20.3%–22.9%) of women had decision-making autonomy on contraceptive use. Community exposure to family planning messages (adjusted odds ratio = 2.22, 95% confidence interval = 1.67–3.05), media exposure (adjusted odds ratio = 2.13, 95% confidence interval = 1.52–3.23), age from 35 to 49 years (adjusted odds ratio = 2.09, 95% confidence interval = 1.36–4.69), living in the richer households (adjusted odds ratio = 1.67, 95% confidence interval = 1.32–3.11), and visiting health facility (adjusted odds ratio = 2.01, 95% confidence interval = 1.34–3.87) were positively associated with women’s decision-making autonomy on contraceptive use. On the contrary, being Muslim (adjusted odds ratio = 0.53, 95% confidence interval = 0.29–0.95), being married before the age of 18 years (adjusted odds ratio = 0.33, 95% confidence interval = 0.12–0.92), and residing in rural residence (adjusted odds ratio = 0.48, 95% confidence interval = 0.23–0.87) were negatively associated with women’s independent decision on contraceptive use. Conclusion: Less than one-fourth of married reproductive age women in Ethiopia had the decision-making autonomy on contraceptive use. Media exposure, women’s age, household wealth, religion, age at marriage, visiting health facilities, community exposure to family planning messages, and residence were the factors associated with women’s decision-making autonomy on contraceptive use. The government should promote women’s autonomy on contraceptive use as an essential component of sexual and reproductive health rights through mass media, with particular attention for adolescent women, women living in households with poor wealth, and those residing in rural settings.

This study assessed the association between microfinance participation and contraceptive use and intention among 46,639 women between the ages of 15 and 49 years from the Bangladesh Demographic and Health Surveys (BDHS) 2007, 2011, and 2014 using chi-square tests and multinomial logistic regression. The multivariate model revealed that the model explained 14 percent of the variance in contraceptive use and intention. Adjusted beta coefficients revealed that when microfinance participation increased by one unit, use of modern methods of contraception significantly increased by 0.32. The study findings suggest that women are more likely to use modern methods of contraception when they participate in microfinance.

Most women of reproductive age have access to highly effective contraception, and all available methods are associated with side effects. Whether a woman will experience side effects is uncertain, however, which can pose challenges for clinicians who discuss the methods with patients. In this study, we analyze 102 contraceptive counseling visits to understand how clinicians discursively construct knowledge in the context of uncertainty. We find that while some present the uncertainty of side effects in a straightforward, patient-accessible way, others negotiate their predictions by (1) differentially constructing uncertainty, suggesting that positive side effects are likely and negative side effects are unlikely, and (2) contesting uncertainty, presenting the risk of serious side effects as controllable. In the end, these strategies deemphasize consideration of negative side effects in women’s contraceptive decision making. Our results demonstrate the importance of elucidating the translation, instantiation, and construction of medical uncertainty both in theory and in practice.

Contraceptive use in Nigeria at 15 per cent is low, despite a high human immunodeficiency virus (HIV) prevalence of 3.4 per cent and fertility rate of 5.7 per cent. We assessed the levels of spousal communication on family planning and contraception (FPC) and HIV/acquired immune deficiency syndrome (HIV/AIDS), influence of demographic characteristics on this communication and association between this communication and the respondents’ health behaviours. We used a cross-sectional and nationally representative data on reproductive health and HIV/AIDS-related issues from randomly selected 30,752 men and women of reproductive age. Descriptive statistics, Pearson chi-square (c2) and logistic regression were used to analyze the data at 5 per cent significance level. About 61 per cent of the respondents were 25–49 years old and mostly from rural areas (65 per cent). Only 20 per cent of the respondents discussed HIV/AIDS with their spouses within 12 months preceding the survey while 15 per cent discussed FPC. A discussion of both HIV/AIDS and FPC among spouses was reported among 9 per cent compared to 26 per cent who reported discussing either. Respondents aged 35–39 years had higher odds of discussing HIV/AIDS (Odds Ratios [OR] = 7.06:6.16–8.09) than those aged 15–19 years. Urban dwellers also had higher odds (OR = 1.24:1.16–1.31) of HIV/AIDS discussions than rural respondents. Modern contraceptive use was 35 per cent and 23 per cent among respondents who discussed FPC and HIV/AIDS compared to 8 per cent and 9 per cent, respectively, among those who did not. Spousal communication on FP and HIV/AIDS was low and has influenced contraceptive use and HIV positivity in Nigeria. There is a need to encourage spousal discussion on FP and HIV/AIDS, especially among the rural dwellers and the poor and uneducated as a strategy for improving modern contraceptive use.

Objectives: The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls’ sexual health knowledge and on its ability to influence their intentions to use effective contraception. Study Design: This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. Results: A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P < .001). Conclusions: This iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.

Although the rate of sexual intercourse among adolescents has increased in Asian countries, including Korea, many sexually active adolescents still do not use contraception. The aim of this study was to identify the risk factors for contraceptive nonuse among adolescents using decision tree analysis of the 2018 Korea Youth Risk Behavior Survey data from 2,460 high school students who had an experience of sexual intercourse. The findings indicated that the highest risk group who did not use contraception during sexual intercourse did not receive sexual health education in school and was involved in habitual or purposeful drug use. The experience of ever receiving treatment due to violence and the experience of sexual intercourse after drinking were also identified as risk factors for contraceptive nonuse. To encourage contraceptive use, development of standard sexual health education, counseling, and educational intervention intended to prevent risky behaviors is needed.

The aim of this article is to show a comparative analysis of contraceptive use in areas of traditionally high fertility that have gone through profound changes. Data have been taken from the latest Demographic and Health Surveys (DHS). Logistic regression models were adopted for four selected representative countries, namely Egypt, Mali, Namibia and Niger. There were two selection criteria: data should be recent, and selected countries should have high (Egypt 57.4%; Namibia 46.4%) or low (Mali 7.5%; Niger 10.0%) contraceptive use. The probability of using contraception when a woman has had one to four children is 2.4 times higher than when they have had no children. Contraception data are always gathered at a point of time, but cross-sectional data are not sufficient to understand all the mechanisms hidden behind contraceptive use. Different contraceptive behaviours need good estimation tools to develop specific family planning programmes.

Despite the progress made in the domain of family planning, the practice of the latter remains a current issue around the world, particularly in emerging and developing countries. This study examines the impact of traditional values and norms regarding family planning in Niger. Self-reported data were gathered – by means of a questionnaire – as to the variables likely to influence family planning practices (through contraceptive use). Participants were married females ( N = 200), between 21 and 50 years of age. The data were analysed using SPSS 15.0 software. The findings suggest that subjective norms have a direct effect on contraceptive use among women with no formal schooling, living in either rural or urban settings. For women with some formal schooling, it was their attitude towards family planning that had a direct effect on family planning practices. Suggestions for devising targeted family planning messages based on cultural values and norms have been proposed.

Background:Hormonal changes in natural menstrual cycles are known to modulate and even worsen headache symptoms in migraineurs; however, the impact of oral contraceptive pills (OCP), including combined oral contraceptive (COC) and progestogen-only pills on migraine symptomatology, is little investigated.Method:In this retrospective cohort study of 1758 migraine patients, data from 1032 female patients aged 15–45 years were accessed and their contraceptive methods, if any, were analyzed. Further comparisons were conducted between patients with OCP use and those without OCP use regarding the demographics, headache symptoms, and associated symptoms. Most OCP users in this study were assumed to have used COC, but information of individual hormone content of OCP was not collected. Patients with nonoral hormonal contraceptives were excluded for further comparison.Results:The use of OCP was common (47.8%) among the study cohort. Compared to those without OCP use ( n = 410), patients with OCP use ( n = 493) were younger (27.4 ± 7.0 vs. 32.8 ± 7.9, p < 0.001), had lower headache frequency (days per month, 11.1 ± 7.5 vs. 12.3 ± 8.8, p = 0.03), were less likely to have osmophobia (47.3 vs. 54.4%, p = 0.033) or cranial autonomic symptoms (44.8 vs. 53.2%, p = 0.013), and more commonly reported menstrually-related worsening of headache (52.3 vs. 42.4%, p = 0.012). The proportion of migraine with aura or other headache characteristics including severity, unilaterality, and pulsatile characteristic showed no differences between groups.Conclusion:Our data provide real-life information about contraceptive use among patients with migraine. The use of OCP is associated with differences in migraine symptomatology. Further studies are needed to determine whether this relationship is causal and any possible underlying mechanism.

Calcifying nested stromal—epithelial tumor (CNSET) of the liver is extremely rare. This tumor is characterized by nests of epithelial and spindle cells, an associated desmoplastic stroma, as well as variable calcifications and ossifications. Only 24 cases have been reported in the literature whereas none has been reported in Asian descendants. The authors report the first case of CNSET in a 34-year-old Asian woman and provide detailed histological and clinical follow-up data. Compared with those reported earlier, the present case with a history of oral contraceptive use displayed most typical features and the oldest age of onset. A retrospective study was made and the characteristics of CNSET were summarized.

This study aimed to determine the predictors of contraceptive use among married female youths and their husbands using the behavioral theory of the Health Belief Model (HBM). A community-based survey was conducted in a rural area of Myanmar in 2008. A total of 444 respondents (222 couples) were interviewed separately using a pretested, structured questionnaire. Significant predictors of contraceptive use were determined by univariate and multivariate analysis. Wife’s HBM perception was a highly significant predictor of contraceptive use in married youths (adjusted odds ratio = 10; 95% confidence interval = 2.7, 37.6). Wives aged 20 to 24 years and having their own income, experience of spousal communication, and shorter distance from home to health center were also significant predictors of contraceptive use. A poor agreement on HBM perception between wife and husband was noted. This study highlights the importance of HBM perceptions, wife’s income, spousal communication, and geographic barriers in contraceptive use among married youths in rural Myanmar.

The contra-life argument against contraception by Germain Grisez, Joseph Boyle, John Finnis, and William May maintains that contraception is always and everywhere morally wrong because it involves a contra-life choice to impede new human life. This article develops four problems that people might have with the contra-life argument and then shows that none of those problems undercut the argument. The most serious problem is that the contra-life argument seems to fail to show adequately what is wrong with impeding new human life, and this article neutralizes that problem by showing that choices to impede new human life are wrong because they involve unreasonable self-preference. Finally, this article shows that the moral character of contraceptive use for non-contraceptive reasons is often difficult to determine.

Religiosity, sexual activity, and contraception were examined via questionnaires and interviews in a diverse sample of 118 high school seniors. The majority reported religion to be important; importance and frequency ratings declined from private (e.g., prayer) to public (e.g., group activities) components of religion. Most were sexually active and used contraception. Nearly half acknowledged religious teachings on sexual activity, and one third believed premarital sex is proscribed. Religiosity items were negatively correlated with approval of sexual activity in hypothetical relationship scenarios, but religiosity was not related to self-reported sexual activity or contraceptive use. Participants emphasized relationships and physical health, not religious proscriptions, in their standards for sexual activity. Older adolescents may believe sexual activity is acceptable in committed romantic relationships.

The present article reports communities’ acceptance of and perceptions on contraceptive services provided by district health system among tribal and rural population of Andhra Pradesh, India. The study has been conducted in two tribal and two rural developmental blocks of Visakhapatnam district. Both quantitative and qualitative data were collected from married women of the age up to 40 years. Around 72 per cent of tribal women and 85 per cent of rural women had used or were currently using contraception. Currently the number of contraception users are higher among rural than tribal areas. The predominant method among both tribal and rural areas is female sterilisation, that is, tubectomy. These results suggest that despite the increased emphasis on contraceptive choice and on spacing methods in government programmes, female sterilisation continues to dominate the method mix, and spacing methods still account for only a negligible amount of contraceptive use. A majority of women received information on family planning from government health staff. Similarly, government institutions are the main source of contraception in both tribal and rural areas. Though, the quality of pre- and post-contraception care among the community is very important, the perceptions of the community on contraception care are not at desirable levels. Also, remarkably higher number of women who have undergone tubectomy (33 per cent of tribal and 45 per cent of rural women) had experienced various problems. These findings emphasise the continuing need to strengthen post-operative care and counselling for sterilisation acceptors. Some of the indicators of contraceptive service outreach are poor among the Scheduled Tribes as well as in rural population. Thus, the centralized top-down planning of healthcare services could not facilitate the tribal and rural people to articulate needs for services.

Understanding the dynamics of contraceptive use among women migrants is considered important, especially to a country like Thailand that is undergoing many changes, and an increasingly female-dominated migration during the last few decades. Using survey data collected in 2000, this study seeks to examine the determinants of modern contraceptive use among women migrants in Nang Rong, Thailand. The study found that several demographic and socioeconomic factors are significant predictors of contraceptive use among women migrants and the magnitude of such effects varies across different migrant types.

This study uses data from National Survey of Family Growth (NSFG) to determine the effect of religious belief among Roman Catholics on contraceptive use and to make recommendations for catechesis and education.

This article examines the effect of family planning programs on reproductive attitudes and contraceptive use behaviors. It aims to investigate the degree to which family planning programs enable Africans to shift to western contraceptive use from traditional and null contraceptive practices. It also examines the impact of the programs for both men and women. Data from the 1988 Ghana Demographic and Health Survey, the 1988–99 Ghana Living Standards Survey, and the 1988 Ghana Population Census are used. Categorical data analysis techniques are used to analyze these data. This study finds that access to family planning services is associated with reduced family size preferences, increased approval of family planning, and knowledge of, and desire to use, contraception among both men and women in rural Ghana. As Ghana, like many parts of rural Africa, is a highly underdeveloped and pro-natalist area, this article concludes that family planning programs have the ability to influence reproductive attitudes and behavior, even under conditions of limited development.

Estimates of fertility and contraceptive prevalence for the development blocks of Madhya Pradesh, based on Madhya Pradesh Target Couple Survey, 1996, indicates that contraceptive use was found to explain only one fifth of the variation in the levels of fertility at the development block level. This observed poor correlation between the fertility level and contraceptive use may be due to two reasons : (i) existing family planning services throughout the State are not of adequate quality and not easily accessible and (ii) they do not have the right orientation, i.e., they do not specifically target highly fecund women wanting to contracept.

Recently it was estimated that about one-third of postmenopausal British women aged 50-64 years currently uses hormone replacement therapy (HRT) for treatment of climacteric symptoms and for other medical reasons. To reduce an excess risk of endometrial cancer induced by oestrogens, modern HRT regimens contain either sequential or continuous progestogens. The protective effect of parity and oral contraceptive use observed in the majority of epidemiological studies on epithelial ovarian cancer (EOC) suggest that hormonal factors are likely to operate in ovarian carcinogenesis. However, the studies where HRT was examined in relation to the risk of EOC have reported conflicting results. The objective of this epidemiological review is to evaluate the risk of EOC in relation to the use of HRT, with particular focus on the few studies where oestrogens and progestogens in HRT were assessed separately. Further, the findings regarding HRT and EOC risk will be discussed in the context of available aetiological hypotheses. Finally, any clinical implications are commented upon.

The aim of this article is to examine the impact of maternal and child health care (MCH) service utilization on the timing of initiation and type of contraceptive use in the subsequent months after delivery of the most recent child. The required data were extracted from India’s third round of National Family Health Survey conducted during 2005-2006, which first time provides the 5 years retrospective monthly information about contraceptive history. Overall, 36,115 currently married women who had delivered live birth during 5 years preceding the survey were included in the analysis. Discrete-time complementary log-log multilevel model was applied to examine the impact of MCH service utilization on the timing of initiation and type of contraceptive use in the subsequent months after delivery of the most recent child. Result shows that after controlling the impact of socioeconomic factors, women who visited health center more than twice for antenatal care (ANC; coefficient = 0.28, SE = .02) were more likely to initiate modern contraceptive methods compared with women who had lower number of visits (coefficient = 0.16, SE = .02). Findings also show that compared with ANC visits, postnatal care did not emerge as a significant factor for contraceptive adoption. Study shows that among programmatic factors, all the three selected MCH indicators emerged as significant predictors of early contraceptive adoption. A significant program implication of the findings is that the promotion of more number of ANC visits, institutional delivery, and postnatal care within 2 weeks of delivery services should be regarded as a mechanism to promote postpartum family planning use.

been a rapId decline in the use of natural methods of family planning; a sharp rise and slow decline in the use of oral contraceptives and, in the past ten years, a major reliance on surgical sterilization for contraception. Information from these national surveys has provided useful information for contraceptive providers, policy makers, and religious groups. The method of avoiding and achieving pregnancy that is promoted and encouraged by the Roman Catholic Church is natural family planning. Since natural methods are the only methods sanctioned by the Catholic Church, an assumption could be made that contraceptive practices among Roman Catholics in the United States would substantially differ from contraceptive use by the general population. The purpose of this article is to describe the use of contraceptives by Roman Catholic women between 1988 and 1995 and to compare contraceptive use by Catholics with national trends. Information on trends in contraceptive use among Catholic women is of interest to Catholic health care providers and policy makers, natural

This letter to the editor reports on two cases of biopsy-confirmed cytolytic hepatitis induced by a levonorgestrel/ethinylestradiol combination oral contraceptive pill.

Objective: To determine the relationship between varicose veins and duration of menstrual life, age of menopause, pregnancy, oral contraceptive use and hormone replacement therapy (HRT). Design: Cross-sectional study. Setting: City of Edinburgh, UK. Participants: Eight hundred and sixty-seven women aged 18–64 years randomly selected from 12 general practices. Methods: After completing a questionnaire, which included questions on reproductive history, the women underwent a comprehensive clinical examination including the assessment of varicose veins (trunk, hyphenweb and reticular varices), followed by duplex scanning of their legs. Results: Women who had been pregnant at least once were more likely to have minor hyphenweb or reticular varices than women who had never been pregnant ( p ≤ 0.05). Women aged 35–54 years who were current users or ex-users of the oral contraceptive pill had a lower prevalence of trunk varicose veins than women who had never taken the pill ( p ≤ 0.10). HRT was also associated with a lower prevalence of trunk varices ( p ≤ 0.05). Conclusions: These results suggest that alterations in the balance of the sex hormones may have a role in the aetiology of varicose veins.

Should oral contraceptive use be prescribed in systemic lupus erythematosus (SLE)? In the last 5 years we have come a long way. The answer today is frequently yes whereas before the answer was almost always never. (excerpt)

This paper discusses methods to model the concept of synergy at the level of manifest categorical variables. First, a classification of concepts of synergy is presented. A dditive and nonadditive concepts of synergy are distinguished. Most prominent among the nonadditive concepts is superadditive synergy. Examples are given from the natural sciences and the social sciences. M delling focuses on the relationship between the agents involved in a synergetic process. These relationships are expressed in form of contrasts, expressed in effect coding vectors in design matrices for nonstandard log-linear models. A method by Schuster is used to transform design matrices such that parameters reflect the proposed relationships. A n example reanalyses data presented by Bishop, Fienberg, and Holland (1975) that describe the development of thromboembolisms in women who differ in their patterns of contraceptive use and smoking. Alternative methods of analysis are com pared. Implications for developmental research are discussed.

A researcher from the US Army Research Institute in Natick Massachusetts and a student from Wellesley College in Massachusetts examined routine use of oral contraceptives (OCs) and caffeine among 43 female college students and their effect on field dependence and color discrimination. They asked the student to complete a questionnaire about OC and caffeine use and characteristics of their menstrual cycles. They used the 100-Hue test to measure color discrimination and the Gottschaldt Hidden Shapes test to determine filed dependence. Since large within subjects variability from month to month in length of menstrual cycle existed the researchers could not collect phase specific color discrimination data from enough students to make accurate projections. 29 students ranked as field independent and 14 as field dependent. Similarly the distribution of color discrimination scores was skewed toward the higher end of the performance continuum (mean total error score=40.9 compared to 67.8 and 69.5 for 2 earlier studies). Field independent students scored better than field dependent students in discrimination of colors. OC nonusers performed significantly better than OC users in color discrimination in all cases. Yet increased caffeine use among OC users resulted in poorer color discrimination than nonusers. In fact high caffeine consumption among nonusers was significantly associated with better color discrimination than OC users. The researchers could not attribute causation to either OCs or caffeine because of study design limitations.

Contraceptive practices, especially oral contraceptive and intrauterine device use, were studied in four Nordic countries by recalculating published and unpublished data from previous surveys and statistics and by collecting new data from Finland. The sales of oral contraceptives were presented in defined daily doses, and the percentages of women using oral contraceptives were estimated from them. The percentages of intrauterine device users were calculated taking into account the number of intrauterine devices sold each year and the continuation of use from previous years. The results of the surveys were reanalysed. We found clear differences in contraceptive practices. Oral contraceptive use was most prevalent in Sweden and Denmark, and, especially at the end of the 1970s, Finnish intrauterine device use was very high. In the 1980s the differences dimished somewhat. These disparities in culturally and economically similar countries indicate that further research is needed to evaluate the factors influencing contraceptive practices.Researchers used sales data and data from fertility surveys to compare contraceptive practices among the 4 Scandinavian countries. Sales of oral contraceptives (OCs) remained relatively stable within each country, but women used OCs more often in Sweden and Denmark than in Finland and Norway. By the end of the 1980s, however, OC use was about the same in all 4 countries. IUD sales increased considerably more in the late 1970s in Finland than Denmark and Norway. The researchers could not find reliable IUD sales data for Sweden after 1981. IUD sales decreased in the late 1980s in all 3 countries, however. These figures did not take into account the fact that the life time of an IUD increased at this time. In addition, sales figures may have overestimated IUD users by 5-10%. In 1971, the condom ranked as the most prevalent contraceptive used among Finnish women (27%) followed by OCs (17%) and withdrawal (15%). In 1981, most Finnish women used the IUD (25%), especially copper releasing IUDs, followed by the condom (20%) and OCs (18%). In 1977, women tended to use the IUD (23%) in Norway. In 1981, the most popular family planning methods in Sweden were barrier methods (21%), OCs (19%), and the IUD (17%). In 1983, 24% of women in Denmark used OCs. An overall view showed that women in Finland and Sweden preferred to use OCs and IUDs than did women in Norway and Denmark. Maternity clinics in Finland tended to favor IUDs when offering contraceptive advise. In conclusion, researchers should conduct studies to determine those factors which influence contraceptive practices.

A study was conducted to determine (a) whether the lower pregnancy risk that sexually active college women attribute to themselves relative to "average"others results from underestimating their own risk or overestimating others' risk and (b) the relationship of this perceived difference to contraceptive use. Sexually active women, on the average, accurately rated their own and their best friend's risk and overestimated others' risk, although users of poor contraception did tend to overestimate the effectiveness of the methods they used. Coitally inexperienced women also overestimated others' pregnancy risk. Contrary to previous findings, perceived relative invulnerability to pregnancy was positively correlated with effectiveness of contraception, and poor contraceptors estimated their pregnancy risk to be higher than that of effective contraceptors. Implications of the findings for the theory of "unique invulnerability" to victimization are discussed.

A 24-year-old woman with a history of hereditary spherocytosis and oral contraceptive use presented with a spontaneous, isolated loss of great toe extension. She had clinical and electrodiagnostic evidence of a localized lesion affecting the nerve supply to the extensor hallucis longus (EHL). Full clinical recovery was apparent within 6 months with nonoperative therapy. Isolated EHL weakness may occur as a rare neurologic complication of procedures such as high tibial osteotomies, but, to our knowledge, this has not been reported in the absence of trauma or surgery. While the coexistence of hereditary spherocytosis and a peripheral neuropathy may have been purely coincidental, it is plausible that the isolated lesion in this patient was due to ischemic changes from underlying rheologic conditions, possibly in association with a variation in the neural or nutrient vessel supply to the EHL.

Purpose To examine the accuracy of Hispanic parents9 beliefs about their adolescents9 use of condoms and oral contraceptives. Design Cross-sectional survey. Setting The UCLA/Les Kelley Family Health Center. Study Participants Hispanic parents of adolescents (12-19 years old). Methods A written survey assessed parental beliefs about the effectiveness, safety, and usability of condoms and oral contraceptives. Preliminary Results Subject recruitment is currently in progress. To date, nine parents have participated in the survey. Sixty-seven percent of participants believe that condoms are very effective for STD prevention. Seventy-eight percent believe that condoms are very effective for pregnancy prevention when used consistently and correctly. Seventy-eight percent believe that oral contraceptive use prevents pregnancy all the time when used consistently and correctly, and 56% think that the pill is very safe to use. However, none of the parents believe that most teenagers are capable of using either condoms or oral contraceptives correctly. Plan Enrol another clinic in the study protocol, Hubert Humphrey Comprehensive Health Center. This clinic is located in south Los Angeles and serves a patient population that is over 50% Hispanic. We plan to collect an additional 91 surveys over the next 3 months.

Purpose Arterial stiffness, assessed by aortic pulse wave velocity (aPWV) and augmentation index (AIx), increases in menopause, yet there are no norms for these indices in younger women. This pilot study estimates ranges of aPWV (m/s) and AIx (%) during regular menstrual cycles (MC, 28 [138} 4 days) or triphasic oral contraceptive use (OC). Study Design Women 18-45 yrs., BMI = 18.5-26 were studied weekly for 8-16 wk. Groups MC (n = 16) and OC (n = 7). Methods Noninvasive applanation tonometry (SphygmoCorTM) supine (position 1) and standing (position 2). Menstrual phase estimated by previous cycle length and first day of menses or 1st day off OC. The distributions of aPWV and AIx in each phase were tested (histogram skewness, kurtosis, Kolmogorov-Smirnoff test) Results Inter-operator measurements were Conclusion Applanation tonometry has excellent inter-observer reproducibility when used by trained observers Reference ranges may be defined for aPWV and AIx in women, during each phase of MC or OC use. Anovulatory cycles may contribute to variability of aPWV and AIx. This pilot study will aid future investigations to detect and monitor cardiovascular disease in women across their reproductive life span. Supported in part by grant M01RR13297 from the National Center for Research Resources, NIH. (Table)

The relationship between the spread of mass education and fertility-limiting behavior is examined. Existing theories relating education to fertility limitation are integrated, including those relating the presence of educational opportunity to fertility decline, theories relating women's education to their fertility behavior, and theories relating children's education to the fertility behavior of their parents. Using survey data from a sample of 5,271 residents of 171 neighborhoods in rural Nepal, the individual-level mechanisms linking community-level changes in educational opportunity to fertility behavior are tested. A woman's proximity to a school during childhood dramatically increases permanent contraceptive use in adulthood. This finding is largely independent of whether the woman subsequently attended school, whether her husband attended school, whether she lived near a school in adulthood, and whether she sent her children to school. Strong fertility limitation effects were also found for husband's education and for currently living near a school. These effects were independent of other education-related measures. The largest education-related effect is for sending children to school