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Introduction : The National Family Planning and Welfare Program has been in place for more than 50 years, yet the high rate of unmet family planning need remains a significant obstacle for the program. The goal is to reach all women whose reproductive behavior necessitates the use of contraception but who, for a variety of reasons, do not use it. Objectives : This study aimed to determine the prevalence of different types of contraceptive methods adopted by eligible couples (aged 15-49 years) as a method of family planning. Methods : The present descriptive, cross sectional study was carried out amongst 200 women of reproductive age group in the Sonarpur rural area of West Bengal. Participants were interviewed by the trained staff using the pre-tested questionnaire. The information about various family planning methods adopted by couple was taken. Study was carried out from August 2023 to December 2023. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results : A total of 200 eligible couples were interviewed. Maximum couples were in the age group of 30-34 years i.e. 44 (40%). Total 110 (55%) couples were using one or the other method of family planning. Condoms were most commonly used method by 52 (47%) couples followed by oral contraceptive pills 32 (29%). Among permanent methods of family planning, tubectomy was adopted by 8 (7%) and vasectomy only by 6 (6%) couples. No one was practising any miscellaneous method of contraception. The percentage of family planning methods used by Hindus was maximum 84 (76.4%). The highest percentage of using family planning methods was used by upper middle class (41.8%) followed by middle class (34.5%) and least by lower middle class (5.5%). Conclusions : Almost 50% of couples who qualified did not use any form of birth control. The adoption of permanent methods of contraception, particularly vasectomy, ought to be encouraged among suitable couples. [ABSTRACT FROM AUTHOR]

Objective: To conduct research in order to determine the effect that antenatal counseling has on the use of contraception during the immediate postpartum period in the conservative society that exists in the rural areas surrounding Lahore, Pakistan. Study Design: Randomized Clinical Trial. Setting: Central Park Teaching Hospital in Lahore, Pakistan. Period: Jan, 2022 to April, 2022. Methods: A random selection was used to divide 400 antenatal patients who were at least 28 weeks along in their pregnancies into two groups. Patients who did not receive antenatal counseling regarding birth control options were included in Group X while patients who received antenatal counseling regarding the use of birth control were included in Group Y. A pre-designed proforma was completed following a written informed consent. Data was analyzed using SPSS 26. Results: Data was collected from 400 females (200 in each group) who visited CPTH. The mean age of the female participants was 27.26 + 4.78 years. Most of the participants lived in extended family systems. Nearly one third of the females was illiterate or has primary level of education. Approximately one-fourth of the females were graduated or above. After first pregnancy, 68% in group I and 86% in group II mentioned that they used contraceptive method, (p = 0.005, statistically significant). After second and fifth pregnancy, effect of counseling was affective and difference was statistically significant. The most common contraceptive method was barrier method followed by injection after first and second pregnancy. Conclusion: Antenatal contraceptive counseling proves to be a highly effective intervention in enhancing the acceptance and utilization of contraceptives within the conservative societies of Pakistan. Health care providers ought to undergo comprehensive training and exhibit unwavering motivation in order to effectively engage in antenatal contraceptive counseling. [ABSTRACT FROM AUTHOR]

Background: The etonogestrel contraceptive implant is currently approved by the United States Food and Drug Administration (FDA) for the prevention of pregnancy up to 3 years. However, studies that suggest efficacy up to 5 years. There is little information on the prevalence of extended use and the factors that influence clinicians in offering extended use. We investigated clinician perspectives on the barriers and facilitators to offering extended use of the contraceptive implant. Methods: Using the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured qualitative interviews. Participants were recruited from a nationwide survey study of reproductive health clinicians on their knowledge and perspective of extended use of the contraceptive implant. To optimize the diversity of perspectives, we purposefully sampled participants from this study. We used content analysis and consensual qualitative research methods to inform our coding and data analysis. Themes arose deductively and inductively. Results: We interviewed 20 clinicians including advance practice clinicians, family medicine physicians, obstetrician/gynecologist and complex family planning sub-specialists. Themes regarding barriers and facilitators to extended use of the contraceptive implant emerged. Barriers included the FDA approval for 3 years and clinician concern about liability in the context of off-label use of the contraceptive implant. Educational materials and a champion of extended use were facilitators. Conclusions: There is opportunity to expand access to extended use of the contraceptive implant by developing educational materials for clinicians and patients, identifying a champion of extended use, and providing information on extended use prior to replacement appointments at 3 years. [ABSTRACT FROM AUTHOR]

Hormonal contraceptives are widely prescribed due to their effectiveness and convenience and have become an integral part of family planning strategies worldwide. In the United States, approximately 65% of reproductive-aged women are estimated to be using contraceptive options, with approximately 33% using one or a combination of hormonal contraceptives. While these methods have undeniably contributed to improved reproductive health, recent studies have raised concerns regarding their potential effect on metabolic health. Despite widespread anecdotal reports, epidemiological research has been mixed as to whether hormonal contraceptives contribute to metabolic health effects. As such, the goals of this study were to assess the adipogenic activity of common hormonal contraceptive chemicals and their mixtures. Five different models of adipogenesis were used to provide a rigorous assessment of metabolism-disrupting effects. Interestingly, every individual contraceptive (both estrogens and progestins) and each mixture promoted significant adipogenesis (eg, triglyceride accumulation and/or preadipocyte proliferation). These effects appeared to be mediated in part through estrogen receptor signaling, particularly for the contraceptive mixtures, as cotreatment with fulvestrant acted to inhibit contraceptive-mediated proadipogenic effects on triglyceride accumulation. In conclusion, this research provides valuable insights into the complex interactions between hormonal contraceptives and adipocyte development. The results suggest that both progestins and estrogens within these contraceptives can influence adipogenesis, and the specific effects may vary based on the receptor disruption profiles. Further research is warranted to establish translation of these findings to in vivo models and to further assess causal mechanisms underlying these effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Contraceptive care is a key element of reproductive health, yet only 12%-30% of women report being able to access and receive the information they need to make these complex, personal health care decisions. Current guidelines recommend implementing shared decision-making approaches; and tools such as patient decision aid (PtDA) applications have been proposed to improve patients access to information, contraceptive knowledge, decisional conflict, and engagement in decision-making and contraception use. To inform the design of meaningful, effective, elegant, and feasible PtDA applications, studies are needed of all users current experiences, needs, and barriers. While multiple studies have explored patients experiences, needs, and barriers, little is known about clinicians experiences, perspectives, and barriers to delivering contraceptive counseling. OBJECTIVE: This study focused on assessing clinicians experiences, including their perspectives of patients needs and barriers. It also explored clinicians suggestions for improving contraceptive counseling and the feasibility of a contraceptive PtDA. METHODS: Following the decisional needs assessment approach, we conducted semistructured interviews with clinicians recruited from the Society of Family Planning. The Ottawa Decision Support Framework informed the interview guide and initial codebook, with a specific focus on decision support and decisional needs as key elements that should be assessed from the clinicians perspective. An inductive content approach was used to analyze data and identify primary themes and suggestions for improvement. RESULTS: Fifteen clinicians (12 medical doctors and 3 nurse practitioners) participated, with an average of 19 years of experience in multiple regions of the United States. Analyses identified 3 primary barriers to the provision of quality contraceptive counseling: gaps in patients underlying sexual health knowledge, biases that impede decision-making, and time constraints. All clinicians supported the development of contraceptive PtDAs as a feasible solution to these main barriers. Multiple suggestions for improvement were provided, including clinician- and system-level training, tools, and changes that could support successful implementation. CONCLUSIONS: Clinicians and developers interested in improving contraceptive counseling and decision-making may wish to incorporate approaches that assess and address upstream factors, such as sexual health knowledge and existing heuristics and biases. Clinical leaders and administrators may also wish to prioritize solutions that improve equity and accessibility, including PtDAs designed to provide education and support in advance of the time-constrained consultations, and strategic training opportunities that support cultural awareness and shared decision-making skills. Future studies can then explore whether well-designed, user-centered shared decision-making programs lead to successful and sustainable uptake and improve patients reproductive health contraceptive decision-making.

Introduction In India, Sustainable Development Goals (SDG) have placed high priority on Maternal and Child Health (MCH) and Family Planning (FP). According to various studies, female contraceptives have been widely accepted and over-reliant by men. In addition, men’s attitudes towards contraception and FP say a lot about gender disparity. Power disparities and gender-restrictive norms have also endured, making it difficult for married women to fulfill their unmet needs. Spouses may find it difficult to openly communicate their need for contraception and their preferences for reproduction if their husbands have a low gender equality mindset. Aim and objectives This study aimed to examine the prevalence and behaviors related to contraception as well as the level of knowledge about family planning (FP) among men in rural areas. It aimed to ascertain the attitude towards the limited participation of rural men in FP. Additionally, the study aimed to identify any associated health issues in females resulting from the absence of adequate family planning measures. Methods This interventional study will be conducted in a rural area of the Wardha district. It includes rural married men (aged 18-45) and a pre-test and post-test study will be conducted to attempt door-to-door visits and local working areas. Study implications This intervention-focused research methodology seeks to evaluate the understanding and behaviors related to contraception and family planning (FP) among rural men. The goal was to assess the effectiveness of a comprehensive FP education program in influencing knowledge, attitudes, and contraceptive utilization among men in rural communities.

The study comprehensively analyzed the nexus between economic growth, health expenditures, education, and the environment in Nigeria, using data obtained from Central bank of Nigeria and World Bank. By utilizing a robust dataset spanning from 1981 to 2021, the study employed autoregressive distributed lag (ARDL) approach to uncover intricate relationships. Results, both short-run and long-run analyses, reveal that health and education spending, and gross fixed capital formation positively correlated with economic growth. Conversely, the findings demonstrated that population growth and carbon dioxide emissions (CO2) exerted detrimental effects on economic growth due to the negative impact on the health of the working population. Additionally, the inverted U-shaped relationship between the macroeconomic footprint and income confirms the validity of Nigeria's Environmental Kuznets Curve (EKC) phenomenon. Lastly, the findings of this study hold important policy implications, emphasizing the need for technological advancements and innovative solutions to address the challenges associated with economic growth, health expenditures, education, and the environment in Nigeria. Policy measures promoting birth control through contraception and family planning should be embraced to effectively manage the country's rapidly growing population. [ABSTRACT FROM AUTHOR]

Objectives: To examine the contraceptive preferences of women based on their age and to track changes in these preferences over time. Methods: This was an observational, retrospective cross-sectional study. Data from 2742 patients were evaluated for this study. The patient group of the first 4 years was classified as Group I (n=1371) and the last 4 years was classified as Group II (n=1371). The preferred contraception methods between the groups and their changes across the years were examined. Results: Coitus interruptus was found to be the prevailing contraceptive method across all age groups, with 304 (70.9%) in 18-24 age group; 1314 (65.4%) in 25-40 age group; and 148 (48.8%) in 41-53 age group using this method. Breastfeeding rates were also analyzed across age groups, revealing that 11% of patients aged 18-24 years, 5% of patients aged 25-40 years, and 1.7% of patients aged 41-53 years were breastfeeding. Among these patients, 114 (74.5%) were not using any contraception method, while coitus interruptus remained the most popular choice. Conclusion: It was determined that there are many couples who do not have sufficient knowledge regarding family planning and birth control in our country. At the same time, the use of birth control methods has increased due to the increase in the education level of women and easier access to sexual health services. [ABSTRACT FROM AUTHOR]

After a spontaneous or induced abortion, people may desire to delay or prevent a future pregnancy and many desire to use contraceptive methods to do so. Contraception counseling and provision at the time of abortion care are important components to improve contraceptive access and convenience for people undergoing abortion care. The majority of hormonal and barrier contraceptive methods may be safely initiated at the time of medication or procedural abortion or shortly thereafter, although delayed initiation may be necessary in certain circumstances. A patient-centered approach to contraceptive counseling can identify patients' priorities and mitigate provider coercion or pressure. [ABSTRACT FROM AUTHOR]

The size of the world’s population has profound implications for demand for food, energy and resources, land use change and greenhouse gas emissions. This study examines why most population projections have underestimated world population growth, and the implications for actions required to achieve sustainable societies. The main determinant of future population is family size choices. Population projections by different research groups embed different assumptions about drivers of fertility decline. The common assumptions that fertility decline is driven by economic betterment, urbanisation or education levels are not well supported in historical evidence. In contrast, voluntary family planning provision and promotion achieved rapid fertility decline, even in poor, rural and illiterate communities. Projections based on education and income as drivers of fertility decline ignore the reverse causation, that lowering fertility through family planning interventions enabled economic advancement and improved women’s education access. In recent decades, support for family planning has waned, and global fertility decline has decelerated as a result. Projections calibrated across the decades of strong family planning support have not acknowledged this change and are consequently underestimating global population growth. Scenarios used to model sustainable futures have used overly optimistic population projections while inferring these outcomes will happen without targeted measures to bring them about. Unless political will is rapidly restored for voluntary family planning programs, the global population will almost certainly exceed 10 billion, rendering sustainable food security and a safe climate unachievable.

Fuelled by nationalism and Catholicism, the wartime Slovak state, a client state of Nazi Germany, aimed to promote population growth by forcing the return of women from public to private life and supporting Slovak Christian families, but also by stigmatizing and restricting any sexuality that was not reproductive. Under these circumstances, where women were shamed for not having enough children, all previously per- mitted methods of birth control were banned, and abortion was criminalized. One of the few remaining options for controlling one's fertility was a clandestine abortion. By examining files that document the criminal persecution of women who underwent abortions, this work aims to track alternative family planning practices, and thus the development of a loosely organized clandestine abortion network. It then examines the possibility of understanding abortion as a form of women's opposition to political and ideological aims to hinder their freedom of choice. At the same time, the article suggests that women's agency of this kind challenged the patriotic imperative to become a mother as well as the hegemonic narrative and idyllic picture of Slovak motherhood. [ABSTRACT FROM AUTHOR]

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The size of the world's population has profound implications for demand for food, energy and resources, land use change and greenhouse gas emissions. This study examines why most population projections have underestimated world population growth, and the implications for actions required to achieve sustainable societies. The main determinant of future population is family size choices. Population projections by different research groups embed different assumptions about drivers of fertility decline. The common assumptions that fertility decline is driven by economic betterment, urbanisation or education levels are not well supported in historical evidence. In contrast, voluntary family planning provision and promotion achieved rapid fertility decline, even in poor, rural and illiterate communities. Projections based on education and income as drivers of fertility decline ignore the reverse causation, that lowering fertility through family planning interventions enabled economic advancement and improved women's education access. In recent decades, support for family planning has waned, and global fertility decline has decelerated as a result. Projections calibrated across the decades of strong family planning support have not acknowledged this change and are consequently underestimating global population growth. Scenarios used to model sustainable futures have used overly optimistic population projections while inferring these outcomes will happen without targeted measures to bring them about. Unless political will is rapidly restored for voluntary family planning programs, the global population will almost certainly exceed 10 billion, rendering sustainable food security and a safe climate unachievable. [ABSTRACT FROM AUTHOR]

Empirically centring the hitherto unexplored mainstream Danish-Greenlandic Depo-Provera media debate, in this article, we show how syringes of synthetic progesterone circulated across bodies, borders, generations, and species to reproduce and disrupt animacy hierarchies in 'post-colonial' times. Feminist scholars have attended to the reproductive injustices revealed in the unequal global distribution of Depo-Provera. However, these critiques have not been brought into conversation with recent environmental humanities scholarship tracing toxic relationalities and their connections to toxic power hierarchies such as settler colonialism. This article connects this scholarship by foregrounding the ways in which birth control injections not only worked on feminised bodies to prevent pregnancies but also to highlight – and further expose – subordinated groups of reproductive subjects, rendered abnormal on the basis of ideas about agency and cognitive ability. To be treated with Depo-Provera was, in the debates, to be marked as Other – and to be marked as Other was to be marked as a candidate for 'The Shot'. [ABSTRACT FROM AUTHOR]

While hormonal contraceptives are efficacious and available in several forms for women, perception of safety and concern over side effects are a deterrent for many. Existing non-hormonal contraceptives include permanent sterilization, copper intrauterine devices (IUDs), chemical/physical barriers such as spermicides and condoms, as well as traditional family planning methods including withdrawal and the rhythm method. Individuals who wish to retain their fertility in the future can achieve highest adherence and efficacy with long-acting, reversible contraceptives (LARCs), though there is only one, the copper IUD, that is non-hormonal. As rates of unintended pregnancies remain high with existing contraceptive options, it is becoming increasingly attractive to develop novel pregnancy prevention methods for both women and men. Non-hormonal contraceptives can target a variety of critical reproductive processes discussed here. This review focuses on identified non-hormonal contraceptive targets and subsequent drug candidates in development. [ABSTRACT FROM AUTHOR]

This article explores the history of family planning during the Brazilian military dictatorship by focusing on the activity of The Society of Family Welfare (Sociedade do Bem-Estar Familiar no Brasil, BEMFAM), founded in 1965 and affiliated with the International Planned Parenthood Federation. BEMFAM's campaigns were met with criticism from various fronts. The Catholic Church condemned the use of contraception methods. The military, which had ruled the country since taking power in 1964, opposed BEMFAM's efforts to curtail population growth and its international partnerships. Leftist organizations attacked BEMFAM as well, denouncing its initiatives as a form of criminal Western imperialism. The denunciations ultimately led to a parliamentary inquiry into the activities of BEMFAM. Analyzing the dictatorship's intelligence reports, state records, and BEMFAM's publications, the article elucidates how population control models, Cold War ideologies, and gendered politics shaped health and reproduction in military Brazil. [ABSTRACT FROM AUTHOR]

Providing the conceptional framework of the special issue and discussing its main hypotheses, the introductory article points out that extraordinary vivid discourses on birth control in journalism emerged during East Central Europe's interwar period. They fought for more liberal attitudes towards birth control, but were combined with a peculiar emphasis on the nation, since they were more intensively colored by and integrated in nationalizing discourses. Thus, they became an essential part of the question of how the society should like, so that they were only partly a reflection of female self-empowerment. Thus, birth control as a core method of family planning at that time had become an issue of national survival. [ABSTRACT FROM AUTHOR]

The article outlines the developments in the national concept of family planning with particular reference to the female agents of healthcare and social policy measures from the turn of the century up to 1944. After the lost war and the shattering Treaty of Trianon in 1920, Hungary found itself in a deepening demographic crisis. High infant mortality and criminal abortion rates, the deficiency of graduate midwives, and the one-child system in the south-western part of the country concerned both politicians and intellectuals. The paper aims at connecting the medical, political, and social discourses based on archival and press sources on family planning by analyzing the role and agency of different women's organizations. I argue that state social policy measures and aid actions of the church and civic organizations and associations principally assigned two types of roles to women. On the one hand, they were active participants and agents, on the other hand, they were passive subjects and beneficiaries of social assistance activities. Furthermore, the article highlights the role of medical professionals (doctors, midwives, nurses) intersecting with the role of women as active agents in the execution of social policy measures. By integrating documents on family planning such as journal articles, political speeches and criminal abortion data into the national and political discourses, the article claims that women have often played contradictory roles in the process of family planning. Midwives and nurses who served as gatekeepers either helped women by providing access to birth control and abortion or complied with the regulations of the pro-natalist state, depriving women of choice. [ABSTRACT FROM AUTHOR]

In the territories of the Russian Empire populated by the Latvians, the years of the First World War (1914–1918) and the ensuing Latvian War of Independence (1918–1920) witnessed a significant transformation in the discourse on family planning and birth control. Because men were mobilized, there was a marked fall in the number of registered marriages, which meant that women had only a slim chance of marrying and planning a family. The nation's ideologues faced a challenge: how to restrain Latvian women from marriages and casual relationships with soldiers of the multi-ethnic Russian army and the occupying German army, who had been stationed in the Latvian-populated provinces since 1915, these having been separated by the battlefront. Women's demographic behavior was changing, with sexual life beginning before marriage, giving rise to a phenomenon of casual liaisons. Latvian nationalists, seeking to prevent such casual relationships in the name of the future they imagined for their people, promoted sexual restraint, which became at this time one of the strategies of the nation-building process. This article examines the wartime possibilities for marriage and the family planning associated with it and investigates the discourse of the propaganda of sexual restraint that was maintained and developed by Latvian nationalists, looking at their assessment of the situation and the principles they formulated for the appropriate (non-) use of sexuality, which in that context acted as a birth control instrument. The article looks at the role of abortion as a traditional means of birth control, and how the wartime conditions affected the number of children born outside of marriage. The research is based mainly on analyses of press materials, statistical data, and archival documents. [ABSTRACT FROM AUTHOR]

The objectives of the debates on birth control and thus of the concepts of family planning had changed in East Central Europe after World War I as a result of the founding of nation states. The respective dominant as well as non-dominant national groups colored them nationally by focusing on the development of their own nation. A particular example of the inherent national coloration of the transnationally effective discourses on birth control is the Polish-Jewish women's weekly Ewa. In the late 1920s, when a nationwide marriage and abortion law was being negotiated under the conditions of an authoritarian regime in Poland, Ewa took up these debates in order to sketch a specific Polish-Jewish image of the family. The publication also embraced birth control as a national challenge, but did so under a Zionist banner. The article assesses Ewa's important contributions to tracing and influencing the understanding of birth control and the images of modern families and women in the Polish-Jewish milieu during the interwar period. [ABSTRACT FROM AUTHOR]

Vijayan K Pillai, SP 1 sp Julieann Lynn Nagoshi SP 2 sp SP 1 sp School of Social Work, University of Texas at Arlington, Arlington, Texas, USA; SP 2 sp Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, Arizona, USA Correspondence: Vijayan K Pillai, School of Social Work, University of Texas at Arlington, 211 South Cooper Street, Arlington, TX, 76019, USA, Email [email protected] Introduction Contraceptive use was a contentious issue during the course of the 19th century with it being illegal to provide contraception information in the US well into the 20th century.[1],[2] In a rapid about-face, the period that followed was marked by the introduction of several birth control methods as well as a feverish stage of contraceptive research and development.[3] The impetus for the innovations in birth control technology was provided by Margaret Sanger, whose activism paved the way for the landmark 1965 Supreme Court case Griswold v. Connecticut which overturned the ban on contraceptives for married couples.[4] In the 1900s, the family planning movement took hold in the US, during a period of intense concern over the socio-economic consequences of overpopulation, poverty, and insecurity, as foretold by Malthus more than two centuries ago.[4] As early as the second decade of the twentieth century, organizations, such as the International Labor Organizations had declared "Poverty anywhere is poverty everywhere".[5] Partly as a measured defense against security concerns, Dr Reimert Ravenholt, the first director of the Office of Population at the US Agency for International Development (USAID), and Global family planning assistance program spearheaded a massive international family planning program primarily to contain poverty.[6] He oversaw the disbursement of nearly 1.4 billion dollars for family planning programs worldwide during his 14 years at the office, 1965-1979. [Extracted from the article]

Contraception is widely used in the United States, and nurses in all settings may encounter patients who are using or want to use contraceptives. Nurses may be called on to anticipate how family planning intersects with other health care services and provide patients with information based on the most current evidence. This article describes key characteristics of nonpermanent contraceptive methods, including mechanism of action, correct use, failure rates with perfect and typical use, contraindications, benefits, side effects, discontinuation procedures, and innovations in the field. We also discuss how contraceptive care is related to nursing ethics and health inequities.

Public funding plays a key role in reducing cost barriers to sexual and reproductive health (SRH) care in the United States. In this analysis, we examine sociodemographic and healthcare seeking profiles of individuals in three states where public funding for health services has recently changed: Arizona, Iowa, and Wisconsin. In addition, we examine associations between individuals' health insurance status and whether they experienced delays or had trouble in obtaining their preferred contraception. This descriptive study draws on data collected between 2018 to 2021 in two distinct cross-sectional surveys in each state, one among a representative sample of female residents aged 18–44 and the other among a representative sample of female patients ages eighteen and older seeking family planning services at healthcare sites that receive public funding to deliver this care. The majority of reproductive-aged women and female family planning patients across states reported having a personal healthcare provider, had received at least one SRH service in the preceding 12 months, and were using a method of birth control. Between 49–81% across groups reported receiving recent person-centered contraceptive care. At least one-fifth of each group reported wanting healthcare in the past year but not getting it, and between 10–19% reported a delay or trouble getting birth control in the past 12 months. Common reasons for these outcomes involved cost and insurance-related issues, as well as logistical ones. Among all populations except Wisconsin family planning clinic patients, those with no health insurance had greater odds of being delayed or having trouble getting desired birth control in the past 12 months than those with health insurance. These data serve as a baseline to monitor access and use of SRH services in Arizona, Wisconsin, Iowa in the wake of drastic family planning funding shifts that changed the availability and capacity of the family planning service infrastructure across the country. Continuing to monitor these SRH metrics is critical to understand the potential effect of current political shifts. [ABSTRACT FROM AUTHOR]

Introduction: in Cameroon, and more specifically in the Buea Health District of the Southwest Region, there are still a few unmet family planning needs. Many women desire to avoid getting pregnant, but do not use an effective form of birth control. A focus group discussion among married women in the Buea health district was necessary to explore the determinants of unmet family planning in order to promote access to and use of long-acting modern contraceptive methods because most research studies have only focused on the quantitative aspect. Methods: focus groups were held in the community and in the medical facilities as part of the study's qualitative exploratory strategy. To invite the participants, invitations were sent out. A qualitative survey of 10-12 respondents was carried out by the researcher, in each Focus Group the discussed topics included factors that encourage the use of FP methods, making the switch from traditional to modern FP methods, family planning methods decision-making, accessibility of FP in the context of the COVID-19 pandemic. Each focus group discussion lasted 1 hour 30 minutes, the perception was collected in an audiotape recorder and later transcript verbatim. The team conducted 10 Focus Group Discussion (FGD) (four of each of the topic areas). The FGD team provided participants with light refreshments. Results: a total of 10 focus groups were conducted, reaching a total participant of 107. The N-Vivo analysis software was used to analyze the data. The following are some of the key participant perceptions that have been reported. Perceptions of family planning; for health reasons as well as social expectations and pressures, having children earlier in marriage was a wise decision. While there are certain issues with having children early in life, such as the mother's maturity and financial stability, having a kid as soon as feasible is the best option. It is best to have children within the first two years of marriage, with a three-to-five-year gap between them. Reasons for changing from traditional to modern family planning; The most significant issues with current birth control techniques (such as condoms, pills (postinor-2), implants, injectables, and IUDs) are those that affect a woman's body. Regardless of the issues, they experience with contraception, there are some benefits to utilizing it. Both modern and classic FP methods have the potential to fail. Making family planning decisions; extended families, particularly mothers-in-law, have a strong influence on family planning and size decisions, and family members assist in resolving FP issues and challenges. Participants want to know about the adverse effects of current birth control techniques, especially in the long run, and how contraceptives affect a future pregnancy. Accessibility of FP in the context of the COVID-19 pandemic; participants have mixed perceptions of whether the COVID-19 context influences their accessibility to family planning. Conclusion: the focus groups demonstrated that participants have a nuanced and sophisticated awareness of pertinent topics that significantly impact them. While cultural and social conventions surrounding family planning difficulties and decision-making continue to put pressure on women, traditional and modern family planning methods are wellknown. Participants also reported a strong desire to learn more about family planning alternatives, the effects of different methods on their bodies, and to have access to a wider selection of general and specialized family planning services. Fear was produced by the backdrop of COVID-19, but women are rapidly overcoming these fears to have access to family planning. [ABSTRACT FROM AUTHOR]

In India, traditional social practices around marriage, such as non-involvement of prospective brides in choice of partner and timing of marriage, child/early marriage, dowry and purdah, compromise women's agency at the time of marriage and may also affect contraceptive practices in marriage. This paper examines the associations between traditional marital practices and contraceptive behaviours, including women's control over contraceptive decision-making, couples' communication about contraception, and ever use of contraceptives, among married women aged 18–29 years (N = 1,200) and their husbands in rural Maharashtra, India. Multivariable logistic regression was used to examine the association between these marginalising social practices and family planning behavioural outcomes, adjusting for demographic and parity confounders. Wives who were the primary decision-makers on who to marry had higher odds of ever having communicated with their husband on pregnancy prevention (AOR 1.76, 95% CI 1.16-2.68), and ever using modern contraceptives (AOR 2.19, 95% CI 1.52-3.16). Wives who were the primary decision-makers on when to marry also had higher odds of ever having used modern contraceptives (AOR 1.86, 95% CI 1.21-2.93). Women's involvement in marital choice may facilitate couples' engagement related to family planning, possibly via the establishment of better communication between partners. [ABSTRACT FROM AUTHOR]

At the same time, most programs focus more on indicators that measure health status, service provision or utilization, or the success of reproductive health interventions at the subnational level (WHO, [40]). Data for these indicators come from nationally representative surveys such as the Demographic and Health Surveys and Multiple Indicator Cluster Surveys, but not all countries conduct these surveys on a regular basis or conduct them using the same population (e.g., exclusion of unmarried youth), and there are limitations to the measures derived from them (e.g., the fixed age range). In August of 2021, the Editorial Committee of I Studies in Family Planning i put out a call for abstracts for a special issue focused on indicators in sexual and reproductive health and rights. Another prevalent theme in the papers in this special issue involves the need for better measurement of psychosocial and socioecological factors that influence sexual and reproductive health-related behaviors. [Extracted from the article]

This study aimed to evaluate the proportion of contraception users among Lebanese youth, and the extent of knowledge and perception on birth control; and to raise awareness and sensitise young adults to sexual health, which remains taboo in Lebanon. The 30-item questionnaire was broadcasted to students in private and public universities in Lebanon, through social media and it collected information on contraception use and student knowledge. Over 30% of responders were medical students, and 41% have ever used contraceptives (mostly women); among which, 52.1% for contraception versus 47.9% for medical reasons. According to responders, the pill ranked high in terms of effectiveness (72.4% of responders perceive the pill as effective), followed by the male condom (69.1%) and the hormonal intrauterine device (29.6%). Some would not use contraception in the future, for religious reasons (30.8%) or for fear of complications (46.2%); indeed, around a third of contraceptive users (all female) have experienced adverse effects. Finally, students expressed concern about long-term complications of contraceptive use (pulmonary embolism/phlebitis, breast/endometrial/ovarian cancer, stroke, depression and myocardial infarction). Though less frequent than in the Western world, contraception use in Lebanon is non-negligible and gaps in university students' knowledge on contraception were identified; which should prompt sexual education and family planning initiatives in Lebanon. [ABSTRACT FROM AUTHOR]

"The Family Planning Association and Contraceptive Science and Technology in Mid-Twentieth-Century Britain" by Natasha Szuhan is a historical account of the Family Planning Association (FPA) in Britain. The book explores the FPA's role in demystifying and legitimizing contraception and sex as medical and social phenomena. It draws on the FPA's archives and engages with recent scholarship on contraceptive technologies. The book examines the FPA's involvement in developing standards for contraceptive care, endorsing specific technologies, conducting research, and lobbying on medical issues. It also explores the relationships between the FPA, the British government, the contraceptive industry, and medical lobbying groups. The book provides valuable insights into the social history of mid-twentieth-century contraceptive technologies and is recommended for researchers interested in sexuality, contraception, and public health. [Extracted from the article]

Background: It is predicted that the population of sub‑Saharan Africa will be thrice its size by the end of the 21st century. Our study compared patterns, incentives and disincentives for the uptake of contraceptives in rural and urban communities of Lagos, Nigeria. Materials and Methods: This is a population‑based cross‑sectional study on 1445 women of reproductive ages 15–49 years using a cluster sampling technique and a pre‑tested, interviewer‑administered electronic questionnaire in 2020. Data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 26.0 and ethical approval was obtained for the study. Results: About 32.4% of the respondents were rural dwellers and 67.6% were urban residents. The overall mean age was 31.7 ± 7.8 years. In terms of pattern, slightly over half (53.3%) of all respondents had ever used family planning (FP), including modern contraceptives and slightly less than a third (30.8%) currently use FP methods in both rural and urban communities, respectively. Predominant disincentives for non‑use of FP include a desire to retain fertility, lack of further need, unbearable side effects and lack of spousal support. The odds of being an urban dweller currently using a method of contraceptive method is 4.169 times higher for earners above ₦60,000, which is twice the minimum wage compared to those without income (adjusted odd’s ratio: 4.169, 95% confidence interval: 1.395–12.462). Conclusion: Sustained effort is required to improve contraceptive uptake, FP service delivery and demand satisfaction for modern contraceptives to enable the achievement of demographic dividends and gains. [ABSTRACT FROM AUTHOR]

The study investigated the determinants of family planning choices and barriers among women attending private fertility clinics in Delta State. A stratified sampling technique was used in selecting three (3) private fertility clinics in Delta State while a simple random sampling technique was employed in selecting 156 participants out of a total population of 1,560 women that are registered with the private fertility clinics. A self-structured, pre-validated questionnaire was designed by the researchers as the instrument for data collection. The questionnaires were administered to the participants and 140 were successfully retrieved for data analysis. Simple percentages and frequency count was adopted as statistical tools for analyzing the obtained data while chi-square technique was used in testing the five (5) formulated hypotheses. Results findings obtained from the analysis revealed that family planning choices and barriers among women attending private fertility clinics in the study area are determined by; health, economic, social, religion, and cultural factors. Hence, the need for the government of Delta State to provide quality, subsidized, and comprehensive family planning services capable of substituting the prevalent traditional family planning methods while considering health, economy, social, religion and culture as necessary factors that might pose as barriers to the choices of these women towards sustainable family planning choices. [ABSTRACT FROM AUTHOR]

This article describes the reproductive governance deployed in Burundi, which promotes fertility control through uptake of modern contraceptives as a solution to the economic hardship and land pressure of individuals and communities. Using a qualitative approach, we explore how women and couples in rural Burundi set their preferences, choices and practices of family planning, and how they relate with the government discourse. We describe how reproductive practices are complex and modulated by social and material factors and power dynamics. We argue that the current hegemonic discourse—largely supported by external donors—adopts a depoliticised and technocratic approach to family planning that aligns with neoliberal development frameworks, leaving existing power dynamics and resources distribution issues unexamined and unaddressed. By situating reproductive navigation in context, we show how medicalisation of reproduction is not fully enacted, and partly resisted by women and other actors. [ABSTRACT FROM AUTHOR]

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Kehinde Osinowo,1 Fintirimam Sambo-Donga,1 Oluwaseun Ojomo,1 Segun Emmanuel Ibitoye,1 Philip Oluwayemi,1 Morounfola Okunfulure,1 Oladapo Alabi Ladipo,1 Michael Ekholuenetale1,2 1Association for Reproductive and Family Health, Trade and Convention Center, Abuja, Nigeria; 2Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, NigeriaCorrespondence: Kehinde Osinowo Email osinowo.k@arfh-ng.orgBackground: Injectable contraceptives are fast becoming the method of choice among women in sub-Saharan Africa (SSA). Specifically, the subcutaneously administered depot–medroxyprogesterone acetate (DMPA-SC) is gaining traction as a convenient, private and effective method to address unmet need for family planning (FP). The objective of this study was to determine the trend in DMPA-SC use in Nigeria.Methods: Data was extracted from the National Health Management Information System (NHMIS) FP register on DMPA-SC uptake in public health facilities and through community-oriented resource providers (CORPS) in 10 Nigerian states. The linear trend model was adopted in data analysis based on lowest measure of dispersion and/or highest adjusted coefficient of determination (R2). The statistical significance was determined at 5%.Results: There was an upward trend in the use of DMPA-SC among clients who received the service through health providers, CORPS and self-injection in the 10 project states over a period of 12 months (August 2019–July 2020). In addition, the linear trend model showed that for every unit increase in months, the average number of women expected to use DMPA-SC through health providers, CORPS and self-injection will increase by 1308.3 (Yt = 3799.7 +1308.3*t), 756.73 (Yt = − 1030.8 +756.73*t) and 77.864 (Yt = − 159.7 +77.864*t) respectively. In all models, the adjusted coefficient of determination was 99.9% which showed good model fitness. The results also showed that the number of DMPA-SC clients varied across the project states with Niger (32,988) and Oyo (31,511) states reporting the highest number of clients over the period of 12 months.Conclusion: There was an increasing use of DMPA-SC and self–injection among clients over time. Health facility and community-based FP programs should be strengthened to ensure improved access to FP services.Keywords: family planning, contraceptive, Nigeria, DMPA-SC, self-injection, birth control

IntroductionContraception discontinuation is a major public health issue that leads to unwanted pregnancies and unsafe abortions. Therefore, this systematic review and meta-analysis aimed to estimate discontinuation of contraceptives and its determinants in Ethiopia.MethodsPubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed.ResultsOut of 654 studies assessed, 20 met our criteria and were included in the study. The total number of study participants was 8,780. The pooled prevalence of discontinuation of long acting reversible contraceptive use was 36.94% (95% CI: 28.547–45.326). According to sub-group analysis, Amhara region (45%) and institution-based studies (47.9%) had the highest prevalence. The most common reason for contraceptive discontinuation was negative side effect (42.3%).Women experienced side effects (AOR = 2.833:95% CI:2.005–4.003), didn't receive counseling on side effects (AOR = 2.417; 95% CI: 1.591–3.672), didn't appoint follow up (AOR = 2.820; 95% CI: 2.048–3.881), dissatisfied with the given service (AOR = 5.156; 95% CI: 3.644–7.296), and a desire to be pregnant (AOR = 2.366; 95% CI: 1.760–3.182) were predictors of discontinuation of contraceptives.ConclusionIn Ethiopia, the pooled prevalence of long acting contraceptive discontinuation was high. Side effects, not being informed about side effects, dissatisfaction with the provided service, no insertion follow-up, and a desire to become pregnant were all associated factors. Healthcare professionals should focus on the client's reproductive goals, proper management of side effects, counseling, and post-insertion visits.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347860, identifier CRD42022347860.

Altered childbearing behaviour has been observed in many settings of violent conflict, but few studies have addressed fertility control. This is the first study to investigate empirically the relationship between local conflict and uptake of sterilization, the only contraceptive method that reflects a definitive stop to childbearing. The study is based on Colombia, a middle-income, low-fertility, and long-term conflict setting. It builds on a mixed methods approach, combining survey and conflict data with expert interviews. Fixed effects regressions show that local conflict is generally associated with an increased sterilization uptake. The interviews suggest that women may opt for sterilization when reversible methods become less accessible because of ongoing violence. Since sterilization is a relatively available contraceptive option in Colombia, it may represent a risk-aversion strategy for women who have completed their fertility goals. These findings can enlighten research and programmes on fertility and family planning in humanitarian contexts. [ABSTRACT FROM AUTHOR]

The first IUD was designed by the German physician Ernst Gräfenberg; Helena Wright began using it with her patients from 1929 onwards (chapter 5), becoming one of the first doctors to recommend IUDs in England, together with Norman Haire. While the women doctors Rusterholz studied show a clear conscience of women's discrimination, contemporary feminist organisations and some of their most important leaders kept their distance from the birth control movement. The international scope of the family planning movement and the important role played by women doctors, especially British women doctors, in this movement, is discussed in chapters 3 and 4. [Extracted from the article]

Long-acting reversible contraceptive (LARC) methods are effective options for pregnancy prevention. Currently available products in the United States include an etonogestrel implant, a copper intrauterine device (IUD), and several levonorgestrel IUDs. With increasing prevalence and duration of use, our understanding of efficacy, risks, and benefits has evolved. In addition to a brief discussion on nomenclature and LARC use within a framework of bodily autonomy and reproductive justice, this review covers clinical challenges with placement and removal, evidence-based duration of use, and how to mitigate side effects. Although all obstetrician-gynecologists as well as primary care clinicians can safely provide LARCs, complex family planning specialists are an expert referral source for challenging cases and evidence-based care as contraceptive technology continues to develop. [ABSTRACT FROM AUTHOR]

Objective: To determine the family planning methods used by refugee women of reproductive age and the factors affecting their choices. Material and Methods: Parameters such as women age, duration of marriage, number of gravidity and birth, socioeconomic status, educational level, and the contraceptive methods preferred by foreign national women who presented to family planning (FP) outpatient clinic between January 1st, 2013, and October 31st, 2020 were documented and assesed. Results: A total of 721 participants were included in the study. The cumulative percentage of Syrian women who applied to FP clinic was 1.7% in 2013, and this rate was 91.1% in 2019. Syrian women made up 93.6%, Afghan women 2.5%, and Iraqi women accounted for 1.9%. The most preferred contraceptive methods were intrauterine devices (IUDs) (51.1%) and bilateral tubal ligation (BTL) (33.2%). Illiterate women preferred IUDs (56.5%) more, and women with university education preferred BTL (74.1%) (p=0.008). Women with low-income mostly preferred IUDs (54.1%), whereas high-income women mostly preferred BTL (56.9%) (p=0.001). IUDs and BTL were the most common birth control methods used by women from countries outside of Syria. Conclusion: Effective and appropriate contraceptive methods should be explained to immigrant women because the education and income levels of refugees affect the choice of contraception. [ABSTRACT FROM AUTHOR]

The majority of people in Poland self‐identified as Catholic throughout the second half of the twentieth century. Despite the Polish Episcopate's unanimous rejection of contraception as immoral and sinful, a considerable proportion of Polish Catholics utilized family planning techniques and technologies explicitly banned by their institutional Church. This article uses personal narratives to show how Polish Catholics negotiated their use of Church‐authorized and Church‐banned family planning methods with their lived experiences of faith in a communist state where both abortion and contraception were legal. We explore the strategies of interpretation, relativisation, and (selective) rejection through which Catholics who self‐identified as "practising" approached birth control as a social issue and an individual practice and show how communist secular approaches to birth control contributed to extending the scope of Catholics' agency in the realm of reproductive decision making. [ABSTRACT FROM AUTHOR]

The prevention of unintended pregnancy was identified as a primary prevention strategy to reduce Zika-related adverse birth outcomes during the 2016-2017 Zika virus outbreak. The Centers for Disease Control and Prevention in partnership with local health agencies conducted formative research to guide the development of culturally appropriate messages and materials to increase awareness of the prevention of unintended pregnancy as a strategy to decrease Zika-related adverse outcomes in American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI). Nine focus groups (N=71) were conducted with women and men aged 18-44 years living in American Samoa and CNMI. Semi-structured interview guides were used to explore participants' knowledge and perceptions of Zika, family planning, and contraception; barriers and facilitators to access contraception and use; and information sources and contraception decision-making. Trained staff from local organizations co-moderated each focus group. Thematic analysis was conducted with NVivo 10. Participants had mixed knowledge about Zika virus and its relation to pregnancy and birth defects. Women and men had varied knowledge of the full range of contraceptive methods available in their jurisdiction and identified barriers to contraceptive access. Social factors including stigma, gender roles, and religion often deterred participants from accessing contraceptive services. Participants highlighted the need for culturally appropriate and clear messaging about contraceptive methods. Results demonstrate the feasibility of conducting formative research as an effective strategy for understanding community perspectives on unintended pregnancy prevention in the context of the Zika virus outbreak to develop health communication materials. [ABSTRACT FROM AUTHOR]

Objective: To assess the level of awareness of contraception among patients of reproductive age groups. Study Design: Cross-sectional analytical study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi Pakistan, between Jul 2018 to Jul 2019. Methodology: Women aged more than 18 years and not disoriented at the time of data collection were included in the study. Women younger than 18 years or those getting treatment for psychiatric illnesses or amenorrhea were excluded from the study. A predefined proforma was used to collect data from the study participants. Results: The mean age of the female patients was 26.5±8.6 years. The awareness regarding contraception was seen in 207(64.2%) female patients. Notably, 190(59.1%) women were aware of contraceptive methods. 210(65.3%) of the female patients considered contraception a safe practice. 225(69.7%) female patients thought contraception was necessary for child spacing. 82(25.4%) female patients had used some contraceptive at least once in their lifetime. Most women use oral contraceptive pills because of their easy-to-use and inexpensive features. Age and marital status significantly associated with the degree of awareness among participants (p

Identifying nonhormonal contraceptives will have profound impacts on avoiding side effects of hormonal birth control methods, minimizing pregnancy complications and infant mortality rates, and promoting family planning. However, phenotypic screening of contraceptives is challenging due to the diverse procedures associated with oocyte culture, biochemical assays, and molecular imaging. This study reports a multifunctional microfluidic platform comprising reconfigurable building blocks and interfaces to implement various cell-based drug screening protocols. This versatile platform has three major layers. The top layer consists of interchangeable 3D microfluidic building blocks (e.g., branching microchannels, chemical gradient generators, pumpless flow controllers, and emulsion generators) or an open interface. The middle layer incorporates a multiwell array with embedded membrane filters for live cell culture, medium exchange, enzymatic cumulus cell removal, washing, and fluorescence staining. The bottom layer is also reconfigurable for waste collection, oocyte culture, plate reader measurement, and high-resolution microscopy. We demonstrate an 8 by 16 (128 wells) system for performing the cumulus–oocyte complex (COC) expansion and oocyte maturation assays for screening nonhormonal contraceptives. The microfluidic building block platform is scalable and can be reconfigured for a variety of drug screening applications in the future. [ABSTRACT FROM AUTHOR]

Objectives: To assess the relative efficacy of post-partum intra uterine contraceptive devices following cesarian and vaginal birth. Study Design: Retrospective study. Setting: Department of Obstetrics and Gynecology Unit B, Lady Reading Hospital, Peshawar, KPK, Pakistan. Period: September, 2020 to June, 2021. Material & Methods: Focusing 948 delivery cases after, the placental delivery intrauterine insertion was done by using CuT-380 A and directed towards cervix. Enough care was taken not to dislodge IUCD as hand is removed. Strings were guide towards lower uterine segment without disturbing IUCD's fundal position. Patients were further monitored for six-month follow-up timecard to assess efficacy of applied contraception method. Results: Only 22 % (66) accepted intra-uterine contraception device intra-cesarian deliveries. In vaginal birth 241 women accepted intra-uterine contraception device. The Chi-Square test outcomes and Pvalue < 0.00001 represent significant acceptance trends (32.3 %) of intra-uterine contraceptive devices in both vaginal and intra-cesarian deliveries (Table.3.1). The mean of participants was 33.26 year ±5.109. About 231 (24.4 %) women were belonging from age range 15-29 year of age. Conclusion: The lack of women knowledge, attitude and mal practices using contraception devices are the key factors for heightened complexity like, expulsion and removal of the contraception devices in both intra-cesarian and vaginal deliveries. Early follow up and patient counselling are essential to minimize common problems associated with contraception device usage and improved efficacy. [ABSTRACT FROM AUTHOR]

The birth control movement in Japan first arose in the early 1920s. The Japanese government disapproved of birth control because it was enthusiastic about population growth to strengthen national power. Simultaneously, the movement was accompanied by a clash of ideologies among its supporters and critics in society. Existing research is especially interested in state policies and management, as well as the viewpoints and activities of birth control activists. This paper delves into a less-discussed topic: the perspectives of birth control opponents, focusing on Yoshioka Yayoi (1871–1959), a gynaecologist, educator, and women's rights activist. It argues that during the early twentieth century, state policies did not always play a decisive role in shaping people's anti-birth control attitudes. Yoshioka's opposing views in interwar Japan incorporated her concerns for women's morals and health, which were heavily influenced by social values and contraceptive technology at the time. As World War II began, her anti-birth control views had a strong political implication – promoting childbirth as a war effort. Despite Yoshioka's alignment with the state, the distinctions that existed between her views and national ideologies should not be overlooked. Yoshioka's ideas are conservative and show limitations. However, through her case, this article hopes to offer insight into the different meanings of birth control for people living in the early twentieth century, not only in Japan but also in a global context. Many people were reluctant to embrace this new family planning method due to moral reasons and uncertainty. Keeping birth control out of people's daily lives, especially for conservatives like Yoshioka, was an optimal way to benefit individuals. [ABSTRACT FROM AUTHOR]